As I read through the comments for the proposed amendment to the Virginia BON, I am excited to see there is some recognition by practicing nurses that perhaps there is more than one way to educate a Registered Nurse, and still be assured that RN is competent to safely practice in Virginia. I recently moved from Texas, where I was nursing faculty for Texas Tech. While I haven’t been here long, I have noticed many issues Texas has struggled with over the past few years regarding nursing education are some of the same for Virginia. Major looming issues have always been the need for more licensed registered nurses at the bedside, and the need for reform in nursing education to assure students are receiving the education they will need to practice in today’s healthcare environment. Innovative ways to deliver nursing content and provide quality clinical experiences which assure requisite competencies are being met should be the priority at all nursing schools. The AACN and NLN have led several calls for reform of didactic and clinical education over the past five years, and have supported the recommendations for reform laid out by several groups, including  The Carnegie Foundation and QSEN.

I understand that supervised clinical education experience is certainly appropriate for a prelicensure student who does not have the clinical background to be able to demonstrate competency, however it is not the only means through which a student can demonstrate safe care.  Excelsior College’s program for which they are seeking licensure by examination for the Commonwealth of Virginia is not one which “dumbs down” nursing, nor does it take lightly the competencies a licensed RN must have in order to practice safely. The program takes into account the student’s knowledge base, and builds from there. This allows the adult learner to feel appreciated for their previous experience, and provides them with the means to use that experience to increase their skills. The method of assessing competencies used by Excelsior is very rigorous, and one which should be looked upon as an innovative way to maintain quality clinical standards. Research shows that graduates from a competency-based curriculum perform just as well on NCLEX, and have just as high or higher employer satisfaction ratings as a student who has completed a traditional nursing curriculum.

I appreciate the dialogue on this forum, and interested to see the outcome of the proposed amendment. I believe it could benefit not only Excelsior College, but other educational institutions within the Commonwealth.

Cathleen A. Collins, PhD, RN, CNE

Associate Professor and Chair, Nursing Department

Kathleen Miller Strunk Endowed Professor

University of Virginia's College at Wise