Hi Suzanne,
My sister needs it for her promotion in the hospital where she works. She is also considering a Clinical Instructor position. She is happy with her work in the Phils and has no immediate plans of going to the US yet. Distance learning program is an option for her because she also has 2 kids to take care of. She was told that the program was started in 1997.
Thank you for your time and helpful insights, as always.