B&M vs Online

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mar1ama, BSN

43 Posts

Ok sounds good

Owlgal

32 Posts

You didn't understand my comment. In my opinion, whether or not a school is distance or on campus is of no consequence. The type of students admitted to either type of program is what matters. If an online program admits high caliber students, and the program is of a high quality, then that NP will probably be a good practitioner. Conversely, if an in person program has low/no admission standards and a poorly constructed curriculum, then the graduate NPs will probably be fairly awful.

I am attending a hybrid program and am loving it. Some classes are recorded lectures and mostly reading, while others are live lectures. I have to go to campus for standardized patient scenarios, skills labs, etc. And all of my tests are proctored. Online programs can be done appropriately, however, there are many that are terrible and embarrassing and should be shut down.

I did understand your comment, I simply am wondering HOW DO YOU KNOW that the programs that you mention are so "easy" are turning out less qualified NPs? -- Simply because you assume lower entrance standards and what you deem to be a poor curriculum (having never attended the schools in question) must equate to poorer NPs doesn't necessarily make it so. That is why I asked if you had any data to back up the assertion. I even asked about anecdotal stories of unqualified NPs that seem to all come from the same "terrible" schools. If we don't have data that clearly points out that these terrible online (for profit) NP programs are truly turning out poor performing NPs, then it just sounds like a bunch of complaining because "those NPs are stealing our jobs" or some-such.

If I had wanted to go to med school, I would have. It's not the model of healthcare that I wish to operate under -- and so I choose to be an NP. I have zero desire to become a medical doctor. They don't teach the skills that I find most helpful to my patients in medical school, it seems. It is a rare physician who has the right combination of skill, knowledge, empathy, and the ability to communicate effectively with patients.

allnurses Guide

BostonFNP, APRN

2 Articles; 5,581 Posts

Specializes in Adult Internal Medicine.
I even asked about anecdotal stories of unqualified NPs that seem to all come from the same "terrible" schools. If we don't have data that clearly points out that these terrible online (for profit) NP programs are truly turning out poor performing NPs, then it just sounds like a bunch of complaining because "those NPs are stealing our jobs" or some-such.

I have seen first hand what lower entrance standards and poorer quality programs produce, it's why my practice and several other practices locally only take students from two local programs (or nurses that we know personally/professionally). In those cases the students were so poorly prepared that too much of a burden fell on the preceptor to teach these students from the ground up, which to be frank, most practicing NPs don't have time to do in clinic. Personally my last attempt at a student from an online program (which, sadly in retrospect, I took because they offered to pay $2500/semester) didn't last the first day as the student arrived having never taken an advanced practice physical assessment course nor any knowledge how to conduct an H&P.

You don't have to take my anecdotes, do your own research. There are plenty of posts here about failing the national board exams multiple times (which I suspect we would all agree is a bare minimum to practice safety), reach out to those posters and see what their incoming gpa and experience was and what program they went to.

Skippingtowork

342 Posts

I have seen first hand what lower entrance standards and poorer quality programs produce, it's why my practice and several other practices locally only take students from two local programs (or nurses that we know personally/professionally). In those cases the students were so poorly prepared that too much of a burden fell on the preceptor to teach these students from the ground up, which to be frank, most practicing NPs don't have time to do in clinic. Personally my last attempt at a student from an online program (which, sadly in retrospect, I took because they offered to pay $2500/semester) didn't last the first day as the student arrived having never taken an advanced practice physical assessment course nor any knowledge how to conduct an H&P.

You don't have to take my anecdotes, do your own research. There are plenty of posts here about failing the national board exams multiple times (which I suspect we would all agree is a bare minimum to practice safety), reach out to those posters and see what their incoming gpa and experience was and what program they went to.

OK, GPAs are overrated. Go to school in Finland, Germany, France, China, Taiwan, Japan, Egypt, Nigeria, etc. etc. Then you can tell me about GPA. Passing or failing boards has nothing to do with the type of school you attended. If you take exams in the U.S., you can eliminate many of the wrong answers by guessing. To really prove that you know your stuff, you have to do ESSAY and oral exams! Some of the smartest people around fail boards, not because they didn't know the material, but because they didn't use good testing techniques. Phrase for the day -- Show me the evidence.

100% of the MDs I've seen giving incorrect diagnosis or treatment came from B&M schools. How's that for statistics? No one is perfect. We are all fallible. Working together to improve a system is better than tearing down one of the walls, causing the whole house to fall down.

If I was an employer and heard one NP speaking negatively about other NP's education I don't think I would want to hire any. MDs don't do that (unless they're whinney and rude). Let's build each other up. And precept.

Skippingtowork

342 Posts

Bad candidates go to bad schools because they are easy.

There are no easy med schools in america.

There are tons of easy NP schools.

Anybody can dunk a ball on a one foot high goal but not everyone can dunk on a 12 foot high goal or however high they are, I hate basketball.

Lectures are pointless but somehow people have to be tested on his or her knowledge prior to clinicals (tests)

Tests serve the purpose of basic understanding of the material, if you are at an online discussion post NP crapatorium, there is no guarantee you will know anything.

NP board exam was way too easy back when i took it. Maybe that has changed but probably not.

Online discussion posts are not exams. Exams are exams. Why would an exam from an online school be any different from an exam at a B&M? All these schools must be accredited. Sometimes we are a product of our environment and experience, which often gets in the way of reality. Unless I personally know that a school is totally online, I wouldn't know one school from another. There are hundreds if not thousands of programs.

There are no easy med schools in America, but I can assure you that there are some that are much easier to get into than others. Do you think graduates of top schools spend their time talking down about graduates from unknown med schools?

Also, before anyone gets carried away about where they're school is ranked, ranking is not primarily based on the education. It is based on multiple factors, such as FUNDING, research (no contribution from NP department), support to students, drop out rates, graduation rates, support and participation from alumni, and the list goes on. And take a look at the experience of some nursing faculty in top schools. Some have very little, so years of experience clearly is not a criteria. Probably more credit is being given for innovation and forward-thinking.

I am not an expert in nursing education, but I am very skeptical of statements that are thrown out there without any reliable evidence to back it up.

Skippingtowork

342 Posts

Not incorrect just unaware that there are global rankings of nursing schools, is Top Universities a reputable site? Not saying either way because I don't know but yeah, mine is up there and actually ahead of one people add on this site as extra fabu, lol. FWIW I am not making allegations about nursing education. I am expressing concerns and sharing my individual experience and opinion as someone who has completed 2 NP programs with first hand knowledge of diagnoses and prescribing patterns of patients of local NPs who I admitted to my acute psychiatric unit after they decompensated n=1 so theres that.

Until recently I was a huge champion of my RN peers becoming NPs however as I have posted, again my opinion only, I have grave concerns at the present based on the product I am seeing and the sheer numbers being churned out.

In addition to competence very high on my list of concerns is the wage issue. In my area new grad PMH-NPs make $150,000 right out of school so the increasing numbers as well as those who are nothing short of clueless as to how to negotiate or what an appropriate wage is in this specialty I remain concerned and far more particular about who I encourage to pursue this profession.

OK if I was an RN with 1 year experience, and saw $150,000 flashing before my eyes, I would go back to school too. I would study morning, noon and night to be the best I could be, but I would be that NP if it killed me (of course, it's best if you like psych). I would do the same to become a basketball player for a few mill. Growth hormones here I come. $150,000 for a new grad while in some places they're offering $60K-$80K for experienced nurses? The cost of living must be very high out there. When I told someone I wanted around $160K, they thought I was being greedy.

allnurses Guide

BostonFNP, APRN

2 Articles; 5,581 Posts

Specializes in Adult Internal Medicine.
OK, GPAs are overrated.

They are inflated not overrated.

Passing or failing boards has nothing to do with the type of school you attended.

To be totally honest, this is just an asinine argument to try and make. Quality programs have consistently higher pass rates than sub-quality programs and relatively stable across graduating classes. This may be due to the quality of the program or the quality of the applicants or both, but there is no arguing that pass rates between programs are significantly different.

100% of the MDs I've seen giving incorrect diagnosis or treatment came from B&M schools. How's that for statistics? No one is perfect. We are all fallible.

I am not sure what you point is here, everyone makes incorrect diagnoses. There is a major logistical fallacy here if you are suggesting that because everyone makes errors then everyone is the same. Out of curiosity, how long have you been practicing and diagnosing? Do you think you have never made an error? Do you think that your error rate as a novice is the same as everyone else's?

Let's build each other up. And precept.

This doesn't have anything to do with "building each other up" we are not talking about individuals. I will always help individuals to the best of my ability but that doesn't erase my concerns, and the concerns of many practicing NPs, re: the exponential increase of poor quality programs and the downstream effects of this, be it B&M or online.

How long have you been precepting?

Owlgal

32 Posts

Are there really "easy" NP schools? -- I suspect the sheer credit requirements coupled with the clinical component wouldn't qualify as "easy", by any imagination. Let alone, studying for and passing boards. I think anyone who says they thought boards were "easy" doesn't readily remember the stress they felt while taking them. Sure, it's convenient to say they were easy after you passed. I bet no one is going into boards 100% confident that it was going to be a breeze.

Skippingtowork

342 Posts

They are inflated not overrated.

To be totally honest, this is just an asinine argument to try and make. Quality programs have consistently higher pass rates than sub-quality programs and relatively stable across graduating classes. This may be due to the quality of the program or the quality of the applicants or both, but there is no arguing that pass rates between programs are significantly different.

I am not sure what you point is here, everyone makes incorrect diagnoses. There is a major logistical fallacy here if you are suggesting that because everyone makes errors then everyone is the same. Out of curiosity, how long have you been practicing and diagnosing? Do you think you have never made an error? Do you think that your error rate as a novice is the same as everyone else's?

This doesn't have anything to do with "building each other up" we are not talking about individuals. I will always help individuals to the best of my ability but that doesn't erase my concerns, and the concerns of many practicing NPs, re: the exponential increase of poor quality programs and the downstream effects of this, be it B&M or online.

How long have you been precepting?

I think we need to dial this down a bit. First, I really did mean overrated, as in too much emphasis. Reason is this: a person who comes into a program with great undergrad or high school grades may not be as knowledgeable as they thought they were. A Youtube video of 2 brothers discussing college entrance, tells freshmen students not to talk about their 4.0. Why? Because you are just one of thousands with those grades. Not having stellar grades in undergrad is not indicative of your ability to make it in grad school. Did you learn the basics and are you now motivated? Show me.

There are many variables involved in pass rates for the boards, including how many people are taking boards in each specialty from each school. If only 3 people took boards in 1 year and 1 failed, you'll have a dismal pass rate. Are NPs practicing successfully without taking the boards? Not all states require you to be board certified prior to practicing. I'm not sure how you obtained the statistics for pass rates for each school. NP certification is not like the NCLEX. Please post your sources. My curiosity is peaked. The new NPs that I spoke to from on-line or for-profit schools have passed their boards on the first try and I saw the proof. They're happily practicing in their first jobs.

I will never say that I have not made an error. In fact, I assume that I make more errors than I am aware of. That's why I feel it's so important to be humble. I am not a novice in practice, so I definitely know that there's a lot to learn beyond school.

I sincerely believe that we are on the same page and have the same desires for our profession. Our view of the actual problem and possible solutions may be a little different, but in the end we want the same thing. I know from living on this earth as long as I have, if you talk about anything as a group, it impacts the entire group. Maybe I'm protesting too much in order to save my own job!

All of us are familiar with the term evidence-based. Our opinion or our experience is of no consequence. Post the research. Post the numbers. It's easier to understand and accept. (I tried to get those numbers. So far the boards don't seem to have them readily available, but it will still be a little suspect, since not everyone takes the board).

If I was an employer and heard one NP speaking negatively about other NP's education I don't think I would want to hire any. MDs don't do that (unless they're whinney and rude). Let's build each other up. And precept.

There are no easy med schools in America, but I can assure you that there are some that are much easier to get into than others. Do you think graduates of top schools spend their time talking down about graduates from unknown med schools?

Ummmm... Do you not know any physicians? The physician route is ALL about rank and prestige. You try to get accepted to the best school, best residency and best fellowship you can. MD>DO>Caribbean>FMG, etc. And each of these categories can be further subdivided. Osteopaths try to pass the allopathic steps in order to attend an allopathic residency because it's more prestigious - they often take the USMLE and also the COMLEX just as a back-up. You have no real understanding of the hierarchy within medicine if you make the above comments.

1. Not having stellar grades in undergrad is not indicative of your ability to make it in grad school.

2. My curiosity is peaked.

3. The new NPs that I spoke to from on-line or for-profit schools have passed their boards on the first try and I saw the proof. They're happily practicing in their first jobs. Our opinion or our experience is of no consequence.

4. Exams are exams. Why would an exam from an online school be any different from an exam at a B&M?

5. Are there really "easy" NP schools? -- I suspect the sheer credit requirements coupled with the clinical component wouldn't qualify as "easy", by any imagination.

1. So many things I couldn't even go through and quote it all. Grades and GPA are essentially the ONLY way (along with pre-admission testing - MCAT, GRE, etc) of assessing a candidates academic abilities. Quite a laughable statement.

2. Piqued

3. You tell your anecdotes and then go on to say that opinion and experience is of no consequence. How would they ever do a study comparing the practice of online graduates to B&M graduates? They would be even more farcical than the studies comparing NP to PA to MDs.

4. Search through this forum. Many NP students from certain online programs will attest to not having tests of any sort in their program. Or if they do they are not proctored and are therefore open book. That's insane.

5. I know this quote is from Owlgal - The sheer credit requirements. 30-50 credits is the average for an NP program. That's nothing. 600-800 clinical hours. Equivalent to 15-20 weeks of full-time work.

If I precept someday I will only take students who attend a school that has proctored testing and mandatory campus time AND who will follow my schedule. I don't care if they only need 100 hours with me over 8 weeks. If they won't put in the hours they can look for a preceptor elsewhere.

Skippingtowork

342 Posts

1. So many things I couldn't even go through and quote it all. Grades and GPA are essentially the ONLY way (along with pre-admission testing - MCAT, GRE, etc) of assessing a candidates academic abilities. Quite a laughable statement.

2. Piqued

3. You tell your anecdotes and then go on to say that opinion and experience is of no consequence. How would they ever do a study comparing the practice of online graduates to B&M graduates? They would be even more farcical than the studies comparing NP to PA to MDs.

4. Search through this forum. Many NP students from certain online programs will attest to not having tests of any sort in their program. Or if they do they are not proctored and are therefore open book. That's insane.

5. I know this quote is from Owlgal - The sheer credit requirements. 30-50 credits is the average for an NP program. That's nothing. 600-800 clinical hours. Equivalent to 15-20 weeks of full-time work.

If I precept someday I will only take students who attend a school that has proctored testing and mandatory campus time AND who will follow my schedule. I don't care if they only need 100 hours with me over 8 weeks. If they won't put in the hours they can look for a preceptor elsewhere.

1. If you had a GPA of 3.0 30 years ago, does that really matter? Most NPs aren't going to grad school straight from BSN, even though that's a growing trend.

2. My bad.

3. A positive statement based on experience is better than negative ones. If statements are going to be made about inadequacies of programs or their graduates, there must be proof. Suppose students are looking into going to an on-line school, they need more information than "my hospital or practice." I was referring to passing the boards. How do we know percentages of students passing the boards from any given school? Most NPs are not on AN.

4. Yes, an open book test in an NP program is insane, but I was referring to the on-line discussion board vs exam. Those are 2 different things.

5. This comment is interesting. They must follow your schedule? We had med students in our office and we could never say that to them. They follow the schedule their school dictates. Same with the residents. When you did your NP rotations, how many hours did you do week? I know more is better, but there's a limit on a student's time. With your NP students, how did they manage?

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