B&M vs Online

Nursing Students NP Students

Published

I see a whole lot of hate for the online Nurse Practitioner programs. I'm wondering if anyone has any statistics regarding poor performance based on whether a NP went the traditional route versus online?

Or are we assuming that they are lesser simply because they "must be" inferior?

Personally, I don't think that anyone should be going through an NP program without at least 3-4 years of solid nursing experience. I'm far more concerned about a young NP straight out of school who has no real-world healthcare experience than I am about an experienced RN going the online route for their NP.

Thoughts?

And to disclose, I am one of those online, for-profit school NP students that seem to draw all the negative attention. Of course, I've also been a nurse for about 14 years and have been in hospital administration for the last several years.

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.

Dodongo, how could you in good conscience ask me if I know any physicians? I really do understand medical school education and the steps they go through, along with prestige of some institutions. There is nothing wrong with pursuing what you perceive to be the best. My post had nothing to do with pursuit.

Dodongo, how could you in good conscience ask me if I know any physicians? I really do understand medical school education and the steps they go through, along with prestige of some institutions. There is nothing wrong with pursuing what you perceive to be the best. My post had nothing to do with pursuit.

Asking you that was my attempt at deriding the comments made... It was said tongue-in-cheek. I wish we could leave voice messages. Things would be so much more clearly understood. And it's more than just physicians pursuing what they think is best. They see themselves as "better than" by having attended X program or holding X degree.

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?

1. I think it matters. Yes. For other programs that have prerequisite requirements, those courses expire within 10 years or so. I think there should be a time limit. You fall outside of that limit you need to retake those courses so the school can see whether you will make a passable student.

2. Pet peeve

3. A positive statement is better simply because it's positive? Disagree. If I'm looking into a program or type of program and enough people have a negative view of it, I'm not going to attend it. Plain and simple.

4. And I think the person you were responding to was regarding programs that don't require testing.

5. Perhaps I should rephrase this better. IF you have class or something for school, then by all means, you can and should attend it, however, work or something else that is not an academic pursuit is not an acceptable reason to miss. PA students and medical students are assigned pretty much full-time to rotations. NPs do 1-2 days a week for a total of 600 hours and think it's so taxing.

I simply have a different view on NP education. I have my preference (the right one) and you have yours. Haha. Why wouldn't we want to elevate NP education to the highest standard we can?

Asking you that was my attempt at deriding the comments made... It was said tongue-in-cheek. I wish we could leave voice messages. Things would be so much more clearly understood. And it's more than just physicians pursuing what they think is best. They see themselves as "better than" by having attended X program or holding X degree.

1. I think it matters. Yes. For other programs that have prerequisite requirements, those courses expire within 10 years or so. I think there should be a time limit. You fall outside of that limit you need to retake those courses so the school can see whether you will make a passable student.

2. Pet peeve

3. A positive statement is better simply because it's positive? Disagree. If I'm looking into a program or type of program and enough people have a negative view of it, I'm not going to attend it. Plain and simple.

4. And I think the person you were responding to was regarding programs that don't require testing.

5. Perhaps I should rephrase this better. IF you have class or something for school, then by all means, you can and should attend it, however, work or something else that is not an academic pursuit is not an acceptable reason to miss. PA students and medical students are assigned pretty much full-time to rotations. NPs do 1-2 days a week for a total of 600 hours and think it's so taxing.

I simply have a different view on NP education. I have my preference (the right one) and you have yours. Haha. Why wouldn't we want to elevate NP education to the highest standard we can?

Actually, I don't think your view is that much different from mine. It may just be more generalized. I do feel that NP education should be standardized, but it is not, so until then how do we help? There are NP residencies popping up, which I think is a great thing, but we really need more NPs and even MDs to step up and give good clinical rotations. It makes a world of difference.

Rotations for med school is on a completely different level. Med school is a job and they are not allowed to work. PA is full-time, but they can work if they want. NP students have to support themselves somehow and that's by working. It would be better if, like med school, the didactics were completed at the beginning of the program, followed by clinicals augmented with short seminars. Then the student can concentrate on performing in the clinical arena, applying the didactic knowledge previously obtained. Students can also go to campus for in-depth skills labs.

As far those old classes. It behooves a person to re-take some of the pertinent sciences, no matter the GPA. But if I'm a high performing nurse with a previous 2.0 GPA from 1970, who cares about my GPA? Retaking those classes won't change those numbers (sad face).

Specializes in Adult Internal Medicine.
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.

Is the source you are citing really a "youtube video of 2 brothers"?

So lets get this straight. I will take 1000 students with a 4.0 GPA and teach them to be an NP. You take 1000 students with a 2.0 GPA and you teach them to be NPs. You think we will have the same outcomes with quality? With board pass rates?

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.

There are very few practicing NPs that have not successfully passed a national board exam. There are 3 states which do not require national certification to practice as an APN, however, there are very few employers, very limited 3rd party payers, and no carries which support this practice. The number of NPs in this category is non-significant.

I have access to my state's pass rates due to the work that I do. There is also a recent online site that sampled 200+ NP programs for their pass rates. For the purpose of your argument we can very easily use NCLEX pass rates to show that some programs are consistently better than others on average. You want me to cite you numbers on that?

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.

How long exactly have you been in NP practice? And how many student have your precepted in APN from various programs?

Maybe I'm protesting too much in order to save my own job!

Did you graduate from an on-line program or B&M? A for-profit or non?

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).

So you say to post data with a pretext that you probably won't believe it based on a small number of outliers? That sounds suspicious for bias...

Jules, you are entitled to your opinion. However, you are incorrect on two counts.

1) There are indeed global rankings of nursing schools

New Ranking of the World's Top Nursing Schools | Top Universities

2) We have had this discussion elsewhere, but the studies that have been done have shown that RN experience actually has NEGATIVE correlation with NP clinical skills and also with MSN academic success.

3) You seem to have a very negative view of NP education in general. I don't know what this is based on. The only thing that matters is outcomes. Your personal biases are irrelevant. Why don't you back up your allegations? I've noticed you never do.

4) As far as online for-profit schools, it depends. Look, if you go to a top-ranked school, but do poorly you are going to be worse off than someone who went to a lesser-ranked school but was an excellent student (academics and clinical). Your prior experience will also matter - if you have solid experience that is a big plus.

5) There are many paths to a successful career. I know an extremely successful CRNA who started out as a "tech," got her RN at a community college and so on. Your posts seem designed to discourage people from becoming NPs, which is unfortunate.

Lol you say prior nursing experience had a negative correlation then later in your post you say it helps. Please quit debating.

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.

It's pretty pathetic people can do 2 or whatever years at some schools doing discussion board posts then 500 clinical hours and get prescriptive rights

It's pretty pathetic people can do 2 or whatever years at some schools doing discussion board posts then 500 clinical hours and get prescriptive rights

I agree that 500 hours is clearly not enough. That's the minimum required by the certification boards.

Is the source you are citing really a "youtube video of 2 brothers"?

So lets get this straight. I will take 1000 students with a 4.0 GPA and teach them to be an NP. You take 1000 students with a 2.0 GPA and you teach them to be NPs. You think we will have the same outcomes with quality? With board pass rates?

There are very few practicing NPs that have not successfully passed a national board exam. There are 3 states which do not require national certification to practice as an APN, however, there are very few employers, very limited 3rd party payers, and no malpractice insurance carries which support this practice. The number of NPs in this category is non-significant.

I have access to my state's pass rates due to the work that I do. There is also a recent online site that sampled 200+ NP programs for their pass rates. For the purpose of your argument we can very easily use NCLEX pass rates to show that some programs are consistently better than others on average. You want me to cite you numbers on that?

How long exactly have you been in NP practice? And how many student have your precepted in APN from various programs?

Did you graduate from an on-line program or B&M? A for-profit or non?

So you say to post data with a pretext that you probably won't believe it based on a small number of outliers? That sounds suspicious for bias...

Actually, BostonFNP, because I saw how passionate you are about the subject, I decided to try to find the information myself. I was trying to see where you are coming from, that's all. The reason I used the word "suspect" is because I know that it would be difficult to get an accurate picture of pass rates. Some people do not take the boards immediately, some not at all. There are many, many NPs who are not board certified, because their state did not require it at the time they completed training. These people are grandfathered in. Of course, every state is different. When you look at the NCLEX, you have a better idea of school pass rates, but I'm still surprised at some of the numbers for programs that are known to be good.

I have been an NP for over 10 years and have been certified the entire time. B&M state school, but I am now going the hybrid route. It's not ideal for me, but only because I like sitting at the front of the classroom. I learn better that way. But it doesn't matter, because I'm already in the real world. I ask other NPs alot of questions about their programs, and get a lot of honest answers. That's why in other threads I have been so strong about schools finding clinicals for their students and standardized curriculums.

I have precepted many students of different levels. Because I have only been precepted by physicians, I tend to precept that way. I don't know if NPs precept differently. My new program requires that I go with an NP for some hours, but that has not be done as yet.

I think you missed my point about the GPA. If I was an admission director looking at someone who graduated 2 years ago, and their GPA was average or below-averge and I only had few seats, I would choose a candidate with a higher GPA, unless there was compelling evidence in favor of the former candidate. If I had someone with a high GPA and one year out of school and someone with a 2+ GPA who was many years out of school and had demonstrated progressive professional growth in the clinical area, I would take the 2+GPA. Of course, most schools require you to repeat required science classes if they're too old.

Also about board certification. Did you know that there a physicians who are not board certified in their specialty, but have been practicing successfully for many years? I don't think there is just one answer to every question.

BostonFNP, I really do want to see that pass rate information, if you don't mind. I'm serious about looking into this. If you can't post anything I understand.

Actually, I don't think your view is that much different from mine. It may just be more generalized. I do feel that NP education should be standardized, but it is not, so until then how do we help? There are NP residencies popping up, which I think is a great thing, but we really need more NPs and even MDs to step up and give good clinical rotations. It makes a world of difference.

Rotations for med school is on a completely different level. Med school is a job and they are not allowed to work. PA is full-time, but they can work if they want. NP students have to support themselves somehow and that's by working. It would be better if, like med school, the didactics were completed at the beginning of the program, followed by clinicals augmented with short seminars. Then the student can concentrate on performing in the clinical arena, applying the didactic knowledge previously obtained. Students can also go to campus for in-depth skills labs.

As far those old classes. It behooves a person to re-take some of the pertinent sciences, no matter the GPA. But if I'm a high performing nurse with a previous 2.0 GPA from 1970, who cares about my GPA? Retaking those classes won't change those numbers (sad face).

NP residencies are fine but they are only to enhance your education - not make up for it.

And why is it that med students and PAs don't have to support themselves but NPs HAVE to support themselves somehow? If you choose to go to school you have to make sacrifices. Take out some loans, cut back on work, and complete a significant amount of clinical hours. 1 year of clinical, full-time like PAs complete should be minimum. It's not hard. You have kids to support? You have a mortgage? Take out loans. Just because it's not a great time in your life to have debt or not be able to work doesn't mean you should be able to cut back on your education. Not everyone who goes to NP school should go to NP school. Standards need to be raised significantly.

Everyone should care about your gpa!!! Each and every school should care. I don't care how super-duper of a nurse you are on your unit. If you had a low gpa, you need to take courses to raise it. Many PA schools will consider an applicant with a lower gpa if the last 60 credits are high (>3.8) as it shows academic improvement. But just because it's been a while since you were a poor academic performer doesn't mean you are all of a sudden a good academic performer.

Specializes in Neurology, Psychology, Family medicine.

Could not agree more with you Dodongo. There are many of us on the boards that agree with you. On the side note concerning working while going to school here is my take. If you believe for a second that a student working and going to school is the same as a full time student then you are a scary provider. Total time put towards studies does matter. These people that can knock out their schooling on the weekend I LOL about.

Could not agree more with you Dodongo. There are many of us on the boards that agree with you. On the side note concerning working while going to school here is my take. If you believe for a second that a student working and going to school is the same as a full time student then you are a scary provider. Total time put towards studies does matter. These people that can knock out their schooling on the weekend I LOL about.

Hmm. Maybe we just learn faster than you? I have never had to spend 40+ hours a week "studying" -- not for my BSN and not for my FNP (thus far). I can't even imagine having to study that hard for something. Certainly, there is whole lot of content to go over, but I'm a rapid reader and tend to remember content. How many times are you having to go over material before you "get it"? Now, things are more difficult, taking online courses, because the content isn't spoon-fed to you like it is by attending a class, listening to lectures in real-time, with real-time Q&A. That's easy. Still, those lectures don't make up a full day, by any means at a B&M program. How much are you studying after attending classes? -- if it's hours on hours, then I really feel kind of bad for you. That's way more effort than I would need, in all honesty, to absorb content.

There is much more discipline, self-motivation, and "work" that goes in to on-line courses. But, I expect that there would be, given the format. And I'm fine with putting in the time/effort required to be so disciplined. But it's not taking me as much time as it's obviously taking you -- different learners learn at different speeds, I guess.

I LOL at your thought that time spent studying correlates with being a better provider. In my experience, that doesn't hold true. Just as it didn't hold true in RN school. Knowledge/skill/experience is what makes for a good provider, IMO.

Specializes in Neurology, Psychology, Family medicine.

Wow, you just do not get it. What I am saying is the content that is taught at NP school is watered down. It lacks the depth that I would like out of a degree. The fact that you're understanding the material is great. I want much more than just to get the minimum from NP school. So moral of the story is yes the amount of time does matter. Especially if you want more than just the fluff information that NP school gives you. Good luck in your endeavors. NP knowledge, unfortunately, will never be enough for me.

+ Add a Comment