We Must Demolish NP Diploma Mills

[cprimavera]

What is AANP doing with those programs??? I think we should unite to take an action on such diploma mills.

[TheMoonisMyLantern, ADN, LPN, RN]

6 minutes ago, juan de la cruz said:

I would gladly repeat a course that would help me understand advanced concepts including anatomy and physiology if I have to especially if it's been too long since I took the course. Nurses commonly practice in a specialized manner so much so that though we all start out with a general nursing education, many branch out where the population and disease focus tends to be specialized (even ICU's have specialzied units).

There is so much about basic health sciences that first, wasn't even taught well in nursing school, and second, is necessary to understand the therapeutic basis for treatments and medications we use. You based your response on you having taken the same course over and over again, an experience you have that does not necessarily translate to other individuals. If we are to standardize educational goals, everyone would come in with a clean slate.

PA programs require prerequisite science courses even for those who are nurses.  Some Nursing PhD programs require a repeat of graduate statistics if they were taken longer than 5 years. This is just to make sure that concepts long forgotten because we don't necessarily think about it in our practice are refreshed. 

I don't know why you even brought this up. I work with nurses everyday and yeah there is variation in skills and knowledge in any group of nurses in any given hospital. I consider many of the senior nurses as my go to for reliable information and patient assessment but that doesn't apply to every single nurse in the unit with 20+ years experience. Let's be real here, years of experience is no guarantee a nurse is that good.

There are ways to assess body of knowledge that don't require a student to repeat (and pay for) courses that they've already completed. The world of academics is already bleeding students dry financially as it is. Now, I am all for expansion of knowledge so if NP programs want to begin having an advanced A/P course that I think that would be great. But sticking a veteran nurse into the same A/P course they've already taken is just wasteful in my opinion.

I bring that up because it's not an uncommon stereotype in nursing and medicine that once you get a little "long in the tooth" you become outdated and can't keep up with what the newbies are learning in school. In some cases I'm sure that does happen, but in my experience that's not the case. Of course competence and experience are two separate entities but some of my best mentors have been crusty old battleaxe nurses who certainly exercised enough knowledge to demonstrate competence and understanding in undergrad A/P. 

[MentalKlarity, BSN, NP]

5 minutes ago, TheMoonisMyLantern said:

There are ways to assess body of knowledge that don't require a student to repeat (and pay for) courses that they've already completed. The world of academics is already bleeding students dry financially as it is. Now, I am all for expansion of knowledge so if NP programs want to begin having an advanced A/P course that I think that would be great. But sticking a veteran nurse into the same A/P course they've already taken is just wasteful in my opinion.

I bring that up because it's not an uncommon stereotype in nursing and medicine that once you get a little "long in the tooth" you become outdated and can't keep up with what the newbies are learning in school. In some cases I'm sure that does happen, but in my experience that's not the case. Of course competence and experience are two separate entities but some of my best mentors have been crusty old battleaxe nurses who certainly exercised enough knowledge to demonstrate competence and understanding in undergrad A/P. 

I agree with this. Repeating A/P at a nursing level is kind of pointless. All NP programs should just include an advanced A/P course, something that goes deeper into the biochemistry and builds on undergrad A&P.

But of course, that's just another silly dream of mine that would require the nursing boards to actually attempt to standardize our education rather than accredit any school willing to pay their fees and offer the 3Ps.

[RN/WI, ADN, BSN, MSN, RN, APRN]

NP programs do have Advanced Pathophysiology, as well as Advanced Pharmacology. These build on undergraduate courses. Does anyone know of Advance Practice degrees that do not require these courses?

 

[JKL33]

2 minutes ago, juan de la cruz said:

Right and the term has been used to denote substandard schools that have predatory practices of recruitment such as the "for profit" programs. The truth is "for profits" are not even that known for handing out diplomas so easily...in most of the complaints on these schools, students are lured into attending their programs by taking loans only to realize that they can't even finish due to program inefficiencies/inadequacies (I.e., lack of clinical placements) and default on those loans.

I think I see what you meant. It's possible that some participants here are talking strictly about for-profits and some are talking about any school that seems to be putting good numbers of students through while aiming for bare minimum active instruction and bare minimum student performance.

Not sure if this has been discussed yet on this topic, but another concerning practice is bare minimum instruction and bare minimum program standards combined with the exit exam. I'm not saying exit exams don't make sense on some level, but they have become the safety net (for schools) that enables them to get by with bare minimum instruction while preserving their first time board pass rates.

[PsychNurse24, BSN, RN]

14 minutes ago, MentalKlarity said:

I agree with this. Repeating A/P at a nursing level is kind of pointless. All NP programs should just include an advanced A/P course, something that goes deeper into the biochemistry and builds on undergrad A&P.

But of course, that's just another silly dream of mine that would require the nursing boards to actually attempt to standardize our education rather than accredit any school willing to pay their fees and offer the 3Ps.

I have spent a lot of time researching NP programs. If you look at the curriculums you can see the different classes. Every single program I looked at (Including those nasty diploma mill schools SARCASM) included advanced A&P, advanced pharmacology, advanced assessment, etc.  I don’t know where you get the idea that the different programs are not standardized, because they are.

[RN/WI, ADN, BSN, MSN, RN, APRN]

I am pretty certain most adults going to college are over the age of 18 and sign a promissory note that they understand they are taking out loans for a service, (education).

I do not know any brick and mortar schools or online NP schools that place students in clinical. It is the responsibility of the student to obtain placement. Before entering the program, the student should prepare and be certain they have secured a clinical spot. Don't believe any school that promises a clinical placement. Even before COVID, I knew of students that were having difficulty finding clinical placement.

 

 

[JKL33]

7 minutes ago, RN/WI said:

NP programs do have Advanced Pathophysiology, as well as Advanced Pharmacology. These build on undergraduate courses. Does anyone know of Advance Practice degrees that do not require these courses?

 

No one has said they don't. ?

The poster was saying it would make sense if they wanted to incorporate advanced anatomy and physiology, but not just repeat the same anatomy and physiology that people already had as undergrads.

(A/P standing for anatomy and physiology, not advanced pathophys.)

 

2 minutes ago, PsychNurse24 said:

Every single program I looked at (Including those nasty diploma mill schools SARCASM) included advanced A&P, advanced pharmacology, advanced assessment, etc.

No, they do not.

They don't. They have advanced pathophys, not necessarily advanced anatomy and physiology taught separately from advanced pathophys

That's why people refer to the ubiquitous 3Ps: Pathophys, Pharm, Physical Assessment.

 

[TheMoonisMyLantern, ADN, LPN, RN]

3 minutes ago, RN/WI said:

I am pretty certain most adults going to college are over the age of 18 and sign a promissory note that they understand they are taking out loans for a service, (education).

I do not know any brick and mortar schools or online NP schools that place students in clinical. It is the responsibility of the student to obtain placement. Before entering the program, the student should prepare and be certain they have secured a clinical spot. Don't believe any school that promises a clinical placement. Even before COVID, I knew of students that were having difficulty finding clinical placement.

 

 

True no one is forcing them to. But the fee for service should reflect the quality of service provided. The fact that people are okay with paying bloated tuition without even getting secured clinicals? What other healthcare profession has to provide their own clinicals? I'm fine with students being able to choose their own, but not requiring the school to be responsible just decreases the barriers for some of these programs to Spring up, get accredited and start pumping out grads every semester.

[MentalKlarity, BSN, NP]

As I said, repeating A&P same as undergrad (name these bones, name these nerves, etc) is not the same. My program had a separate "advanced A & P" course that went much more in depth and used the same textbook used by our medical students at the school. All NP programs should be teaching at that level.

 

Furthermore, the "discussion board, weekly quizzes, and papers" model of the diploma mills doesn't really inspire confidence either.

[djmatte, ADN, MSN, RN, NP]

1 hour ago, RN/WI said:

I am pretty certain most adults going to college are over the age of 18 and sign a promissory note that they understand they are taking out loans for a service, (education).

I do not know any brick and mortar schools or online NP schools that place students in clinical. It is the responsibility of the student to obtain placement. Before entering the program, the student should prepare and be certain they have secured a clinical spot. Don't believe any school that promises a clinical placement. Even before COVID, I knew of students that were having difficulty finding clinical placement.

 

 

More and more schools are starting to do the leg work. Even some online from what I hear.  Though in the same breath they still “highly encourage” the student to find their own site. University of Michigan for instance only in the last 3 years created an ancillary company to handle theirs. Note a major university and medical educational center didn’t have any form of clinical placement until 3 years ago. I also believe mandatory clinical placement was supposed to be a requirement by ACEN. Unsure how that washed out in the long run though. 

[PsychNurse24, BSN, RN]

5 minutes ago, MentalKlarity said:

As I said, repeating A&P same as undergrad (name these bones, name these nerves, etc) is not the same. My program had a separate "advanced A & P" course that went much more in depth and used the same textbook used by our medical students at the school. All NP programs should be teaching at that level.

 

Furthermore, the "discussion board, weekly quizzes, and papers" model of the diploma mills doesn't really inspire confidence either.

Still waiting to hear the data that NP’s educated in the so-called diploma mills are worse practitioners than others.  But if the teaching methods at diploma mill schools don’t inspire your confidence, I guess that’s all the proof we need!  Your wonderful school must not have had a very good research class though, because you don’t understand the concept of evidence.

[MentalKlarity, BSN, NP]

16 minutes ago, PsychNurse24 said:

Still waiting to hear the data that NP’s educated in the so-called diploma mills are worse practitioners than others.  But if the teaching methods at diploma mill schools don’t inspire your confidence, I guess that’s all the proof we need!  Your wonderful school must not have had a very good research class though, because you don’t understand the concept of evidence.

As mentioned earlier in this thread, thankfully that research has not been completed as it would be an embarrassment and ruin our profession. I don't even like to acknowledge that these diploma mills exist when speaking to colleagues, let alone have journals putting a spotlight on them.

I'll create a scenario though. Imagine you're about to have surgery and have 2 options of surgeon. Option one went to a traditional medical school and residency after taking the MCAT and excelling in undergraduate science courses. Option two couldn't be bothered with all that and went to an online program that waived the MCAT, doesn't do interviews and accepts students with 2.0 GPAs as long as they're willing to pay. They advertise their "24 month MD degree online!" on billboards and websites and the "admissions counselors" (salesman) are able to get potential applicants from phonecall to their first self-directed module within 4 weeks. 

 

If offered these choices would you say "Well either is fine until I see empirical evidence!" Or would you just realize that while option two MAY be fine, the standards just aren't strong enough to ensure someone incompetent didn't slip through the cracks and won't know what theyre doing.