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We Must Demolish Traditional Universities

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Specializes in Internal Medicine, ICU, Med-Surg. Has 9 years experience.

Can we address this line of thinking -"We must demolish diploma factories"? The hubris and the arrogance abounds. If we can take anything away from 2020 it is this, the traditional brick and mortar school needs rethought. It no longer serves a purpose, and is not what the future holds in terms of efficiency and sustainability. 

The original post below this one fails to recognize the actual problem our society faces, that being "traditional universities". These institutions no longer exist to produce a beneficial product, if this was the case we would not have thousands of people demanding loan forgiveness; if the product is sound, why would it need subsidized?

The real problem is simply this, universities are now centers to push one-sided ideologies, redistribute wealth through preferenced funding, and ultimately prop up a bankrupt government through 7% interest rate loans. Why do you think programs that could once be finished in 1.5 years, paid for by hospital systems/practices/clinics, now take upwards of 3.5 years, with tuition costs that have went beyond the moon; it makes no sense, even more so when you account for the much discussed provider shortage. These dudes are lining their pockets fraudulently, and it is at the cost of students and  subsequently patients.

Imagine if banks were doing what FASFA and the universities have been doing for the last 3 decades. People would be in the streets rioting. "Fraudulent business practices" would be the term of the day. Unfortunately, these institutions get a hard pass, mainly due to people like the OP below that feel there is a certain prestige associated with given schools.

I live in Western PA, I went to a 3.5 year program that cost me roughly 27k, I would be hard pressed to go to a "respected school" that would cost someone like me +$90k. I passed my boards the same as the OP did, I and I am told, that I do a pretty good job.

Ultimately, knowledge is being decentralized at a rapid pace, we would do well to recognize this and stay with the times. I can buy lectures, given by Harvard historians, for $10 on Amazon, hours of content! If Harvard is your thing, why can't we make all these lectures available and free for all? Share the wealth so to say? In the coming future, there will likely no longer be a monopoly on knowledge, as such the current cost of tuition should no longer be defended, and we should leave arrogance of "prestigious institutions" at the door.

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

As was stated in the other thread and many other threads on this topic, online education isn't really the problem. It certainly has a place in higher education and even education in advanced practice. The problem is in content delivery, lack of rigor, few admission standards, and tuition price inflation. 

B/M schools are certainly guilty of tuition price gouging but so too are many online schools. Walden, Chamberlain, Phoenix, and others have quite expensive tuition for the product they're peddling. You mention that you can buy recorded lectures off of Amazon, many of these online schools don't even provide any kind of lecture recorded or live and the student is told to read a textbook, post in a discussion board, and write a paper. 

For profit online schools do nothing to further our profession, they are simply honey traps taking advantage of students.

I think online learning is excellent, I just think our standards and expectations need to be higher, and that's not a bad thing!

Online learning can be done right.  Recorded lectures that you can complete at your own convenience.  Weekly assignments.  Weekly or biweekly synchronous meetings with the class and instructor.

I completed my bachelors degree through online programs offered by respected brick and mortar schools.  I've had excellent classes as described above, and I've also had classes which were basically "here's the textbook, there's 3 quizzes and 2 papers, see you in 15 weeks, thanks for the $1,000"..

I'm certain the quality classes are difficult on the instructors, possibly even more-so than a traditional class, which is probably why so many of them end up being the latter.

To the original point, I actually agree that the college bubble needs to burst.  Our kids are drilled that college is a MUST, no matter what.  I have a daughter accumulating student debt right now who has absolutely zero idea what she wants to do with her life.  I've told her repeatedly over the last several years that she doesn't need to go to college and waste money right now until she figures life out, but it is so engrained in her mind from her primary education that she just feels like she has no choice. 

Shamrock1145, BSN, MSN, APRN

Specializes in Internal Medicine, ICU, Med-Surg. Has 9 years experience.

20 minutes ago, TheMoonisMyLantern said:

For profit online schools do nothing to further our profession, they are simply honey traps taking advantage of students.

I am not really familiar with the "for profit" schools. But I can only assume that they are no more predatory in their peddling than many of the B/M schools. 

Basic economics states that services exist to provide a product. If that product is inferior, unworthy, or simply put - hazardous, then it will not last. When we get into the practice of over regulating, we hamper innovation. 

10 minutes ago, FiremedicMike said:

Our kids are drilled that college is a MUST, no matter what. 

Mike Rowe has an absolutely amazing organization that was founded for this very point!

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

17 minutes ago, Shamrock1145 said:

I am not really familiar with the "for profit" schools. But I can only assume that they are no more predatory in their peddling than many of the B/M schools. 

Basic economics states that services exist to provide a product. If that product is inferior, unworthy, or simply put - hazardous, then it will not last. When we get into the practice of over regulating, we hamper innovation. 

Mike Rowe has an absolutely amazing organization that was founded for this very point!

Over regulating certainly can hamper innovation but regulation is vital when a life sustaining service will be provided as a result of the education delivered. I would argue that the online for profit schools are more predatory simply due to the fact that their admission criteria are usually even less than B/M schools that are attempting to squeeze their students as well. 

That being said, there is a local B/M college here that charges 30,000 for their LPN program, and 50,000 for their ADN. They also have a BSN and MSN program, I don't know the cost of those, but I do know that their credits won't transfer to other colleges and universities. 

They advertise "guaranteed acceptance" which is very enticing to people who are desperate to further their education and to change their life circumstances. These schools are down right predatory!

Shamrock1145, BSN, MSN, APRN

Specializes in Internal Medicine, ICU, Med-Surg. Has 9 years experience.

On 2/17/2021 at 6:49 PM, TheMoonisMyLantern said:

Over regulating certainly can hamper innovation but regulation is vital when a life sustaining service will be provided as a result of the education delivered. I would argue that the online for profit schools are more predatory simply due to the fact that their admission criteria are usually even less than B/M schools that are attempting to squeeze their students as well. 

That being said, there is a local B/M college here that charges 30,000 for their LPN program, and 50,000 for their ADN. They also have a BSN and MSN program, I don't know the cost of those, but I do know that their credits won't transfer to other colleges and universities. 

Two points to be made here. You are omitting certification as a requirement for licensure. Furthermore, do we have data that would actually show these schools are dangerous? If so, then thats an entirely different story and would go back to the basic laws of economics. Withstanding such evidence, the entire argument must be viewed as being rooted in a position of arrogance.

In speaking to predatory practices. A University in my area offers only a DNP for family practice, they completely did away with the MSN. The program would run someone $90,000, last time I looked. I paid1/3 of the price for my advanced degree. But I now have a certification, a license, a job, and am quite good at it. I am doing the exact same thing someone that spent $90k could possibly be doing. Now tell me, what do you think the result of decreasing access and choice in institutions would do to the price here? It certainly would not lead to less "predatory practices".

Edited by dianah
continuity

Emergent, RN

Specializes in ER. Has 28 years experience.

I agree,  higher education has become a corrupt,  agenda-driven bureaucracy. It's filled with lowest common denominator garbage and low standards. They've made most bachelor degrees useless in the marketplace, forcing students to keep coughing up big bucks for post-graduate degrees. 

djmatte, ADN, MSN, RN, NP

Has 7 years experience.

2 minutes ago, Shamrock1145 said:

Two points to be made here. You are omitting certification as a requirement for licensure. Furthermore, do we have data that would actually show these schools are dangerous? If so, then thats an entirely different story and would go back to the basic laws of economics. Withstanding such evidence, the entire argument must be viewed as being rooted in a position of arrogance.



"Evidence" doesn't exist for the same reason real evidence doesn't study the implication of direct to practice NPs vs value of actual nursing experience prior to NP school: nobody is willing to put the profession on the line for a public calling out of practices that could put our profession at risk.  We have noted concerns about NPs who actively precepted students from these schools where their preparedness for even a student role was questioned.  We see persistent anecdote by "colleagues" of other disciplines displayed across the internet who talk daily about the inept NP from a Walden or Chamberlain who asked a question a pre-med student would/should know the answer to.  Nobody will study it because it will severely damage the gains our profession has made.  

djmatte, ADN, MSN, RN, NP

Has 7 years experience.

2 minutes ago, djmatte said:

"Evidence" doesn't exist for the same reason real evidence doesn't study the implication of direct to practice NPs vs value of actual nursing experience prior to NP school: nobody is willing to put the profession on the line for a public calling out of practices that could put our profession at risk.  We have noted concerns about NPs who actively precepted students from these schools where their preparedness for even a student role was questioned.  We see persistent anecdote by "colleagues" of other disciplines displayed across the internet who talk daily about the inept NP from a Walden or Chamberlain who asked a question a pre-med student would/should know the answer to.  Nobody will study it because it will severely damage the gains our profession has made.  

And it isn't from a position of arrogance.  It's from a position of concern for our livelihood as opportunities disappear and also for the respect of our profession.

Shamrock1145, BSN, MSN, APRN

Specializes in Internal Medicine, ICU, Med-Surg. Has 9 years experience.

1 minute ago, djmatte said:

...nobody is willing to put the profession on the line for a public calling out of practices that could put our profession at risk... We see persistent anecdote by "colleagues" of other disciplines displayed across the internet who talk daily about the inept NP...

Ethical concern here for sure, placing perception over safety. We practice evidence-based, we train as such also, or so I assumed.

Shamrock1145, BSN, MSN, APRN

Specializes in Internal Medicine, ICU, Med-Surg. Has 9 years experience.

5 minutes ago, djmatte said:

And it isn't from a position of arrogance.  It's from a position of concern for our livelihood as opportunities disappear and also for the respect of our profession.

You are right, I over spoke and oversimplified here, but ultimately, from reading many of these posts, arrogance/man on the ivory town/hubris plays a factor for sure. Ultimately, this is a forum and prone to much nonsense.

Shamrock1145, BSN, MSN, APRN

Specializes in Internal Medicine, ICU, Med-Surg. Has 9 years experience.

8 minutes ago, djmatte said:

It's from a position of concern for our livelihood as opportunities disappear and also for the respect of our profession.

And this is how prices ultimately become inflated. 

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

On 2/17/2021 at 8:58 PM, Shamrock1145 said:

Two points to be made here. You are omitting certification as a requirement for licensure. Furthermore, do we have data that would actually show these schools are dangerous? If so, then thats an entirely different story and would go back to the basic laws of economics. Withstanding such evidence, the entire argument must be viewed as being rooted in a position of arrogance.

In speaking to predatory practices. A University in my area offers only a DNP for family practice, they completely did away with the MSN. The program would run someone $90,000, last time I looked. I went to another, 1/3 of the price. But I now have a certification, a license, a job, and am quite good at it. I am doing the exact same thing someone that spent $90k could possibly be doing. Now tell me, what do you think the result of decreasing access and choice in institutions would do to the price here? It certainly would not lead to less "predatory practices".

Arrogance is assuming that because a study hasn't been done to prove there are problems that no problems exist within nursing education. Certification exams are a low bar to demonstrate competence, testing has been studied for decades and shows it is a poor way to assess a person's knowledge. Because of this it cannot be the only barrier and safeguard for nursing practice. I don't know about the exams for NP's. But the NCLEX is a joke when it comes to assessing nursing knowledge so much so nursing professors often use the analogy "Remember in the NCLEX hospital things are done this way versus that way." our licensure exam is literally rooted in a fantasy setting and yet we think it is sufficient to "weed" out potentially unsafe nurses. Because of the weakness of our licensure exams, college programs must be rigorous and have admission standards. That's not arrogance. Reality is that not everyone is meant to be a nurse, NP, doctor, pharmacist, respiratory therapist, etc. and you know what? That is perfectly fine! I have no problem with expanding access through online programs, but some integrity has to be maintained. Your GPA, GRE scores, recommendations, years of experience, should all be considered for graduate education. Curriculum should be delivered in ways other than exclusively self directed learning. Clinical placement should be provided by the school and clinicals should be standardized as they are for undergraduate students.  Does that limit who can become an NP, yes it does.

See one of the problems with the philosophy of NP education, is that now the attitude is that RN experience is of little importance when continuing education, and whether that's true or not is not what I'm arguing. But in addition to this schools are saying that 18 months of self direct learning at 500 hours of clinicals is sufficient for a provider to independently practice in many states with an almost identical scope of practice to their physician counterparts. If RN education and experience is of such little value, how on earth can an NP be adequately prepared in 18-24 months of self directed study and 500 clinical hours the quality of which can vary widely. It doesn't take a study or even very much critical thinking to realize how problematic this could be.

As Emergent said, all of higher education has become corrupt, it is all about making money even when the colleges are "Non-profit", b/m or online they are all trying to make a buck by making students take out loans, milking Pell grant funds, and requiring extensive general ED classes to make the student "well rounded". In my opinion the for profits are more predatory. I have colleagues that have taught at for profits and they were not allowed to fail students in lecture or clinicals, they all quit teaching due to the ethical concerns they had. 

I will say that I think the reason people bemoan those who criticize schools with loose standards as snobbish, elitist, arrogant, are simply trying to deflect damage to their own egos. And there's no need, as has been stated by numerous poster in numerous threads obviously there are exceptional students that will succeed and be competent providers no matter what school they attend, no one is saying that all students of these schools are incompetent or ill prepared.

And as far as disregarding people anecdotal experiences; anecdotal experiences guide a lot of the decisions providers make, so many medications and treatments are really poorly understood and there's not a whole lot of evidence to support every single treatment under the sun. So disregarding people's experiences just because they haven't been published isn't always wise.

Shamrock1145, BSN, MSN, APRN

Specializes in Internal Medicine, ICU, Med-Surg. Has 9 years experience.

2 hours ago, TheMoonisMyLantern said:

Arrogance is assuming that because a study hasn't been done to prove there are problems that no Curriculum should be delivered in ways other than exclusively self directed learning.... Clinical placement should be provided by the school and clinicals should be standardized as they are for undergraduate students.  

Okay so let’s reverse this line of thinking please. Apply it the other way around.

I think many lack the ability to be successful with self-directed learning, and this is why so many aggressively push back against change. There is also a component of market manipulation here that has little to do with concern for patients and more to do with “perceptions” and “our opportunities” by way of limiting entrance into the field. The failure is an inability at looking at viable alternatives for training. The root of this failure is in fact partially arrogant, but also something more nefarious, hubris in the logic that nobody can do what we do unless it is done exactly in the way in which we did it. Complete lack of original thinking. This is ultimately a product of our defunct educational system.

Psychiatrist

Specializes in Psychiatry.

I am new to this site. I am a Psychiatrist. I precept PMNHP students. My experience with the students from the local university is a complete 180 from the recent students I have had to date (I would prefer not to name the school). I will continue with the other students from the institution that I have already agreed to precept, but I am trying the figure out the best way forward once I am done. I like to teach, but I do not want my name attached to a subpar student (and likely eventual provider). If anyone is inclined to provide me with any suggestions, it would be greatly appreciated.

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

2 hours ago, Shamrock1145 said:

Okay so let’s reverse this line of thinking please. Apply it the other way around.

I think many lack the ability to be successful with self-directed learning, and this is why so many aggressively push back against change. There is also a component of market manipulation here that has little to do with concern for patients and more to do with “perceptions” and “our opportunities” by way of limiting entrance into the field. The failure is an inability at looking at viable alternatives for training. The root of this failure is in fact partially arrogant, but also something more nefarious, hubris in the logic that nobody can do what we do unless it is done exactly in the way in which we did it. Complete lack of original thinking. This is ultimately a product of our defunct educational system.

You make a valid point that when we think others should go through what we went through, that type of thinking can certainly stifle innovation. But the innovation from schools like Walden isn't improving education, it's making money and enrolling as many students as possible, turn and burn. There is a need for NP's but as was posted in another thread the amount of NP's graduating each year increased by 300%. There are reports of NP's starting out at 65k per year because markets are getting so saturated. NP's feeling overwhelmed with their new jobs and needing significant amount of help from other providers when the other providers are expecting the NP to be able to be up and running. And everyone wants to be a psych NP because "they make more money" even though a lot of these nurses have never really dealt with acute psych and the attitude is "so what, it's just psych how much harm can you do?" And by golly right now all you have to do is have a pulse and you can certainly teach yourself to become one. 

My question is why do we need universities and professors if I can just read a textbook, submit a paper, and work a couple weeks in a clinic just have the board give me a license and we can all be NP's. 

I fear that if we wait until studies and data become available the damage will have already been done and NP's will have their practice micromanaged, wages diminished, and that much desired autonomy will be censured. The studies showing NP efficacy were done before the self directed study became all the rage, and at that time the studies were in our favor, NP education was effective. Yet in the name innovation we changed it and consequences have already occurred. 

MentalKlarity, BSN, NP

Specializes in Psychiatry. Has 8 years experience.

3 hours ago, Psychiatrist said:

I am new to this site. I am a Psychiatrist. I precept PMNHP students. My experience with the students from the local university is a complete 180 from the recent students I have had to date (I would prefer not to name the school). I will continue with the other students from the institution that I have already agreed to precept, but I am trying the figure out the best way forward once I am done. I like to teach, but I do not want my name attached to a subpar student (and likely eventual provider). If anyone is inclined to provide me with any suggestions, it would be greatly appreciated.

Let the institution know that the students are not up to standard and unless they up their admission standards and beef up their curriculum you have no interest in working as a preceptor for them any longer.

Psychiatrist

Specializes in Psychiatry.

1 hour ago, MentalKlarity said:

Let the institution know that the students are not up to standard and unless they up their admission standards and beef up their curriculum you have no interest in working as a preceptor for them any longer.

Thank you for your input. Unfortunately, it is a bit more complicated than that and my apologies for not including more background information. 

These students are also employees and I (and everyone else) know they would like to work there upon graduation. The higher ups know they rotated with me. I do not want my impressions of their substandard advanced practice education to cause them problems for their current positions. I am involved in direct clinical education for a variety of mental health disciplines, and this cohort to date is the weakest of the the groups.

Upon further investigation, the curriculum has excessive requirements that take away from patient care and there are not enough required patient contact hours to develop proficiency. Technically based on what they were expected to do during their time with me would be acceptable by their school's standards at that stage of their educations, but completely unacceptable for graduation in the near future and subsequent advanced practice patient care. 

I will check with the site coordinator on our end to see if/how I can relay these concerns to the institution. Thank you for your recommendation.