We Must Demolish Traditional Universities

Nurses Activism

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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.

Specializes in Mental health, substance abuse, geriatrics, PCU.
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.

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.

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.

Specializes in Mental health, substance abuse, geriatrics, PCU.
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. 

Specializes in Psychiatry.
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.

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.

7 hours ago, TheMoonisMyLantern said:

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.

Interesting thought, somewhat extreme example, but nonetheless this may be something that higher education will move towards in some fashion. Current model is not sustainable, or efficient.

13 minutes ago, Shamrock1145 said:

Interesting thought, somewhat extreme example, but nonetheless this may be something that higher education will move towards in some fashion. Current model is not sustainable, or efficient.

That's exactly what some of the aforementioned called out "universities" are doing.

26 minutes ago, djmatte said:

That's exactly what some of the aforementioned called out "universities" are doing.

You misunderstand my reply, which is completely understandable after I go back and read what was wrote. The “extreme” label was meant to be applied to the idea that “...have the board give me a license and anybody can be a nurse practitioner”. You really undercut a large amount of NPs currently practicing, their preceptors, and also the amount of work that was put into their studies. Furthermore, you call in to question the credential information process (which is another subject but whatever). Ultimately, this logic is in essence the arrogance and lack of foresight I was referencing in my prior replies.

It’s not arrogance to advocate for the improvement of our professions education credentialling process. At the least, it’s a good show of humility to recognize the value of a more rigorous education. One that even preceptors evidenced here are questioning from certain for profit schools. 

12 minutes ago, djmatte said:

One that even preceptors evidenced here are questioning from certain for profit schools. 

To be clear, there has been absolutely ZERO evidence presented for either side in this debate. 

16 minutes ago, djmatte said:

It’s not arrogance to advocate for the improvement of our professions education credentialling process. At the least, it’s a good show of humility to recognize the value of a more rigorous education. One that even preceptors evidenced here are questioning from certain for profit schools. 

And the preceptor you are referencing in this post probably needs to take a course on preceptorship if he is unable to handle the given scenario. 

Honestly, his post inadvertently highlights how subpar programs will not last anyway. If quality and an inability to secure preceptorship would continue to exist for these programs, then the program will ultimately fail.

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