Academic Leadership: Reducing Barriers to Student Veterans in Nursing Education

Background: One of the identified barriers to veterans returning to academia is the transition from military culture to civilian and academic life.  The transition from the regimented lifestyle of military teamwork, individual sacrifice, and “no-excuses” goal achievement, to the less structured and self-seeking individualism sometimes encouraged in U.S. higher education, can be difficult for veterans to navigate.  Further, challenges to traditional ideas of patriotism and altruism that some in American higher education promote, are sometimes difficult for veterans to overcome (McReynolds, 2014).  This culture shock for returning veteran students can be difficult, and without concerted efforts by faculty and staff within higher education to assist, listen and offer counsel, veteran students are vulnerable to self-isolating behaviors that may result in the veteran withdrawing from class participation, and eventually in leaving the institution.  Understanding of the cultural changes awaiting transitioning veteran students, as well as implementation of strategies to avoid the possible pitfalls associated with the transition, are foundations of the Michigan Veterans Bachelor of Science in Nursing (VBSN) program.

Veteran population: The state of Michigan boasts more than 660,000 veterans ranking it 11^th nationally for veteran population. UM-Flint is located in Genesee County, and ranks 5^th out of all Michigan counties with 30,000 veteran residents (Michigan Dept. of Military & Veteran Affairs, 2016; U.S. Census Bureau, 2015). The current overall unemployment rate in Michigan is at 5.0% (U.S. Bureau of Labor Statistics, 2015) however, among 18-24 year old Michigan veterans the unemployment rate of 6.8% continues to exceed that of non-veterans, according to the U.S. Congress Joint Economic Committee (2014).

University of Michigan Flint is nationally recognized for its exemplary service to student veterans and recently placed in the top 15% of all schools nationwide for being a “Military Friendly School” by G.I. Jobs, and was also named a “Best for Vets” College by EDGE Magazine (Military Times, 2015).  Among all of the student veterans at UM-Flint, 18% are declared as either Nursing or Pre-nursing for the Winter 2016 semester, making our campus one of the regional leaders in transitioning veterans and training them to be nurses.

Theoretical background: Two of the seminal studies about collegiate student success suggests that adaptation to the institution and social interaction among peers is key to traditional student success (Tinto, 1993).  Conversely, studies by Bean and Metzner (1985) have shown that similar social interaction is not nearly as important for non-traditional (and therefore veteran) students to be successful, but that environmental support services are most important to the academic success of this population. Bean and Metzner concluded that, regardless of a non-traditional student’s academic success, if adequate environmental support is not in place then that student may not persist.  Further, non-traditional students are shown to persist if the environmental support is favorable, despite marginal academic performance (Bean & Metzner, 1985).  This suggests that given adequate academic support and services, a veteran student will persist and graduate despite a lack in the institutional and social interactions that traditional students may require.

Methodology: Through a focus on innovative reduction of the barriers that interfere with nursing education and career transition for veterans, coupled with awarding of academic credit for prior military education and health-oriented training, University of Michigan-Flint Nursing will address both veteran unemployment and increased demands for BSN prepared registered nurses.  The project will:

1. Develop and integrate BSN career ladder programs targeted to the unique needs of veterans with prior military health and other career experience and training into University of Michigan Flint BSN programs.  
2. Reduce barriers through provision of an array of transition enrichment and support services, including tutoring and writing assistance, and competency assessments to identify nursing academic credits to be awarded that enable veterans to successfully progress through the BSN program, NCLEX licensure exam, and employment in professional nursing.
3. Employ UM Flint Nursing’s reputable faculty experience, knowledge and resources to support and prepare a diverse veteran student body in the provision of culturally sensitive and competent quality nursing services.      

The VBSN program will be guided by the mission and values of UM Flint’s Department of Nursing, and the Essentials of Baccalaureate and Graduate Education for Professional Nursing Practice (Essentials, 2008).  The Michigan VBSN Program is open to all honorably or generally discharged service members with healthcare training and experience, and offers the opportunity for veterans to build on prior learning to obtain a BSN degree.  Nursing as a career option for returning veterans will also help fill the expected growth of 500,000 professional nursing jobs over the next decade (Bureau of Labor Statistics, 2015; Occupational Outlook, 2015), while concurrently reducing veteran unemployment.   

The Michigan VBSN program seeks to discover non-traditional educational pedagogies for student veterans that encompass an expedited admission process for newly entering veterans and those returning from deployments, early assurance of entry into the nursing program (upon completion of three required prerequisites with a minimum GPA of 3.0), allowances for stop-outs/restarts for deployments, and a 16 month accelerated nursing program.  From the time of University admission through graduation, students are assigned a Nursing Department Academic Advisor who provides individualized guidance and counsel, referrals and follow-up regarding program matriculation, transition, and/or disability accommodation services. 

Military training, college transcripts, and other challenge test certifications from veterans are evaluated for transfer and college credit by the Undergraduate Admissions office; evaluations and granting of college credit will be guided by the American Council on Education (ACE) guidelines and nursing department predetermined parameters.  Health Education Systems Incorporated (HESI) practice and validation assessments will be utilized to identify student veteran levels of nursing licensure exam readiness, required remediation, and additional needed support. 

Students will be admitted into a compressed accelerated nursing program that will be able to accommodate nursing program completion within 16 months.  Students will be encouraged to take prerequisite courses over a one to two year period depending on the number of college credits of record at time of selection into the nursing program.  After successful completion and graduation from the program, students will be eligible to sit for the National Council Licensure Examination (NCLEX) examination.  

Transition into professional nursing: To strengthen student employment opportunities and address employer retention interests, a hospital-university employment-on boarding partnership has been implemented. The program is designed to track graduate progress for one year after graduation, and to complement facility orientation processes by assisting graduates to successfully transition into their new professional nurse roles. 

Graduates are prepared to provide services to underserved populations by virtue of the curriculum’s cultural competence focus and student clinical experiences conducted at clinical facilities across the Mid-Michigan region.  In the most recent two year period, 60-70% of the UMF graduates have been employed in medically underserved communities in and around Flint, Michigan and Genesee County.  These areas have high populations of persons living in poverty (42% and 22%, respectively); higher than the state average of 16.2% (US Census Bureau, 2015).