Serving Those Who Served: The MedVet to BSN Educational Option

In 2013, over 75,000 enlisted military personnel worked in collaboration with nurses and physicians to provide patient care services (US Department of Labor, Bureau of Labor Statistics, 2013). Included in this group are soldier medics, who provide emergency medical treatments to troops in the field and more routine care for soldiers and their families at home. Recently, Congress created The Veteran Emergency Medical Technician Support Act; H.R. 235 (Kinzinger, 2013) to assist medics with their transition into civilian EMT positions as they leave their military assignments (Energy and Commerce Committee, US House of Representatives, 2013). Emergency medical training and military leadership skills also provide the military medic with an advantageous background for the registered nurse (RN) role. The projected availability of RNs to meet the future health care demands of the public varies by state. Approximately US 16 states, more so in the west, are predicted to have nursing shortages 2025 (US Department of Health and Human Services, HRSA, 2014). Ideally, nursing education for the experienced military medics can provide career opportunities for veterans who have served our country and positively impact the nursing shortage in selected states. The MedVet Option of our baccalaureate nursing program was developed to meet the educational needs of military medics and meet the public need for nurses as veterans move into the civilian workforce. The components of our MedVet to BSN Option will be described along with specific option outcomes during this presentation. 

Background/Recruitment: A federal grant from the Health Resources and Services Administration (HRSA) funded the development of a MedVet Option in our baccalaureate nursing program for medics with military medical training. Approximately five to ten student veterans will be recruited each semester during the three year funding period for a total cohort of 25-50 veterans by 2017. Goals of the option are to 1) develop and implement nursing career development strategies for student veterans, 2) provide academic credit for previous training through competency-based learning/ testing, 3) assemble a network of support, 4) educate nursing faculty on military culture, specific learning needs for student veterans, and available resources to promote student veteran success, and, 5) collaborate with on-campus and community veteran resources.

Curriculum: The student veterans will be accepted into the five semester BSN curriculum that is offered to our second-degree/career students; traditional students complete the curriculum in six semesters. The usual admission standards apply for fall and spring admissions with prerequisites completed before entry into the sophomore year of the program. Student veterans may receive academic credit for clinical competencies developed during medic training (Bureau of Medicine and Surgery, BUMED courses) such as medication administration and patient assessment when these skills are demonstrated in the Clinical Learning and Simulation Center. Evidence-based strategies for facilitation, debriefing, assessment and evaluation will be used during laboratory instruction and competency testing (Sittner, Aebersold, Paige, Graham, Schram, Decker, & Lioce, 2015). 

Veteran Cohort: All student veterans will be placed in a single clinical group during their first nursing semester in a second degree/career course. After the first semester, the student veteran will assimilate into the traditional student courses. The clinical instructor will remain the same for all student veterans in the first semester to provide support, consistency, and to model caring behaviors, a strategy associated with increased student perceptions of their own caring capabilities (Labrague, McEnroe-Petitte, Papathanasiou, Edet, & Arulappan, 2015). Faculty and students will receive continuing education to increase their understanding of the challenges faced by our returning student veterans, as well as the resources available on campus and in the community for student veteran success.

Challenges: Student veterans can experience gaps in academic preparedness and study skills when previous collegiate education has occurred in the distant past. In addition to university writing and counseling center resources, student veterans will receive professional development through positive organization behavior (POB) workshops and attain other supplementary support throughout their progression. Writing and test-taking experts will create toolkits for writing, presenting, and test-taking skills. Furthermore, specific requirements for the first semester course are provided during an extensive orientation with written instructions for all assignments. Introducing the student veterans to the professional role and language and science of nursing will take place during the first semester with clinical assignments in an acute care setting, a learning strategy highly valued by undergraduate students (Shaha et al., 2013).

Enrichment:  All student veterans will participate in interprofessional education activities with students from other health care disciplines to enhance their communication and collaboration skills. Students from nursing, pharmacy, medicine and other professions will engage in case study work after instruction throughout the first year of the nursing curriculum to practice principles of effective communication (Baerg, Lake, & Paslawski, 2012; Conigliaro, Kuperstein, Welsh, Taylor, Weber, & Jones, 2015). Voluntary participation in research, teaching, and practice internships for academic credit is also possible.

Project Outcomes: The principal investigator for the HRSA grant funding this pilot option established outcome measures for the MedVet – BSN Option students and faculty (table 1).

Table 1. Project performance measurement

Goal	Measurement/Instrument	Objective(s)
NCLEX-RN Pass Rate	Percentage of MV-BSN students who pass on first attempt	90% of students will pass within 4 months of graduation
Student Satisfaction	De-identified web-based clinical evaluations	Satisfaction scores ≥ 85% in clinical experiences
Career Transition Priority senior clinical placement Enrichment opportunities	Percentage of MV-BSN students in preferred clinical experience	100% of students graduate within 5 semesters of enrollment
	Percentage of MV-BSN students receiving information of enrichment opportunities	100% of students enrolled in opportunities will complete  capstone
Academic Course Credit	American Council on Education standards Medicaid Nursing Assistant standards American Association of Colleges of Nursing and CON standards	100% of prerequisite work that meets ACE standards will be accepted as transfer credits 100% of students will score a minimum of 76% on nursing module and MNA exam; and perform all skills at basic competency levels.
Transition to Campus/Civilian Life	Qualitative data from focus groups to include satisfaction with support systems and perceived value of POB workshops	100% of students will develop learning plans based on POB guidelines 100% of students expressed positive perception of campus and community resources
Faculty Development	Number of undergraduate faculty who attend ≥ 10 educational presentation/webinars during first 12 months of project Number of faculty able to meet presentation objectives	100% attend at least 10 educational sessions 100% of UG faculty able to list five academic and non-academic difficulties in student veterans and 1-2 strategies to effectively address each of those difficulties.