School Nurse Services Credential Program

1. Program Summary

Program Design

The SNSC program is designed for registered nurses employed full-time or part-time as school nurses. The SNSC is an employment-embedded three-semester program with completion expected within five years from activation of the preliminary SNSC credential. The SNSC program includes coursework and field experiences designed to provide nurses with opportunities to demonstrate that they have developed the knowledge and skills necessary for full credentialing. Individualized goal setting based on competency evaluation, professional learning opportunities, practical application of learning and skills, and ongoing assessments are emphasized. Program coursework consists of 21 units of study over three semesters, with an additional three units taken at an approved program that prepares them to meet the requirements for their school audiometrist certificate, required by the end of the first year.

Courses are mainly delivered online, asynchronously. Most courses also include several synchronous class meetings via zoom, dispersed throughout the program. Synchronous classes allow candidates to meet for lectures, networking, small group discussions and collaboration, and/or learning from expert guest speakers. Coursework provides a comprehensive educational foundation that encompasses child development and health, health management within school systems, health education, and skills and competencies required for school nursing practice. This foundation prepares school nurses to promote health and safety, intervene in actual and potential health problems, provide case management, and collaborate with teachers, school staff, and administrators to help students develop capacity for self-management, self-advocacy, and learning.  

Leadership within the credential program

Dr. Rachel McClanahan, the coordinator for the SNSC program, works closely with Rachel Wiedemann, Graduate Nursing Advisor, to review all applications for candidates entering the program and communicate with students throughout the program. Dr. McClanahan is involved in managing the clinical practicum experience with the practicum course faculty. Credential faculty members teaching the Fieldwork practicum course assure that the clinical practicum site, student experience goals, and preceptors meet CTC and program requirements. Dr. McClanahan is responsible for verifying that completing candidates have met all credential requirements. Dr. Penny Weismuller, Director of the School of Nursing (SON), is additionally involved in the credential program by providing consultation on additional School of Nursing or University requirements and in preparation of documents for the reaccreditation process.

Communication within the credential program and with the institution

Dr. McClanahan, Rachel Wiedemann, and credential program faculty members communicate regularly with credential students. Communication is completed via CSUF student email, Canvas Learning Management System course email and announcements, and the Canvas Community page. Drs. McClanahan and Weismuller are responsible for communicating with the College of Health and Human Development leadership regarding the program's operation and credentialing. Dr. McClanahan communicates with the College of Education credential analyst to verify that completing candidates have met all practicum and academic requirements for the credential. Dr. McClanahan communicates with leaders and representatives from the CSUF College of Education and the CTC as questions arise about program standards and during the reaccreditation process.

Structure of coursework and field experiences in the credential program.

Fieldwork and practicum experiences are completed in five of the seven credential classes. Starting with completing health, developmental, and behavioral assessments in NURS 524 to more in-depth 135-hour fieldwork experiences with an expert nurse preceptor in NURS 533L. Along the way, candidates complete community agency visits (NURS 508) and lead a committee to conduct a school health and safety policy self-evaluation (NURS 532). In their final semester (in NURS 507), students develop a legislative brief about a school-health related topic, make an appointment with and complete a visit to a local legislator to discuss the issue.

Table 1: Structure of Coursework and Field Experiences

Course	Fieldwork Experience
NURS 524: Advanced Health Assessment- Ambulatory Pediatrics (Semester 1)	Candidates perform two health, developmental, and behavioral assessments, one complete health history assessment, and one complete system assessment on students in the candidate’s own or local school district
NURS 508: Advanced Nursing Practice: Vulnerable Populations (Semester 2)	Candidates conduct one on-site visit to investigate a community agency serving a chosen vulnerable population. The visit includes a tour of the facility (when possible) and an interview with an agency representative
NURS 532: School Nurse Specialist II (Semester 2)	Candidates organize and assume leadership of a Coordinated School Health Committee in their own or a local school district. As committee leaders, candidates administer the CDC’s School Health Index (SHI) survey, a self-evaluation and planning tool to identify strengths and weaknesses of school health and safety policies, and use findings to develop a plan for improvement
NURS 533L: School Nurse Practicum (Semester 2)	Candidates complete an individualized learning plan with faculty- and self-designed goals and objectives to ensure the knowledge, competency, and skills required in school nursing practice. 135 hours are with a credentialed school nurse preceptor
NURS 507: Advanced Decision Making-Nursing Issues (Semester 3)	Candidates develop a legislative brief about a school health-focused topic, complete a visit with a legislator to present their brief, and reflect on their experience once completed.

Program modifications over the recent two years

Table 2: Courses added as requirements in the program

Name	Course
NURS 507: Advanced Decision-Making: Nursing Issues	Content strengthens skills and competencies in policy analysis and development and professional advocacy
NURS 508: Advanced Nursing Practice: Vulnerable Populations	Content adds a focus on the identification and care of vulnerable populations, a focus on culturally competent care, and addresses biases
NURS 552: Pharmacology for Advanced Practice Nursing	Content builds on current knowledge to enhance understanding of the complexities of treatment with pharmacological interventions

Means for stakeholder input

The SON hosts an annual Community Partners meeting made up of partners from the community and clinical agencies, including school nurses and school nurse leaders, to review SON programs, including the SNSC, and provide feedback. Within the SNSC program, preceptors give feedback on their experience as a preceptor and working with faculty, the Program Coordinator, and Graduate Program Advisor. Preceptors provide feedback on candidates’ performance in the clinical practicum via an evaluation at the midterm and end of the course. Students give feedback on the courses, instructors, and the program when they complete course and instructor evaluations at the end of each semester and an exit survey upon completion of the program.

Table With Location, Delivery Model, and Pathway

Table 3: Location, Delivery Model, Pathway

Location	Delivery Model	Pathway
Main Campus	Online	School Nurse Services Credential

Course of Study (Curriculum and Field Experience)

Description of the sequence of coursework

Course descriptions can be found in the CSUF Catalog

Table 4: Study Plan & Description of the sequence of coursework

Semester/ Course	Description
Fall Year 1 – Semester 1 (6 units)	NURS 524 and NURS 530 build a foundation for school nursing practice. NURS 524 Advanced Pediatric Heath Assessment provides the knowledge and skills to perform and document health history and physical exams in the school setting. Students complete one full health history assessment, one full system assessment, and two developmental /behavioral screenings using a standardized tool. Students will also develop and present a case study on a student with a critical health need and discuss their health care plan recommendations. NURS 530 School Nurse Specialist I provides knowledge in the basic practices and competencies of school nursing by examining topics including the profession, roles, legal underpinnings, care of children with special healthcare needs, and the school nurses’ role in special education. Students develop a complete toolkit to care for students with an assigned healthcare need.
NURS 524 – Advanced Health Assessment: Ambulatory Pediatrics (3)
NURS 530 – School Nurse Specialist I (3)
Spring Year 1 – Semester 2 (9 units)	NURS 508 and NURS 532 build a foundation for school nursing practice. NURS 508 candidates examine theories of vulnerability, demonstrate cultural diversity competence in providing nursing care to vulnerable populations, and conduct one on-site visit to investigate a community agency serving a chosen vulnerable population. NURS 532 students explore the school nurse's role in research and health education with an emphasis on health promotion; they develop a health lesson and provide peer review on another School Nurse student’s lesson that they carry out in NURS 533L. In NURS 532, students lead a team in completing the CDC’s School Health Index (SHI) survey, a self-evaluation and planning tool to identify strengths and weaknesses of school health and safety policies, and, with the team, develop recommendations for improvement. NURS 533L students complete their 135-hour practicum with a school nurse preceptor completing activities based on self-assessment of their level of competence in school nursing practice.
NURS 508 - Advanced Nursing: Vulnerable Populations (3)
NURS 532 - School Nurse Specialist II (3)
NURS 533L - School Nurse Specialist Practicum (3)
Fall Year 2 – Semester 3 (6 units)	NURS 508 and NURS 532 build a foundation for school nursing practice. NURS 507 students continue to develop essential skills and competencies in analyzing and influencing health policy and conducting professional advocacy activities, including developing a policy brief and visiting a legislator’s office. NURS 552 school nurse students explore the principles of advanced pharmacology, including pharmacokinetic and pharmacodynamic principles of medications commonly used in the diagnosis, prevention, and treatment of conditions common in preschool, school-age children, adolescents, young adults, and across the lifespan.
NURS 507 - Advanced Decision Making: Nursing Issues (3)
NURS 552 - Advanced Pharmacology: Prescriptive Authority (3)
Audiology pre/corequisite course requirement - must be completed by the end of the first year (3)
TOTAL UNITS = 24

Coordination of coursework with fieldwork

Coursework in the first semester (NURS 524 & NURS 530) and second semester (NURS 508 & NURS 532) provide a foundation for applying theories, concepts, and research to practice in the NURS 533L practicum course. Program courses utilize audio-visual materials, case studies, reflective writing, discussions, computer-assisted instruction, problem-solving activities, presentations, and hands-on experiences to practice desired skills and work toward competency. Upon entry into the second semester 135-hour clinical practicum course (NURS 533L), students, in consultation with their preceptor, complete an initial self-assessment to determine areas of strength and weakness in meeting the required school nurse competencies and develop an individualized learning plan to be accomplished during the semester. In their final semester, students strengthen skills and competencies in policy analysis and development and professional advocacy, culminating in a visit with a legislator.

Types of coursework in critical areas (e.g., English learners for all initial teaching programs)

Program coursework provides opportunities for candidates to interact with content that builds on their understanding and competence in functioning independently as a school nurse. Coursework focuses on linking content to school nursing clinical practice in a variety of care delivery models, including prevention, health promotion, and meeting health requirements in the school setting for both elementary and secondary students with various health concerns.

Number and type of field placements

Students complete fieldwork requirements in four courses (see Table 1). The second semester 135-hour clinical practicum (NURS 533L) is completed in consultation with a school nurse preceptor who acts as a guide, expert clinician, and resource person. The consulting preceptorship model accelerates the socialization process in the school nurse’s role and encourages more intensive self-evaluation of the student's nursing practice. The consulting preceptorship allows the school nurse credential student to structure their work situation to meet clinical objectives and experiences that go beyond specific employment responsibilities. The experience is characterized by independence, allowing students to identify and meet their learning needs and build a unique clinical experience. Clinical hours are further refined and developed in accompanying faculty-designed clinical assignments and expectations, including completing a health lesson for students on a chosen topic at a grade level selected (PreK – grade 12).

Connection of field experience with coursework

The coursework and field experiences of the SNSC provided candidates with a range of experiences working with students from diverse ethnic, cultural, linguistic, and socio-economic backgrounds and emphasizes the development of skillful, autonomous practitioners. Combining theory, practice, and research provides a foundation to advance knowledge and produce competent, informed decision-makers able to influence the health and well-being of individual students, their families, and the community.

Field supervision, advisement, evaluation: frequency, type, from BOTH the program personnel and the district employed individual (master teacher) when required in a program

Table 5: Field supervision, advisement, evaluation

Who	Beginning of Semester:	Weekly:	Mid-Semester:	End of Semester:
Student & Preceptor	Meet to complete student’s initial self-evaluation of competencies and develop individualized learning goals.	Complete clinical contract to agree on dates and times for meetings, not to go more than two weeks between appointments.  Meet weekly to review student activities, troubleshoot issues, and revise goals.	Meet to assure that the student is on track in developing and progressing toward completing learning activities to achieve goals and objectives. Revise plans to meet objectives based on findings from mid-semester evaluation.	Meet to review goals and complete student’s final self-evaluation of competencies.
Student, Preceptor, & 533L Faculty	Meet (in-person, telephone, zoom) to discuss the self-evaluation findings and proposed learning goals at the beginning of the semester to advise and make recommendations.	Review weekly student reflections on their learning from the previous week and logging of hours. As needed, connect with student/ preceptor to troubleshoot issues or make recommendations.	Review mid-semester student reflections on learning and logging of hours. As needed, meet with student/ preceptor to advise and make recommendations.	Review final self-evaluation and assure completion of all course requirements.

Assessment of Candidates

How, when candidates are assessed for program competencies

SNSC Candidates are assessed for program competencies through graded critical assessments and completion of fieldwork goals.

Table 6: Essential Assignments/Assessments

Course/Timing	Essential Assignments/Assessments
NURS 524 (Semester 1)	Health History Assessment & Write-up (rubric out of 20 points, score of 16.6 [83%] to pass) Physical Examination Demonstration (rubric out of 15 points, score of 12.45 [83%] to pass)
NURS 530 (Semester 1)	School Health Concern Management Packet and Presentation (rubric out of 25 points, score of 20.75 [83%] to pass)
NURS 532 (Semester 2)	School Health Index (rubric out of 25 points, score of 20.75 [83%] to pass)
NURS 533L (Semester 2)	Initial self-evaluation and Final self-evaluation. Final self-evaluation ratings of ‘consistently’ or ‘often’ for sections 1 & 2 and ‘Proficient’ or ‘Emerging’ for section 3 are required to pass. Successful completion of individualized goals to meet competencies based on self-evaluation with consultation from on-site preceptor and clinical faculty. Students reflect on their learning of competencies and skills weekly throughout the semester

What advice candidates receive about how they will be assessed in the program and informed of the results of those assessments

Critical assessments are identified in each syllabus, and all utilize grading rubrics. All rubrics are shared with students ahead of their completion of the assignment. Graded assignments are returned to students within two weeks of submission. A one-on-one meeting is conducted between course faculty and students who do not pass critical assessments with an 83% to develop a remediation plan. The program coordinator will be informed of or participates in one-on-one remediation meetings.