State of Nursing Education and Proposed Solutions Think Tank
Executive Summary

Florida Center for Nursing
Headquartered at the University of South Florida College of Nursing
12901 Bruce B. Downs Blvd., MDC 22
Tampa, FL 33612

Report Prepared By:

Mara Raggi
PhD(c), MSN, RNC-NIC, PHN, NE-BC
Director of Health Care Research, Florida Center for Nursing

Rayna Letourneau
PhD, RN
Executive Director, Florida Center for Nursing
Associate Professor, University of South Florida College of Nursing

Report Citation Information:

Florida Center for Nursing (2024). Florida Nursing State of Nursing Education and Proposed Solutions Think Tank Executive Summary. Tampa, FL.

If you require this report in an alternative format, please contact the Florida Center for Nursing at flcenterfornursing@usf.edu

Acknowledgements

Special thanks to the organizations that hosted Florida Center for Nursing’s State of Nursing Education and Proposed Solutions Think Tank regional workshops: Florida State University, Valencia College, and University of Miami.

Additionally, the Florida Center for Nursing extends gratitude to each State of Nursing Education and Proposed Solutions Think Tank participant for engaging in the regional workshops and for providing feedback and insightful input. Hearing directly from our communities of interest has significantly enriched the discussions and will undoubtedly enhance the overall success of the Florida Center for Nursing’s strategic endeavors.

Introduction

The Florida Center for Nursing (FCN) was established in 2001 to address issues of supply and demand for nurses, including issues of recruitment, retention, and utilization of nursing workforce resources (Florida Statute §464.0195). The vision of FCN is to ensure that the health care needs of the residents and visitors of Florida are met by a competent and sufficient nursing workforce.

Consistent with Florida Statute §464.0195(2)(c), in 2023, FCN offered workshops to
convene various groups representative of nurses, other health care providers, business and industry partners, consumers, lawmakers, and educators to:

• review and comment on nursing education data analysis prepared by the Florida Center for Nursing and
• recommend systemic changes and outline strategies for implementation of changes.

The Florida Center for Nursing’s State of Nursing Education and Proposed Solutions Think Tank was an innovative program designed to convene these various groups to review and comment on NCLEX data analysis and highlight key findings of Florida’s Nursing Education Program Report for academic years 2020-2021 and 2021-2022.

Background

Increase the Number of Nursing Faculty and Clinical Preceptors in Florida

During Think Tank strategic break-out sessions, participants were assigned the goal of identifying strategies that can increase the number of nursing faculty and clinical preceptors in Florida. Participants first outlined critical challenges surrounding the nursing faculty and clinical preceptor workforce, which include vacancies, qualifications, education and training, mentoring, workload, and compensation.
Increasing and enhancing the nursing faculty and clinical preceptor workforce involves addressing the identified challenges and implementing targeted strategies to attract, train, and retain qualified individuals.

Increase Florida’s Nursing Workforce

Strengths of the nursing workforce include opportunities to achieve and sustain a workforce that is sufficient in size, distribution, expertise, and representation. The National Academy of Medicine’s Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity report recommended ensuring a nursing workforce that reflects the people and communities for whom they care. Representation matters in improving quality of care and patient outcomes for all. Participants in Florida Center for Nursing’s State of Nursing Education and Proposed Solutions Think Tank considered factors related to nursing students, faculty, and workforce.

Improve Florida’s NCLEX Pass Rates

The National Council of State Boards of Nursing (NCSBN) develops the NCLEX to test the competency of nursing program graduates in the United States and Canada. The NCLEX is a variable-length, valid, and reliable computerized adaptive test to measure nursing competence. The passing standards for the NCLEX-RN and NCLEX-PN reflect the amount of nursing knowledge, skills, and attitudes required to practice competently at the entry level of the profession. Prelicensure nursing programs are the pipeline to the nursing workforce. Graduates prepared for success on the national licensure examination are critical so employers can fill vacant and new positions. A persistent inability for employers to fill vacant nursing positions may result in decreased access to quality and safe nursing care for the people of Florida. Therefore, the Florida Center for Nursing requested State of Nursing Education and Proposed Solutions Think Tank participants to deliberate and identify strategies to improve Florida’s NCLEX pass rates.

Method

The Florida Center for Nursing (FCN) executed the State of Nursing Education and Proposed Solutions Think Tank three times in 2023. Workshops were conducted across the northern, central, and southern regions of the state to allow participants throughout the entire state to review and comment. The dates and locations of each workshop are listed below:

• February 7, 2023, at Florida State University, Tallahassee
• June 8, 2023, at Valencia College, Orlando
• October 19, 2023, at University of Miami, Coral Gables

Florida’s Nursing Education Program Report for academic years 2020-2021 and 2021-2022 were shared with participants. Workshop participants reviewed and commented on nursing education data analysis prepared by the Florida Center for Nursing. Lastly, participants recommended systemic changes and outlined strategies for implementation of changes to increase the number of nursing faculty and clinical preceptors in Florida, increase the nursing workforce in Florida, and improve Florida’s NCLEX pass rates. Feedback and recommendations to guide strategic actions were collected.

Attendees

Participation at the regional State of Nursing Education and Proposed Solutions Think Tank included people representative of various groups across Florida and included nurses, other health care providers, business and industry partners, health care consumers, lawmakers, and educators.

Date                   Location                                     Number of Attendees
2/7/2023           Florida State University           76
6/9/2023          Valencia College                      54
10/19/2023        University of Miami                  41

Nurses were eligible to claim continuing education credits for attending the Florida Center for Nursing’s State of Nursing Education and Proposed Solutions Think Tank. A total of 120 continuing education units were awarded to nurses demonstrating their development of new knowledge and expansion of perspectives related to the state of nursing education in Florida.

Summary of Key Findings

The key findings listed in the following tables identify barriers and recommendations provided by the Florida Center for Nursing’s State of Nursing Education and Proposed Solutions Think Tank participants. Many of the themes identified are echoed by expert organizations and scholarly literature (Institute of Medicine, 2011; American Association of Colleges of Nursing, 2024). These findings provide insights that will guide the Florida Center for Nursing’s actions in the development and execution of nursing workforce strategies specific to the needs of Florida’s citizens, visitors, and nursing workforce. These insights will inform the statewide strategic plan for the nursing workforce.

Increase the Number of Nursing Faculty in Florida

Problems, Barriers, and Contributing Factors

• Lack of faculty training, preparation, and mentoring
• Workplace culture and bullying
• Time pressure and scarce resources
• Some faculty lack teaching skills
• Lack of qualified candidates for faculty positions
• Salary for faculty is much lower than salary for clinicians
• Faculty retention

Recommended Actions

• Improve collaboration and spread best practices
• Provide statewide onboarding and mentoring programs for expert clinicians transitioning to the role of nursing faculty
• Standardize faculty requirements for employment by program across the state
• Provide professional development of new faculty and part-time faculty
  • Extend mentorship for novice faculty beyond the first semester
• Develop a “faculty campaign” to promote faculty employment 
• Promote work-life balance
• Establish, develop, and standardize professional role identity for the academic practice role
• Promote academic fellowship at the state level using an “exchange student” model 
• Create a “shared faculty” program or “teacher exchange”
• Create academic/leadership internship programs
• Allow BSN-prepared nurses to teach clinical courses 
• Expand academic-practice partnerships
  • Consider hospital financial support for adjunct faculty time 
  • Consider in-kind exchange for professional development opportunities 
• Increase faculty salaries through Title VIII
• Increase funds for faculty
• Continue with faculty development, such as the Florida Center for Nursing’s Shaping the Future: Becoming Nursing Faculty activity

Florida Center for Nursing’s Initiatives

• Research
  • The Florida Center for Nursing collects, analyzes, and reports nursing education program data annually, including institutional faculty data (e.g., faculty counts, faculty vacancies, highest degree held by faculty, and faculty age).
• Encourage and coordinate the development of academic-practice partnerships 
• Pilot innovative projects to support the recruitment, development, and retention of nurse faculty
• Shaping the Future: Becoming Nursing Faculty
  • The purpose of this continuing education program is to explore the role of nursing faculty for nurses that may be interested in this vital career path.

Increase the Number of Clinical Preceptors in Florida

Problems, Barriers, and Contributing Factors

• Lack of qualified and available preceptors
• Inadequate workload management and compensation, including salary, benefits

Recommended Actions

• Create academic-practice partnerships with contractual agreement 
• Support faculty scholar programs that allow a full-time role to be half clinical and half academic (e.g., clinical scholar role, AdventHealth hybrid role)
• Provide formalized training for clinical preceptors
• Allow clinical preceptors to seamlessly transition to adjunct faculty
• Provide clinical preceptors with access to the university library system
• Offer a tuition waiver for preceptors
• Consider preceptor pay models and incentive pay for preceptors 
• Provide well-being and mental health programs

Florida Center for Nursing’s Initiatives

• Collect, analyze, and report data on nurse employment, retention, and distribution
• Encourage and coordinate the development of academic-practice partnerships 
• Develop recommendations to increase clinical preceptors and promote advanced nurse education
• Develop best practices for the continuing education needs of clinical preceptors

Increase Florida’s Nursing Workforce

Problems, Barriers, and Contributing Factors

• Recruitment of students by high school may be too late
• Barriers to becoming a nurse include family responsibilities, childcare, program admission requirements, standardized testing, and the cost of education
• Students who start earning a livable salary may not want to further advance their career

Recommended Actions

• Aim to reach younger students through school-based initiatives (e.g., Great American Teach-In and mini-nurse program)
• Expand existing programs (e.g., BEST Academy)
• Partner with community recreational programs so they understand how nursing will impact their communities
• Collaborate with CareerSource Florida to market existing nursing education programs and available wraparound services
• Maintain curriculum standards but diversify based on geographic location
• Provide students with flexible schedules, tuition reimbursement, career guidance, and apprenticeships
• Consider a systemic culture change in nursing

Florida Center for Nursing’s Initiatives

• Frontline Nursing Podcast
  • Presented by the Florida Center for Nursing, Frontline Nursing is a podcast that recognizes the impact nurses have on our lives and our communities. 
• Great American Teach-In
  • The Great American Teach-In and school career days can make a significant impact on children. FCN provides resources to assist nurses with classroom presentations. 
• Prelicensure Professional Networking Program (PPNP)
  • PPNP provides nursing students with a platform for networking and promotes active engagement and a sense of community among students. Immersive experiences can enhance student understanding of complex health care organizations. The PPNP offers prelicensure students the opportunity to gain knowledge, confidence, and collaborative skills to navigate and excel within the health care system.

Improve Florida’s NCLEX Pass Rates

Problems, Barriers, and Contributing Factors

• Regional differences regarding percentage of accredited programs
• Length of time from graduation to test taking 
• Language barriers 
• Education program variation (e.g., class size, number of faculty, proportion of experiential learning in curricula, clinical settings)
• Lack of resources dedicated to student success

Recommended Actions

• Provide student-centered education that addresses diversity
• Promote dedicated educational units (DEUs) 
• Utilize NCLEX success coaches in prelicensure nursing education programs
• Provide additional support and resources to faculty because support of faculty impacts students’ success
• Increase best practices, such as simulation, to support learning infrastructure 
• Create standardized admission requirements and qualifications for applicants to prelicensure nursing education programs
• Encourage oversight of nursing education programs by the Florida Board of Nursing to ensure quality of nursing education in the State of Florida

Florida Center for Nursing’s Initiatives

• Conduct a statistically valid, annual evaluation of nursing education programs in the state and report findings
• Encourage and coordinate the development of academic-practice partnerships
• Support nurse faculty employment and advancement
• Convene various groups representative of nurses, other health care providers, business and industry, consumers, lawmakers, and educators to review and comment on data analysis prepared for the center and recommend systemic changes, including strategies for implementation of recommended changes

References

American Association of Colleges of Nursing (AACN) (2024). Fact Sheet: Enhancing Diversity in the Nursing Workforce. https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/Enhancing-Diversity-Factsheet.pdf

Florida Center for Nursing (2022). Florida Nursing Education Report, Academic Year 2020-2021. Tampa, FL. https://www.flcenterfornursing.org/DesktopModules/Bring2mind/DMX/API/Entries/Download?Command=Core_Download&EntryId=1919&PortalId=0&TabId=151

Florida Center for Nursing (2023). Florida Nursing Education Report, Academic Year 2021-2022. Tampa, FL. https://www.flcenterfornursing.org/DesktopModules/Bring2mind/DMX/API/Entries/Download?Command=Core_Download&EntryId=1925&PortalId=0&TabId=151

National Academy of Medicine (previously the Institute of Medicine [IOM]) (2011). The Future of Nursing. National Academies Press.