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Advising 101: Lessons in advising for nursing student success
Teaching and Learning in Nursing (2016) xx, xxx–xxx
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Advising 101: Lessons in Advising for Nursing Student Success1,2 Teresa Shellenbarger PhD, RN, CNE, ANEF⁎, Riah Hoffman PhD, RN 3 Indiana University of Pennsylvania, Indiana, PA, 15705, USA KEYWORDS: Academic advising; Community colleges; College students
Abstract Faculty teaching associate degree nursing students should use advising approaches that will provide support for students, facilitate success, and enhance retention. This manuscript discusses issues advisors encounter, approaches to advising, and strategies for faculty, students, and administrators to use to help students. © 2016 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
Employment prospects in nursing have fueled the demand for nursing education and have led to nursing program growth. With nursing job opportunities available, a diverse group of students are entering nursing programs. However, these students bring differing backgrounds, knowledge, abilities, and skills that may impact their success in higher education programs. Nursing faculty face many teaching challenges when working with such diverse students. Despite these challenges, faculty want students to succeed, enter the nursing workforce, and help meet the demand for qualified health care providers. Since 2003, community college enrollments have grown by 21%, representing over 45% of all undergraduate enrollments in the United States (American Association of Community Colleges, 2013). Community colleges enroll large numbers of older students, first generation students, working students, students with family demands and responsibilities, those from diverse ethnic backgrounds, or who come from lower socioeconomic backgrounds. Many of 1 The authors have not received grant support or financial assistance in the preparation of this manuscript. 2 This information has not been previously presented. ⁎ Corresponding author. Tel.: +1 724 357 2559. E-mail addresses: [email protected] (T. Shellenbarger), [email protected] (R. Hoffman) 3 Tel.: +1 724 357 2557.
these students may have poor academic preparation or have characteristics that threaten persistence and graduation (American Association of Community Colleges, 2015; Education Advisory Board, 2014; Gordon, Habley, Grites, et al., 2008; United States Department of Education, 2011). They present a unique challenge for nurse educators. These students may need special attention and support to ensure that they receive the necessary educational guidance and services. This manuscript will discuss some of the challenges that nursing students face, review advising models, and then make suggestions for best practices for advisors, students, and administration that may facilitate a successful nursing education experience. Many nursing schools are making efforts to expand student capacity within their programs. These expansions are because of the high demands of the nursing job market and projected nursing shortage. According to the Bureau of Labor Statistics (2013), the Registered Nurse workforce is expected to grow from 2.71 million in 2012 to 3.24 million in 2022, an increase of 526,800 or 19%. This growth will bring the total number of job openings for nurses because of growth and replacements to 1.05 million by 2022. Health care faces an anticipated shortage that will significantly impact the ability for facilities to provide safe, quality patient care to the community. Having an inadequate number of nurses to care for patients will increase the patient to nurse
http://dx.doi.org/10.1016/j.teln.2016.01.006 1557-3087/© 2016 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
2 ratio and significantly hinder patient safety and satisfaction. Medication errors, increased infection rates, increased readmission rates, and/or increased patient mortality may be impacted. According to a study conducted by Blegen, Goode, Spetz, Vaughn, and Park (2011) on nurse staffing effects on patient outcomes, better nurse staffing levels were associated with fewer deaths, lower failure-to-rescue incidents, lower rates of infection, and shorter hospital stays. Increased workloads in health care settings can also adversely affect nurses. Demanding patient assignments are stressful and can lead to negative physical and psychological effects on the nurse. Ultimately, these nurses may burn out and leave the workforce, further impacting the nursing shortage. While recruitment and having adequate openings for nursing students remains critical, it is also imperative that strategies for ensuring program progression and success are implemented so that current students are retained within nursing programs. When students are not retained, there is a significant financial impact on taxpayers. The American Institutes for Research (2011) reports that nearly 4 billion dollars was spent by federal, state, and local governments on students who dropped out of community colleges after their first year. Not only are the financial implications a serious economic issue but, given the demographics of community college students, this also represents a loss of a diverse nursing workforce. Faculty need to consider how to stop this financial and human resource drain associated with student attrition. Drake (2011) reported that three elements aid in student persistence within a program: connecting students early in the program through learning support systems (e.g., tutoring, supplemental instruction), first-year programming, and academic advising. Faculty advisors serve a pivotal role in ensuring ongoing student progression in nursing programs. Academic advising may be the only opportunity for students to develop a personal, consistent relationship within the institution with someone who cares about them and their success (Drake, 2011). Strong professional integration increases student commitment, persistence, and retention within nursing programs. Factors that increase professional integration of the student include faculty helpfulness and advisement (Jeffreys, 2015). Good academic advising not only aids in persistence and retention of students but it also assists students to value the learning process, develop decision-making skills, and to set priorities (Drake, 2011). These attributes are essential for those embarking into the nursing profession.
1. Student Concerns There are a variety of issues that nursing students face that may impact their progression. Many students do not have the essential knowledge of basic skills, such as math, writing, or reading comprehension, making them inadequately prepared for the rigors of the nursing education curricula. Others encounter
T. Shellenbarger, R. Hoffman financial constraints and do not have the resources to commit to exclusive enrollment in a nursing program but must work while taking classes. Approximately three out of five students work while attending a community college (American Association of Community Colleges, 2014a). Of those employed, 62% are working full time while enrolled in school. These working students must balance the competing time demands of school and employment. In addition, students may also have family obligations which place additional demands on their time. Some students have children that require childcare or have aging parents with health problems. Almost one third of community college students are parents and of those 53% are single parents (American Association of Community Colleges, 2014b). These parents juggle family responsibilities, face additional expenses associated with childcare, and confront the stress of added family responsibilities. These multiple demands impact students and their academic performance. Approximately 30% of college students report stress. Over 21% report anxiety and sleep difficulties during the last 12 months (American College Health Association, 2014). Clearly, students contend with multiple life stressors and must make difficult choices that impact their lives. Advising by knowledgeable and caring faculty and staff may help these students with decision making, shape the learning experience, and ultimately enhance student retention and graduation rates.
2. Advising Models There are various approaches to advising. The National Academic Advising Association outlines different advising models found at 2-year institutions. The National Academic Advising Association suggests that the shared split model and the self-contained model of advising are used most frequently. The shared split model involves a division of advising responsibilities between nursing faculty members and other campus advisors. Typically, this model involves a central advising office with trained advisors providing admission and general program advising. The advisors provide guidance and support that help to promote general academic success. Once students have met specified milestones, such as completing specific courses, then a nursing advisor is assigned. The nursing advisor then assumes advising responsibilities and assists students with discipline-specific guidance focusing on professional and career opportunities. This shared advising model is the most popular advising model used in higher education (Gordon et al., 2008). The self-contained model, or centralized approach, is the second most frequently occurring approach. This advising model has all advising occurring in an advising center (Miller, 2012). Advisors in a self-contained model represent a variety of staff including counselors, staff, peers, and other campus support personnel. Those working in this advising model provide a full array of services from remediation and counseling, to career planning. A third approach to advising involves a decentralized model. This method of advising is popular in
Advising 101
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private 2-year schools (Gordon et al., 2008). With this model, nursing faculty are responsible for all advising from admission to graduation. Regardless of the model used, it is imperative that advisors have the appropriate knowledge and expertise to assist with course planning and goal setting. Advisors need to help students to connect with critical campus resources that will promote academic success. In addition, advisors should also provide role and career guidance as students advance through the program and transition to practice. Each of the identified models has strengths and weaknesses. Institutional leaders will consider a variety of factors when determining the appropriate model to implement. Some general considerations that may influence the model selected include institution size, mission, and structure; financial resources, size, composition, and demographics of students; size, background, and expertise of faculty; institutional policies; and programs. Regardless of the model selected, it should be evaluated on a regular basis to determine effectiveness and need for modification. Effective academic advising can assist students in program progression and academic success, but it requires the effective cooperation of multiple participants including the advisee (student), advisor (faculty or staff), and other institutional services (Filson & Whittington, 2013; Gasper, 2009; Kot, 2014; McClellan, 2013). All participants must demonstrate accountability and preparedness for the advising process. The following section provides a general discussion of the essential advising roles and responsibilities of the academic advisor, advisee, and administration. Key roles and responsibilities are summarized in Table 1.
3. Academic Advisor Academic advisors who actively engage with students play a vital role in the student's ability to successfully Table 1
progress in the nursing program (Filson & Whittington, 2013). To become competent in this role, the advisor must demonstrate a unique set of skills and attributes including having adequate knowledge regarding the curriculum, policies, and resources available (Gasper, 2009). Interpersonal traits such as approachability and accessibility enhance communication and promote effective interactions. Advisors should advocate for the student, collaborate with others, and make necessary referrals to assist the advisee. The use of a variety of therapeutic communication techniques can assist in establishing an appropriate relationship with advisees, cue advisors into problems, and establish an environment that promotes an open expression of issues and concerns. Advisors can employ strategies including the use of focusing, clarifying, restating, reflecting, and summarizing techniques. Attention to body language, the use of neutral expressions, and acceptance are also important when sensitive issues surface. Actively listening, asking relevant questions, making observations, and encouraging collaborative planning are also helpful. One critical aspect needed by the academic advisor is knowledge about the advising process. The advisor needs to know academic policies, the curriculum plan or course sequence, referral resources within the institution, and technology or electronic advisement systems (if available). They also should be familiar with any forms needed for the advising process (Gasper, 2009). The advisor should thoroughly review the program's academic advising policies, curriculum plan, sequencing of courses, and prerequisites of courses so that accurate information can be shared with students. Faculty members that are new to advising or the institution should have an orientation which may involve individual guidance or mentoring by an experienced faculty member, or it could involve attendance at educational sessions including workshops and/or Webinars. The advisor can also seek assistance from experienced faculty colleagues,
Key Roles and Responsibilities for Effective Student Advising
Student 1. Seek education regarding the advising process from advisor. 2. Respond promptly to advisor. 3. Attend advising sessions. 4. Bring scheduling plan to advising session. 5. Prepare for the advising session-bring a list of questions for the advisor. 6. Communicate with advisor frequently regarding progression and other issues/concerns. 7. Seek prompt assistance when needed. 8. Keep own record of advising information and referral resources. 9. Report difficulties or problems to the advisor.
Faculty
Administration–Program Director/Chair/Dean
1. Seek education regarding the advising process from the department or campus services. 2. Be approachable and available for advising appointments. 3. Prepare for advising appointments including student record, curriculum plan, and contact information for any services needed outside of the department. 4. Communicate with advisees frequently and audit adherence and progression of the students. 5. Follow FERPA regulations and maintain student confidentiality. 6. Advocate for the student and program success including coordination with outside departments. 7. Mentor the student for program success and career/professional development. 8. Keep meticulous records of advising sessions. 9. Demonstrate interest, respect, and caring attitude with students. 10. Consult with experts when needed to ensure appropriate guidance provided to students.
1. Orient advisors and advisees about the advising process. 2. Provide the advisor with an experienced mentor to assist with advising issues. 3. Be approachable and available to advisors for advising issues and to answer questions. 4. Provide the advisor with contacts of campus services and support needed for student issues/referrals. 5. Monitor program and advising issues and problems. 6. Evaluate the advising process for effectiveness. 7. Recognize and reward effective advising.
4 program administrators, or campus resources such as admissions and enrollment services, central advising centers, or information technology departments (Gasper, 2009). Another essential aspect required by the academic advisor includes knowledge of the advisee. Academic advisors in the college setting may encounter advisees that represent diverse backgrounds including the traditional, nontraditional, and second-degree students. Advisors need to understand the unique needs and issues facing adult learners in order to establish a rapport with those advisees and to best meet their needs. Knowles et al. (1984) theory of andragogy is an adult learning theory that proposed that people become adults when they become responsible for their own lives and become self-directed. There are six assumptions of adult learners that are the basis for Knowles theory: self-concept, role of experience, readiness to learn, orientation to learning, internal motivation, and the need to know (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam, Caffarella, & Baumgartner, 2007). Understanding these assumptions can assist the advisor in meeting the adult learners' needs. In regard to self-concept, adult learners are self-directed and independent (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Therefore, advisees need to be a part of the advising process and be expected to come prepared for advising sessions. Advisors need to assess and encourage the advisee's participation and active engagement in the advising process. Offering adult students choices of classes and schedules will support their need for independence. Another concept of Knowles theory, the role of the experience, refers to adults learning from their past experiences (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Advisors need to evaluate past advising, academic performance, and life experiences of the advisee. Try to ensure that the first and all future advising experiences favorably meet student needs so as to create an effective advising environment. If advisees had a previous bad experience, they may become discouraged and disengaged with the advising process and subsequent advising sessions. The advisor can ask questions about prior academic success and problems and use this information to guide the advisee. Adult learners believe that they are ready to learn what they feel they need to know (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Advisors need to enforce that learning and participating in the advising process is essential for the student's successful academic progression in the program. Advisors can help students to see the relevance of courses to their current and future nursing career, thus helping students to understand what they need to know to be successful. Learning orientation in adults is task and life focused (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Advisors can help advisees understand that lack of appropriate advising may hinder program progression and completion. Assessing what internally
T. Shellenbarger, R. Hoffman motivates each advisee for successful program completion may be beneficial for the advisor to explore. Adults are more internally than externally motivated (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). The advisor needs to assess the advisee's self-esteem and desire to learn and succeed within the program. As previously discussed, advisees need to know the value of academic advising and how it will assist them in successful program completion. These assumptions, based on Knowles et al. (1984) theory, can aid in adult learning but can also guide successful academic advising and establish a rapport with the advisee, while also providing advisors with ways to successfully meet adult student needs. Academic advisors need to use effective communication skills when interacting with students, other faculty, administration, and other departments that play an integral part of student success. Regular contact between the student and the advisor allows the student to remain engaged in the educational process and the academic institution (Filson & Whittington, 2013). Contact with the student also allows the advisor to assess progress and performance and intervene early with problems. Some colleges and universities require mandatory advising making it necessary for the student to meet with his or her advisor each semester to get an individualized identification number needed for course registration. Without such mechanisms in place, some students may not seek out their advisor. Therefore, the advisor needs to develop a plan to communicate with students to ensure regular contact. At the start of each semester, advisors could send an initial welcome communication to their advisees that identifies them as the academic advisor and provides information about availability for appointments throughout the semester. This not only establishes contact but also helps establish a link to the student. Depending upon the student demographics, the academic advisor may need to determine the best method for communication. While younger students are more technologically savvy and may respond best to electronic communication such as e-mail and text messaging, the older student may respond better to telephone communication. In a study conducted by Filson and Whittington (2013), the majority of the undergraduate students communicated with their academic advisor by e-mail or scheduled appointment. A variety of technology applications can also be used to enhance electronic communication with advisees. Group text messaging tools such as Remind (formerly Remind 101), BuzzMob, or Kikutext allow advisors to send notices or alerts to students' electronic devices. Group reminder messages can be sent via these messaging services to provide students with important reminders throughout the year. When using these services, students get a text message from the advisor sent directly to their cell phones. Finally and most importantly, the faculty advisor needs to keep a record of all communication with the students. For this reason, electronic communication may be the best choice because of the ease of recording and storing such correspondence. If
Advising 101 telephone calls are made, then the advisor needs to summarize and record notes from the conversation. In addition, it may be necessary to send reminder communication to advisees throughout the semester via e-mail or texts to remind students of important events and deadlines during the semester such as course drop deadlines, registration times, and final examination schedules. Advisors need to display accessibility and approachability to develop the advisor–advisee relationship. Accessibility can be achieved by maintaining regular office hours and offering special advising appointments during peak registration or scheduling times (Gasper, 2009). It may be helpful and time efficient to schedule individual appointments with advisees. Faculty can use traditional paper sign-up appointment sheets or electronic scheduling using programs such as Doodle or Meeting Wizard. These electronic applications allow faculty to indicate appointment availability and then students select a time on-line for an appointment. Goals for the academic advising appointment should be developed by the advisor (Gasper, 2009). Having preplanned and scheduled appointments with advisees will facilitate the advisor's ability to accomplish goals in a timely fashion. The advisor and advisee should arrive on time for the scheduled appointment and be prepared for the session. Faculty should have either hard copy or an electronic version of the student's academic record, curriculum plan, and contact information. Having this information accessible during advising appointments will assist the advisor if problems are identified and referrals may be necessary for the student (Gasper, 2009). Individual student advising, rather than group advising, allows a personalized approach and provides an environment that allows open discussion about specific, individualized academic needs. Group advising can be effective when discussing routine requirements such as the sequence of courses in a curriculum, basic policies applicable to all students, or program expectations. However, if conducting group advising, it is still important to allow students an opportunity to ask questions and to hear the questions raised by peers and the responses provided (Battin, 2014). The advisor should also offer individualized appointments as needed or meet with students individually after the group discussion. These private meetings allow time to discuss individual issues or concerns and ensure compliance with privacy requirements. As discussed previously, the advisor needs to keep meticulous records of all student meetings and correspondence. An individual record should be kept by the advisor for each student. The advisor should maintain copies of all e-mail communication with the advisee. A document of the student's schedule and curriculum plan should be developed by the advisor and the advisee and signed by both parties. A copy of this record should be kept in the student file and another copy provided to the advisee. The advisee should also be encouraged to use a filing system to keep important papers such as transcripts, relevant resources, and advising materials. Faculty will also want to keep a file or resource of
5 commonly used academic advisement materials such as a curriculum sequence, progression policies, and other forms that may be used routinely. Advisors should also create documentation of advising sessions, issues raised, and referrals made. If the college or university utilizes an electronic academic advising system, advising notes can be documented in these systems. Usually, the electronic notes can be viewed by both the advisor and the student. When students are not regularly seeing the advisor or missing appointments, this behavior pattern should be documented in the students' advising record. Such documentation allows the advisor to display the student's lack of accountability for his or her advising process and a place for documentation if a student issue arises. Another important resource for faculty advisors involves the development of an advisee database. This electronic database should include student name, contact information, dates of student meetings, referrals, and a section for any additional important notes. This database provides an efficient method of record keeping and facilitates recall of advising activities. It will allow for consistency of advising. For example, if the student is transferred to another advisor because of change in status or change of major, the student's new advisor will be able to visualize the advising assistance the student has already received and allow for follow-up with the student. The advisor should remain in contact with the student throughout the semester. Advisors should audit the progress of their advisee periodically. It is important to review students' schedules to ensure adherence to the academic plan discussed. It is also helpful to review the students' mid-term grades to identify those students needing assistance or at risk for academic failure. The advisor should monitor the student's progression prior to the end of the semester so that needed assistance can be provided. However, at the end of the semester the advisor must also assess the student's final grades to identify course failures and assist the student in planning a modified schedule, develop remediation plans, and strategize approaches for success. At times, faculty, especially new faculty, may need to enlist the assistance of others when faced with unique or complicated issues, or the student requires services that are beyond the scope of the advisor role. An experienced advisor or the program director, dean, or chair can provide clarification of policies or advice about how to proceed. The college or university may have a designated advising center or a center for student success that may also assist the faculty member with guidance and resources. When a student presents with issues that are beyond the scope of the academic advisor, such as psychological, financial, or social issues, the faculty member may need to implement student referrals. Students may also present with physical or psychological disabilities and may require accommodations or assistance from disability services or a campus resource center. The advisor needs to develop collegial relationships with other departments and campus resources. It is helpful to
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T. Shellenbarger, R. Hoffman Table 2
Potential Referrals for Advisees
Counseling/Mental health services Health services Veteran resource centers International student services Career services Financial aid services Learning resources (tutoring, supplemental instruction) Testing services/disabilities services Adapted from a table created by Gasper (2009).
develop a reference list of contact people and information to provide to the students if needed. Potential referral departments for advisees are listed in Table 2. Referrals and availability of services may vary depending on the institution and the student needs. Faculty should watch for concerning behaviors such as absenteeism, extreme changes in behavior, dramatic changes in academic performance, or signs of alcohol or drug abuse (Gasper, 2009). Extreme changes in behavior may be manifested from the stressful nature of the nursing curriculum, from psychological issues such as anxiety and depression, exposure to a traumatic event such as physical or sexual assault, and/or substance abuse. Behaviors that are imperative for the advisor to watch for and report promptly are displayed in Tables 3 and 4. These issues fall out of the scope of the academic advisor and require immediate intervention and referral (Gasper, 2009). The student may require prompt, early intervention by the advisor and referrals to counseling/mental health and/or health services. These referrals can also provide the student with access to community resources that may be beneficial to the student. For example, a student that is being physically or verbally abused may need appropriate support. An advisor referral to counseling
Table 3
and health services can assist the student with legal assistance and help provide for student safety. Students may also require referrals to campus or community health services for acute or chronic health concerns. Students that are displaying poor academic performance issues may require evaluation for learning disabilities and referral to testing/disabilities services. If learning problems are identified, then the student may need additional resources and accommodations such as a note taker, extended examination completion time, and/or a private testing environment. Students will be evaluated by trained personnel and, based upon expert recommendations, will be provided with appropriate reasonable accommodations that should enable student success. Students with other needs, such as veterans, international students, or those with financial concerns, may be referred for additional services based on their individualized backgrounds. Veterans may require specialized assistance with educational funding or need veteran counseling services. Referrals to support groups or to the Veterans Affairs department may be indicated. International students may also have special needs that require referrals. International offices can be beneficial in assisting international students adjusting to the American culture and academic environment. They can provide assistance with international paperwork such as VISA applications, unique financial aid concerns, or help students improve their language skills. Academic advisors are usually knowledgeable about program curricula; however, they may not be as comfortable advising students about financial aid concerns. Students should be referred to campus offices that can assist with financial aid questions regarding educational funding or completion of financial aid paperwork. It is also important to
Examples of Changes in Behavior Related to Stress, Anxiety, and Depression
Signs and Symptoms of Stress: • Memory problems • Inability to concentrate • Poor judgment • Feeling overwhelmed • Procrastination or neglecting responsibilities • Physiologic indicators: gastrointestinal disturbances, increased vital signs (blood pressure, pulse, respirations), sleep disturbances, weight loss or gain, decreased sex drive Signs and symptoms of anxiety: • Mild: sleep disturbances, restlessness, and increased questioning • Moderate: focus on immediate concerns, inattention to other communication or details, tremors, increased muscle tension, and slight increase heart rate and respiratory rate • Severe: impaired learning, easily distracted, fear of a danger that is not real, emotional distress, difficulty communicating, headache, nausea, tachycardia, dizziness, and hyperventilation • Panic: disorganized emotional state, dyspnea, palpitations, choking sensation chest pain/pressure, feeling of doom Signs and symptoms of depression: • Sadness • Negativism • Poor appetite • Withdrawal from social activities • Suicidal ideations (Lewis, Dirksen, Heitkemper, & Bucher, 2014; Taylor, Lillis, LeMone, & Lynn, 2011.)
Advising 101 Table 4 Examples of Signs and Symptoms of Commonly Used Substances Signs and symptoms of alcohol abuse: • Odor of alcohol on breath • Slurred speech • Staggering gait • Drowsiness • Glazed or bloodshot (red) eyes Signs and symptoms of stimulant use (cocaine and amphetamines) • Euphoria • Increased vital signs (blood pressure, heart rate, respirations) • Restlessness • Insomnia • Anorexia • Chest pain • Rapid speech Signs and symptoms of depressant use (sedative–hypnotics) • Relaxation • Decreased inhibitions • Drowsiness • Slurred speech • Decreased vital signs (blood pressure, heart rate, respirations) • Constricted pupils Signs and symptoms of opioid use • Drowsiness • Slurred speech • Decreased respirations • Constricted pupils • Detachment from the environment • Nausea • Constipation Signs and symptoms of cannabis use • Euphoria • Sedation • Hallucinations • Glazed or bloodshot (red) eyes (Lewis et al., 2014.)
advise students to contact appropriate financial aid offices when dropping or withdrawing from courses. Those schedule changes may impact the student's financial aid status because of a change in credit load. The advisor must assess student needs and issues and identify the specific referral required and provide appropriate contact information for the student. Advisors should also follow up to ensure that the student utilizes the referral services. Advisors may benefit from the development of an advising binder with information on all college services, departments and majors, contact persons, and information to utilize as a reference for student needs and concerns. Circumstances may occur when an academic advisor must coordinate with other departments to advocate for student success, especially when faced with scheduling needs. For example, a student may require a science course for progression in the nursing program; however, space is not available in current course offerings. The faculty advisor may need to advocate with administration for student enrollment to assist with timely program progression. Another example of coordination with other departments would include assisting a student that wishes to change a
7 major. During coursework, students may realize they are not suited for the nursing curriculum or the nursing profession and require assistance in choosing another major. The academic advisor needs to maintain a beginning knowledge of other majors and departments and establish relationships with individuals from those areas. The academic advisor should have information to provide to the student on other majors and whom he or she may contact for additional information. They may also be referred to campus career services to assist with résumé building and interview skills. Students may also seek out the advisor if experiencing academic difficulty in coursework. According to Gasper (2009), the first step when a student displays poor academic performance includes exploration of the potential causes. Causes may include poor study habits, poor time management, difficulty juggling multiple roles, lack of motivation, and/or test anxiety (Gasper, 2009). Depending upon the course, faculty may need to contact other departments to determine whether those courses offer any type of remediation, tutoring, or supplemental instruction to assist the struggling student. The advisor can provide the student with valuable strategies and tips for successful test taking. He or she may assist the student advisee with finding a peer tutor or support system that has been successful in similar coursework. The advisor can also implement institutional services that may be offered. For example, a writing center that assists students with editing and formatting written assignments may help students with written assignments. Students may also be referred to library resources for the creation of written assignments and for reference searching and retrieval. These resources may vary among institutions. The advisor should be familiar with the student resources at his or her institution. When preparing for advising sessions, the faculty member must also recognize the student's level in the program. Academic needs of students who are beginning a program will differ from students near completion. New students may seek advice on scheduling issues, socialization to higher education, and training about the advising process such as navigating the electronic scheduling and advising system. Students progressing through the program may require more referrals for academic support services as they encounter difficulty with course work. Students nearing completion of the program need advisement regarding curriculum completion, preparing for the licensure examination, potential advancement of their education, and employment guidance. Many times advisors may be contacted for information about a student. Requests for information may come from potential employers, from family members such as parents, or from others needing to verify information about a student. Advisors need to protect the privacy of advisees and their records and obtain appropriate permission prior to releasing certain information. The Family Educational Rights and Privacy Act (FERPA) protects the disclosure of select personally identifying information including grades, transcripts, class schedules, and enrollment status. Schools that receive federal funds are required to abide by
8 FERPA regulations. Advisors need to obtain written permission from students prior to releasing the protected information (Shellenbarger & Perez-Stearns, 2010). Some schools have specific forms that students can complete that grant permission to release the information, whereas other institutions may have electronic systems that allow students to grant release of information. Regardless of the method used, advisors must ensure that students have authorized the release of protected information as required by FERPA and institutional policies. There is an exception to the FERPA regulations and release of information. Sometimes an advisor may learn of personal student information that may pose a significant health or safety threat to either the advisee or another person. If it is a serious and imminent emergency, such as an epidemic outbreak, certain mental health situations, or a natural disaster, the advisor may disclose that information to appropriate persons such as parents, medical personnel, or appropriate public health officials without needing the student's consent. These situations are usually handled on a case-by-case basis, and they only allow for the release of information during the emergency. It does not permit a blanket release of all personally identifiable information (Association of State and Territorial Health Officials, 2015; United States Department of Education, 2015). Advisors fulfill many roles in order to meet student needs and facilitate their success. Major roles of the advisor include mentoring and empowering the student advisee to succeed within the program. The advisor should empower the student to take responsibility for his or her own success and encourage decision-making and leadership skills of the student (McClellan, 2013).
4. Advisee Although the faculty advisor has multiple responsibilities for effective advising, the student must also take responsibility for the effectiveness of his or her advisement. The advisor can only provide the advisee with information, and the advisee has to be responsible for actions, strive to succeed in the program, and utilize the advice and resources provided by the advisor. The student needs to be accountable for scheduling, be prepared for advising sessions, and communicate effectively with the advisor. It is helpful if the advisees prepare a tentative course schedule in preparation for the advising session and develop a list of questions he or she may have for the advisor. During busy registration times, advising sessions are often limited so that adequate preparation will allow the student to ensure that all questions and concerns are addressed during the advising session. The student should also be encouraged to keep his or her own personal record of academic advisement, proposed schedule, and any recommended referrals or resources provided by the advisor. If an advisee is having problems, he or she should contact the advisor as soon as possible to address the issue promptly and should maintain periodic contact with the advisor to discuss progress.
T. Shellenbarger, R. Hoffman
5. Administration The program director, department chair, or dean also plays a role in the effective advisement of students. Administrators need to ensure that advisors and advisees are provided with necessary education on the advising process, advising policies, required forms, and technology applications used for advising. When orienting new faculty, administrators need to provide faculty with education about student needs and issues and ensure that advisors have the information, tools, and resources to support this role. It is also helpful to identify an experienced faculty who can serve as a resource or mentor to assist when questions arise. Advisors also require professional development to address opportunities to engage advisees through academic advising (Filson & Whittington, 2013; Wallace, 2011). The program director, department chair, or dean should be accessible to advisors to assist with issues beyond the scope of the faculty role or other issues involving administrative clarification. Understanding the success of academic advisement is also important for administrators to know about. Powers, Carlstrom, and Hughey (2014) recommended the utilization of assessment results regarding student satisfaction with advisement. Assessing student satisfaction with academic advising should include areas such as knowledge of the advisor regarding program curriculum, availability of the advisor, and advisor knowledge of campus resources and referrals available to the student. Because effective academic advising is known to promote persistence and success in students, retention rates, grade point averages, and graduation rates should also be assessed. Evaluation of the effectiveness of student advisement should be performed at the administrative level. Recommendations should be instituted if the process is deemed ineffective by the students or faculty. Last, recognition, rewards, and incentives for quality advising are helpful and demonstrate the institutional commitment for advising (Wallace, 2011).
6. Conclusion Effective advising takes time and resources. In order for effective advising to take place, all parties including the advisor, advisee, and administration need to make academic advising a priority. Proper academic advising requires preparation, dedication, and adherence to the advising process. When advising is done appropriately, it can lead to many benefits including students' successful completion of a program. High retention and graduation rates are important for the school. In addition, a successful educational outcome also helps to ensure that appropriate numbers of nursing students are completing degrees and are ready to begin their work as a professional nurse.
References American Association of Community Colleges (2013). Overview of undergraduate enrollment. (Retrieved from http://www.aacc.nche.edu/ Publications/datapoints/Documents/Enrollment_102413.pdf).
Advising 101 American Association of Community Colleges (2014). Juggling jobs and school. (Retrieved from http://www.aacc.nche.edu/Publications/ datapoints/Documents/JugglingJobs_04022014.pdf). American Association of Community Colleges (2014). Juggling school and parenthood. (Retrieved from http://www.aacc.nche.edu/Publications/ datapoints/Documents/DataPoints_July_10.pdf). American Association of Community Colleges (2015). 2015 fact sheet. (Retrieved from http://www.aacc.nche.edu/AboutCC/Documents/ FactSheet2015_grey.pdf). American College Health Association (2014). National College Health Assessment: Spring 2014 reference group executive summary. Retrieved from http://www.acha-ncha.org/docs/ACHA-NCHAReferenceGroupExecutiveSummary-Spring2014.pdf. American Institutes for Research (2011). Community college dropouts cost taxpayers nearly $4 billion. (Retrieved from http://www.air.org/news/pressrelease/community-college-dropouts-cost-taxpayers-nearly-4-billion). Association of State and Territorial Health Officials (2015). Comparison of FERPA and HIPAA privacy rule for accessing student health data. (Retrieved from http://www.atho.rg/programs/preparedness/ public_health_emergency-law/public-health-and-schools-toolkit/ comparison-of-ferpa-and-hipaa-privacd-rule/). Battin, J. R. (2014). Improving academic advising through student seminars: A case study. Journal of Criminal Justice Education, 25(3), 354−367, http://dx.doi.org/10.1080/10511253.2014.910242. Blegen, M. A., Goode, C. J., Spetz, J., Vaughn, T., & Park, S. H. (2011). Nurse staffing effects on patient outcomes: Safety-net and non-safetynet hospitals. Medical Care, 49(4), 406−414, http://dx.doi.org/10.1097/ MLR.0b013e318202e129. Bureau of Labor Statistics (2013). Occupations with the largest projected number of job openings due to growth and replacement needs, 2012 and projected 2022. Retrieved from http://www.bls.gov/news.release/ ecopro.t08.htm. Chan, S. (2010). Applications of andragogy in multi-disciplined teaching and learning. Journal of Adult Education, 39(2), 25−35. Drake, J. K. (2011). The role of academic advising in student retention and persistence. About Campus, 16(3), 8−12, http://dx.doi.org/10.1002/abc.20062. Education Advisory Board (2014). Optimizing academic advising at community colleges: Guiding students through college to completion. Retrieved from http://www.eab.com. Filson, C., & Whittington, M. S. (2013). Engaging undergraduate students through academic advising. North American Colleges and Teachers of Agriculture, 57(4), 10−17. Forrest, S. P., & Peterson, T. O. (2006). It’s called andragogy. Academy of Management Learning and Education, 5(1), 113−122. Gasper, M. L. (2009). Building a community with your advisees. Nurse Educator, 34(2), 88−94, http://dx.doi.org/10.1097/NNE.06013e3181990eb9.
9 Gordon, V. N., Habley, W. R., Grites, T. J., et al. (2008). Academic advising: A comprehensive handbook. San Francisco, CA: Jossey-Bass. Jeffreys, M. R. (2015). Jeffrey’s nursing universal retention and success model overview and action ideas for optimizing outcomes A-Z. Nurse Education Today, 35, 425−431, http://dx.doi.org/10.1016/j.nedt.2014.11.004. Knowles, M. S., et al. (1984). Andragogy in action: Applying modern principles of adult learning. San Francisco, CA: Jossey-Bass. Kot, F. C. (2014). The impact of centralized advising on first-year academic performance and second-year enrollment behavior. Research in Higher Education, 55, 527−563, http://dx.doi.org/10.1007/s11162-013-9325-4. Lewis, S. M., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems, (9th ed.). St Louis, MO: Mosby. McClellan, J. L. (2013). Contributing to the development of student leadership through academic advising. Journal of Leadership Education, 12(1), 207−233, http://dx.doi.org/10.12806/v12/i1/207. Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2007). Learning in adulthood: A comprehensive guide, (3rd ed.). San Francisco, CA: Jossey-Bass. Miller, M.A. (2012). Structuring the conversation: Shifting to four dimensional advising models. In Carlstrom, A., 2012 national survey of academic advising. (Monograph No. 25). Manhattan, KS: National Academic Advising Association. Retrieved from the NACADA Clearinghouse of Academic Advising Resources Web site: https:// www.nacada.ksu.edu/Resources/Clearinghouse/View-Articles/2011data-for-organizational-structuring.aspx. Powers, K. L., Carlstrom, A. H., & Hughey, K. F. (2014). Academic advising assessment practices: Results of a national study. NACADA Journal, 34(1), 64−77. Shellenbarger, T., & Perez-Stearns, C. (2010). From classroom to clinical: A Family Educational Rights and Privacy Act primer for the nurse educator. Teaching and Learning in Nursing, 5(4), 164−168, http:// dx.doi.org/10.1016/j.teln.2010.05.002. Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing: The art and science of nursing care, (7th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins. United States Department of Education (2011). Community college student outcomes 1994–2009. (Retrieved from nces.ed.gov/pubs2012/ 201253.pdf). United States Department of Education (2015). FERPA general guidance for students. (Retrieved from. http://www2ed.gov/policy/gen/guid/fpco/ ferpa/students.hmtl). Wallace, S. (2011). Implications for faculty advising. (Retrieved from the NACADA Clearinghouse of Academic Advising Resources Web Site: http://www.nacada,ksu.edu/Resources/Clearinghouse/View-Articles/ Implications-for-faculty-advising-2011-National-Survey.aspx).
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Advising 101: Lessons in Advising for Nursing Student Success1,2 Teresa Shellenbarger PhD, RN, CNE, ANEF⁎, Riah Hoffman PhD, RN 3 Indiana University of Pennsylvania, Indiana, PA, 15705, USA KEYWORDS: Academic advising; Community colleges; College students
Abstract Faculty teaching associate degree nursing students should use advising approaches that will provide support for students, facilitate success, and enhance retention. This manuscript discusses issues advisors encounter, approaches to advising, and strategies for faculty, students, and administrators to use to help students. © 2016 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
Employment prospects in nursing have fueled the demand for nursing education and have led to nursing program growth. With nursing job opportunities available, a diverse group of students are entering nursing programs. However, these students bring differing backgrounds, knowledge, abilities, and skills that may impact their success in higher education programs. Nursing faculty face many teaching challenges when working with such diverse students. Despite these challenges, faculty want students to succeed, enter the nursing workforce, and help meet the demand for qualified health care providers. Since 2003, community college enrollments have grown by 21%, representing over 45% of all undergraduate enrollments in the United States (American Association of Community Colleges, 2013). Community colleges enroll large numbers of older students, first generation students, working students, students with family demands and responsibilities, those from diverse ethnic backgrounds, or who come from lower socioeconomic backgrounds. Many of 1 The authors have not received grant support or financial assistance in the preparation of this manuscript. 2 This information has not been previously presented. ⁎ Corresponding author. Tel.: +1 724 357 2559. E-mail addresses: [email protected] (T. Shellenbarger), [email protected] (R. Hoffman) 3 Tel.: +1 724 357 2557.
these students may have poor academic preparation or have characteristics that threaten persistence and graduation (American Association of Community Colleges, 2015; Education Advisory Board, 2014; Gordon, Habley, Grites, et al., 2008; United States Department of Education, 2011). They present a unique challenge for nurse educators. These students may need special attention and support to ensure that they receive the necessary educational guidance and services. This manuscript will discuss some of the challenges that nursing students face, review advising models, and then make suggestions for best practices for advisors, students, and administration that may facilitate a successful nursing education experience. Many nursing schools are making efforts to expand student capacity within their programs. These expansions are because of the high demands of the nursing job market and projected nursing shortage. According to the Bureau of Labor Statistics (2013), the Registered Nurse workforce is expected to grow from 2.71 million in 2012 to 3.24 million in 2022, an increase of 526,800 or 19%. This growth will bring the total number of job openings for nurses because of growth and replacements to 1.05 million by 2022. Health care faces an anticipated shortage that will significantly impact the ability for facilities to provide safe, quality patient care to the community. Having an inadequate number of nurses to care for patients will increase the patient to nurse
http://dx.doi.org/10.1016/j.teln.2016.01.006 1557-3087/© 2016 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
2 ratio and significantly hinder patient safety and satisfaction. Medication errors, increased infection rates, increased readmission rates, and/or increased patient mortality may be impacted. According to a study conducted by Blegen, Goode, Spetz, Vaughn, and Park (2011) on nurse staffing effects on patient outcomes, better nurse staffing levels were associated with fewer deaths, lower failure-to-rescue incidents, lower rates of infection, and shorter hospital stays. Increased workloads in health care settings can also adversely affect nurses. Demanding patient assignments are stressful and can lead to negative physical and psychological effects on the nurse. Ultimately, these nurses may burn out and leave the workforce, further impacting the nursing shortage. While recruitment and having adequate openings for nursing students remains critical, it is also imperative that strategies for ensuring program progression and success are implemented so that current students are retained within nursing programs. When students are not retained, there is a significant financial impact on taxpayers. The American Institutes for Research (2011) reports that nearly 4 billion dollars was spent by federal, state, and local governments on students who dropped out of community colleges after their first year. Not only are the financial implications a serious economic issue but, given the demographics of community college students, this also represents a loss of a diverse nursing workforce. Faculty need to consider how to stop this financial and human resource drain associated with student attrition. Drake (2011) reported that three elements aid in student persistence within a program: connecting students early in the program through learning support systems (e.g., tutoring, supplemental instruction), first-year programming, and academic advising. Faculty advisors serve a pivotal role in ensuring ongoing student progression in nursing programs. Academic advising may be the only opportunity for students to develop a personal, consistent relationship within the institution with someone who cares about them and their success (Drake, 2011). Strong professional integration increases student commitment, persistence, and retention within nursing programs. Factors that increase professional integration of the student include faculty helpfulness and advisement (Jeffreys, 2015). Good academic advising not only aids in persistence and retention of students but it also assists students to value the learning process, develop decision-making skills, and to set priorities (Drake, 2011). These attributes are essential for those embarking into the nursing profession.
1. Student Concerns There are a variety of issues that nursing students face that may impact their progression. Many students do not have the essential knowledge of basic skills, such as math, writing, or reading comprehension, making them inadequately prepared for the rigors of the nursing education curricula. Others encounter
T. Shellenbarger, R. Hoffman financial constraints and do not have the resources to commit to exclusive enrollment in a nursing program but must work while taking classes. Approximately three out of five students work while attending a community college (American Association of Community Colleges, 2014a). Of those employed, 62% are working full time while enrolled in school. These working students must balance the competing time demands of school and employment. In addition, students may also have family obligations which place additional demands on their time. Some students have children that require childcare or have aging parents with health problems. Almost one third of community college students are parents and of those 53% are single parents (American Association of Community Colleges, 2014b). These parents juggle family responsibilities, face additional expenses associated with childcare, and confront the stress of added family responsibilities. These multiple demands impact students and their academic performance. Approximately 30% of college students report stress. Over 21% report anxiety and sleep difficulties during the last 12 months (American College Health Association, 2014). Clearly, students contend with multiple life stressors and must make difficult choices that impact their lives. Advising by knowledgeable and caring faculty and staff may help these students with decision making, shape the learning experience, and ultimately enhance student retention and graduation rates.
2. Advising Models There are various approaches to advising. The National Academic Advising Association outlines different advising models found at 2-year institutions. The National Academic Advising Association suggests that the shared split model and the self-contained model of advising are used most frequently. The shared split model involves a division of advising responsibilities between nursing faculty members and other campus advisors. Typically, this model involves a central advising office with trained advisors providing admission and general program advising. The advisors provide guidance and support that help to promote general academic success. Once students have met specified milestones, such as completing specific courses, then a nursing advisor is assigned. The nursing advisor then assumes advising responsibilities and assists students with discipline-specific guidance focusing on professional and career opportunities. This shared advising model is the most popular advising model used in higher education (Gordon et al., 2008). The self-contained model, or centralized approach, is the second most frequently occurring approach. This advising model has all advising occurring in an advising center (Miller, 2012). Advisors in a self-contained model represent a variety of staff including counselors, staff, peers, and other campus support personnel. Those working in this advising model provide a full array of services from remediation and counseling, to career planning. A third approach to advising involves a decentralized model. This method of advising is popular in
Advising 101
3
private 2-year schools (Gordon et al., 2008). With this model, nursing faculty are responsible for all advising from admission to graduation. Regardless of the model used, it is imperative that advisors have the appropriate knowledge and expertise to assist with course planning and goal setting. Advisors need to help students to connect with critical campus resources that will promote academic success. In addition, advisors should also provide role and career guidance as students advance through the program and transition to practice. Each of the identified models has strengths and weaknesses. Institutional leaders will consider a variety of factors when determining the appropriate model to implement. Some general considerations that may influence the model selected include institution size, mission, and structure; financial resources, size, composition, and demographics of students; size, background, and expertise of faculty; institutional policies; and programs. Regardless of the model selected, it should be evaluated on a regular basis to determine effectiveness and need for modification. Effective academic advising can assist students in program progression and academic success, but it requires the effective cooperation of multiple participants including the advisee (student), advisor (faculty or staff), and other institutional services (Filson & Whittington, 2013; Gasper, 2009; Kot, 2014; McClellan, 2013). All participants must demonstrate accountability and preparedness for the advising process. The following section provides a general discussion of the essential advising roles and responsibilities of the academic advisor, advisee, and administration. Key roles and responsibilities are summarized in Table 1.
3. Academic Advisor Academic advisors who actively engage with students play a vital role in the student's ability to successfully Table 1
progress in the nursing program (Filson & Whittington, 2013). To become competent in this role, the advisor must demonstrate a unique set of skills and attributes including having adequate knowledge regarding the curriculum, policies, and resources available (Gasper, 2009). Interpersonal traits such as approachability and accessibility enhance communication and promote effective interactions. Advisors should advocate for the student, collaborate with others, and make necessary referrals to assist the advisee. The use of a variety of therapeutic communication techniques can assist in establishing an appropriate relationship with advisees, cue advisors into problems, and establish an environment that promotes an open expression of issues and concerns. Advisors can employ strategies including the use of focusing, clarifying, restating, reflecting, and summarizing techniques. Attention to body language, the use of neutral expressions, and acceptance are also important when sensitive issues surface. Actively listening, asking relevant questions, making observations, and encouraging collaborative planning are also helpful. One critical aspect needed by the academic advisor is knowledge about the advising process. The advisor needs to know academic policies, the curriculum plan or course sequence, referral resources within the institution, and technology or electronic advisement systems (if available). They also should be familiar with any forms needed for the advising process (Gasper, 2009). The advisor should thoroughly review the program's academic advising policies, curriculum plan, sequencing of courses, and prerequisites of courses so that accurate information can be shared with students. Faculty members that are new to advising or the institution should have an orientation which may involve individual guidance or mentoring by an experienced faculty member, or it could involve attendance at educational sessions including workshops and/or Webinars. The advisor can also seek assistance from experienced faculty colleagues,
Key Roles and Responsibilities for Effective Student Advising
Student 1. Seek education regarding the advising process from advisor. 2. Respond promptly to advisor. 3. Attend advising sessions. 4. Bring scheduling plan to advising session. 5. Prepare for the advising session-bring a list of questions for the advisor. 6. Communicate with advisor frequently regarding progression and other issues/concerns. 7. Seek prompt assistance when needed. 8. Keep own record of advising information and referral resources. 9. Report difficulties or problems to the advisor.
Faculty
Administration–Program Director/Chair/Dean
1. Seek education regarding the advising process from the department or campus services. 2. Be approachable and available for advising appointments. 3. Prepare for advising appointments including student record, curriculum plan, and contact information for any services needed outside of the department. 4. Communicate with advisees frequently and audit adherence and progression of the students. 5. Follow FERPA regulations and maintain student confidentiality. 6. Advocate for the student and program success including coordination with outside departments. 7. Mentor the student for program success and career/professional development. 8. Keep meticulous records of advising sessions. 9. Demonstrate interest, respect, and caring attitude with students. 10. Consult with experts when needed to ensure appropriate guidance provided to students.
1. Orient advisors and advisees about the advising process. 2. Provide the advisor with an experienced mentor to assist with advising issues. 3. Be approachable and available to advisors for advising issues and to answer questions. 4. Provide the advisor with contacts of campus services and support needed for student issues/referrals. 5. Monitor program and advising issues and problems. 6. Evaluate the advising process for effectiveness. 7. Recognize and reward effective advising.
4 program administrators, or campus resources such as admissions and enrollment services, central advising centers, or information technology departments (Gasper, 2009). Another essential aspect required by the academic advisor includes knowledge of the advisee. Academic advisors in the college setting may encounter advisees that represent diverse backgrounds including the traditional, nontraditional, and second-degree students. Advisors need to understand the unique needs and issues facing adult learners in order to establish a rapport with those advisees and to best meet their needs. Knowles et al. (1984) theory of andragogy is an adult learning theory that proposed that people become adults when they become responsible for their own lives and become self-directed. There are six assumptions of adult learners that are the basis for Knowles theory: self-concept, role of experience, readiness to learn, orientation to learning, internal motivation, and the need to know (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam, Caffarella, & Baumgartner, 2007). Understanding these assumptions can assist the advisor in meeting the adult learners' needs. In regard to self-concept, adult learners are self-directed and independent (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Therefore, advisees need to be a part of the advising process and be expected to come prepared for advising sessions. Advisors need to assess and encourage the advisee's participation and active engagement in the advising process. Offering adult students choices of classes and schedules will support their need for independence. Another concept of Knowles theory, the role of the experience, refers to adults learning from their past experiences (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Advisors need to evaluate past advising, academic performance, and life experiences of the advisee. Try to ensure that the first and all future advising experiences favorably meet student needs so as to create an effective advising environment. If advisees had a previous bad experience, they may become discouraged and disengaged with the advising process and subsequent advising sessions. The advisor can ask questions about prior academic success and problems and use this information to guide the advisee. Adult learners believe that they are ready to learn what they feel they need to know (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Advisors need to enforce that learning and participating in the advising process is essential for the student's successful academic progression in the program. Advisors can help students to see the relevance of courses to their current and future nursing career, thus helping students to understand what they need to know to be successful. Learning orientation in adults is task and life focused (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). Advisors can help advisees understand that lack of appropriate advising may hinder program progression and completion. Assessing what internally
T. Shellenbarger, R. Hoffman motivates each advisee for successful program completion may be beneficial for the advisor to explore. Adults are more internally than externally motivated (Chan, 2010; Forrest & Peterson, 2006; Knowles et al., 1984; Merriam et al., 2007). The advisor needs to assess the advisee's self-esteem and desire to learn and succeed within the program. As previously discussed, advisees need to know the value of academic advising and how it will assist them in successful program completion. These assumptions, based on Knowles et al. (1984) theory, can aid in adult learning but can also guide successful academic advising and establish a rapport with the advisee, while also providing advisors with ways to successfully meet adult student needs. Academic advisors need to use effective communication skills when interacting with students, other faculty, administration, and other departments that play an integral part of student success. Regular contact between the student and the advisor allows the student to remain engaged in the educational process and the academic institution (Filson & Whittington, 2013). Contact with the student also allows the advisor to assess progress and performance and intervene early with problems. Some colleges and universities require mandatory advising making it necessary for the student to meet with his or her advisor each semester to get an individualized identification number needed for course registration. Without such mechanisms in place, some students may not seek out their advisor. Therefore, the advisor needs to develop a plan to communicate with students to ensure regular contact. At the start of each semester, advisors could send an initial welcome communication to their advisees that identifies them as the academic advisor and provides information about availability for appointments throughout the semester. This not only establishes contact but also helps establish a link to the student. Depending upon the student demographics, the academic advisor may need to determine the best method for communication. While younger students are more technologically savvy and may respond best to electronic communication such as e-mail and text messaging, the older student may respond better to telephone communication. In a study conducted by Filson and Whittington (2013), the majority of the undergraduate students communicated with their academic advisor by e-mail or scheduled appointment. A variety of technology applications can also be used to enhance electronic communication with advisees. Group text messaging tools such as Remind (formerly Remind 101), BuzzMob, or Kikutext allow advisors to send notices or alerts to students' electronic devices. Group reminder messages can be sent via these messaging services to provide students with important reminders throughout the year. When using these services, students get a text message from the advisor sent directly to their cell phones. Finally and most importantly, the faculty advisor needs to keep a record of all communication with the students. For this reason, electronic communication may be the best choice because of the ease of recording and storing such correspondence. If
Advising 101 telephone calls are made, then the advisor needs to summarize and record notes from the conversation. In addition, it may be necessary to send reminder communication to advisees throughout the semester via e-mail or texts to remind students of important events and deadlines during the semester such as course drop deadlines, registration times, and final examination schedules. Advisors need to display accessibility and approachability to develop the advisor–advisee relationship. Accessibility can be achieved by maintaining regular office hours and offering special advising appointments during peak registration or scheduling times (Gasper, 2009). It may be helpful and time efficient to schedule individual appointments with advisees. Faculty can use traditional paper sign-up appointment sheets or electronic scheduling using programs such as Doodle or Meeting Wizard. These electronic applications allow faculty to indicate appointment availability and then students select a time on-line for an appointment. Goals for the academic advising appointment should be developed by the advisor (Gasper, 2009). Having preplanned and scheduled appointments with advisees will facilitate the advisor's ability to accomplish goals in a timely fashion. The advisor and advisee should arrive on time for the scheduled appointment and be prepared for the session. Faculty should have either hard copy or an electronic version of the student's academic record, curriculum plan, and contact information. Having this information accessible during advising appointments will assist the advisor if problems are identified and referrals may be necessary for the student (Gasper, 2009). Individual student advising, rather than group advising, allows a personalized approach and provides an environment that allows open discussion about specific, individualized academic needs. Group advising can be effective when discussing routine requirements such as the sequence of courses in a curriculum, basic policies applicable to all students, or program expectations. However, if conducting group advising, it is still important to allow students an opportunity to ask questions and to hear the questions raised by peers and the responses provided (Battin, 2014). The advisor should also offer individualized appointments as needed or meet with students individually after the group discussion. These private meetings allow time to discuss individual issues or concerns and ensure compliance with privacy requirements. As discussed previously, the advisor needs to keep meticulous records of all student meetings and correspondence. An individual record should be kept by the advisor for each student. The advisor should maintain copies of all e-mail communication with the advisee. A document of the student's schedule and curriculum plan should be developed by the advisor and the advisee and signed by both parties. A copy of this record should be kept in the student file and another copy provided to the advisee. The advisee should also be encouraged to use a filing system to keep important papers such as transcripts, relevant resources, and advising materials. Faculty will also want to keep a file or resource of
5 commonly used academic advisement materials such as a curriculum sequence, progression policies, and other forms that may be used routinely. Advisors should also create documentation of advising sessions, issues raised, and referrals made. If the college or university utilizes an electronic academic advising system, advising notes can be documented in these systems. Usually, the electronic notes can be viewed by both the advisor and the student. When students are not regularly seeing the advisor or missing appointments, this behavior pattern should be documented in the students' advising record. Such documentation allows the advisor to display the student's lack of accountability for his or her advising process and a place for documentation if a student issue arises. Another important resource for faculty advisors involves the development of an advisee database. This electronic database should include student name, contact information, dates of student meetings, referrals, and a section for any additional important notes. This database provides an efficient method of record keeping and facilitates recall of advising activities. It will allow for consistency of advising. For example, if the student is transferred to another advisor because of change in status or change of major, the student's new advisor will be able to visualize the advising assistance the student has already received and allow for follow-up with the student. The advisor should remain in contact with the student throughout the semester. Advisors should audit the progress of their advisee periodically. It is important to review students' schedules to ensure adherence to the academic plan discussed. It is also helpful to review the students' mid-term grades to identify those students needing assistance or at risk for academic failure. The advisor should monitor the student's progression prior to the end of the semester so that needed assistance can be provided. However, at the end of the semester the advisor must also assess the student's final grades to identify course failures and assist the student in planning a modified schedule, develop remediation plans, and strategize approaches for success. At times, faculty, especially new faculty, may need to enlist the assistance of others when faced with unique or complicated issues, or the student requires services that are beyond the scope of the advisor role. An experienced advisor or the program director, dean, or chair can provide clarification of policies or advice about how to proceed. The college or university may have a designated advising center or a center for student success that may also assist the faculty member with guidance and resources. When a student presents with issues that are beyond the scope of the academic advisor, such as psychological, financial, or social issues, the faculty member may need to implement student referrals. Students may also present with physical or psychological disabilities and may require accommodations or assistance from disability services or a campus resource center. The advisor needs to develop collegial relationships with other departments and campus resources. It is helpful to
6
T. Shellenbarger, R. Hoffman Table 2
Potential Referrals for Advisees
Counseling/Mental health services Health services Veteran resource centers International student services Career services Financial aid services Learning resources (tutoring, supplemental instruction) Testing services/disabilities services Adapted from a table created by Gasper (2009).
develop a reference list of contact people and information to provide to the students if needed. Potential referral departments for advisees are listed in Table 2. Referrals and availability of services may vary depending on the institution and the student needs. Faculty should watch for concerning behaviors such as absenteeism, extreme changes in behavior, dramatic changes in academic performance, or signs of alcohol or drug abuse (Gasper, 2009). Extreme changes in behavior may be manifested from the stressful nature of the nursing curriculum, from psychological issues such as anxiety and depression, exposure to a traumatic event such as physical or sexual assault, and/or substance abuse. Behaviors that are imperative for the advisor to watch for and report promptly are displayed in Tables 3 and 4. These issues fall out of the scope of the academic advisor and require immediate intervention and referral (Gasper, 2009). The student may require prompt, early intervention by the advisor and referrals to counseling/mental health and/or health services. These referrals can also provide the student with access to community resources that may be beneficial to the student. For example, a student that is being physically or verbally abused may need appropriate support. An advisor referral to counseling
Table 3
and health services can assist the student with legal assistance and help provide for student safety. Students may also require referrals to campus or community health services for acute or chronic health concerns. Students that are displaying poor academic performance issues may require evaluation for learning disabilities and referral to testing/disabilities services. If learning problems are identified, then the student may need additional resources and accommodations such as a note taker, extended examination completion time, and/or a private testing environment. Students will be evaluated by trained personnel and, based upon expert recommendations, will be provided with appropriate reasonable accommodations that should enable student success. Students with other needs, such as veterans, international students, or those with financial concerns, may be referred for additional services based on their individualized backgrounds. Veterans may require specialized assistance with educational funding or need veteran counseling services. Referrals to support groups or to the Veterans Affairs department may be indicated. International students may also have special needs that require referrals. International offices can be beneficial in assisting international students adjusting to the American culture and academic environment. They can provide assistance with international paperwork such as VISA applications, unique financial aid concerns, or help students improve their language skills. Academic advisors are usually knowledgeable about program curricula; however, they may not be as comfortable advising students about financial aid concerns. Students should be referred to campus offices that can assist with financial aid questions regarding educational funding or completion of financial aid paperwork. It is also important to
Examples of Changes in Behavior Related to Stress, Anxiety, and Depression
Signs and Symptoms of Stress: • Memory problems • Inability to concentrate • Poor judgment • Feeling overwhelmed • Procrastination or neglecting responsibilities • Physiologic indicators: gastrointestinal disturbances, increased vital signs (blood pressure, pulse, respirations), sleep disturbances, weight loss or gain, decreased sex drive Signs and symptoms of anxiety: • Mild: sleep disturbances, restlessness, and increased questioning • Moderate: focus on immediate concerns, inattention to other communication or details, tremors, increased muscle tension, and slight increase heart rate and respiratory rate • Severe: impaired learning, easily distracted, fear of a danger that is not real, emotional distress, difficulty communicating, headache, nausea, tachycardia, dizziness, and hyperventilation • Panic: disorganized emotional state, dyspnea, palpitations, choking sensation chest pain/pressure, feeling of doom Signs and symptoms of depression: • Sadness • Negativism • Poor appetite • Withdrawal from social activities • Suicidal ideations (Lewis, Dirksen, Heitkemper, & Bucher, 2014; Taylor, Lillis, LeMone, & Lynn, 2011.)
Advising 101 Table 4 Examples of Signs and Symptoms of Commonly Used Substances Signs and symptoms of alcohol abuse: • Odor of alcohol on breath • Slurred speech • Staggering gait • Drowsiness • Glazed or bloodshot (red) eyes Signs and symptoms of stimulant use (cocaine and amphetamines) • Euphoria • Increased vital signs (blood pressure, heart rate, respirations) • Restlessness • Insomnia • Anorexia • Chest pain • Rapid speech Signs and symptoms of depressant use (sedative–hypnotics) • Relaxation • Decreased inhibitions • Drowsiness • Slurred speech • Decreased vital signs (blood pressure, heart rate, respirations) • Constricted pupils Signs and symptoms of opioid use • Drowsiness • Slurred speech • Decreased respirations • Constricted pupils • Detachment from the environment • Nausea • Constipation Signs and symptoms of cannabis use • Euphoria • Sedation • Hallucinations • Glazed or bloodshot (red) eyes (Lewis et al., 2014.)
advise students to contact appropriate financial aid offices when dropping or withdrawing from courses. Those schedule changes may impact the student's financial aid status because of a change in credit load. The advisor must assess student needs and issues and identify the specific referral required and provide appropriate contact information for the student. Advisors should also follow up to ensure that the student utilizes the referral services. Advisors may benefit from the development of an advising binder with information on all college services, departments and majors, contact persons, and information to utilize as a reference for student needs and concerns. Circumstances may occur when an academic advisor must coordinate with other departments to advocate for student success, especially when faced with scheduling needs. For example, a student may require a science course for progression in the nursing program; however, space is not available in current course offerings. The faculty advisor may need to advocate with administration for student enrollment to assist with timely program progression. Another example of coordination with other departments would include assisting a student that wishes to change a
7 major. During coursework, students may realize they are not suited for the nursing curriculum or the nursing profession and require assistance in choosing another major. The academic advisor needs to maintain a beginning knowledge of other majors and departments and establish relationships with individuals from those areas. The academic advisor should have information to provide to the student on other majors and whom he or she may contact for additional information. They may also be referred to campus career services to assist with résumé building and interview skills. Students may also seek out the advisor if experiencing academic difficulty in coursework. According to Gasper (2009), the first step when a student displays poor academic performance includes exploration of the potential causes. Causes may include poor study habits, poor time management, difficulty juggling multiple roles, lack of motivation, and/or test anxiety (Gasper, 2009). Depending upon the course, faculty may need to contact other departments to determine whether those courses offer any type of remediation, tutoring, or supplemental instruction to assist the struggling student. The advisor can provide the student with valuable strategies and tips for successful test taking. He or she may assist the student advisee with finding a peer tutor or support system that has been successful in similar coursework. The advisor can also implement institutional services that may be offered. For example, a writing center that assists students with editing and formatting written assignments may help students with written assignments. Students may also be referred to library resources for the creation of written assignments and for reference searching and retrieval. These resources may vary among institutions. The advisor should be familiar with the student resources at his or her institution. When preparing for advising sessions, the faculty member must also recognize the student's level in the program. Academic needs of students who are beginning a program will differ from students near completion. New students may seek advice on scheduling issues, socialization to higher education, and training about the advising process such as navigating the electronic scheduling and advising system. Students progressing through the program may require more referrals for academic support services as they encounter difficulty with course work. Students nearing completion of the program need advisement regarding curriculum completion, preparing for the licensure examination, potential advancement of their education, and employment guidance. Many times advisors may be contacted for information about a student. Requests for information may come from potential employers, from family members such as parents, or from others needing to verify information about a student. Advisors need to protect the privacy of advisees and their records and obtain appropriate permission prior to releasing certain information. The Family Educational Rights and Privacy Act (FERPA) protects the disclosure of select personally identifying information including grades, transcripts, class schedules, and enrollment status. Schools that receive federal funds are required to abide by
8 FERPA regulations. Advisors need to obtain written permission from students prior to releasing the protected information (Shellenbarger & Perez-Stearns, 2010). Some schools have specific forms that students can complete that grant permission to release the information, whereas other institutions may have electronic systems that allow students to grant release of information. Regardless of the method used, advisors must ensure that students have authorized the release of protected information as required by FERPA and institutional policies. There is an exception to the FERPA regulations and release of information. Sometimes an advisor may learn of personal student information that may pose a significant health or safety threat to either the advisee or another person. If it is a serious and imminent emergency, such as an epidemic outbreak, certain mental health situations, or a natural disaster, the advisor may disclose that information to appropriate persons such as parents, medical personnel, or appropriate public health officials without needing the student's consent. These situations are usually handled on a case-by-case basis, and they only allow for the release of information during the emergency. It does not permit a blanket release of all personally identifiable information (Association of State and Territorial Health Officials, 2015; United States Department of Education, 2015). Advisors fulfill many roles in order to meet student needs and facilitate their success. Major roles of the advisor include mentoring and empowering the student advisee to succeed within the program. The advisor should empower the student to take responsibility for his or her own success and encourage decision-making and leadership skills of the student (McClellan, 2013).
4. Advisee Although the faculty advisor has multiple responsibilities for effective advising, the student must also take responsibility for the effectiveness of his or her advisement. The advisor can only provide the advisee with information, and the advisee has to be responsible for actions, strive to succeed in the program, and utilize the advice and resources provided by the advisor. The student needs to be accountable for scheduling, be prepared for advising sessions, and communicate effectively with the advisor. It is helpful if the advisees prepare a tentative course schedule in preparation for the advising session and develop a list of questions he or she may have for the advisor. During busy registration times, advising sessions are often limited so that adequate preparation will allow the student to ensure that all questions and concerns are addressed during the advising session. The student should also be encouraged to keep his or her own personal record of academic advisement, proposed schedule, and any recommended referrals or resources provided by the advisor. If an advisee is having problems, he or she should contact the advisor as soon as possible to address the issue promptly and should maintain periodic contact with the advisor to discuss progress.
T. Shellenbarger, R. Hoffman
5. Administration The program director, department chair, or dean also plays a role in the effective advisement of students. Administrators need to ensure that advisors and advisees are provided with necessary education on the advising process, advising policies, required forms, and technology applications used for advising. When orienting new faculty, administrators need to provide faculty with education about student needs and issues and ensure that advisors have the information, tools, and resources to support this role. It is also helpful to identify an experienced faculty who can serve as a resource or mentor to assist when questions arise. Advisors also require professional development to address opportunities to engage advisees through academic advising (Filson & Whittington, 2013; Wallace, 2011). The program director, department chair, or dean should be accessible to advisors to assist with issues beyond the scope of the faculty role or other issues involving administrative clarification. Understanding the success of academic advisement is also important for administrators to know about. Powers, Carlstrom, and Hughey (2014) recommended the utilization of assessment results regarding student satisfaction with advisement. Assessing student satisfaction with academic advising should include areas such as knowledge of the advisor regarding program curriculum, availability of the advisor, and advisor knowledge of campus resources and referrals available to the student. Because effective academic advising is known to promote persistence and success in students, retention rates, grade point averages, and graduation rates should also be assessed. Evaluation of the effectiveness of student advisement should be performed at the administrative level. Recommendations should be instituted if the process is deemed ineffective by the students or faculty. Last, recognition, rewards, and incentives for quality advising are helpful and demonstrate the institutional commitment for advising (Wallace, 2011).
6. Conclusion Effective advising takes time and resources. In order for effective advising to take place, all parties including the advisor, advisee, and administration need to make academic advising a priority. Proper academic advising requires preparation, dedication, and adherence to the advising process. When advising is done appropriately, it can lead to many benefits including students' successful completion of a program. High retention and graduation rates are important for the school. In addition, a successful educational outcome also helps to ensure that appropriate numbers of nursing students are completing degrees and are ready to begin their work as a professional nurse.
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