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Enrollment update: Comparison of fall 1984 and 1985 enrollments in American association of colleges of nursing member schools and with trends in higher education enrollments
Enrollment Update: Comparison of Fall 1984 and 1985 Enrollments in American Association of Colleges of Nursing Member Schools and With Trends in Higher Education Enrollments BARBARA K. REDMAN, P H D ,
RN, FAAN,*
has surfaced about enrollments in college and university schools of nursing, t In this article data are presented on fall 1985 enrollments reported by American Association of Colleges of Nursing (AACN) member schools to clarify the status of collegiate nursing enrollments in a time of fiscal restraint and declining college-age population. Special concern has been voiced about the numbers of new applicants to baccalaureate programs in nursing. ~The AACN survey gathered data only on total full-time and part-time enrollments in graduate and undergraduate programs. Beginning in fall 1986, the AACN survey will request information about first-time nursing students, in order to track this indicator of the nursing profession's ability to recruit students. Several comparisons are presented here, so that schools of nursing may examine their enrollments in a national context. Comparisons are made between enrollments in fall 1985 and fall 1984, by degree program, by full-time and part-time students, by full-time equivalents (one full-time student = three part-time students), by sponsorship (public, private secular, private religious), by institutional type (academic health center, university, or four-year college), by geographic region, and with national figures on enrollments in four-year colleges and universities. ECENTLY, INCREASING CONCERN
Methods In August 1985 survey forms were sent to all 383 AACN member schools; with several follow-ups, a * ExecutiveDirector, AmericanAssociationof Collegesof Nursing. t Research Associate, AmericanAssociationof Collegesof Nursing, and PhD candidate in Nursing at the Universityof Maryland. No endorsement by the AmericanAssociationof Colleges of Nursing of the ideas is intended or should be inferred. Address correspondenceand reprint requests to Dr. Redman:AmericanAssociationof Collegesof Nursing, One Dupont Circle,N.W.,Suite 530, Washington, D.C. 20036. JOURNAL OF PROFESSIONAL NURSING •
AND BARBARA PILLAR,
MSN
96 per cent return was attained. The following definitions were used:
Sdmol represents the academic unit in higher education institutions that offer baccalaureate, master's, or doctoral programs in nursing; Academic health center is any institution that includes a school of medicine, a teaching hospital, and at least one additional health education program, specifically nursing; Generfc student is one who has no previous nursing education before entering the baccalaureate program; RN student is one who is licensed as a registered nurse; Full-time (FT) and part-time (PT) status were defined by the criteria of the individual schools. Headcount (HC) is the summing of these two figures; full-time equivalent (FTE) is calculated as three part-time students equal one full-time student. Findings At all degree levels in all types of institutions, total fall 1985 enrollment of nursing students (head count) remained stable at + 0.5 per cent, or using full-time equivalents, fell by 2.2 per cent in the 367 respondent schools. Numbers of students reported by respondent schools (n = 367) are: FT Generic Baccalaureate RNBaccalaureate
69,720 9,220 5,931 21,575
ALL BACCALAURFATE 75,651 Master's Doctoral TOTAL
PT
6,438 765
30,795 13,552 1,115
82,854 45,462
HC
FTE
78,940 27,506
72,793 13,123
106,446 85,916 19,990 1,880
10,955 1,137
128,316 98,008
Based on full-time equivalents, RNs constituted 15
MARCH-APRIL1986
129
130 T A B L E 1.
JOURNAL OF PROFESSIONAL NURSING
MARCH-APRIL1986
Percentage Changes in Enrollment From Fall 1984 to Fall 1985 Reported by AACN Member Schools Providing Data for Both Years RN Baccalaureate
Generic Baccalaureate Institution Sponsorship
All Institutions (n = 331) Public (n = 178) Private Secular (n = 58) Private Religious (n = 95)
FT
PT
Total HC
-8.2 -6.5 - 9.0 - 12.1
8.5 0.1 70.8 3.7
-6.5 -5.7 -2.8 - 10.9
Total FTE
FT
PT
Total HC
Total FTE
-7.6 -6.3 -6.9 - 11.7
- 14.1 -7.9 -27.3 -22.5
13.0 20.8 - 1.7 6.0
6.4 13.3 -8.2 1.2
-0.2 6.0 - 14.8 -4.7
Abbreviations: FT, full-time; PT, part-time; HC, h e a d count; FTE, full-time equivalent.
TABLE 2. PercentageChanges in Enrollment From Fall 1984 to Fall 1985 Reported by AACN Member Schools by Institutional Type Generic Baccalaureate Type of Institution
Four-Year Colleges (n = 113) Universities (n = 163) A c a d e m i c Health Centers (n = 84)
FT
PT
1.1 -3.8 -4.2
42.4 11.3 4.1
Total HC
5,5 -2.3 -3.4
RN Baccalaureate Total FI'E
FT
2.7 -3.3 -4.0
PT
18.7 -9.5 17.5
18.6 13.5 -4.4
Total HC
Total FTE
18.6 7.2 2.3
18.6 1.3 8.1
Abbreviations: FT. full-time; PT, part-time; HC, head count; FTE, full-time equivalent.
per cent of all baccalaureate students, and generic students 85 per cent; of total enrollment, 87 per cent was baccalaureate, 12 per cent master's, and 1 per cent doctoral students. Based on head count, RNs constituted 26 per cent of baccalaureate students, generic students 74 per cent; and of total enrollment, 82 per cent was baccalaureate, 16 per cent master's, and 2 per cent doctoral. In Tables 1-4, variations based on institution sponsorship, type or location are illustrated, and AACN enrollment data are compared with trends in higher education. Data on the same 331 schools that reported their enrollments in 1984 and 1985 are presented in Table 1. Baccalaureate programs generally showed significant drops, especially in generic students, while master's enrollment remained stable and doctoral enrollment expanded. In general, private institutions, which enroll about one third of baccalaureate students, showed larger percentages of decreases in baccalaureate enrollment than did public institutions. In master's education, where private institutions en-
TABLE3.
roll 35 per cent of the students, both losses and gains were shown, and in doctoral education, where about 40 per cent of the students are enrolled in private universities, gains were shown. Similar data are shown in Table 2, with the schools divided by institutional type. Four-year colleges enroll about 22 per cent of baccalaureate students, universities 51 per cem, and academic health centers 27 per cent. Master's students are predominantly enrolled in universities (37 to 42 per cent), and academic health centers (53 to 59 per cent), with 4 to 5 per cent in four-year colleges. Doctoral students are about evenly divided between universities and academic health centers (ranges represent headcount versus FTE counts). Four-year colleges show strong growth in enrollment. Universities and academic health centers showed a slight decline in baccalaureate enrollment but strong graduate enrollment. Table 3 aligns the data by geographic region and shows that the strongest patterns of maintenance or expansion are in the West and in the South, with
Percentage Changes in Enrollment From Fall 1984 to Fall 1985 Reported by AACN Member Schools by Geographic Region Generic Baccalaureate
Region
West (n = 41) Northeast (n = 94) South (n = 126) Midwest (n = 106)
F-I"
-2.3 - 9.1 -0.2 - 7.5
RN Baccalaureate
PT
Total HO
Total FTE
FT
PT
Total HC
Total F-rE
11.3 44.0 -3.8 17.8
-0.1 - 5.3" -0.6 - 4.9
-1.9 - 7.8 -0.3 - 6.6
-9.7 - 7.1 28.4 - 20,0
50.9 0.7 16.1 10.3
26.9 - 0.4 20.2 3.8
10.7 - 1.8 23.4 - 3.3
Abbreviations: FT, full-time; PT, part-time; HC, head count; FTE, full-time equivalent.
131
All Baccalaureate FT
PT
Total HC
--8.6 --6.6 --11.0 --12.6
11.6 13.5 12.0 5.4
--3.5 --1.6 -4.5 -8.4
Master's Total FI'E
1=3"
--6.6 --4.6 --8.3 --10.9
--0.4 0.8 --5.5 1.7
PT
Total FTE
FT
PT
Total HC
Total FTE
3.1 1.7 0.3 14.3
2.0 1.4 1.4 10.9
1.1 1.1 --2.9 7.7
3.3 1.7 1.4 92.3
18.0 18.2 18.7 9.3
11.5 8.4 14.8 25.4
7.7 4.8 10.4 45.2
PT
Total HC
Total ME
M
15.0 2.3 4.2
22.4 3.0 5.0
32.9 3.8 5.4
. 15.5 -2.0
All Baccalaureate M
PT
Total HC
2.3 -4.3 -2,9
24.6 12.8 -1.0
9.1 -0.2 -2.5
Master's Total ME
M
5.2 -2.6 -2.7
75.0 5,5 6+0
Discussion
It has been projected that in the year 2000, the need for personnel with baccalaureate degrees in nursing will be almost double the number of nurses so prepared in 1980, and will almost triple for those
All Baccalaureate FT
PT
-3.5 -9.0 2.0 -8.4
39.9 8.6 7.1 12.5
7.2 -4.0 3.1 -2.9
Doctoral
Master's Total FTE
FT
0.8 -6.9 2.4 -6.2
27.1 -2.8 5,0 0.1
PT
.
. 16.4 21.3
Total HC
Total RE
16.1 8.7
15.8 3.1
.
with master's degrees in nursing.3 The Committee on Nursing and Nursing Education, sponsored by the Institute of Medicine, identified a wide range of problems that it believed can be alleviated only by increasing substantially the supply of nurses with advanced education.4 Finally, a number of nursing service administrators, in informal discussion, predict a serious shortage of professional nurses, with some areas of health care delivery already experiencing this problem. In the AACN survey, data were not gathered on whether respondent schools intended to decrease, increase, or maintain enrollment levels, or on the reasons for changes in enrollment patterns. Clearly, increased student debt load, competition from other fields for recruitment of recent high school graduates, and reluctance of potential students to leave jobs are barriers with which the profession needs to contend. Fall 1985 enrollment trends show a number of shifts and a mixture of decreases and increases due to numerous factors beyond the scope of this arti-
especially strong growth in RNs enrolling in baccalaureate programs. Comparison with national figures for total enrollment in four-year colleges and universities also provides a point against which to measure trends for nursing. These national figures were obtained from data gathered by the American Council on Education from more than 70 per cent of the nation's colleges and universities and show changes in fall enrollment from 1984 to 1985,2 just as do the AACN nursing data (Table 4). The data from four-year colleges and universities indicate relatively small changes in fall 1985 enrollment. Nursing enrollments show significant shifts to part-time study.
Total HC
Doctoral
Total HC
Doctoral
PT
Total HC
Total FTE
FT
PT
Total HC
Total FTE
8,7 3.5 7,4 -0.3
18.1 1.9 6.6 -0.2
22.7 0.3 5.9 -0.1
2.4 16.7 8.8 - 10.3
32.5 12.0 16.4 36.8
7.3 12.9 12.6 13.2
4.6 13.8 10.9 1.3
JOURNAL OF PROFESSIONAL NURSING • MARCH-APRIL 1986
132 T A B L E 4.
Percentage Changes in Enrollment From Fall 1984 to .Fall 1985 for Four-Year Institutions and Nursing Programs by Attendance Status of Students and by Level of Attendance
Public four-year coIleges and universities Public nursing programs Private four-year colleges and universities Private nursing programs
FT
PT
Total HC
FTE
Undergraduate
Graduate
-1.9 - 3.2 - 0.1 -5.9
1.7 8.4 - 2.3 13.3
-0.8 0.5 - 0.8 0.4
-"1.4 - 1.6 - 0.4 -3.2
-0.2 -0.6 0.2 -0.3
4.8 5.8 0.6 4.5
Abbreviations: FT, full-time; PT, part-time; HC, head count; FTE, full-time equivalent.
cle. Concerted action is needed to deal with those enrollment trends that are not in the interests of consumers of nursing services. References 1. Schools Alarmed by Downturn in Applications. AmJ Nuts 85:1292, 1299, 1300, 1985
2. American Council on Education: College Holds Steady, Survey Shows. The Council, Washington, D.C., 1985 3. Report to the President and Congresson the Status of Health Personnel in the United States. DHHS, Washington, D.C., May 1984 4. InstituteofMedicine:NursingandNursingEducation: Public Policies and Private Actions. National Academy Press, Washington, D.C., 1983
RN, FAAN,*
has surfaced about enrollments in college and university schools of nursing, t In this article data are presented on fall 1985 enrollments reported by American Association of Colleges of Nursing (AACN) member schools to clarify the status of collegiate nursing enrollments in a time of fiscal restraint and declining college-age population. Special concern has been voiced about the numbers of new applicants to baccalaureate programs in nursing. ~The AACN survey gathered data only on total full-time and part-time enrollments in graduate and undergraduate programs. Beginning in fall 1986, the AACN survey will request information about first-time nursing students, in order to track this indicator of the nursing profession's ability to recruit students. Several comparisons are presented here, so that schools of nursing may examine their enrollments in a national context. Comparisons are made between enrollments in fall 1985 and fall 1984, by degree program, by full-time and part-time students, by full-time equivalents (one full-time student = three part-time students), by sponsorship (public, private secular, private religious), by institutional type (academic health center, university, or four-year college), by geographic region, and with national figures on enrollments in four-year colleges and universities. ECENTLY, INCREASING CONCERN
Methods In August 1985 survey forms were sent to all 383 AACN member schools; with several follow-ups, a * ExecutiveDirector, AmericanAssociationof Collegesof Nursing. t Research Associate, AmericanAssociationof Collegesof Nursing, and PhD candidate in Nursing at the Universityof Maryland. No endorsement by the AmericanAssociationof Colleges of Nursing of the ideas is intended or should be inferred. Address correspondenceand reprint requests to Dr. Redman:AmericanAssociationof Collegesof Nursing, One Dupont Circle,N.W.,Suite 530, Washington, D.C. 20036. JOURNAL OF PROFESSIONAL NURSING •
AND BARBARA PILLAR,
MSN
96 per cent return was attained. The following definitions were used:
Sdmol represents the academic unit in higher education institutions that offer baccalaureate, master's, or doctoral programs in nursing; Academic health center is any institution that includes a school of medicine, a teaching hospital, and at least one additional health education program, specifically nursing; Generfc student is one who has no previous nursing education before entering the baccalaureate program; RN student is one who is licensed as a registered nurse; Full-time (FT) and part-time (PT) status were defined by the criteria of the individual schools. Headcount (HC) is the summing of these two figures; full-time equivalent (FTE) is calculated as three part-time students equal one full-time student. Findings At all degree levels in all types of institutions, total fall 1985 enrollment of nursing students (head count) remained stable at + 0.5 per cent, or using full-time equivalents, fell by 2.2 per cent in the 367 respondent schools. Numbers of students reported by respondent schools (n = 367) are: FT Generic Baccalaureate RNBaccalaureate
69,720 9,220 5,931 21,575
ALL BACCALAURFATE 75,651 Master's Doctoral TOTAL
PT
6,438 765
30,795 13,552 1,115
82,854 45,462
HC
FTE
78,940 27,506
72,793 13,123
106,446 85,916 19,990 1,880
10,955 1,137
128,316 98,008
Based on full-time equivalents, RNs constituted 15
MARCH-APRIL1986
129
130 T A B L E 1.
JOURNAL OF PROFESSIONAL NURSING
MARCH-APRIL1986
Percentage Changes in Enrollment From Fall 1984 to Fall 1985 Reported by AACN Member Schools Providing Data for Both Years RN Baccalaureate
Generic Baccalaureate Institution Sponsorship
All Institutions (n = 331) Public (n = 178) Private Secular (n = 58) Private Religious (n = 95)
FT
PT
Total HC
-8.2 -6.5 - 9.0 - 12.1
8.5 0.1 70.8 3.7
-6.5 -5.7 -2.8 - 10.9
Total FTE
FT
PT
Total HC
Total FTE
-7.6 -6.3 -6.9 - 11.7
- 14.1 -7.9 -27.3 -22.5
13.0 20.8 - 1.7 6.0
6.4 13.3 -8.2 1.2
-0.2 6.0 - 14.8 -4.7
Abbreviations: FT, full-time; PT, part-time; HC, h e a d count; FTE, full-time equivalent.
TABLE 2. PercentageChanges in Enrollment From Fall 1984 to Fall 1985 Reported by AACN Member Schools by Institutional Type Generic Baccalaureate Type of Institution
Four-Year Colleges (n = 113) Universities (n = 163) A c a d e m i c Health Centers (n = 84)
FT
PT
1.1 -3.8 -4.2
42.4 11.3 4.1
Total HC
5,5 -2.3 -3.4
RN Baccalaureate Total FI'E
FT
2.7 -3.3 -4.0
PT
18.7 -9.5 17.5
18.6 13.5 -4.4
Total HC
Total FTE
18.6 7.2 2.3
18.6 1.3 8.1
Abbreviations: FT. full-time; PT, part-time; HC, head count; FTE, full-time equivalent.
per cent of all baccalaureate students, and generic students 85 per cent; of total enrollment, 87 per cent was baccalaureate, 12 per cent master's, and 1 per cent doctoral students. Based on head count, RNs constituted 26 per cent of baccalaureate students, generic students 74 per cent; and of total enrollment, 82 per cent was baccalaureate, 16 per cent master's, and 2 per cent doctoral. In Tables 1-4, variations based on institution sponsorship, type or location are illustrated, and AACN enrollment data are compared with trends in higher education. Data on the same 331 schools that reported their enrollments in 1984 and 1985 are presented in Table 1. Baccalaureate programs generally showed significant drops, especially in generic students, while master's enrollment remained stable and doctoral enrollment expanded. In general, private institutions, which enroll about one third of baccalaureate students, showed larger percentages of decreases in baccalaureate enrollment than did public institutions. In master's education, where private institutions en-
TABLE3.
roll 35 per cent of the students, both losses and gains were shown, and in doctoral education, where about 40 per cent of the students are enrolled in private universities, gains were shown. Similar data are shown in Table 2, with the schools divided by institutional type. Four-year colleges enroll about 22 per cent of baccalaureate students, universities 51 per cem, and academic health centers 27 per cent. Master's students are predominantly enrolled in universities (37 to 42 per cent), and academic health centers (53 to 59 per cent), with 4 to 5 per cent in four-year colleges. Doctoral students are about evenly divided between universities and academic health centers (ranges represent headcount versus FTE counts). Four-year colleges show strong growth in enrollment. Universities and academic health centers showed a slight decline in baccalaureate enrollment but strong graduate enrollment. Table 3 aligns the data by geographic region and shows that the strongest patterns of maintenance or expansion are in the West and in the South, with
Percentage Changes in Enrollment From Fall 1984 to Fall 1985 Reported by AACN Member Schools by Geographic Region Generic Baccalaureate
Region
West (n = 41) Northeast (n = 94) South (n = 126) Midwest (n = 106)
F-I"
-2.3 - 9.1 -0.2 - 7.5
RN Baccalaureate
PT
Total HO
Total FTE
FT
PT
Total HC
Total F-rE
11.3 44.0 -3.8 17.8
-0.1 - 5.3" -0.6 - 4.9
-1.9 - 7.8 -0.3 - 6.6
-9.7 - 7.1 28.4 - 20,0
50.9 0.7 16.1 10.3
26.9 - 0.4 20.2 3.8
10.7 - 1.8 23.4 - 3.3
Abbreviations: FT, full-time; PT, part-time; HC, head count; FTE, full-time equivalent.
131
All Baccalaureate FT
PT
Total HC
--8.6 --6.6 --11.0 --12.6
11.6 13.5 12.0 5.4
--3.5 --1.6 -4.5 -8.4
Master's Total FI'E
1=3"
--6.6 --4.6 --8.3 --10.9
--0.4 0.8 --5.5 1.7
PT
Total FTE
FT
PT
Total HC
Total FTE
3.1 1.7 0.3 14.3
2.0 1.4 1.4 10.9
1.1 1.1 --2.9 7.7
3.3 1.7 1.4 92.3
18.0 18.2 18.7 9.3
11.5 8.4 14.8 25.4
7.7 4.8 10.4 45.2
PT
Total HC
Total ME
M
15.0 2.3 4.2
22.4 3.0 5.0
32.9 3.8 5.4
. 15.5 -2.0
All Baccalaureate M
PT
Total HC
2.3 -4.3 -2,9
24.6 12.8 -1.0
9.1 -0.2 -2.5
Master's Total ME
M
5.2 -2.6 -2.7
75.0 5,5 6+0
Discussion
It has been projected that in the year 2000, the need for personnel with baccalaureate degrees in nursing will be almost double the number of nurses so prepared in 1980, and will almost triple for those
All Baccalaureate FT
PT
-3.5 -9.0 2.0 -8.4
39.9 8.6 7.1 12.5
7.2 -4.0 3.1 -2.9
Doctoral
Master's Total FTE
FT
0.8 -6.9 2.4 -6.2
27.1 -2.8 5,0 0.1
PT
.
. 16.4 21.3
Total HC
Total RE
16.1 8.7
15.8 3.1
.
with master's degrees in nursing.3 The Committee on Nursing and Nursing Education, sponsored by the Institute of Medicine, identified a wide range of problems that it believed can be alleviated only by increasing substantially the supply of nurses with advanced education.4 Finally, a number of nursing service administrators, in informal discussion, predict a serious shortage of professional nurses, with some areas of health care delivery already experiencing this problem. In the AACN survey, data were not gathered on whether respondent schools intended to decrease, increase, or maintain enrollment levels, or on the reasons for changes in enrollment patterns. Clearly, increased student debt load, competition from other fields for recruitment of recent high school graduates, and reluctance of potential students to leave jobs are barriers with which the profession needs to contend. Fall 1985 enrollment trends show a number of shifts and a mixture of decreases and increases due to numerous factors beyond the scope of this arti-
especially strong growth in RNs enrolling in baccalaureate programs. Comparison with national figures for total enrollment in four-year colleges and universities also provides a point against which to measure trends for nursing. These national figures were obtained from data gathered by the American Council on Education from more than 70 per cent of the nation's colleges and universities and show changes in fall enrollment from 1984 to 1985,2 just as do the AACN nursing data (Table 4). The data from four-year colleges and universities indicate relatively small changes in fall 1985 enrollment. Nursing enrollments show significant shifts to part-time study.
Total HC
Doctoral
Total HC
Doctoral
PT
Total HC
Total FTE
FT
PT
Total HC
Total FTE
8,7 3.5 7,4 -0.3
18.1 1.9 6.6 -0.2
22.7 0.3 5.9 -0.1
2.4 16.7 8.8 - 10.3
32.5 12.0 16.4 36.8
7.3 12.9 12.6 13.2
4.6 13.8 10.9 1.3
JOURNAL OF PROFESSIONAL NURSING • MARCH-APRIL 1986
132 T A B L E 4.
Percentage Changes in Enrollment From Fall 1984 to .Fall 1985 for Four-Year Institutions and Nursing Programs by Attendance Status of Students and by Level of Attendance
Public four-year coIleges and universities Public nursing programs Private four-year colleges and universities Private nursing programs
FT
PT
Total HC
FTE
Undergraduate
Graduate
-1.9 - 3.2 - 0.1 -5.9
1.7 8.4 - 2.3 13.3
-0.8 0.5 - 0.8 0.4
-"1.4 - 1.6 - 0.4 -3.2
-0.2 -0.6 0.2 -0.3
4.8 5.8 0.6 4.5
Abbreviations: FT, full-time; PT, part-time; HC, head count; FTE, full-time equivalent.
cle. Concerted action is needed to deal with those enrollment trends that are not in the interests of consumers of nursing services. References 1. Schools Alarmed by Downturn in Applications. AmJ Nuts 85:1292, 1299, 1300, 1985
2. American Council on Education: College Holds Steady, Survey Shows. The Council, Washington, D.C., 1985 3. Report to the President and Congresson the Status of Health Personnel in the United States. DHHS, Washington, D.C., May 1984 4. InstituteofMedicine:NursingandNursingEducation: Public Policies and Private Actions. National Academy Press, Washington, D.C., 1983