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Exploring and developing a college’s community of interest: an appreciative inquiry
Exploring and Developing a College’s Community of Interest: An Appreciative Inquiry MARIE FARRELL, EDD, MPH, RN, FAAN,* DIANNA DOUGLAS, DNS, RN, CNS,† AND SUSAN SILTANEN, PHD‡
This study examined what the Commission on Collegiate Nursing Education identifies as a college of nursing’s internal and external “community of interest.” Using “appreciative inquiry” in this study of a college campus, we examined the parts of the historical past that the community believed should be maintained, its vision of excellence for the college, the ways in which the vision could be realized, and its part in fulfilling the expectations of a shared, co-created vision. Investigators collected data using a self-developed, one-on-one interview and focus-group format and analyzed the data using content analysis. The findings suggest that the community shared values of preserving the college’s past and of its vision for the college’s future. However, it differed in the means of putting its cocreated vision into practice and in defining its contributions in realizing the vision it created for the college. (Index words: Commission on Collegiate Nursing Education (CCNE); College of nursing; Internal community of interest; External community of interest; Appreciative inquiry) J Prof Nurs 19:364-371, 2003. © 2003 Elsevier Inc. All rights reserved.
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OLLEGES OF NURSING in the United States answer to many stakeholders. A college of nursing’s graduates provide health care services at a community’s hospitals, visiting nurses’ associations, home health agencies, schools, prisons, local health departments, and physicians’ group practices. They also provide community services through their own private entrepreneurial practices and conduct research through colleges in their own or other universities. Each of these institutions and organizations constitutes a college’s
*Dean and Professor of Nursing, University of Southern Mississippi College of Nursing, Hattiesburg, MS. †Assistant Professor of Nursing, University of Southern Mississippi College of Nursing, Hattiesburg, MS. ‡Assistant Provost for Institutional Research, University of Southern Mississippi, Hattiesburg, MS. Address correspondence and reprint requests to Dr. Farrell: University of Southern Mississippi College of Nursing, Box 5095, Hattiesburg, MS 39406. © 2003 Elsevier Inc. All rights reserved. 8755-7223/03/1906-0000$30.00/0 doi:10.1016/S8755-7223(03)00129-7 364
“community of interest” (AACN, 2003) and is linked to the college in a variety of formal and informal ways, all with a stake in the college’s ability to help maintain a high level of community health. Yet little is known of this community, and few efforts have been made to explore the ways in which it might assist a college in expanding its vision for the future, putting the vision into practice, and identifying ways in which it might contribute to the realization of a shared, cocreated vision. The purpose of this study was to examine a college community at a state university. To meet this purpose, a team of faculty, students, and administrative staff met with its internal and external community to use “appreciative inquiry,” an innovative approach to organizational assessment (Barrett & Cooperrider, 1990; Farrell, George, Brukwitzki, & Burke, 2002; George, Farrell, & Brukwitzki, 2002). Appreciative inquiry invites participants to identify the parts of the historical past that the community believes should be maintained, to articulate its vision of excellence for the college and the ways in which the vision can be realized, and to identify its part in fulfilling the expectations of a shared, cocreated vision. A college must meet criteria that address national, state, regional, and local expectations. In addition, colleges are accountable to their stakeholders—those in the college and university community and those external to it. The support and feedback from stakeholders are critical components that ensure the viability and relevance of a nursing program. Students develop impressions and perceptions of a college that influence their application, progression, and eventual graduation from its program. Families have a stake in the college because they cover the financial costs of the educational experience and often pay the costs of having an adult away from home who is not contributing to the family during school periods. Colleges, like other enterprises, interact with several cultures, each having its own perceptions and expectations that influence its responsiveness and willingness
Journal of Professional Nursing, Vol 19, No 6 (November–December), 2003: pp 364-371
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to partner with the college as it addresses its strategic objectives. For example, a college might have an international component in its strategic plan and needs the collaboration of the university’s international program. That program administrator’s view of the viability of the college is critical to the successful bid for partnering with that international program. In addition to these factors, the external community is the focus of a college’s nursing curriculum, and this community must have a voice in the nature and extent of services that the nursing program is expected to offer. These expectations, in turn, affect the willingness of the community to support the college’s program and hire its graduates. In this regard, the college seeks to validate itself through its query of the community it ultimately intends to serve (Lindeman, 2000). This study is significant for several reasons. In Mississippi, an extensive community-college system produces hundreds of graduates each year, many of whom expect to continue their education through the state college system that offers baccalaureate and higher degrees in nursing. Because many graduates live and plan to work in the state, they look to a reasonably affordable state university in their areas to realize their career aspirations. The College of Nursing of the University of Southern Mississippi (USM) is the largest statefunded nursing program in southern Mississippi and is the recipient for the community-college feeder schools in the southern part of the state. The CON is also the educator of nurses for health care organizations, with 80 contracting partners.
Conceptual Framework
Nursing is a dynamic discipline that changes as the society it serves changes, and it is defined as the diagnosis and treatment of the human response to health and health care conditions. Nursing is a scholar-practitioner professional discipline of discovery teaching and integration (American Association of Colleges of Nursing, 1999) and includes theory and practice components. It is a part of society and also owned by society because it “acquires recognition, relevance, and meaning in terms of its relationship to the society, its culture and institutions and its other members” (Lindeman, 2000). Society is a stakeholder in the preparation, formal approval of, and users of professional nursing. Specifically, these stakeholders are considered an external community of interest and an internal community of interest. The external community of interest includes
individuals and groups that influence or participate in the nursing education program to ensure the achievement of its expected results. Example of external groups include prospective students and their families, organizations of professional nurses and nurse educators, employers, legislators, health care providers, volunteer organizations, and consumers. The internal community is made up of institutionally based individuals and groups that include university and college-ofnursing administration, faculty and students, and groups that govern the activities of faculty and students (AACN Accreditation). Those who hire or work with practicing nurses, or who are cared for by them, perceive the educational system that prepared the nurse. These users hold particular attitudes about both the practicing nurse and the educational system, and they express these views about characteristics, roles, and the organizational system. These attitudes can be described in terms of the profession, specifically its preparation, its requirements for practice, and its practice. Attitudes are expressed relating to the education of the nurse, his or her practice, and the functions she or he carries out. The system of nursing education in this framework includes nursing education, entry to practice, and nursing practice.
Operational Definitions
The investigators developed a “code book” that defined and numbered the characteristics of community members, the roles played, the components of the organizational system, and attitudes. For the purposes of this study, the following operational definitions were used: 1. Attitude is a propensity for a particular view or sentiment and is assessed by using ratings from low (1) to high (5). 2. Characteristics of faculty/students consist of (a) their education, specifically their knowledge, understanding, and competencies in analysis and synthesis; (b) their practice, specifically their knowledge and practice of theory, management skills, standards of practice, code of ethics, and observation of disciplinary principles; and (c) their functioning as nurses, specifically their competence in providing direct care, teaching/learning, coordination of and ensuring referral, and participation in research.
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3. Roles are the performers and the characterizations of the behaviors carried out. Specifically, performers can include the community, university, college, nursing faculty, administration, students, and alumni. The roles assumed include agent of change, mentor, counselor, leader, ambassador, recruiter, and role model for diversity. 4. The nursing educational organizational system addresses the needs of society in its curriculum and provides learning experiences for students within that society. The system includes nursing education, entry to practice, and nursing practice. a. Nursing education in this study is made up of the components students experience as they progress through the system, specifically: admission, progression through the curriculum and program, faculty, resources, interactions and relationships, physical environment, and reputation of the program. b. Entry to practice is defined as preparing for and successfully meeting the requirements of the educational program and the practice of professional nursing in the workplace. Entry to practice begins with the receipt of the college diploma and ends with the successful completion of the National Council Licensure Examination and fulfillment of the state requirements for professional practice. c. Nursing practice is defined as being engaged in the diagnosis and treatment of the human response to health and health care conditions, using nursing and related theory, managing client care, and applying codes of ethics and practice (Farrell, 1987).
(4) “What part does a community perceive itself playing to actualize the co-created vision of a college of nursing?” Assumptions and Limitations
In this study, it was assumed that the respondents would represent the community and the college and that its members would answer truthfully and honestly. The study acknowledges three limitations. First, the study sample was limited to stakeholders who were available at the time of the interviews and might not include people whose working schedules prevented their participation. Second, the study’s data collection period was limited to one event and might not represent views held over a long period of time. Third, the study was limited to one-on-one interviews and focus groups with members of the research team, and this structure might have constricted the openness with which the respondents discussed their interests and views. Methods SETTING
The setting for the study was the integrated campus of the USM, specifically the campuses in Hattiesburg, Meridian, and the Gulf Coast. Data were collected between June and August 2002. DESIGN
The research design consisted of either a one-time, one-on-one interview between the research team and the interviewee, or a single, focus-group event between the research team and representatives of a stakeholder group from the community (Kerlinger, 1978). SAMPLE
Study Questions
The main study question was “In what ways does a college of nursing contribute to the health and excellence of the community it serves as perceived by its internal and external community?” Specifically, four subquestions were asked: (1) “What does the college mean to its community relative to its shared historical past?” (2) “What is the vision the community shares for the college?” (3) “In what ways does the community perceive its cocreated vision being put into practice?”
The administrator of the college telephoned each element of the intended, stratified, random sample of approximately 200 subjects from the community at each of the three campuses. The final sample consisted of 57 volunteer participants— 46 from the internal community of interest and 11 from the external community of interest. The final sample fell short of the intended sample due, in part, to the time frame (summer) that was available to the researchers for data collection. The final sample was composed of 43 women and
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14 men; 53 were White, and 4 were African American. The participants were between 20 and 60 years old, and their educational level ranged from high school through doctoral study: 8 were high school graduates, 17 had baccalaureate degrees, 18 held master’s degrees, and 14 held doctoral degrees. The external community of interest included one United States congressman, three mayors, one chief executive officer (CEO) of an area hospital, one vice-president for nursing, and one parent and one spouse of nursing students. INSTRUMENT
A self-developed interview protocol was used to elicit selected demographic information on the respondent and his or her organization. Four categories of questions informed the creation of the data-collection instrument. These addressed the competencies that Barrett and others outlined in their description of appreciative inquiry (Barrett & Cooperrider, 1990; Farrell et al., 2002; George et al., 2002). 1. The best of the past: “What parts of the historical past would you want to keep alive and bring forward into the present?” 2. Visioning: “Given this historical past you would want to bring forward, what would be your vision of the college for the future?” 3. Putting the vision into operation: “Given the elements you wish to preserve from the past, and given this cocreated vision for the future you have just described, how would you put that vision into practice? What specifically would the college have to do to realize that vision?” 4. Community’s role: “You have identified the parts of the past you wish to preserve. You have cocreated a vision for the college, and you have described ways the vision can be put into practice. Given all this, what is your part in this process? What would be your or your organization’s role to realize the vision?” To address the validity of the data-collection instrument, the protocol was sent to three experts in community assessment and studies related to the investigation of stakeholder analyses and communities of interest. The three experts determined face and content validity, made revisions, and indicated that, overall, the instrument fulfilled its purpose, and the questions were relevant and appropriate to the purpose of
the study. The final code book also received approval by the three experts. Initially, the investigators coscored a pilot focus group until they agreed on the mapping scheme for the code book. Then they trained seven coders to use the final revision of the code book. The investigators determined the reliability of the data-collection instrument using percentages of agreement. An intercoder reliability for percentage of agreement of 0.86 was achieved. The protocol was easily coded and scored. Attitude was assessed with ranges from “negative” and “neutral” to “good” and “very good.” If a respondent used no adjective to describe an element, a score of 3 was assigned. If the respondent used “good” or “very good” to describe an element, scores of 4 and 5, respectively, were assigned. Codes were also assigned to characteristics, roles, and the organizational system.
Procedures
The USM’s Internal Review Board approved the study protocol, after which the researchers conducted a pilot study to test the data-collection instrument and the methods and procedures surrounding the collection of data. In addition to computing intercoder reliability, the research team revised the transcript format to ensure ease of coding and interpretation and changed the audio recording devices to ensure full accountability of all voices during the focus-group sessions. After repeated revisions and input of the content-analysis expert (the third investigator) and a statistician, the final qualitative coding of the pilot was conducted. The administrator in the College of Nursing telephoned approximately 200 randomly selected, potential study participants, provided information about the study, and extended invitations to participate. Upon acceptance of the invitation, study participants determined the time and place of the interview or focus group, and these arrangements were coordinated with the research team. Two of the three investigators conducted the oneon-one interview and focus groups. Each team included a faculty member and a staff member. During the one-hour sessions, the investigator conducted the interviews or focus groups, and the administrator welcomed the study participants, distributed and collected the demographic information forms, and kept watch over the time, the functioning of the tape recorder, and the physical aspects of the room.
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Results
Immediately after the data-collection sessions, the staff member of the research team transcribed the interview, matching persons with the comments made during the session. The statistician entered the data into SPSS for Windows (Chicago, IL), and the data for the qualitative analysis was documented in transcripts that were then mapped to the conceptual framework. The investigators used quantitative and qualitative methods to analyze the data. The quantitative data showed the frequency with which the respondents identified the various elements of the conceptual framework. The investigators then used content analysis to map the elements and the respondents’ attitudes toward those elements in the framework and analyzed the data according to the four steps of appreciative inquiry. The Best of the Past
The first question respondents addressed dealt with the historical past of the college and their relationship to it. Specifically, they were asked about the parts of the past that they would want to bring forward into the present. Overall, both the internal- and external-community respondents expected the college to preserve its premier role as a leader, within both the university community and the greater community, particularly in relation to the issue of diversity. They saw both the faculty and the alumni maintaining this tradition. In addition, both wished the college to maintain its coordination role in the community and in the practice area. On the quantitative assessment, the range of possible scores fell between 1 and 5. On this question, the lowest mean score was 3 and the highest 5, with a modal score of 4. The community saw faculty assuming the roles of counselor, leader, and recruiter, students as recruiters, and the college as the deliverer of knowledge and understanding, maintaining itself as a place for teaching and learning. Attitudes. The attitudes of the respondents were analyzed as “negative,” “neutral,” “positive,” or “very positive” and reported as a percentage of total responses. Positive or very positive attitudes (100 percent) were expressed about the history of the college as a place for understanding and diversity, as a leader, and as a place for mentoring. The100-percent positive or very positive attitudes were expressed toward the faculty as counselors and as supporters of diversity. Students were also seen historically as agents of change and
supporters of diversity. Alumni were also seen very positively as promoters of diversity. Respondents viewed as positive the recruitment efforts that occurred during entry to the program. The only negative attitudes related to the historical past of the college concerned practice (22.2 percent) and educational resources (12.5 percent). Respondents noted the past for its close-knit relationships among the faculty. Words and phrases used included “caring,” “work as a team,” “studentfriendly attitudes,” and “cohesiveness among faculty.” Doctoral students underscored the personal touch faculty used to mentor them and sustain relationships of substance. Faculty members were remembered as those “who listened to me, who challenged me to stretch myself, to become an independent learner, to increase my self-confidence.” The politicians and community leaders included a U.S. congressman, three mayors, a hospital CEO, a vice-president for nursing, a parent, and a spouse of nursing students. They noted the past reputation of the college and its relationships with the health care community. The CEO noted the historical role of the college as preparing “a well-trained graduate” and as an opportunity for his employees to obtain advanced degrees. University faculty, as members of the internal community of interest, wanted to retain the college’s excellent reputation and its interaction with other colleges and departments on campus. Visioning
The second study question, building on the first, asked, “Given this historical past you would want to bring forward, what would be your vision of the college for the future?” The internal- and external-community respondents overwhelmingly saw the college as a leader in the university community. This was the only comment receiving a rating of 5. As with the past, the respondents saw the college as leading in understanding, the analysis and synthesis of knowledge, management skills in the practice area, and, with its alumni, the promotion of diversity. The college as an educational institution that promoted diversity was also part of the vision for the future. Attitudes. Study participants’ attitudes about the vision of the college were positive (100 percent) for promoting knowledge, understanding, and analysis of theory. For 100 percent of respondents, the college as a university leader was seen as very positive as were its alumni for promoting diversity. All respondents saw the college in the future in a very positive way as an organizational system supporting the disciplinary prac-
EXPLORING A COLLEGE’S COMMUNITY OF INTEREST
tice of nursing, an element seen as negative in the college’s historical past. Again, negative future expectations of the college were related to resources (21 percent) and issues concerning the progression of students through the program (20 percent). The environment played a large role in the vision of doctoral students. They called for a light, warm, comfortable, climate-controlled teaching/ learning environment with state-of-the-art equipment and accessible library resources. They saw positive attitudes and characterized the faculty as nurturing people working in cooperative relationships. The politicians and community leaders saw the college in the future as providing community service, as ensuring upward mobility for community-college graduates, and as recruiting men and other minorities into the discipline. The CEO’s vision was broad, yet detailed. Overall, he envisioned a new image for nursing and for marketing nursing to be more visible in the community and schools. He saw the college as a seamless mechanism for higher education for a variety of learners. He underscored the role of the college in elementary and high schools and noted the need to recruit early a diverse student body that would sustain a passion for clinical work. Nonnursing university faculty saw the future of the college as part of the university rather than part of a medical center. Their vision for the student of nursing was both to know nursing and to be a well-rounded, educated graduate with a liberal-arts background and a solid foundation in biology and biochemistry. A spouse and member of the external community of interest saw the future with nursing redefined, with the baccalaureate as the entry level of preparation, more nurse practitioner programs, more nurses with doctoral degrees, and a greater number serving in nursing leadership roles. A parent and a member of the external community wished to sustain the college’s good relationships with the area’s hospitals, its national excellent reputation, its well-rounded curriculum, and its high-quality staff and instructors, all experts in their respective fields. Putting the Vision into Practice
The third question, building on the first two, was, “Given the elements you wish to preserve from the past, and given this co-created vision for the future you have just described, how would you put that vision into practice? What specifically would the college have to do to realize that vision?” Again, the respondents provided a wide range of
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actions that addressed each element in the conceptual framework. The greatest frequency of responses focused on harnessing the large alumni body and actively using the alumni as mentors, leaders, and promoters of diversity; strengthening the organization of the college to promote a strong educational environment and its reputation; and focusing on faculty in counseling roles and as leaders in the university community. Although they shared this vision for the college, students differed somewhat when it came to putting the vision into operation. For example, graduate students envisioned more time with their mentors, but faculty identified the physical environment and the resources required to enable them to serve as better mentors. These factors included smart classrooms, conference rooms for small meetings, and enhanced hours for the learning resource center. Students underscored a vision of the college as one with such an excellent reputation that many would want to attend. They saw the community knowing who they were and what they were doing, and they saw themselves showing the community “the possibilities of nursing practice.” Doctoral students called for faculty who practice as well as teach: “people who walk the talk.” This quality was essential, they said, to ensure that practice and theory are not separate. Doctoral students envisioned faculty members who create enthusiasm and are visible, available, and professional. These faculty members interact with students so that true discussion occurs, disagreement is welcomed, and honest give-and-take occurs with collegiality and openness. The politician and the community leaders called for greater community involvement, particularly with vulnerable groups and in K–12 schools, and with recruiting efforts that raise consciousness among young people regarding nursing as a career. Attitudes. The ways in which respondents described putting vision into practice varied, but their attitudes were consistent with earlier views. They saw the college as focusing on its reputation (80 percent), its faculty as counselors (100 percent), and its actions to ensure its historical role as a leader in the university (95 percent). Faculty respondents underscored the need for generating excitement for learning, being with students, and learning together, and for minimizing negativity in the college community. Students saw the vision being put into operation through research, public policy, and the demonstration of leadership. They saw the vision being realized through the development of a passion for nursing and through consciousness-raising about what they as students need to get from the program.
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The hospital CEO suggested that a dialogue between faculty and clinicians/practicing nurses be initiated to strengthen the bonds between education and practice, to sustain morale, interest and, motivation, and to “regain excitement and joy in this work—to reawaken the passion for care and reduce compassion fatigue.” Nonnursing, university faculty want to work collaboratively with student and faculty in nursing. Specifically, they envision collaborating on research, attending conferences together, and writing together, especially at the graduate level. A spouse and member of the external community of interest indicated that the way forward was to strengthen community-based projects and time spent in the community. The parent underscored the quality of interactions and the state of the physical environment: “The building would be perfect; equipment with technology and computers, multimedia, lots of space with nice offices for faculty, research labs, a faculty lounge, and places where students and faculty members are interacting, talking, communicating.” The Community’s Role
The final statement and question to the respondents were, “You have identified the parts of the past you wish to preserve. You have cocreated a vision for the college, and you have described ways the vision can be put into practice. Given all this, what is your part in this process? What would be your or your organization’s role to realize the vision?” As with the others, these questions prompted a range of elements mapped to the conceptual framework. Respondents saw themselves as active community representatives—students and alumni serving as recruiters, promoting the educational reputation of the college, and providing support as agents of change, mentors, and leaders. Students saw themselves as assuming the roles of writers, researchers, productive members of society, and ambassadors of the college. Doctoral students saw themselves as contributing through their commitment and dedication to learning, by conducting research with faculty, by serving as ambassadors to enhance the college’s public image, and by sharing with others “what [they] have been privileged to learn.” Attitudes. Participants saw their roles positively or very positively as agents of change in the community, particularly as promoters of diversity, mentors in the college, and recruiters for the program (85.7 percent). Again, faculty maintained a positive attitude. They saw themselves engaged in research along with their stu-
dents and able to provide their students with the full scope of nursing practice. They saw themselves as instilling professionalism and being facilitators of learning who show respect for their students and others. The politicians and community leaders saw the college as becoming synonymous with nursing: “When you think of USM, you think of nurses.” They saw themselves as taking on a supportive role by acting as brokers between the college and sources of political support and funding, and for facilitating the college in becoming part of the city’s “Strategic Plan for Improvement.” One mayor, convinced that “legislation is everything” saw himself as “fighting for funding for nursing education and maintaining relationships with senators and representatives to interpret the needs of USM and the CON.” The hospital CEO saw himself as forming an advisory group, initiating leadership training, sign-on bonuses, and other benefits to make the workplace an attractive environment for recruiting and keeping nurses. Nonnursing university faculty saw themselves as teaching nursing students and bringing graduate students into some of their courses. They saw themselves as sitting on master’s and doctoral thesis committees and designing and teaching classes with nursing faculty members. A spouse who was a member of the external community (and a provider in a mental health facility) saw himself as inviting students to his institution for clinical experiences and preceptorships. The parent of a nursing student saw herself involved in public relations, recruiting volunteers, and identifying people willing to donate their time to the college.
Discussion
In mapping the elements identified by respondents, the major points of emphasis appear to be the faculty and the roles they play in relation to students and the community. These roles are teacher, mentor, agent of change, and leader. Other areas often identified by both the internal and external communities relate to the roles alumni, politicians, and community leaders can play to strengthen the college. Within the organizational area of the framework, faculty and their contributions to the college’s atmosphere and to student learning appear paramount. The environment and the curriculum were also prominent, as were the state of technology and the resources for teaching and learning. Less visible was the administration of the college. Overall, responses of the study’s participants were
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enthusiastic and supportive, and they voiced a wide range of expectations for the college. They expected a great deal of the college, its faculty, and themselves. They emphasized the quality of the environment, using descriptions related to light, sunshine, friendliness, and concern. Most wished for faculty who were well prepared in theory and practice, related well to students, mentored them, provided strong research support, and spent time and interacted with them in a collegial and respectful manner. They wished to see an environment for faculty that provided ample space to park, prepare their classes, meet with students, conduct their research, and facilitate their teaching with state-of-theart technology and equipment. The environment was prominent as the context in which teaching, mentoring, and learning could take place. Almost all respondents noted the relationship between the college and the community, particularly the college’s excellent reputation, its ability to graduate well-prepared nurses, and its roles as leader, mentor, and agent of change in the university and community. Many called for greater involvement of the college in the lives of young people in the community, particularly students from minority backgrounds. They also called for greater collaboration at the university level, both in teaching and in working interdepartmentally with nursing students. Overall, all those interviewed and all who participated in the focus groups wanted to be linked to the college in some way. They were proud of the college’s
history and wanted to preserve many features of its past. They shared their vision for the college within a larger picture of nursing internationally, nationally, in the community, and in the individual health care facility. Not surprisingly, the major strength of the college appears to be its faculty and the faculty’s ability to provide an educational program that prepares graduates well for practice. The college as an organization needs to strengthen its practice focus through outreach to the community and its vulnerable populations. The internal and external communities of interest saw themselves as active participants in keeping the college’s history and reputation alive as a leader in the university and the community—a premier institution with an outstanding reputation for its attention to diversity and quality education. The respondents saw themselves as supporters of the college: a place to come to in the future, educate their children and grandchildren, and look to for quality and excellence in nursing education. Acknowledgments We thank Ms Lenell Ford, Administrative Assistant to the Dean, University of Southern Mississippi College of Nursing, Hattiesburg, who provided administrative and technical assistance to this project; Ms. Julie Ford for her painstaking data entry; Dr. J. T. Johnson for conducting statistical analysis and assistance in interpretation of data; Drs. Mary Coyne and Kandy Smith, who ensured data collection on the Gulf Coast campus of the USM; and Dr. Luann Daggett for ensuring data collection on the Meridian campus.
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(2002). Trust through feedback to the chief nurse executive: Preliminary results of a pilot study to evaluate performance competence. Nursing Administration Quarterly, 26(3), 26-33. George, V., Farrell, M., & Brukwitzki, G. (2002). Performance competencies of the chief nurse executive in an organized delivery system. Nursing Administrative Quarterly, 26(3), 34-43. Kerlinger, F.N. (1978). Behavioral research: A conceptual approach). Philadelphia: Holt, Rinehart and Winston. Lindeman, C.A. (2000). The future of nursing education. Journal of Nursing Education, 39, 5-12. Neuendorf, K.A. (2002). The Content Analysis Guidebook). London: Sage.
This study examined what the Commission on Collegiate Nursing Education identifies as a college of nursing’s internal and external “community of interest.” Using “appreciative inquiry” in this study of a college campus, we examined the parts of the historical past that the community believed should be maintained, its vision of excellence for the college, the ways in which the vision could be realized, and its part in fulfilling the expectations of a shared, co-created vision. Investigators collected data using a self-developed, one-on-one interview and focus-group format and analyzed the data using content analysis. The findings suggest that the community shared values of preserving the college’s past and of its vision for the college’s future. However, it differed in the means of putting its cocreated vision into practice and in defining its contributions in realizing the vision it created for the college. (Index words: Commission on Collegiate Nursing Education (CCNE); College of nursing; Internal community of interest; External community of interest; Appreciative inquiry) J Prof Nurs 19:364-371, 2003. © 2003 Elsevier Inc. All rights reserved.
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OLLEGES OF NURSING in the United States answer to many stakeholders. A college of nursing’s graduates provide health care services at a community’s hospitals, visiting nurses’ associations, home health agencies, schools, prisons, local health departments, and physicians’ group practices. They also provide community services through their own private entrepreneurial practices and conduct research through colleges in their own or other universities. Each of these institutions and organizations constitutes a college’s
*Dean and Professor of Nursing, University of Southern Mississippi College of Nursing, Hattiesburg, MS. †Assistant Professor of Nursing, University of Southern Mississippi College of Nursing, Hattiesburg, MS. ‡Assistant Provost for Institutional Research, University of Southern Mississippi, Hattiesburg, MS. Address correspondence and reprint requests to Dr. Farrell: University of Southern Mississippi College of Nursing, Box 5095, Hattiesburg, MS 39406. © 2003 Elsevier Inc. All rights reserved. 8755-7223/03/1906-0000$30.00/0 doi:10.1016/S8755-7223(03)00129-7 364
“community of interest” (AACN, 2003) and is linked to the college in a variety of formal and informal ways, all with a stake in the college’s ability to help maintain a high level of community health. Yet little is known of this community, and few efforts have been made to explore the ways in which it might assist a college in expanding its vision for the future, putting the vision into practice, and identifying ways in which it might contribute to the realization of a shared, cocreated vision. The purpose of this study was to examine a college community at a state university. To meet this purpose, a team of faculty, students, and administrative staff met with its internal and external community to use “appreciative inquiry,” an innovative approach to organizational assessment (Barrett & Cooperrider, 1990; Farrell, George, Brukwitzki, & Burke, 2002; George, Farrell, & Brukwitzki, 2002). Appreciative inquiry invites participants to identify the parts of the historical past that the community believes should be maintained, to articulate its vision of excellence for the college and the ways in which the vision can be realized, and to identify its part in fulfilling the expectations of a shared, cocreated vision. A college must meet criteria that address national, state, regional, and local expectations. In addition, colleges are accountable to their stakeholders—those in the college and university community and those external to it. The support and feedback from stakeholders are critical components that ensure the viability and relevance of a nursing program. Students develop impressions and perceptions of a college that influence their application, progression, and eventual graduation from its program. Families have a stake in the college because they cover the financial costs of the educational experience and often pay the costs of having an adult away from home who is not contributing to the family during school periods. Colleges, like other enterprises, interact with several cultures, each having its own perceptions and expectations that influence its responsiveness and willingness
Journal of Professional Nursing, Vol 19, No 6 (November–December), 2003: pp 364-371
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to partner with the college as it addresses its strategic objectives. For example, a college might have an international component in its strategic plan and needs the collaboration of the university’s international program. That program administrator’s view of the viability of the college is critical to the successful bid for partnering with that international program. In addition to these factors, the external community is the focus of a college’s nursing curriculum, and this community must have a voice in the nature and extent of services that the nursing program is expected to offer. These expectations, in turn, affect the willingness of the community to support the college’s program and hire its graduates. In this regard, the college seeks to validate itself through its query of the community it ultimately intends to serve (Lindeman, 2000). This study is significant for several reasons. In Mississippi, an extensive community-college system produces hundreds of graduates each year, many of whom expect to continue their education through the state college system that offers baccalaureate and higher degrees in nursing. Because many graduates live and plan to work in the state, they look to a reasonably affordable state university in their areas to realize their career aspirations. The College of Nursing of the University of Southern Mississippi (USM) is the largest statefunded nursing program in southern Mississippi and is the recipient for the community-college feeder schools in the southern part of the state. The CON is also the educator of nurses for health care organizations, with 80 contracting partners.
Conceptual Framework
Nursing is a dynamic discipline that changes as the society it serves changes, and it is defined as the diagnosis and treatment of the human response to health and health care conditions. Nursing is a scholar-practitioner professional discipline of discovery teaching and integration (American Association of Colleges of Nursing, 1999) and includes theory and practice components. It is a part of society and also owned by society because it “acquires recognition, relevance, and meaning in terms of its relationship to the society, its culture and institutions and its other members” (Lindeman, 2000). Society is a stakeholder in the preparation, formal approval of, and users of professional nursing. Specifically, these stakeholders are considered an external community of interest and an internal community of interest. The external community of interest includes
individuals and groups that influence or participate in the nursing education program to ensure the achievement of its expected results. Example of external groups include prospective students and their families, organizations of professional nurses and nurse educators, employers, legislators, health care providers, volunteer organizations, and consumers. The internal community is made up of institutionally based individuals and groups that include university and college-ofnursing administration, faculty and students, and groups that govern the activities of faculty and students (AACN Accreditation). Those who hire or work with practicing nurses, or who are cared for by them, perceive the educational system that prepared the nurse. These users hold particular attitudes about both the practicing nurse and the educational system, and they express these views about characteristics, roles, and the organizational system. These attitudes can be described in terms of the profession, specifically its preparation, its requirements for practice, and its practice. Attitudes are expressed relating to the education of the nurse, his or her practice, and the functions she or he carries out. The system of nursing education in this framework includes nursing education, entry to practice, and nursing practice.
Operational Definitions
The investigators developed a “code book” that defined and numbered the characteristics of community members, the roles played, the components of the organizational system, and attitudes. For the purposes of this study, the following operational definitions were used: 1. Attitude is a propensity for a particular view or sentiment and is assessed by using ratings from low (1) to high (5). 2. Characteristics of faculty/students consist of (a) their education, specifically their knowledge, understanding, and competencies in analysis and synthesis; (b) their practice, specifically their knowledge and practice of theory, management skills, standards of practice, code of ethics, and observation of disciplinary principles; and (c) their functioning as nurses, specifically their competence in providing direct care, teaching/learning, coordination of and ensuring referral, and participation in research.
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3. Roles are the performers and the characterizations of the behaviors carried out. Specifically, performers can include the community, university, college, nursing faculty, administration, students, and alumni. The roles assumed include agent of change, mentor, counselor, leader, ambassador, recruiter, and role model for diversity. 4. The nursing educational organizational system addresses the needs of society in its curriculum and provides learning experiences for students within that society. The system includes nursing education, entry to practice, and nursing practice. a. Nursing education in this study is made up of the components students experience as they progress through the system, specifically: admission, progression through the curriculum and program, faculty, resources, interactions and relationships, physical environment, and reputation of the program. b. Entry to practice is defined as preparing for and successfully meeting the requirements of the educational program and the practice of professional nursing in the workplace. Entry to practice begins with the receipt of the college diploma and ends with the successful completion of the National Council Licensure Examination and fulfillment of the state requirements for professional practice. c. Nursing practice is defined as being engaged in the diagnosis and treatment of the human response to health and health care conditions, using nursing and related theory, managing client care, and applying codes of ethics and practice (Farrell, 1987).
(4) “What part does a community perceive itself playing to actualize the co-created vision of a college of nursing?” Assumptions and Limitations
In this study, it was assumed that the respondents would represent the community and the college and that its members would answer truthfully and honestly. The study acknowledges three limitations. First, the study sample was limited to stakeholders who were available at the time of the interviews and might not include people whose working schedules prevented their participation. Second, the study’s data collection period was limited to one event and might not represent views held over a long period of time. Third, the study was limited to one-on-one interviews and focus groups with members of the research team, and this structure might have constricted the openness with which the respondents discussed their interests and views. Methods SETTING
The setting for the study was the integrated campus of the USM, specifically the campuses in Hattiesburg, Meridian, and the Gulf Coast. Data were collected between June and August 2002. DESIGN
The research design consisted of either a one-time, one-on-one interview between the research team and the interviewee, or a single, focus-group event between the research team and representatives of a stakeholder group from the community (Kerlinger, 1978). SAMPLE
Study Questions
The main study question was “In what ways does a college of nursing contribute to the health and excellence of the community it serves as perceived by its internal and external community?” Specifically, four subquestions were asked: (1) “What does the college mean to its community relative to its shared historical past?” (2) “What is the vision the community shares for the college?” (3) “In what ways does the community perceive its cocreated vision being put into practice?”
The administrator of the college telephoned each element of the intended, stratified, random sample of approximately 200 subjects from the community at each of the three campuses. The final sample consisted of 57 volunteer participants— 46 from the internal community of interest and 11 from the external community of interest. The final sample fell short of the intended sample due, in part, to the time frame (summer) that was available to the researchers for data collection. The final sample was composed of 43 women and
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14 men; 53 were White, and 4 were African American. The participants were between 20 and 60 years old, and their educational level ranged from high school through doctoral study: 8 were high school graduates, 17 had baccalaureate degrees, 18 held master’s degrees, and 14 held doctoral degrees. The external community of interest included one United States congressman, three mayors, one chief executive officer (CEO) of an area hospital, one vice-president for nursing, and one parent and one spouse of nursing students. INSTRUMENT
A self-developed interview protocol was used to elicit selected demographic information on the respondent and his or her organization. Four categories of questions informed the creation of the data-collection instrument. These addressed the competencies that Barrett and others outlined in their description of appreciative inquiry (Barrett & Cooperrider, 1990; Farrell et al., 2002; George et al., 2002). 1. The best of the past: “What parts of the historical past would you want to keep alive and bring forward into the present?” 2. Visioning: “Given this historical past you would want to bring forward, what would be your vision of the college for the future?” 3. Putting the vision into operation: “Given the elements you wish to preserve from the past, and given this cocreated vision for the future you have just described, how would you put that vision into practice? What specifically would the college have to do to realize that vision?” 4. Community’s role: “You have identified the parts of the past you wish to preserve. You have cocreated a vision for the college, and you have described ways the vision can be put into practice. Given all this, what is your part in this process? What would be your or your organization’s role to realize the vision?” To address the validity of the data-collection instrument, the protocol was sent to three experts in community assessment and studies related to the investigation of stakeholder analyses and communities of interest. The three experts determined face and content validity, made revisions, and indicated that, overall, the instrument fulfilled its purpose, and the questions were relevant and appropriate to the purpose of
the study. The final code book also received approval by the three experts. Initially, the investigators coscored a pilot focus group until they agreed on the mapping scheme for the code book. Then they trained seven coders to use the final revision of the code book. The investigators determined the reliability of the data-collection instrument using percentages of agreement. An intercoder reliability for percentage of agreement of 0.86 was achieved. The protocol was easily coded and scored. Attitude was assessed with ranges from “negative” and “neutral” to “good” and “very good.” If a respondent used no adjective to describe an element, a score of 3 was assigned. If the respondent used “good” or “very good” to describe an element, scores of 4 and 5, respectively, were assigned. Codes were also assigned to characteristics, roles, and the organizational system.
Procedures
The USM’s Internal Review Board approved the study protocol, after which the researchers conducted a pilot study to test the data-collection instrument and the methods and procedures surrounding the collection of data. In addition to computing intercoder reliability, the research team revised the transcript format to ensure ease of coding and interpretation and changed the audio recording devices to ensure full accountability of all voices during the focus-group sessions. After repeated revisions and input of the content-analysis expert (the third investigator) and a statistician, the final qualitative coding of the pilot was conducted. The administrator in the College of Nursing telephoned approximately 200 randomly selected, potential study participants, provided information about the study, and extended invitations to participate. Upon acceptance of the invitation, study participants determined the time and place of the interview or focus group, and these arrangements were coordinated with the research team. Two of the three investigators conducted the oneon-one interview and focus groups. Each team included a faculty member and a staff member. During the one-hour sessions, the investigator conducted the interviews or focus groups, and the administrator welcomed the study participants, distributed and collected the demographic information forms, and kept watch over the time, the functioning of the tape recorder, and the physical aspects of the room.
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Results
Immediately after the data-collection sessions, the staff member of the research team transcribed the interview, matching persons with the comments made during the session. The statistician entered the data into SPSS for Windows (Chicago, IL), and the data for the qualitative analysis was documented in transcripts that were then mapped to the conceptual framework. The investigators used quantitative and qualitative methods to analyze the data. The quantitative data showed the frequency with which the respondents identified the various elements of the conceptual framework. The investigators then used content analysis to map the elements and the respondents’ attitudes toward those elements in the framework and analyzed the data according to the four steps of appreciative inquiry. The Best of the Past
The first question respondents addressed dealt with the historical past of the college and their relationship to it. Specifically, they were asked about the parts of the past that they would want to bring forward into the present. Overall, both the internal- and external-community respondents expected the college to preserve its premier role as a leader, within both the university community and the greater community, particularly in relation to the issue of diversity. They saw both the faculty and the alumni maintaining this tradition. In addition, both wished the college to maintain its coordination role in the community and in the practice area. On the quantitative assessment, the range of possible scores fell between 1 and 5. On this question, the lowest mean score was 3 and the highest 5, with a modal score of 4. The community saw faculty assuming the roles of counselor, leader, and recruiter, students as recruiters, and the college as the deliverer of knowledge and understanding, maintaining itself as a place for teaching and learning. Attitudes. The attitudes of the respondents were analyzed as “negative,” “neutral,” “positive,” or “very positive” and reported as a percentage of total responses. Positive or very positive attitudes (100 percent) were expressed about the history of the college as a place for understanding and diversity, as a leader, and as a place for mentoring. The100-percent positive or very positive attitudes were expressed toward the faculty as counselors and as supporters of diversity. Students were also seen historically as agents of change and
supporters of diversity. Alumni were also seen very positively as promoters of diversity. Respondents viewed as positive the recruitment efforts that occurred during entry to the program. The only negative attitudes related to the historical past of the college concerned practice (22.2 percent) and educational resources (12.5 percent). Respondents noted the past for its close-knit relationships among the faculty. Words and phrases used included “caring,” “work as a team,” “studentfriendly attitudes,” and “cohesiveness among faculty.” Doctoral students underscored the personal touch faculty used to mentor them and sustain relationships of substance. Faculty members were remembered as those “who listened to me, who challenged me to stretch myself, to become an independent learner, to increase my self-confidence.” The politicians and community leaders included a U.S. congressman, three mayors, a hospital CEO, a vice-president for nursing, a parent, and a spouse of nursing students. They noted the past reputation of the college and its relationships with the health care community. The CEO noted the historical role of the college as preparing “a well-trained graduate” and as an opportunity for his employees to obtain advanced degrees. University faculty, as members of the internal community of interest, wanted to retain the college’s excellent reputation and its interaction with other colleges and departments on campus. Visioning
The second study question, building on the first, asked, “Given this historical past you would want to bring forward, what would be your vision of the college for the future?” The internal- and external-community respondents overwhelmingly saw the college as a leader in the university community. This was the only comment receiving a rating of 5. As with the past, the respondents saw the college as leading in understanding, the analysis and synthesis of knowledge, management skills in the practice area, and, with its alumni, the promotion of diversity. The college as an educational institution that promoted diversity was also part of the vision for the future. Attitudes. Study participants’ attitudes about the vision of the college were positive (100 percent) for promoting knowledge, understanding, and analysis of theory. For 100 percent of respondents, the college as a university leader was seen as very positive as were its alumni for promoting diversity. All respondents saw the college in the future in a very positive way as an organizational system supporting the disciplinary prac-
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tice of nursing, an element seen as negative in the college’s historical past. Again, negative future expectations of the college were related to resources (21 percent) and issues concerning the progression of students through the program (20 percent). The environment played a large role in the vision of doctoral students. They called for a light, warm, comfortable, climate-controlled teaching/ learning environment with state-of-the-art equipment and accessible library resources. They saw positive attitudes and characterized the faculty as nurturing people working in cooperative relationships. The politicians and community leaders saw the college in the future as providing community service, as ensuring upward mobility for community-college graduates, and as recruiting men and other minorities into the discipline. The CEO’s vision was broad, yet detailed. Overall, he envisioned a new image for nursing and for marketing nursing to be more visible in the community and schools. He saw the college as a seamless mechanism for higher education for a variety of learners. He underscored the role of the college in elementary and high schools and noted the need to recruit early a diverse student body that would sustain a passion for clinical work. Nonnursing university faculty saw the future of the college as part of the university rather than part of a medical center. Their vision for the student of nursing was both to know nursing and to be a well-rounded, educated graduate with a liberal-arts background and a solid foundation in biology and biochemistry. A spouse and member of the external community of interest saw the future with nursing redefined, with the baccalaureate as the entry level of preparation, more nurse practitioner programs, more nurses with doctoral degrees, and a greater number serving in nursing leadership roles. A parent and a member of the external community wished to sustain the college’s good relationships with the area’s hospitals, its national excellent reputation, its well-rounded curriculum, and its high-quality staff and instructors, all experts in their respective fields. Putting the Vision into Practice
The third question, building on the first two, was, “Given the elements you wish to preserve from the past, and given this co-created vision for the future you have just described, how would you put that vision into practice? What specifically would the college have to do to realize that vision?” Again, the respondents provided a wide range of
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actions that addressed each element in the conceptual framework. The greatest frequency of responses focused on harnessing the large alumni body and actively using the alumni as mentors, leaders, and promoters of diversity; strengthening the organization of the college to promote a strong educational environment and its reputation; and focusing on faculty in counseling roles and as leaders in the university community. Although they shared this vision for the college, students differed somewhat when it came to putting the vision into operation. For example, graduate students envisioned more time with their mentors, but faculty identified the physical environment and the resources required to enable them to serve as better mentors. These factors included smart classrooms, conference rooms for small meetings, and enhanced hours for the learning resource center. Students underscored a vision of the college as one with such an excellent reputation that many would want to attend. They saw the community knowing who they were and what they were doing, and they saw themselves showing the community “the possibilities of nursing practice.” Doctoral students called for faculty who practice as well as teach: “people who walk the talk.” This quality was essential, they said, to ensure that practice and theory are not separate. Doctoral students envisioned faculty members who create enthusiasm and are visible, available, and professional. These faculty members interact with students so that true discussion occurs, disagreement is welcomed, and honest give-and-take occurs with collegiality and openness. The politician and the community leaders called for greater community involvement, particularly with vulnerable groups and in K–12 schools, and with recruiting efforts that raise consciousness among young people regarding nursing as a career. Attitudes. The ways in which respondents described putting vision into practice varied, but their attitudes were consistent with earlier views. They saw the college as focusing on its reputation (80 percent), its faculty as counselors (100 percent), and its actions to ensure its historical role as a leader in the university (95 percent). Faculty respondents underscored the need for generating excitement for learning, being with students, and learning together, and for minimizing negativity in the college community. Students saw the vision being put into operation through research, public policy, and the demonstration of leadership. They saw the vision being realized through the development of a passion for nursing and through consciousness-raising about what they as students need to get from the program.
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The hospital CEO suggested that a dialogue between faculty and clinicians/practicing nurses be initiated to strengthen the bonds between education and practice, to sustain morale, interest and, motivation, and to “regain excitement and joy in this work—to reawaken the passion for care and reduce compassion fatigue.” Nonnursing, university faculty want to work collaboratively with student and faculty in nursing. Specifically, they envision collaborating on research, attending conferences together, and writing together, especially at the graduate level. A spouse and member of the external community of interest indicated that the way forward was to strengthen community-based projects and time spent in the community. The parent underscored the quality of interactions and the state of the physical environment: “The building would be perfect; equipment with technology and computers, multimedia, lots of space with nice offices for faculty, research labs, a faculty lounge, and places where students and faculty members are interacting, talking, communicating.” The Community’s Role
The final statement and question to the respondents were, “You have identified the parts of the past you wish to preserve. You have cocreated a vision for the college, and you have described ways the vision can be put into practice. Given all this, what is your part in this process? What would be your or your organization’s role to realize the vision?” As with the others, these questions prompted a range of elements mapped to the conceptual framework. Respondents saw themselves as active community representatives—students and alumni serving as recruiters, promoting the educational reputation of the college, and providing support as agents of change, mentors, and leaders. Students saw themselves as assuming the roles of writers, researchers, productive members of society, and ambassadors of the college. Doctoral students saw themselves as contributing through their commitment and dedication to learning, by conducting research with faculty, by serving as ambassadors to enhance the college’s public image, and by sharing with others “what [they] have been privileged to learn.” Attitudes. Participants saw their roles positively or very positively as agents of change in the community, particularly as promoters of diversity, mentors in the college, and recruiters for the program (85.7 percent). Again, faculty maintained a positive attitude. They saw themselves engaged in research along with their stu-
dents and able to provide their students with the full scope of nursing practice. They saw themselves as instilling professionalism and being facilitators of learning who show respect for their students and others. The politicians and community leaders saw the college as becoming synonymous with nursing: “When you think of USM, you think of nurses.” They saw themselves as taking on a supportive role by acting as brokers between the college and sources of political support and funding, and for facilitating the college in becoming part of the city’s “Strategic Plan for Improvement.” One mayor, convinced that “legislation is everything” saw himself as “fighting for funding for nursing education and maintaining relationships with senators and representatives to interpret the needs of USM and the CON.” The hospital CEO saw himself as forming an advisory group, initiating leadership training, sign-on bonuses, and other benefits to make the workplace an attractive environment for recruiting and keeping nurses. Nonnursing university faculty saw themselves as teaching nursing students and bringing graduate students into some of their courses. They saw themselves as sitting on master’s and doctoral thesis committees and designing and teaching classes with nursing faculty members. A spouse who was a member of the external community (and a provider in a mental health facility) saw himself as inviting students to his institution for clinical experiences and preceptorships. The parent of a nursing student saw herself involved in public relations, recruiting volunteers, and identifying people willing to donate their time to the college.
Discussion
In mapping the elements identified by respondents, the major points of emphasis appear to be the faculty and the roles they play in relation to students and the community. These roles are teacher, mentor, agent of change, and leader. Other areas often identified by both the internal and external communities relate to the roles alumni, politicians, and community leaders can play to strengthen the college. Within the organizational area of the framework, faculty and their contributions to the college’s atmosphere and to student learning appear paramount. The environment and the curriculum were also prominent, as were the state of technology and the resources for teaching and learning. Less visible was the administration of the college. Overall, responses of the study’s participants were
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enthusiastic and supportive, and they voiced a wide range of expectations for the college. They expected a great deal of the college, its faculty, and themselves. They emphasized the quality of the environment, using descriptions related to light, sunshine, friendliness, and concern. Most wished for faculty who were well prepared in theory and practice, related well to students, mentored them, provided strong research support, and spent time and interacted with them in a collegial and respectful manner. They wished to see an environment for faculty that provided ample space to park, prepare their classes, meet with students, conduct their research, and facilitate their teaching with state-of-theart technology and equipment. The environment was prominent as the context in which teaching, mentoring, and learning could take place. Almost all respondents noted the relationship between the college and the community, particularly the college’s excellent reputation, its ability to graduate well-prepared nurses, and its roles as leader, mentor, and agent of change in the university and community. Many called for greater involvement of the college in the lives of young people in the community, particularly students from minority backgrounds. They also called for greater collaboration at the university level, both in teaching and in working interdepartmentally with nursing students. Overall, all those interviewed and all who participated in the focus groups wanted to be linked to the college in some way. They were proud of the college’s
history and wanted to preserve many features of its past. They shared their vision for the college within a larger picture of nursing internationally, nationally, in the community, and in the individual health care facility. Not surprisingly, the major strength of the college appears to be its faculty and the faculty’s ability to provide an educational program that prepares graduates well for practice. The college as an organization needs to strengthen its practice focus through outreach to the community and its vulnerable populations. The internal and external communities of interest saw themselves as active participants in keeping the college’s history and reputation alive as a leader in the university and the community—a premier institution with an outstanding reputation for its attention to diversity and quality education. The respondents saw themselves as supporters of the college: a place to come to in the future, educate their children and grandchildren, and look to for quality and excellence in nursing education. Acknowledgments We thank Ms Lenell Ford, Administrative Assistant to the Dean, University of Southern Mississippi College of Nursing, Hattiesburg, who provided administrative and technical assistance to this project; Ms. Julie Ford for her painstaking data entry; Dr. J. T. Johnson for conducting statistical analysis and assistance in interpretation of data; Drs. Mary Coyne and Kandy Smith, who ensured data collection on the Gulf Coast campus of the USM; and Dr. Luann Daggett for ensuring data collection on the Meridian campus.
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