Nurse Education, Practice, Quality and Retention - Transition to Practice Program - The Indiana State University School of Nursing (ISU SON) undergraduate tracks propose the S.T.R.E.N.G.T.H.E.N. project, which stands for Simulation innovation; Targeted assessments and instruction; Recruitment and retainment; Engagement with instructors, preceptors, and tutors; Non-traditional clinical placements; Guided pace and progression; Tailored competency-based learning pathways; Healthcare experience/credentials; Experiential learning; and Navigating MAHA integration. This initiative is designed to address critical nursing shortages and geographic maldistribution in rural and medically vulnerable communities by increasing the supply of a high-quality nursing workforce. The project specifically prepares students in the LPN-to-BSN, Traditional BSN, and Accelerated Second-Degree BSN tracks for practice in both traditional and nontraditional community-based settings. The project is structured around four core objectives aimed at enhancing student progression and clinical readiness. The first objective focuses on workforce pathways and competency-based education, prioritizing the recruitment and retention of individuals with prior healthcare experience, such as LPNs, EMTs, and CNAs. This competency-based education framework will organize content around instruction, assessment, and progression to provide individualized learning pathways. The second objective centers on nontraditional clinical partnerships, expanding the school's network to include schools, homeless shelters, nurse-led clinics, mobile health units and the like. Students will complete no less than 100 clinical hours in these settings, with no more than 50% simulation hours, emphasizing the Social Determinants of Health (SDOH) and Healthy People 2030 frameworks to address root causes of health disparities. The curriculum further prioritizes Make America Healthy Again (MAHA) goals (specifically chronic disease management, metabolic health, wellness, and nutrition) by integrating these priorities into simulations. To ensure the success of these initiatives, the third objective involves faculty and preceptor development, including mandatory training on the integration of innovative simulation technology and conducting evidence-backed debriefing. This training includes Avkin wearable simulators to facilitate realistic human interaction. The final objective expands experiential learning by the purchase and integration of these technologies. Avkin wearables will be utilized with live standardized patients to replace traditional manikins with technical realism to drive skill proficiency, clinical confidence, communication, and empathy. To support student success, the project allocates funding for direct student assistance in the form of stipends, alongside support from faculty, preceptors, tutors, and university systems. ISU SON undergraduate tracks project that 355 to 413 students with prior healthcare experience will be recruited and supported, with 144 receiving stipends, over the four-year performance period from 2026 to 2030. Program effectiveness will be monitored by successful student progression and data collection from the Skills-Based Training Evaluation Tool, Student Satisfaction and Self-Confidence in Learning survey, and post-graduation tracking using practice setting surveys (Casey-Fink Graduate Nurse Experience and Nurse Retention surveys) to evaluate practice readiness, workforce impact and practicing in rural areas that qualify as a medically underserved area/population. The combined information will enhance iterative curriculum enhancement for the ISU SON undergraduate tracks and provide quality trained registered nurses that will increase the workforce in rural and medically vulnerable areas.
