FACULTY PROFILE TABLE Agency Information
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1 FACULTY PROFILE TABLE Agency Information Directions: Instructions for completing the Faculty Profile Table can be found at of Institution: Date Form Completed: of Nursing Education Unit: Agency of Agency Full- and Part-Time Faculty Requirements Directions: List the specific academic, licensure, practice/teaching, and/or other requirements (as applicable) for full and part-time faculty by agency and include the reference (link or location) where information can be verified. If requirements are not applicable for an agency, provide a brief explanation why. The program s state regulatory agency for nursing Other state agency (e.g., state department of education, state system, etc.) The program s governing organization The governing organization s accrediting agency
2 Qualifications of Full-Time Faculty Exclusive to [Insert program type] Nursing Program Directions: Complete requested information below for each full-time exclusive faculty member teaching at the time of the site visit. of degree/date of state/license number/ type/date acquired/
3 Qualifications of Part-Time Faculty Exclusive to [Insert program type] Nursing Program Directions: Complete requested information below for each part-time exclusive faculty member teaching at the time of the site visit. of degree/date of state/license number/ type/date acquired/
4 Qualifications of Full-Time Faculty Shared Teaching Responsibilities in More than One Nursing Program Directions: Complete requested information below for each full-time shared faculty member teaching at the time of the site visit. of degree/date of state/license number/ type/date acquired/
5 Qualifications of Part-Time Faculty Shared Teaching Responsibilities in More than One Nursing Program Directions: Complete requested information below for each part-time shared faculty member teaching at the time of the site visit. of degree/date of state/license number/ type/date acquired/
6 Qualifications of Non-Nurse Faculty Directions: Complete requested information below for all exclusive or shared non-nursing faculty and all full-time and part-time nonnurse faculty members teaching at the time of the site visit. Insert additional rows as needed. Each person listed here should also be included in the Qualification and Professional Development Full-time or Part-time Exclusive or Shared of degree/date of AREA OF EXPERTISE/ EXPERIENCE Area of expertise/experience Licensure/Certification (if applicable): type/number/date acquired/expiration date ASSIGNED NURSING COURSES Course: Prefix, Number, Role/Responsibilities
7 Qualifications and Professional Development Addendum Directions: Complete requested information below for each full- and part-time nursing and nonnursing faculty member currently teaching in the nursing program. Details should be relevant (1 2 pages per faculty member) to how the faculty member is qualified (or maintains qualifications) for their assigned nursing course(s). Faculty : List relevant: Area(s) of expertise and experience (e.g., medical-surgical, leadership, geriatrics) Clinical practice and/or teaching experience: (Job title/place of employment/start date/ending date/very brief summary of role responsibilities) Professional development and/or Scholarly work: (e.g., research, publications, presentations, etc.) for the last three (3) years (date/title/very brief summary)
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