Request for Authorization to Implement: Clinical Nurse Specialist Adult/Gerontology Capstone Certificate

February 14, 2017 TO: FR: RE: Sarah C. Mangelsdorf, Provost and Vice Chancellor for Academic Affairs William Karpus, Dean, Graduate School Linda D. Scott, Dean, School of Nursing Request for Authorization to Implement: Clinical Nurse Specialist Adult/Gerontology Capstone Certificate I write to express my enthusiastic endorsement of this proposal to create the Clinical Nurse Specialist Adult/Gerontology Capstone Certificate offered by the School of Nursing. Attached please find the full program proposal, including the assessment plan, budget, and a letter of support from Beth Houlahan, DNP, RN, Chief Nurse Executive at UW Health. The proposed certificate is slated to launch fall 2017. This is an aggressive timeline but the school has been working closely with Academic Planning and Institutional Research, as well as with Marty Gustafson in Academic Planning and Assessment in the Graduate School, to prepare the proposal. We are eager to offer this certificate to meet an overall demand but particularly to help current Clinical Nurse Specialists (CNSs) pursue the formal education and certification necessary to support their title and role. CNSs are uniquely prepared and situated to positively impact health outcomes. They improve the health and well-being of patients, enhance the practice of nurses and nursing units, and improve the quality of health organizations and systems of care. There is a documented shortage of qualified CNSs in Wisconsin, with a current vacancy rate for CNS positions at 7.8%. This certificate will allow the School of Nursing to better address the needs of our partner organizations and the overarching workforce needs of the state. Pending your approval, I look forward to discussing this proposal with the Graduate Faculty Executive Committee and the University Academic Planning Committee. Sincerely, Linda D. Scott, PhD, RN, NEA-BC, FAAN Dean and Professor, School of Nursing CC: Pamela McGranahan, Clinical Assistant Professor, School of Nursing Karen Mittelstadt, Assistant Dean, Academic Affairs, School of Nursing Jocelyn Milner, Vice Provost and Director, Academic Planning and Institutional Research Marty Gustafson, Assistant Dean, Academic Planning and Assessment, Graduate School Jeff Russell, Vice Provost for Lifelong Learning, and Dean, Division of Continuing Studies Sarah Barber, Assistant Dean, Division of Continuing Studies School of Nursing University of Wisconsin Madison 701 Highland Avenue Madison, Wisconsin 53705

Implementation Form Capstone Certificates This form must accompany a capstone certificate proposal. An updated form should be submitted when changes to the certificate are made and when a certificate is reviewed. It is used by administrative offices to better assist departments and programs with implementation. Questions in this form reflect guidelines in the Full Guidelines for For-Credit Certificates, http://apir.wisc.edu/certificates.htm. Document Date: 2/12/17 Name of Capstone Certificate: Clinical Nurse Specialist Adult/Gerontology Capstone Certificate Faculty Program Director: Pamela A. McGranahan, Clinical Assistant Professor, DNP Program Director, pmcgranahan@wisc.edu Primary Faculty/Staff Contact: Karen Mittelstadt, Assistant Dean for Academic Affairs, mittelstadt@wisc.edu Home Department/Academic Unit (Name/UDDS): School of Nursing/A545000 Approval Date: 2/10/17 School/College: School of Nursing Approval Date: 2/10/17 GFEC Approval Date: UAPC Approval Date: Implementation Term (typically the fall term after UAPC approval): Fall 2017 Year that first program review is scheduled (usually 5 years after implementation) or year most recent program review completed: 2022 Information to be completed by RO and APIR: Plan Code (assigned by the Registrar s Office): CIP Code (assigned by Academic Planning and Institutional Research): Primary Divisional Disciplinary Assignment (assigned by APIR for analysis purposes only): Capstone Certificate Implementation Form 2/12/17 - Page 1 of 3

Curriculum (9-12cr) - List of required and elective courses and any other program requirements: Semester students will take the course Department Course Number Fall Nursing N726 Foundations for APN Clinical Practice I Fall Nursing N728 Advanced Practice Clinical Application and Role Development I Spring Nursing N727 Foundations for APN Clinical Practice II Spring Nursing N729 Advanced Practice Clinical Application and Role Development II Summer Nursing N702 Health Promotion/Illness Prevention in Diverse Communities Learning Goals: List 1 to 5 certificate learning goals: 1. Integrate nursing science with knowledge from the biophysical, psychosocial, analytical, and organizational sciences as the basis for advanced nursing practice in the CNS role. 2. Demonstrate advanced nursing knowledge of assessment and disease management in the adult-gerontological patient populations, including the use of pharmacologic and nonpharmacologic interventions to promote and maintain health. 3. Demonstrate advanced levels of clinical judgment, systems thinking, and professional accountability in designing, delivering, and evaluating evidence-based care to support positive patient outcomes and systems of care. 4. Strategically practice and demonstrate effectiveness within the three spheres of influence that comprise CNS practice: clients, nurses and nursing practice, and organizational systems of care. 5. Guide, mentor, and support other nurses to achieve excellence in clinical nursing practice. Projections for annual enrollment: 12 Course Title Credits Instructor Semester & year last taught 3 Endicott, Sarah FA16 3 Williams, Andrea FA16 3 Endicott, Sarah SP17 3 Williams, Andrea SP17 3 Lothe, Katie SP17 Specify overlap provisions name degree/major, minor or certificate programs that a student may have previously earned that disqualify them from being admitted to the capstone certificate program. None Capstone Certificate Implementation Form 2/12/17 - Page 2 of 3

Please answer the following: Yes No Confirm that the capstone certificate is open to only non-degree seeking University X Special students who hold a bachelor s degree. Confirm that all credits are required to be earned in residence at UW-Madison. X Will there be limits on number of students who can enroll? X If Yes, please explain: Confirm that all core/required courses are approved through the school/college X curriculum committee. Confirm that courses in curriculum are offered on a regular basis and have space for X students in this program. Confirm that required courses in the curriculum are numbered 300 or above. X Confirm that courses taken as Pass/Fail or Audit are not included in the curriculum. X Are courses taken Credit/No Credit allowed? X If yes, specify limits: Confirm that special topics courses are only used if all instances count for the certificate. X Confirm that, at a minimum, C grades must be earned on all course work attempted for X the capstone certificate program. (Only graduate-level work from the capstone that is earned with a grade of B or better is eligible for subsequent application to a UW-Madison graduate degree program.) If other requirements, please specify: Will exceptions to the course core requirements be allowed? X If yes, specify limits and process: Confirm that the program/department has a process in place to monitor student progress X and to notify the Registrar s Office when students complete the certificate requirements. Assessment plan confirm that the proposal includes a plan that describes how the X program faculty will regularly evaluate student learning. Confirm that the program/department understands that international students who must X request a UW-Madison-issued I-20 (for the F-1 student visa needed for legal study in the US) will only be eligible to participate in the program if it is offered full-time and if the program has been approved by the US government to receive such international students. If the program is offered entirely online or the international student is here legally on another visa (such as the JS, H, etc.) and an I-20 from UW-Madison is not needed, then this provision does not apply. Will this capstone certificate be implemented as a Fund 131 tuition program? If yes, has a budget been developed with the Division of Continuing Studies and the sponsoring school/college dean s office? Who is the appropriate school/college contact for questions? Karen Mittelstadt, Assistant Dean for Academic Affairs, mittelstadt@wisc.edu X X Capstone Certificate Implementation Form 2/12/17 - Page 3 of 3

INSTRUCTIONS FOR PROPOSING CAPSTONE CERTIFICATES and USE OF PROPOSAL FORM A Capstone certificate program is a designated set of for-credit courses focused upon a specific topic or theme that give students the opportunity to pursue a subject of interest in a formalized way that is documented on the transcript. Capstone certificates are designed to offer a focused educational experience in a format that is friendly to working professionals. The curriculum may represent a more practice oriented subset of an existing graduate discipline or field of study. PLANNING THE CAPSTONE CERTIFICATE Planning starts with idea development among the program faculty and staff. Begin to fill out the Capstone Certificate Proposal Form. When your ideas are starting to take shape, consult with your school/college dean s office. Non-pooled Capstone certificates should also contact the school/college budget officer. If you aren t sure who to talk to in your school/college dean s office or if you have questions and want to discuss your plans, contact Jocelyn Milner, Director of Academic Planning and Institutional Research. When you have a full draft of a completed Capstone Certificate Proposal Form, and ideally before school/college approval, send the proposal to Jocelyn Milner and Graduate School Assistant Dean Marty Gustafson for a check-in and proposal review. This will help make sure that the certificate meets all components of the UAPC guidelines and will identify any implementation questions. APPROVAL STEPS FOR CAPSTONE CERTIFICATES 1. The program faculty who are sponsoring the Capstone certificate program (most often the faculty or executive committee in a department) formally approve the certificate proposal. 2. The school/college that houses the certificate considers the certificate for approval, usually at the school/college Academic Planning Council. 3. After school/college approval, the dean forwards the proposal to the provost and the dean of the Graduate School with a copy to the director of Academic Planning and Institutional Research and the Graduate School Assistant Dean for Academic Planning and Assessment. 4. The Graduate Faculty Executive Committee considers the certificate for approval. 5. The provost will seek a recommendation for approval from the University Academic Planning Council. Faculty Discussion Certificate Proposal Discussion with School/College APC and campus colleagues Faculty Executive Committee Vote School/College APC Review & Vote GFEC Review & Vote UAPC Review & Vote Implementation FOR INFORMATION AND FORMS: http://apir.wisc.edu/certificates.htm At this URL you will find links to the following information: Detailed instructions and the Capstone Certificate Proposal Form Capstone Certificate Guidelines, which is the policy framework for the proposal form (adopted April 2013) Certificate Knowledge Base - The KB houses certificate forms and frequently asked questions. QUESTIONS: Sarah Kuba, Academic Planner, APIR (sarah.kuba@wisc.edu ) Jocelyn Milner, Director, Academic Planning and Institutional Research (jocelyn.milner@wisc.edu ) rev. 02.12.17 Page 1 of 10

PROPOSAL FORM CAPSTONE CERTIFICATE PROGRAMS Capstone certificates are available to University Special (non-degree seeking) students who hold a bachelor s degree or equivalent credential from an accredited college or university and are designed to offer a focused professionally oriented educational experience. This form is to be used in concert with the Capstone certificate guidelines. Complete the form and save as a Microsoft Word document. 1. Capstone certificate name and academic home 1.1. Capstone certificate name: Clinical Nurse Specialist Adult/Gerontology Capstone Certificate 1.2. Home Department/Academic Unit (Name/UDDS): School of Nursing/A545000 The home department/academic unit is responsible for the academic oversight, delivery, and administration of the certificate. 1.3. Home School/College: Nursing, School of 1.4. Additional Department(s)/Academic unit(s) information, if relevant: N/A 1.5. Faculty director of the Capstone certificate program (name, title email): Pamela A. McGranahan, Clinical Assistant Professor, DNP Program Director, pmcgranahan@wisc.edu 1.6. Primary Capstone certificate program contact (name, title, email): Karen Mittelstadt, Assistant Dean for Academic Affairs, mittelstadt@wisc.edu 1.7. Primary school/college dean s office contact (name, title, email): Linda D. Scott, Dean and Professor, ldscott@wisc.edu 1.8. Date form completed: 2/12/2017 2. Approval, Implementation, and Review 2.1. School/College Approval Date: 2/10/2017 2.2. GFEC Approval Date: Click here to enter a date. 2.3. UAPC Approval Date: Click here to enter a date. 2.4. Expected first term of student enrollment (usually 2-3 terms after UAPC approval; typically the following Fall term): Fall 2017 2.5. Year of three year check-in to GFEC (3 years after first student enrollment): 2020 2.6. Year of first program review (5 years after first student enrollment): 2022 2.7. Are all academic programs in the home academic unit are up to date for program review? Yes Information to be completed by RO and APIR: Plan Code (assigned by the Registrar s Office): CIP Code (assigned by Academic Planning and Institutional Research): Primary Divisional Disciplinary Assignment (assigned by APIR for analysis purposes only): rev. 02.12.17 Page 2 of 10

3. Purpose, rationale, justification Describe the purpose, rationale, and justification for the Capstone certificate: 3.1. What is the purpose of the Capstone certificate program? How does it contribute to the mission of the sponsoring unit(s)? The stated primary purpose of UW Madison is to provide a learning environment that contributes meaningfully to the survival of this and future generations and improves the quality of life for all. Embedded in this resolve lies The Wisconsin Idea, the long-held conviction that the work of the university should yield positive impacts far beyond the boundaries of the classroom. In accordance, the mission of the UW-Madison School of Nursing is to develop leaders for the profession and society; we make discoveries, enhance systems, and improve health through research, education and practice. The role of the Clinical Nurse Specialist (CNS) brings to life these consistently nested ideals. Unique among other advanced practice nursing roles, certified CNSs are educationally prepared to practice within three spheres of professional influence. Their charge is to better the health and well-being of patients, enhance the practice of nurses and nursing units, and improve the quality of health organizations and systems of care. As health-related challenges become increasingly complex in our country, the CNS is uniquely prepared and situated to positively impact health outcomes and support organizations to achieve. Despite high rates of job satisfaction and an expressed need for the CNS within the clinical setting, there is currently a workforce shortage. As a result, many master s-prepared nurses are working in CNSlike roles without the educational preparation required to sit for national certification as a Clinical Nurse Specialist. Core competencies for the certified CNS were established through a consensus process, and specific educational criteria for CNS programs has been set by the National Association of Clinical Nurse Specialists National Task Force. They reflect eligibility standards to sit for national certification as a CNS through the American Nurse Credentialing Center (ANCC), and were used by the Commission on Collegiate Nursing Education (CCNE) to help guide the re-accreditation of the UW Madison School of Nursing DNP program in November 2016. This proposed post-master s certificate program will rely on existing courses to provide masters -prepared nurses with the specific education, training, and academic credentials required to sit for national certification as a Clinical Nurse Specialist and practice more effectively within the CNS role. 3.2. What is the evidence that there is a student demand for the Capstone certificate program? Passage of the APRN Uniformity Act in Wisconsin is a priority of the Wisconsin Nurses Association (WNA), as well as the Wisconsin Association of Clinical Nurse Specialists (WACNS). This pending legislation will add clarity to Wisconsin s existing Nurse Practice Act, State Statute Chapter 441, and afford title protection to the legal role and practice of Advanced Practice Nurses in Wisconsin. APRNs are registered nurses with additional graduate-level education, advanced clinical expertise, and standardized national certification to practice within their designated role. These include nurse practitioners, nurse midwives, registered nurse anesthetists, and clinical nurse specialists. The proposed APRN Uniformity legislation reflects principles delineated in the National Consensus Model for Advanced Practice Registered Nurses and speaks specifically to the expected role, licensure, accreditation, certification, and education of the APRN in all its forms, including the CNS. This act includes protections around the use of professional title. As title protection for certified CNSs is gaining traction in the Wisconsin state legislature, master sprepared nurses currently working in the CNS role are seeking opportunities to certify. Healthcare organizations are concerned that mandated title protection will force them to reassign practicing staff and seek to hire new staff with CNS certification. The current shortage of certified CNSs within the state compounds these challenges. The post-master s Clinical Nurse Specialist Adult/Gerontology Capstone rev. 02.12.17 Page 3 of 10

Certificate Program will allow the School of Nursing to better address the needs of our partner organizations, as well as the overarching workforce needs of the state. 3.3. What is the evidence that there is a market demand for graduates of the Capstone certificate program? In 2015, CNNMoney/PayScale listed the Clinical Nurse Specialist as number 7 of 100 Best Jobs in America on the CNN website. The list included occupations that demonstrate significant growth potential, great pay, and high levels of job satisfaction. (CNN/ Money, http://money.cnn.com/gallery/pf/2015/01/27/bestjobs-2015/7.html). As noted earlier in this proposal, the certified CNS is positioned to positively impact an increasingly complex and dynamic work environment. As the demand for high-quality, cost-effective care continues to rise among consumers, payers, and healthcare organizations alike, demand for effective practitioners in the CNS role is only expected to rise. Furthermore, as more practicing nurses and students become aware of the potentials of the CNS as a career choice, the popularity of the CNS specialty track in advanced nursing education can be expected to increase. According to not-yet-published workforce data from the Wisconsin Center for Nursing, there are currently just over 300 master s-prepared certified CNSs in Wisconsin, accounting for only 7.2% of the total APRN workforce. Nearly half of these individuals (154) work in concentrated areas of southeastern Wisconsin, with the remainder scattered across the state. The mean age of the practicing CNS in Wisconsin is 52 years, with 40% being over the age of 55. Despite high levels of job satisfaction, almost 40% of clinical nurse specialists in Wisconsin have expressed intent to leave their current position within five years and 60% have acknowledged that they plan to leave within the next nine years (Wisconsin Health Care 2016 Workforce Report; and Wisconsin Center for Nursing internal data, 2016). There is a documented shortage of qualified CNSs in Wisconsin, and the current vacancy rate for CNS positions is 7.8% (WHA, 2016). Our clinical partners at the University of Wisconsin Hospitals and Clinics (UWHC) have supported these findings with their own anecdotal evidence, sharing that they can t find a CNS to hire them (personal communication, S. Berns, UWHC, 12/6/2016). The School of Nursing has been in conversation with the chief nursing officers of the large hospitals and health centers in the Madison area. All anticipate having a number of current CNSs who will need to certify. UW Hospitals and Clinics estimates there are at least 25 nurses on its staff who will need to complete additional coursework (that included in this proposed certificate program) in order to be eligible to sit for the exam and gain certification. Similar numbers are expected at St. Mary s Hospital, UnityPoint Health Meriter, and the William S. Middleton Memorial Veterans Hospital. The courses taught in the certificate program will be hybrid with a combination of face-to-face instruction and online learning activities, which will allow the school to draw students from beyond the Madison metropolitan area. Wisconsin Health Care 2016 Workforce Report Accessed 1/6/2017 at: http://www.wha.org/pdf/2016workforcereport.pdf rev. 02.12.17 Page 4 of 10

4. Curriculum 4.1. Delivery modality: Face-to-face Distance 4.2. Provide a complete list of requirements. 15 credits Courses: N726, N727, N728, N729, N702 Students in the certificate sequence will enroll in courses with students in the CNS track of the Doctor of Nursing Practice (DNP) program. Separate sections of the courses will be activated to track certificate student enrollment. No new courses will be needed to offer the certificate as it will draw from existing courses currently taught for students in the CNS Adult/Gerontology track of the DNP program; the certificate will add additional students to existing courses. 4.3. Chart student progression through the curriculum. Department Course Number Semester students will take the course Fall Nursing N726 Foundations for APN Clinical Practice I Fall Nursing N728 Advanced Practice Clinical Application and Role Development I Spring Nursing N727 Foundations for APN Clinical Practice II Spring Nursing N729 Advanced Practice Clinical Application and Role Development II Summer Nursing N702 Health Promotion/Illness Prevention in Diverse Communities Course Title Credits Instructor Semester & year last taught 3 Endicott, Sarah FA16 3 Williams, Andrea FA16 3 Endicott, Sarah SP17 3 Williams, Andrea SP17 3 Lothe, Katie SP17 4.4. Total credits required: 15 Capstone certificate programs are usually 9 to 12 credits and may not be more than 15 credits. 4.5. Semesters to completion: 3 (Fall, Spring, Summer) rev. 02.12.17 Page 5 of 10

4.6. Describe the student progression (one-course per semester for several semesters, all courses taken in one intensive semester, other: Part-time (< 8 credits fall and spring semesters, < 4 credits summer term) Students enter the program in the fall term taking two courses (N726/N728, 6cr total), which is the first course-pairing of theory and clinical application. The spring term is again two courses (N727/N729, 6cr total), the theory/clinical pairing at a higher level of complexity. Students complete the program with one course in the summer, N702 Health Promotion (3cr). It is expected that students will move through the curriculum as a cohort, however if extenuating circumstances require a student to move off the fall/spring/summer sequence, exceptions will be granted though it will extend the time to certificate completion as not all required courses are offered every semester. Full-time, time-compressed, intensive Other Checklist for Verification of Curricular Policy Requirements* You will have an opportunity to provide explanation and rationale for any Curricular Policy Requirements that have not been affirmed in the text box that follows the check list, below. Courses for the Capstone certificate are numbered 300 or higher. Courses are offered on a regular basis (as identified in student progression chart in section 4). Courses have enrollment capacity for students in the Capstone certificate program. Courses in the proposed Capstone certificate have been approved. All of the Capstone certificate credits must be earned in residence (which includes on campus and distance-delivered courses) at UW-Madison while enrolled in the Capstone certificate program. Because a Capstone certificate is comprised of just a few courses, it is not appropriate for students who already have completed the same or similar coursework at UW-Madison or another institution. Students must earn a minimum grade of C on all attempted Capstone certificate coursework. Courses in which a student elects the pass/fail option will not meet Capstone certificate requirements. All Capstone certificate program requirements must be met; waiving requirements is not permitted. Units must maintain Capstone certificate requirements so that they are up to date; all curriculum changes must be approved through the appropriate school/college academic planning council (APC) or curriculum committee. The school/college APC or curriculum committee will notify the Office of the Registrar, the Graduate School, and DCS ACSSS about approved curricular changes to the certificate. Typically, any changes in requirements will be effective no sooner than the fall semester after approval. 5. Student Services & Advising 5.1. List the names of Capstone certificate program advisor(s) with title and departmental affiliation(s). Andrea Williams, School of Nursing 5.2. How will the resource load of the additional student services support and advising be met? The Office of Academic Affairs has the capacity to provide student services to additional students enrolled in this CNS certificate program. The office is in the midst of a reorganization that will result in a new Graduate Academic Student Service Coordinator role. The individual in this role will advise DNP, PhD, and certificate students. 5.3. Confirm that program advisor(s) have been consulted and reviewed this proposal. rev. 02.12.17 Page 6 of 10

6. Admissions 6.1. Minimum bachelor s degree GPA for admission to the Capstone certificate program (if relevant): N/A 6.2. List additional admission criteria: Master s degree from an accredited nursing program Current RN licensure in Wisconsin (or eligibility) Prerequisites: Graduate courses (3 credits each) in physiology, physical assessment, and pharmacology are required with a grade of B or better. Physiology and physical assessment must be within the previous 5 years and pharmacology must be within 3 years. Note: Evidence of prescriptive authority granted through a state board of nursing will be accepted in place of graduate pharmacology. Checklist for Verification of Admission Policy Requirements* You will have an opportunity to provide explanation and rationale for any Admission Policy Requirements that have not been affirmed in the text box that follows the checklist. Degree seeking students may not be concurrently enrolled in a Capstone certificate program. To be eligible for admission to a Capstone program, a student must hold an earned bachelor s degree or equivalent credential from an accredited college or university. Prospective Capstone certificate students apply to the University and are admitted through the Adult Career and Special Student Services office in the Division of Continuing Studies (DCS ACSSS) in consultation with the Capstone certificate faculty program director or designee. Once admitted, Capstone certificate students carry a University Special student classification (UNCS). University Special students apply via an online application system by selecting the Capstone certificate program of choice from a program list on the application. DCS ACSSS codes the applicant for that program and defers final admission until a decision is made by the Capstone program faculty/staff. DCS ACSSS serves as the advising, admissions, and academic dean's office for all University Special students. 7. Enrollment Planning and Marketing 7.1. Projected annual enrollment: 12 Capstone certificates that will be supported by non-pooled tuition should project enrollments of at least 30 students; experience shows this is the threshold for generating sufficient revenue to meet direct program costs. 7.2. Maximum enrollment that can be supported with existing instructional and student services resources: 18 7.3. Describe plans for supporting enrollments that are much higher or much lower than the anticipated enrollment. Securing and supervising clinical practica requires a faculty-to-student ratio of no more than 1:6. The availability of high-quality clinical sites/partners is limited. These factors prevent enrollment projects from reaching past ~18. In part, these barriers also provide the impetus for the program. 7.4. Will this Capstone certificate enroll international students? No 7.5. What is the marketing plan for the Capstone certificate? We will maximize marketing support services from DCS. In addition, we will work directly with UW Hospitals and Clinics (UWHC) to recruit students and secure clinical sites through our academicpractice partnership. rev. 02.12.17 Page 7 of 10

8. Assessment 8.1. Attach an assessment plan when submitting this proposal. 8.2. Provide a summary of the Capstone certificate s assessment plan, including learning goals, key methods and assessment approaches, and how assessment information will be reviewed and acted on. The School of Nursing has provided detailed information on learning goals and methods and assessment approaches in the attached Assessment Plan 9. Related Programs 9.1. This Capstone certificate will be offered as a: Capstone certificate only. Students may not earn a Capstone certificate and Graduate/Professional Certificate of the same name. If the Capstone certificate will be offered as a Capstone certificate and a new Graduate/Professional certificate, a Graduate/Professional certificate proposal form must be completed. 9.2. Specify any other major/degree or certificate program that is related to this Capstone certificate. N/A Related programs include those that share a student audience, represent a closely related area of study, or have program names that are similar. These programs must provide a supporting memo (see required attachments). Capstone certificates supported using non-pooled tuition cannot compete with or draw students away from existing programs that support the central tuition pool. 10. Governance & Faculty 10.1. The Capstone certificate is governed by: Existing department and school/college governance committees New Capstone certificate governance committees 10.2. List the core program faculty and staff with title and departmental affiliation(s) who are primarily involved and will participate in delivery and oversight of the Capstone certificate. Pamela A. McGranahan, Clinical Assistant Professor, DNP Program Director Karen Mittelstadt, Assistant Dean for Academic Affairs Andrea Williams, PhD, Clinical Associate Professor Linda D. Scott, Dean and Professor 11. Progress & Certificate Completion 11.1. Using SIS, the faculty program director and staff will be able to identify University Special students enrolled in the Capstone certificate program. 11.2. Using DARS, the faculty program director and staff will monitor students progress in the Capstone certificate program. 11.3. The faculty program director will notify the degree audit department in the Registrar s Office and DCS/ACSSS by email (degreeaudit@em.wisc.edu, karen.ripley@wisc.edu) when a student has completed all of the requirements for the Capstone certificate. When the certificate is completed, the program faculty director or designee must notify the Registrar s Office in order for the Capstone certificate to be recorded on the official student record and for it to print to the transcript. If the program wishes to provide a physical certificate of completion for the student, they may do so. 11.4. Identify standards for good academic standing. Students must maintain a minimum GPA of 3.00 in graduate-level courses. A student may not receive more than one grade below a B in any 12 month period. rev. 02.12.17 Page 8 of 10

At a minimum, C grades must be earned on all course work attempted for the certificate program. Academic standing is verified by the program faculty and staff. (Only graduate level work from the Capstone certificate that is earned with a grade of B or better is eligible for subsequent application to a UW Madison graduate degree minimum graduate-level credit requirement.) 12. Fiscal Structure and Ongoing Commitment 12.1. The Capstone certificate program will be supported using non-pooled tuition 12.2. For programs that will be supported using standard general purpose revenue, what resources are allocated or reallocated to the Capstone certificate program? 12.3. For programs supported using non-pooled tuition, what resources are allocated to the Capstone certificate program? This capstone certificate will use existing resources and courses in its administration. CNS certificate students will enroll in designated sections of existing courses in the Doctor of Nursing Practice (DNP) program. This is similar to the Post-Master s Psychiatric-Mental Health Certificate program, which is also non-pooled tuition. The school anticipates needing to hire one additional faculty member; student services will be provided by existing staff in the Office of Academic Affairs. 12.4. For programs supported using non-pooled tuition, planned enrollment is expected to generate enough paid tuition to cover instructional costs, direct student support costs, and any other fixed or required costs. Although detailed fiscal plans are not required in the academic program proposal, it is helpful to provide the following summary taken from the non-pooled tuition budget: Fiscal Annual Summary Planned enrollment: 12 Estimated paid tuition: $10,050 per student (15 total credits over 3 semesters at $670/cr); $120,685 total Core Instructional costs: Direct student support costs: $94,880 Overhead assessment/allocation: $12,068 Total costs: $106,948 Excess tuition available for reinvestment: $13,737 Briefly list planned reinvestment uses: Funding of clinical education, including simulation and academic technology, as well as some financial aid. Additional revenue will provide resources for program reinvestment and for campus-level support of the program. 12.5. The department or program will consider students enrolled in the Capstone certificate for departmental financial aid. Capstone certificate students cannot receive federal financial aid. 12.6. Students enrolled in Capstone certificate programs are NOT eligible for teaching assistant (TA), research assistant (RA), project assistant (PA) nor graduate fellowship support. Programs must disclose this program policy to Capstone certificate students in the recommendation of admission letter, program website, program handbook, and program orientation. 12.7. The Capstone certificate program faculty are responsible for seeking appropriate governance approval for significantly altering the Capstone certificate s curriculum, suspending admissions or discontinuing the certificate program. rev. 02.12.17 Page 9 of 10

12.8. The faculty/staff will check-in with GFEC three years after first student enrollment. 12.9. The faculty/staff will engage in program review five years after implementation and at least once every ten years after that. 12.10. The program faculty/staff will ensure the program is encoded into DARS and will work with the Registrar s Office DARS liaison to keep approved revisions to the curriculum current. 12.11. The program faculty/staff will ensure the program website and Advance Your Career materials are current and consistent across all locations where information is provided. Required attachments Supporting letters/memos UW Health (Beth Houlahan, Chief Nurse Executive; Susan Rees, Associate CNO) Provide letters or memos from other academic units that will have overlapping interest. This will include departments/schools/colleges that provide courses for the certificate, share a student audience, represent a closely related area of study, have overlapping faculty, or have program names that are similar. Assessment plan Programs supported using non-pooled tuition must attach: Budget Core Criteria Checklist Additional Requirements Checklist See the current Non-pooled Program Requirements Process document posted at http://apir.wisc.edu/academicplanning.htm rev. 02.12.17 Page 10 of 10

ASSESSMENT PLAN Post-Master s Adult-Gerontology Clinical Nurse Specialist Capstone Certificate Program Capstone Certificate Program Name: Post-Master s Adult-Gerontology Clinical Nurse Specialist Capstone Certificate Faculty Director Name, Contact information, Title: Pamela A. McGranahan, Clinical Assistant Professor, DNP Program Director, pmcgranahan@wisc.edu Primary Program Contact Name, Contact information, Title: Karen Mittelstadt, Assistant Dean for Academic Affairs, mittelstadt@wisc.edu Date this Assessment Plan was adopted by the program faculty: TBD Student Learning Goals (What) After successful completion of the CNS Capstone Certificate Program, the graduate will be eligible to sit for national certification as a clinical nurse specialist in adult-gerontology. Eligibility will be verified through completion of 500 clinical practicum hours and achievement of the following learning goals: 1. Integrate nursing science with knowledge from the biophysical, psychosocial, analytical, and organizational sciences as the basis for advanced nursing practice in the CNS role. 2. Demonstrate advanced nursing knowledge of assessment and disease management in the adult-gerontological patient populations, including the use of pharmacologic and nonpharmacologic interventions to promote and maintain health. 3. Demonstrate advanced levels of clinical judgment, systems thinking, and professional accountability in designing, delivering, and evaluating evidence-based care to support positive patient outcomes and systems of care. 4. Strategically practice and demonstrate effectiveness within the three spheres of influence that comprise CNS practice: clients, nurses and nursing practice, and organizational systems of care. 5. Guide, mentor, and support other nurses to achieve excellence in clinical nursing practice. 01.09.17, Page 1 of 9

Curriculum Map (Where) Capstone Certificate Program Courses N702 Health Promotion/Illness Prevention in Diverse Communities N726 Foundations for APN Clinical Practice I N727 Foundations for APN Clinical Practice II N728 Advanced Practice Clinical Application and Role Development I N729 Advanced Practice Clinical Application and Role Development II Enter certificate-level learning goals and mark which course contributes to which learning goal. LG#1 LG#2 LG#3 LG#4 LG#5 (guide, (integrate (demonstrate (demonstrate (strategically mentor, and nursing advanced advanced practice and support) science) nursing levels of demonstrate knowledge) clinical effectiveness) judgement) X X X X X X X X X X X X X X X X X X X X X X 01.09.17, Page 2 of 9

Assessment Planning (How) Method for assessing learning (at least one direct method required) Timetable for assessment activity (at least one activity each year; all goals reviewed in a 3-year cycle) For each learning goal, indicate how you plan to assess whether or not students are meeting the expectation, as well as when each learning goal will be assessed. Keep in mind that each academic degree program is expected to engage in at least one assessment activity per year and assessment activities, in total, must include one direct assessment method. LG#1 (integrate nursing science) Written assignments and quiz Performance in N726 At completion of course LG#2 (demonstrate advanced nursing knowledge) Individual course project in N702 At completion of course LG#3 (demonstrate advanced levels of clinical judgement) Clinical evaluations from N728/N729 (preceptor input) At completion of course LG#4 (strategically practice and demonstrate effectiveness) Clinical evaluations from N728/N729 (preceptor input) At completion of course LG#5 (guide, mentor, and support) Application project in N729 At completion of course 01.09.17, Page 3 of 9

Course Course Description Course Learning Objectives N702 Health Promotion/Illness Prevention in Diverse Communities Health promotion and disease prevention interventions are examined for populations, incorporating multidisciplinary approaches. Focus of course is on developing increased knowledge, appreciation, and skills for health promotion and disease prevention among diverse communities. Course addresses epidemiological, individual, socioeconomic, and environmental factors related to health status. This course proposes strategies to reduce health disparities among vulnerable populations. 1. Evaluate national and state health agendas and apply them in developing health promotion and disease prevention priorities in particular communities 2. Analyze concepts, models, theories, and current research as a foundation for population-based health promotion, disease prevention, and health behavior change in diverse populations. 3. Select and apply appropriate conceptual models, frameworks, and theories for guiding population based health promotion and disease prevention programs. 4. Examine and propose strategies to address ethical issues involved in planning, implementing, and evaluating community-based participatory programs for health promotion and disease prevention. 5. Consider and Delineate effective strategies for collaborative partnerships among leaders of health and community agencies and groups for health promotion and disease prevention and reduction of health disparities among populations. Post-MS CNS Certificate Expected Student Learning Outcomes 1. Integrate nursing science with knowledge from the biophysical, psychosocial, analytical, and organizational sciences as the basis for advanced nursing practice in the CNS role. 2. Demonstrate advanced nursing knowledge of assessment and disease management in the adultgerontological patient populations, including the use of pharmacologic and nonpharmacologic interventions to promote and maintain health. 3. Demonstrate advanced levels of clinical judgment, systems thinking, and professional accountability in designing, delivering, and evaluating evidence-based care to support positive patient outcomes and systems of care. 4. Strategically practice and demonstrate effectiveness within the three spheres of influence that comprise CNS practice: clients, nurses and nursing practice, and organizational systems of care. Exemplars of Assignments and Student Assessment Strategies N702 Summer+2016 Course syllabus and 01.09.17, Page 4 of 9

Course Course Description Course Learning Objectives N726 Foundations for APN Clinical Practice I Designed to advance students knowledge for clinical decision making in their specialty field. Health promotion, illness prevention and common health conditions are emphasized. Content tailored to APN role and population focus. 1. Apply advanced assessment skills, risk analysis, risk reduction, screening, and disease detection strategies into health management plans. 2. Incorporate primary, secondary and tertiary prevention in the clinical management of patients wellness and health care needs. 3. Integrate and evaluate evidence-based interventions and clinical guidelines into patient health promotion, disease prevention, and illness management plans. 4. Identify and use appropriate counseling and education strategies to promote positive lifestyle and behavior changes. 5. Incorporate advanced physiological, pathophysiological, pharmacologic and psychosocial concepts and principles into the clinical management of common and complex health problems. 6. Develop clinical management plans that are culturally congruent and reflect patients and family beliefs and value systems across the lifespan. Post-MS CNS Certificate Expected Student Learning Outcomes 1. Integrate nursing science with knowledge from the biophysical, psychosocial, analytical, and organizational sciences as the basis for advanced nursing practice in the CNS role. 2. Demonstrate advanced nursing knowledge of assessment and disease management in the adultgerontological patient populations, including the use of pharmacologic and nonpharmacologic interventions to promote and maintain health. 3. Demonstrate advanced levels of clinical judgment, systems thinking, and professional accountability in designing, delivering, and evaluating evidence-based care to support positive patient outcomes and systems of care. 4. Strategically practice and demonstrate effectiveness within the three spheres of influence that comprise CNS practice: clients, nurses and nursing practice, and organizational systems of care Exemplars of Assignments and Student Assessment Strategies 01.09.17, Page 5 of 9

Course Course Description Course Learning Objectives N727 Foundations for APN Clinical Practice II Designed to continue to advance students knowledge for clinical decision making. Complex and chronic health conditions are emphasized while continuing to promote health maintenance within the context of existing health problems. Content tailored to the APN role and population focus. 1. Evaluate strategies of risk analysis and reduction, screening, and disease detection. 2. Refine primary, secondary and tertiary prevention strategies into the clinical management of a patient s wellness and health care needs. 3. Analyze and integrate evidence-based interventions & clinical guidelines in health promotion, disease prevention, and illness management plans. 4. Initiate and evaluate appropriate counseling and education strategies to help patients to make positive lifestyle and behavioral changes. 5. Apply advanced physiological, pathophysiological, pharmacologic and psychosocial concepts and principles into the clinical management of common and complex health problems across a variety of settings. 6. Collaborate with individuals & families to implement clinical management plans that are culturally congruent and reflect patient and family beliefs and value systems across the lifespan. 7. Analyze patient data and develop individualized management plans based on current evidence and appropriate resources. Post-MS CNS Certificate Expected Student Learning Outcomes 1. Integrate nursing science with knowledge from the biophysical, psychosocial, analytical, and organizational sciences as the basis for advanced nursing practice in the CNS role. 2. Demonstrate advanced nursing knowledge of assessment and disease management in the adultgerontological patient populations, including the use of pharmacologic and nonpharmacologic interventions to promote and maintain health. 3. Demonstrate advanced levels of clinical judgment, systems thinking, and professional accountability in designing, delivering, and evaluating evidence-based care to support positive patient outcomes and systems of care. 4. Strategically practice and demonstrate effectiveness within the three spheres of influence that comprise CNS practice: clients, nurses and nursing practice, and organizational systems of care. Exemplars of Assignments and Student Assessment Strategies N 727 PMHNP Final Project Presentation 01.09.17, Page 6 of 9

Course Course Description Course Learning Objectives N728 Advanced Practice Clinical Application and Role Development I This supervised clinical practicum focuses on the development and application of advanced health promotion, assessment and clinical management skills in a variety of health care settings. Practicum tailored to the APN role and population focus. 1. Perform and record complete health histories and physical examinations; including health risk assessments on well adolescent, adult, and/or geriatric clients. Develop the problem list and prioritize management plan. 2. Select screening tests appropriate to age, gender, and risk factors. 3. Demonstrate ability to teach clients self care strategies (i.e., stress reduction techniques, self-breast exam, testicular self-exam, injections). 4. Perform & record focused health histories & physical exams. Establish a diagnosis and management plan for acute illnesses. 5. Administer appropriate standardized screening instruments (mental status, functional assessment, alcohol or other drug abuse (AODA) screening, depression screening) and develop a plan that incorporates the findings. 6. Maintain a working database of clients, including diagnoses, types and levels of NP decision making and special skill training acquired during the preceptorship. The data will be used to document specific clinical experiences for certification requirements, scope of practice assessment, experience and job placements Post-MS CNS Certificate Expected Student Learning Outcomes 1. Integrate nursing science with knowledge from the biophysical, psychosocial, analytical, and organizational sciences as the basis for advanced nursing practice in the CNS role. 2. Demonstrate advanced nursing knowledge of assessment and disease management in the adultgerontological patient populations, including the use of pharmacologic and nonpharmacologic interventions to promote and maintain health. 3. Demonstrate advanced levels of clinical judgment, systems thinking, and professional accountability in designing, delivering, and evaluating evidence-based care to support positive patient outcomes and systems of care. 4. Strategically practice and demonstrate effectiveness within the three spheres of influence that comprise CNS practice: clients, nurses and nursing practice, and organizational systems of care. 5. Guide, mentor, and support other nurses to achieve excellence in clinical nursing practice. Exemplars of Assignments and Student Assessment Strategies N728 Policy Paper Assignment.docx N 728 Rubric Policy Project.docx 01.09.17, Page 7 of 9