2019 FNU President's Annual Report

2019 President’s Annual Report

Creating a Culture of Caring

Founded in 1939, Frontier Nursing University seeks to meet the needs of prospective nursemidwives and nurse practitioners who want to remain in their home communities while studying to obtain a graduate education to fulfill their professional goals. Students start by completing web-based didactic coursework with the encouragement and support of academic advisers, classmates, a strong curriculum, and active and engaged faculty. Working with clinics, hospitals, and preceptors in their own communities, students gain the hands-on clinical experience required for these exciting health care professions. FNU’s more than 150 faculty members, who are located all over the country, are national leaders in advanced practice nursing and midwifery education.

The Frontier Nursing University Vision:

The Frontier Nursing University:

To continually improve our status as a center of excellence for midwifery and nurse practitioner education.

• Professionalism

The Frontier Nursing University Mission:

• Positive Communications

To provide accessible nurse-midwifery and nurse practitioner education to prepare competent, entrepreneurial, ethical, and compassionate leaders in primary care to serve all individuals with an emphasis on women and families in diverse, rural, and underserved populations.

FNU’s Culture of Caring initiative drives these values into our talented and diverse community of students, alumni, faculty, staff, couriers, and preceptors. We are inspired by a culture of caring among all members of our university community and it strengthens our focus on our mission of educating nurse-midwives and nurse practitioners to deliver quality health care to underserved and rural populations.

• Inclusivity • Respect • Mutual Support

2019 PRESIDENT’S REPORT

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FNU

at a Glance

years of experience in graduate nursing and nurse-midwifery education

Family Nurse Practitioner

276 Offers the oldest and largest continually operating

nurse-midwifery education program in the United States

Retention in 2019:

91.8% (those who started in 2018 and completed their first full year in 2019) 2

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2,300 students Number of new enrollees in each program in 2019

81

Students and alumni represent every U.S. state and several foreign countries

Current enrollment of more than

Nurse-Midwifery

421

Psychiatric Mental Health Nurse Practitioner

201

Women’s Healthcare Nurse Practitioner

39

Doctor of Nursing Practice

270

Offered the first family nurse practitioner program in the United States Total degrees awarded in 2019:

951

Number of graduates from each program in 2019

Number of students by race/ethnicity enrolled in 2019

Family Nurse Practitioner

Black or African American

315

332

Nurse-Midwifery

317

Psychiatric Mental Health Nurse Practitioner

73

Women’s Healthcare Nurse Practitioner

46

Doctor of Nursing Practice

183

MSN Completion

3

WH Completion for Midwifery Grads

14

Number of primary care visits completed

by NP students in 2019 FNP

217,094

2018 and 2019 winner of the Insight Into Diversity Higher Education Excellence in Diversity Award

33,391 49,530

73%

of FNU’s students live in health professional shortage areas (HPSA) as defined by Health Resources and Services Administration (HRSA)

216 Asian

67

Two or more races

108

Native Hawaiian or Other Pacific Islander

Women’s Healthcare NP

Psychiatric-Mental Health NP

Hispanic

7 Number of preceptor sites utilized in 2019:

1,565

American Indian or Alaska Native

21

White

2275 Not Disclosed

91

Number of Births Attended by CNEP students in 2019:

7,138

2019 PRESIDENT’S REPORT

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Contents About FNU FNU at a Glance

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2-3

Letter from Dr. Stone

5

Letter from Dr. Carter

6

2019 Strategic Plan

7

2019 Strategic Plan Goal 1 Outcomes

8-10

2019 Strategic Plan Goal 2 Outcomes

11-13

2019 Strategic Plan Goal 3 Outcomes

14-16

2019 Strategic Plan Goal 4 Outcomes

17

2019 Strategic Plan Goal 5 Outcomes

18-21

2019 Strategic Plan Goal 6 Outcomes

22-23

2019 Strategic Plan Goal 7 Outcomes

24-25

2019 Strategic Plan Goal 8 Outcomes

26-27

2019 Strategic Plan Goal 9 Outcomes

28-30

2019 Strategic Plan Goal 10 Outcomes

4

IFC - 1

31

2020-22 Strategic Plan

32-33

2019 Events, Awards, News & Notes

34-35

2019 Annual Awards

36-37

Dear Friends, In 2019, Frontier Nursing University came to the end of its 2015-2019 strategic plan. Even as we continued to implement the plan throughout the year, we also began to measure our progress toward our strategic plan goals.

Where did we succeed? Where did we come up short?

Most importantly, in what areas were we on the right track, and where did we need to change direction entirely? Those questions and the analysis that answered them led to the year-long development of our strategic plan for 2020-22.

In this President’s Annual Report, we are excited to share with you highlights of our 2019 accomplishments, our strategic planning process, and our strategic plan goals for 2020-22. We are eager to highlight the results of our previous plan and how our successes and dedication to our mission inspired our next steps.

The 2020-22 strategic planning process included input from the entire FNU community -- faculty, staff, the board of directors, students, and alumni. Every opinion was sought, and every voice was heard. Fittingly, every one of these constituent groups is represented in this report as we celebrate their accomplishments of the past year.

We hope you enjoy reading this report and learn something new about Frontier Nursing University. We are proud of our growth and progress, but far from satisfied. We continue to push forward, determined to provide accessible nurse-midwifery and nurse practitioner education that prepares our graduates to make a difference in their communities, particularly serving diverse, rural, and underserved populations where the need is greatest.

We hope that you find this report informative, inspiring, thought-provoking. Thank you for taking the time to read this report and for your continued support of Frontier Nursing University.

Sincerely,

Susan Stone Susan E. Stone, DNSc, CNM, FAAN, FACNM President

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Dear Friends, The Board of Directors of Frontier Nursing University is honored to share the 2019 President’s Annual Report with you. In this report, you will learn about the structure, goals, and planning implementation that made FNU’s 80th anniversary such a successful and busy year. Our mission remains very clear and our progress toward it is thoughtful, measured, and data-driven.

We are committed to providing an excellent education for nurse-midwives and nurse practitioners at a cost made affordable by our proven and well-established distance learning model. We know that allowing our students to continue to work in their home communities while they pursue their advanced degrees helps address the healthcare gaps that persist within rural and underserved populations across the country. We also know that our curriculum prepares students to address the ongoing maternal mortality crisis in America, which is particularly impactful among women of color. As we witness the disproportionately severe effects of COVID-19 on the African American population, we are intent on preparing our students to provide culturally competent care to help reduce these tragic disparities.

The 2019 strategic planning process focused heavily on analyzing and anticipating the nation’s current and future healthcare needs. We are proud of the work that has been done and excited to make even greater progress in the future.

Thank you for your support of FNU and the health and well-being of our country.

Sincerely,

Michael Carter Michael Carter, DNSc, DNP, FAAN, FNP/GNP-BC Chair, Board of Directors

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2019 Strategic Plan Goals Within FNU’s 2015-2019 overall strategic plan were yearly strategic plans designed to provide additional focus on specific goals for each year of the plan. At the end of each year, the progress toward these goals was measured and the outcomes analyzed.

Within the following pages is a detailed look at the 10 goals included in the 2019 strategic plan, including the data and stories that demonstrate the results from the last calendar year. These results are part of the framework for FNU’s 2020-2022 strategic plan, which is outlined on page 2-3. The strategic planning process, which is described on page 32-33, is integral to FNU’s strategic adherence to its mission and growth.

Goal 1

Goal 2

Continue to develop new and improve current programs.

Explore new educational program options that support and enhance the mission of FNU.

Goal 3

Goal 4

Create a diverse environment that promotes and enriches the opportunity for all persons to succeed.

Increase the retention rate to 85% or greater across all programs.

Goal 5

Goal 6

Foster a productive, inclusive, creative, and positive university environment for all constituents

Provide faculty development opportunities designed to assure success in their roles as teacher, practitioner, and scholar.

Goal 7

Goal 8

Ensure the effective use of administrative and technical systems to improve service.

Develop and implement programs designed to secure resources to support programs and operations.

Goal 9

Goal 10

Continually improve and maintain facilities to meet the needs of students, faculty, and staff.

Develop a long-range financial plan to support the strategic planning process.

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Goal 1 Continue to develop new and improve current programs.

Straight-through DNP In alignment with this overarching strategic plan goal to continue to develop, evaluate, and improve programs and services that further our mission, FNU diligently follows healthcare trends across the country. The results are datadriven decisions to ensure that our curriculum is meeting the needs of our students and the communities they serve.

48.2% of the 3,136 U.S. counties lack a single OB/GYN and 55.1% of the counties do not have a certified nurse-midwife.[4]

These shortages are one reason that nurses are increasingly serving as primary caregivers in hospitals and clinics around the United States. Another important reason is that It is no secret that healthcare shortages, the practice of nurse-midwives and nurse gaps in accessible care for rural, diverse, and practitioners has a core focus on promoting underserved communities, closure of many optimal health. This is an important issue, not rural hospitals, and other factors are leading only to provide care to the sick but to provide to healthcare deserts across the United the needed guidance and support to assist States. To better understand how these people to be healthy for the long term. Studies changes impact our students and graduates suggest that the focus on health maintenance is and the people they serve, we take a closer an important core characteristic of the practice look at the numbers and trends revealed by of nurse-midwives and nurse practitioners. The recent studies. model of care practiced by nurse-midwives and nurse practitioners includes a partnership As events in the U.S. and around the world with the patient, a focus on promoting optimal Dr. Joan Slager continue to reveal, the role of nurses in health as well as treating illness. This model FNU Dean of Nursing primary care continues to evolve. The of care has a significant impact on improving Association of American Medical Colleges long-term healthcare outcomes. A study on the predicts a primary care physician shortage of more than prevention of chronic disease published by the Centers for 21,000 physicians by 2032. [1] Rural areas are impacted Disease Control concluded that “across all conditions, NPs most significantly by such shortages, with the number of provide health education to patients more frequently than physicians per 10,000 people averaging 33 in urban areas physicians.�[5] Midwifery care as defined by the American versus just 13 in rural communities.[2] Social determinants of College of Nurse-Midwives includes much-needed health health impact every rural demographic, but they impact rural promotion, disease prevention, individualized wellness communities of color the most. Compared to rural white education and counseling, and full-scope primary care people, rural black and indigenous people are more than services including maternity care. four times as likely to live in areas designated as persistent poverty counties. As a result, mortality rates are higher Decades of research indicate that primary care services for both black and indigenous residents than for white provided by advanced practice nurses and nurse-midwives residents.[3] are safe and effective.[6] It is clear that working together, nurse-midwives, nurse practitioners, and physicians can Healthcare shortages also significantly impact maternal care. attain the best outcomes for the people they serve.

Maternity care providers are distributed unevenly across the U.S., leading to access inequities in certain communities FNU is aware of the importance of its graduates in such as rural counties. More than 20 million women live serving their communities. FNU graduates will increasingly in counties without a maternity care provider. Additionally, be responsible for primary care, particularly in rural

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communities. This reinforces our mission to provide accessible nurse-midwifery and nurse practitioner education to prepare competent, entrepreneurial, ethical, and compassionate leaders in primary care to serve all individuals with an emphasis on women and families in diverse, rural, and underserved populations.

complex healthcare environment which involves the rapid expansion of knowledge, increasing complexity of patient care, national concerns about the quality of care and safety, and shortages of doctorally prepared nursing faculty. FNU responded by developing a post-masters DNP program that enrolled its first class in 2008.

In 2004, member schools affiliated with the American Association of Colleges of Nursing (AACN) voted to endorse the DNP Position Statement which called for moving the current level of preparation necessary for advanced nursing practice to the doctoral level by the year 2015. Some reasons cited included the demands of the increasingly

In recognition of the increasing reliance on NPs to fill the nation’s primary care shortage gap, in 2018, the National Organization of Nurse Practitioner Faculties (NONPF) made the commitment to move all entry-level nurse practitioner (NP) education to the DNP degree by 2025. In making the declaration, NONPF stated “we recognize that as the

DNP enrollment, 2009-2019 Graph 1.1 Total Enrollment 600

400

305

200 35 0

464

405

2009

57

64

76

2010

2011

2012

103

2013

Graph 1.2 Comp DNP

138

152

2014

2015

200

2016

2017

2018

2019

Graph 1.3 PMDNP 500

500 152

231

233

2018

2019

152

149

153

174

2015

2016

2017

2018

231

51 0

2016

2017

0

2019

2019 PRESIDENT’S REPORT

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Goal 1 health care delivery system has grown increasingly complex, the role of NPs has evolved. The DNP degree reflects the rigorous education that NPs receive to lead and deliver quality health care.”

NONPF further stated its support of an integrated DNP curriculum without a master’s exit point as preparation for entry to the NP role. “The DNP NP curriculum is not an add-on to the master’s curriculum; instead, the curriculum integrates objectives and learning opportunities for students to achieve the NP core and populationfocused competencies that are written for doctoral-level education.”[7]

(ACNM) has not. It is the position of the ACNM that: “The Doctor of Nursing Practice may be one option of some nurse-midwifery programs, but should not be a requirement for entry into midwifery practice.” ACNM cites their commitment to competency-based education, a lack of evidence to support the move to the DNP, and decades of evidence to support that graduates of Accreditation Commission for Midwifery Education accredited midwifery programs, regardless of terminal degree, are safe, costeffective care providers of maternity and women’s health care. For this reason, FNU will continue to provide an MSN degree for nurse-midwives with a post-masters DNP as an additional option.

FNU continued offering the DNP over the past 12 years, providing much-needed support to rural communities all over the country. By the end of 2019, the DNP had significantly grown (see graph 1.1). Now, guided by NONPF’s support of moving all entry-level nurse practitioner education to the DNP, FNU has adopted the development of a straight-through DNP track into its 2020-22 strategic plan. FNU further intends to increase the DNP Plan of Study by two credits to address gaps in the program.

“The DNP prepares nurse practitioners and nurse-midwives to impact care beyond the individual patient,” Slager said.

“The NONPF position is not the only driver to this move toward a straight-through DNP program,” said FNU Dean of Nursing Joan Slager, CNM, DNP, FACNM. “In today’s healthcare environment, educating our students to be expert clinicians is not enough. Our graduates must learn skills in change management, quality improvement, health policy, and leadership that will equip them to become clinical leaders contributing to changes in health systems affecting the communities they serve.”

[3] Advisory Board. “The Dire State of Rural Health Care: The impact on rural patients and provider organizations.” April 2020.

The increased role of nurse practitioners and nursemidwives in primary care also dictates that they become more involved in the decision-making that impacts health care policy, planning, and reform across the country. The DNP is intended to help students understand and embrace that leadership role.

Although NONPF has declared the straight through DNP as a primary goal, the American College of Nurse-Midwives

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FNU’s transition to the straight-through DNP is expected to be completed and implemented by 2022.

[1] Association of American Medical Colleges. “The Complexities of Physician Supply and Demand: Projections From 2018 to 2033The Complexities of Physician Supply and Demand: Projections From 2018 to 2033.” June 2020.

[2] March of Dimes. “Nowhere to Go: Maternity Care Deserts Across the U.S.” 2018.

[4] March of Dimes. “Nowhere to Go: Maternity Care Deserts Across the U.S.” 2018.

[5] Ritsema TS, Bingenheimer JB, Scholting P, Cawley JF. “Differences in the Delivery of Health Education to Patients With Chronic Disease by Provider Type”, 2005–2009.

[6] The National Organization of Nurse Practitioner Faculties. “The Doctor of Nursing Practice Degree: Entry to Nurse Practitioner Practice by 2025.” May 2018.

[7] Newhouse RP, Stanik-Hutt J, White KM, et al. Advanced practice nursing outcomes 1990- 2008: a systematic review. Nurs Econ. 2011;29(5):1-22

Goal 2 Explore new educational program options that support and enhance the mission of FNU. FNU consistently evaluates its programs, services, and their relation to the current healthcare environment. As demonstrated in the DNP article on page 8-10, there is a growing need for primary healthcare providers, particularly in rural areas. Increasingly, this need is being filled by nurse-midwives and nurse practitioners, who have demonstrated the ability to provide high-quality primary care including maternity care. As noted in the story on page 8-10, the healthcare shortage has a particularly significant impact on rural communities. One of the primary tenets of FNU’s mission is to focus on rural areas where health care shortages are often prevalent. FNU places extra emphasis on recruiting students from rural and underserved communities, understanding that these students are more likely to address this rural healthcare shortage by continuing to work in the communities in which they live.

However, in recent years, FNU has seen a general decline in the percentage of students who come from rural areas.

According to research released by the Carsey School of Public Policy at the University of New Hampshire in 2019, nearly 35 percent of rural counties in the United States are experiencing protracted and significant population loss, Those counties are now home to 6.2 million residents, a third fewer than lived there in 1950. In all, the researchers found that 746 counties representing 24 percent of all U.S. counties are depopulating and 91 percent of them are rural.

[1] FNU believes that decreasing ruralization contributed to the decline in students from rural areas. As the population in rural areas declines, so too do the health care services that are available. In response, FNU has revised its admissions

Graph 2.1 New Enrollments in MSN and Certificate by Specialty 1,000 750 500 250 0

327 342

354 2

3 302 26 2015

2 400

374 26 2016

86 37 2017

276

278

1

2

421

400 149

201

35 2018

39 2019

Family Nurse Pract Nurse-Midwifery

MSN Competion Psych-Mental Health

WH Comp

Womens Health Care

Graph 2.2 New Enrollments in the DNP by Curriculum 500

222

250 80 0

2015

270

267

133

2016

2017

2018

2019

Table 2.1 Year

Total Degrees Awarded

HPSA Degrees Awarded

Rural Degrees Awarded

HPSA %

Rural %

2015

559

357

133

63.86%

23.79%

2016

545

362

125

66.42%

22.94%

2017

639

392

133

61.35%

20.81%

2018

820

498

177

60.73%

21.59%

2019

951

512

198

53.84%

20.82%

2019 PRESIDENT’S REPORT

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Goal 2 scoring rubric to give applicants additional points for being from a rural area, increasing their chance of receiving an offer of admission.

The overarching goal of the FNU ANEW program is to expand formal academic-practice partnerships in order to co-design and implement strategies to enhance the preparation and distribution of APRNs and nurse-midwives practicing in rural settings. Among the steps in achieving this goal is the objective to “recruit, train, support, and evaluate clinical preceptors located in rural areas nationwide as program partners in order to leverage the quality and distribution of primary care preceptors in rural settings.”

In addition, FNU has placed a particular emphasis on securing clinical sites in these rural areas so these students can complete their degrees without moving to larger communities. In 2018, FNU was awarded the Advanced Nursing Education Workforce (ANEW) grant from the Health Resources and Services Administration (HRSA).

The grant, which totals $1,376,800 in funding from 2018-2020, is intended to support innovative academicpractice partnerships to prepare primary care advanced practice registered nursing students to practice in rural and underserved settings through academic and clinical training. The partnerships support traineeships as well as infrastructure funds to schools of nursing and their practice partners who deliver longitudinal primary care clinical training experiences with rural and/or underserved populations.

Via the ANEW grant, FNU has partnered with five rural clinical sites to form a Clinical Practicum Advisory Committee (CPAC). The sites include White House Clinic in Richmond, Kentucky, Tuba City Health Care in Tuba City, Arizona, Summit Pacific Healthcare Clinic in Elma, Washington, Cherokee Nation Hastings Hospital in Tahlequah, Oklahoma, and United Memorial Women’s Care Center at United Memorial Medical Center in Batavia, New York. These sites are all located in and serving federally designated rural populations.

Graph 2.3 Degrees Awarded

285 2015

Doctor of Nursing Practice Family Nurse Practitioner

183 2017

MSN Completion Nurse-Midwifery Psych-Mental Health Nurse Practitioner

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2018

73 14 46

3

3

30 27 22

131 1 16 28

1

111 2016

17 28

3

84

10 24

2

0

73

100 50

236

246 210

203

150

209

200

241

250

317

324

300

315

3500

2019

WH Comp Women’s Health Care Nurse Practitioner

Each of these sites is hosting FNU students for their clinical practicum, participating in quarterly CPAC meetings, and meeting monthly with FNU Regional Clinical Faculty (RCF).

The RCF serves as the student’s advisor during the clinical portion of the program. The RCF approves the overall clinical plan and provides guidance and support to both the student and preceptor during this time in the student’s curriculum.

The RCF evaluates both the clinical site and preceptor to ensure excellence before the student begins the clinical experience. Like our students and course faculty, our RCFs are located across the United States. Most students are matched with an RCF who lives in the region of the country close to them.

This joint venture with the ANEW grant academic-practice partners has enabled FNU to test, implement, evaluate, and improve training for primary care preceptors and Advanced Practice Registered Nurse (APRN) students. It is a model FNU intends to build upon as the university focuses on its 20202022 strategic plan objectives educating health care sites and systems about the benefits of taking students and creating a positive environment for preceptors.

With more than 2,300 nurse-midwife and nurse practitioner students from all 50 states, FNU must have established relationships with preceptors and clinical sites nationwide.

In any given term, FNU has approximately 600 students in clinical courses.

FNU seeks to make the experience a positive one for preceptors by offering two free online training courses for preceptors and providing an honorarium based on the preceptor’s percentage of time spent precepting students.

By sharing their expertise and time, these preceptors help expand access to quality, compassionate care, to rural and underserved populations.

[1] University of New Hampshire. “Shrinking population in more than a third of rural U.S. counties.” ScienceDaily. ScienceDaily, 6 February 2019.

Department of Clinical Outreach and Placement In 2019, FNU created the Department of Clinical Outreach and Placement, the mission of which is to support FNU students by: • providing assistance and resources in locating clinical sites and preceptors, • troubleshooting challenging situations, • working one-on-one with students to navigate the overall clinical search process, and • bringing support and customer service to FNU’s vast preceptor network The unit is led by Director of Clinical Outreach and Placement Stephanie Boyd and supported by Clinical Advisors Carisa Lipp and Jamie Wheeler as well as Clinical Services Coordinator Brittany Bachman. The Clinical Advisors work with students one-on-one and in small groups while the Clinical Services Coordinator provides service and support to FNU preceptors.

“The convenience that distance education brings to nurse-midwifery and nurse practitioner students is one of FNU’s primary advantages, but it can also present unique challenges in locating quality clinical sites and preceptors to meet each student’s needs,” Boyd said. “Preceptors play a crucial role in mentoring students and helping them gain the clinical experience they need for long-term success.”

The Department focuses on identifying appropriate clinical sites and preceptors for each student’s unique situation, facilitating student-preceptor relationships, and collaborating with Regional Clinical Faculty (RCFs) to better support each student.

“I am so glad that Frontier listens to the voice of the student body and cares enough to act,” said FNU student Loy Watson, ADN, RN, CFNP. “What a wonderful thing that Frontier is, yet again, filling a gap. The ongoing desire to meet the needs of students is truly what sets Frontier apart from other schools.”

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Goal 3 Create a diverse environment that promotes and enriches the opportunity for all persons to succeed.

Dr. Geraldine Young Joins FNU as New Chief Diversity and Inclusion Officer In late 2019, Dr. Geraldine Young, DNP, APRN, FNP-BC, CDE, FAANP, was appointed as the new Chief Diversity and Inclusion Officer (CDIO) at Frontier Nursing University.

Dr. Young, whose service in the nursing profession spans over 20 years, holds a Doctor of Nursing Practice Dr. Geraldine Young Chief Diversity and (DNP) from the University Inclusion Officer of Alabama at Birmingham (2010), an MSN from Alcorn State University (2005), and a BSN from the University of Mississippi Medical Center (2001). She is also a boardcertified family nurse practitioner (FNP) (2005) and a certified diabetes educator (2011).

“It is truly an honor and a pleasure to be selected as the Chief Diversity and Inclusion Officer at Frontier Nursing University,” Dr. Young said. “I, along with my colleagues, look forward to transforming Frontier Nursing University to the next level by continuing to strengthen an environment that promotes diversity, equity, and inclusion and promotes the success of all community members.”

Dr. Young is a National Organization of Nurse Practitioner Faculties (NONPF) Leadership Fellow and Fellow of the American Association of Nurse Practitioners (FAANP).

She has been deemed a content expert for one of the leading credentialing bodies for NPs, the American Nurses Credentialing Center (ANCC). She serves on an array of national committees to advance nurse practitioner education, including the NONPF Curricular Leadership Committee (co-chair) and Conference Committee. She was recently selected as a NONPF Board Member. She is also a member of the American Association of Colleges of Nursing Essentials Task Force.

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As a member of the Essentials Task Force, Dr. Young is ensuring cultural diversity, equity, and inclusion are at the forefront of nursing education to address the health disparities and inequalities that exist in our nation. She has effectively delivered models of clinical practice to improve the outcomes of underserved and historically marginalized populations with diabetes in conjunction with the Health Resources and Services Administration (HRSA) and the Centers for Medicare and Medicaid (CMS).

FNU’s Diversity, Equity, and Inclusion Initiatives Guided by the FNU mission statement which reads in part to “serve all individuals with an emphasis on… diverse, rural, and underserved populations” (read the full mission statement page 1 of this report), FNU has made diversity, equity, and inclusion a priority throughout the university.

Diversity, equity, and inclusion action items and goals have been fixtures in recent strategic plans, including the 2020-22 strategic plan.

In 1999, recognizing the benefits of a diverse healthcare workforce and recognizing that FNU’s student body included only 9% of students of color, FNU first established a strategic goal to increase the number of students of color from 9% to 15%. In 2010, FNU implemented the Diversity Impact Program, and by 2019, the percentage of students of color enrolled at FNU had grown to 23%. Additionally, FNU has placed a priority on increasing the retention rate of students of color, with a minimum goal of 80%. The retention rate for students of color who entered FNU in 2018 was 87.05% at 15-18 months.

The success of student retention rates is the result of diligent student support and progress monitoring. In 2019, 196 students utilized FNU’s free tutoring program, attending

a total of 1,436 tutoring sessions. Additionally, in 2017, FNU began using the Dropout Detective retention tool to identify students who may be in need of assistance. In the last three years, 2,551 students have been identified for assistance via this early warning system. Via the Professional Organization Mentoring Program (POMP), FNU’s Office of Diversity, Equity, and Inclusion also provides mentoring services for underrepresented students at professional conferences.

FNU faculty mentors and attends professional conferences with students from historically marginalized populations.

FNU’s Office of Diversity, Equity, and Inclusion (DEI) was formed in 2018. The office includes The Chief Diversity and Inclusion Officer, the Assistant Director of Diversity and Inclusion, and the Diversity and Inclusion Coordinator. The goal of the Office of DEI is to ensure students, faculty, and staff are provided with an environment that promotes DEI and encourages the success of all community members.

The Office of DEI solicits the equitable perspectives of students, faculty, and staff regardless of race, gender, sexual preference or identity, disability, and/or religion.

While the focus on diversity and retention among the student population was the driving force behind FNU’s initial diversity, equity, and inclusion initiatives more than 20 years ago, those diversity goals and efforts now encompass all facets of the university. From faculty, staff, and the board of directors, to curriculum, marketing, and communications, FNU has engaged in careful self-examination and assessment to instill a university-wide focus and commitment to diversity, equity, and inclusion.

outreach activities in an effort to recruit faculty of color.

There was an increase in faculty of color from 11% in 2018 to 13% in 2019.

As part of the Health Resources and Services Administration Nursing Workforce Diversity grant program, FNU has engaged diversity consultant, Dr. Mona Wicks, from the University of Tennessee Health Science Center. Together, we have developed Diversity, Equity, and Inclusion faculty/staff course modules titled, Building Bridges in a Diverse World and The Link between Mental Health, Culture, Bias, and Stigma. These modules are required for all faculty and staff and are also made available to FNU’s Board of Directors.

For the past 10 years, FNU has held the Diversity Impact Conference. The annual conference is open to everyone who wants to become part of FNU's legacy of providing culturally competent care to rural and underserved communities. Each year, students engage in cross-cultural and inter-cultural workshop activities, along with leadership strategies and collaborative discussions to improve minority health among underrepresented and marginalized groups as it relates to patient-provider care.

While the 2020-2022 strategic plan clearly indicates FNU’s ongoing commitment to improving its diversity, equity, and inclusion efforts, the university’s progress has been

FNU has a clear agenda to increase the percentage of faculty of color.

This agenda was developed during our annual strategic planning retreat and is clear to all faculty administrators that hiring faculty of color is essential to diversity, equity, and inclusion efforts at FNU. The Diversity and Inclusion Coordinator and Assistant Director of Diversity and Inclusion have successfully organized and/or attended multiple 2019 PRESIDENT’S REPORT

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Goal 3 FNU Admissions:

recognized via the Insight Into Diversity Higher Education Excellence in Diversity Award. FNU was a recipient of this prestigious award in both 2018 and 2019.

“To receive this award two years in a row is a wonderful honor,” FNU President Dr. Susan Stone said. “Our graduates serve people of all races and cultures and are increasingly coming from diverse backgrounds. It is imperative that our students, faculty, and staff have cultural awareness and competency in order to effectively advance our mission. The HEED Award confirms the value of our efforts and validates our continued emphasis on diversity, equity, and inclusion within the culture of FNU.”

FNU implemented a revised holistic admissions process in the Winter of 2019, including race and ethnicity.

This process has provided a balance between merit and non-merit admissions. At the end of 2018, 22.18% of FNU students reported as members of racial and ethnic underrepresented groups. At the end of 2019, 24.11% reported as members of racial and ethnic underrepresented groups, a 1.93% increase. FNU is committed to the mission of creating nurse practitioners and nurse-midwives from diverse backgrounds to meet the healthcare needs in rural and underserved areas.

Graph 3.1 % of Students of Color per year

19.36%

2016

21.31%

22.08%

2017

2018

24.06%

2019

Graph 3.2 New Enrollments by Year-Unduplicated Headcount 95

100 55

51

2017

2018

34

50 17 0

2015 New Enrollments

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2016

2019

Goal 4 Increase the retention rate to 85% or greater across all programs.

FNU’s goal to increase its retention rate to 85% or greater is supported by several different programs and strategies to help students who might be struggling and on the verge of dropping out. The process begins with gaining a better understanding of which students are most apt to drop out, when they are most apt to drop out, and why they are most apt to drop out. Retention analysis reveals that the largest percentage of attrition occurs in year one. For that reason, starting from day one, students are paired with an academic advisor who will remain their advisor throughout their time at FNU. In place since 2014, the academic advisors are responsible for engaging each student in the education process, educating students regarding curricular requirements, and monitoring students’ progress toward degree completion. The advisor and student meet a minimum of once per term and more as necessary. Students are also paired with a Regional Clinical Faculty member (RCF) to provide support and direction.

Faculty mentors who model professional roles and responsibilities, clarify expectations for graduate-level coursework and promote professional development.

Additionally, FNU’s Office of Diversity, Equity, and Inclusion provides mentoring services for underrepresented students at professional conferences. The Professional Organization Mentoring Program (POMP) pairs underrepresented students with FNU faculty members as attendees at professional conferences throughout the year.

With these basic support systems in place, FNU continues to analyze data and understand how best to identify and assist students in need of help. In 2019, Director of Student Retention and Records Abby McCarthy, worked with the IT Department and the Retention Committee to create an online dashboard that produces, disseminates and analyzes detailed enrollment and retention reports with a focus on underrepresented students. This data is used to develop evidence-based programs designed to meet the needs of the student body.

One such program is free tutoring support for all students.

In 2019, the tutoring support assisted 196 students. In total, those students participated in 225 courses and attended 1,436 tutoring sessions.

In 2017, FNU also began using the retention tool Dropout Detective, which is designed to help identify students who are at risk of dropping out. In the last three years, this earlywarning system has identified 2,551 students for assistance.

In 2019, alone there were 14,027 notes regarding 2,675 unique students and 793 alerts guiding faculty to 270 students in need of academic assistance.

FNU attempts to address a common reason for students to drop out -- financial hardship due to events and situations beyond their control. FNU established the Student Emergency Scholarship Fund in 2016 to assist students who are experiencing a financial need due to an unforeseen emergency. The Student Emergency Scholarship Fund has been able to help students who have financial needs due to domestic violence, medical needs, death of a spouse, and natural disasters.

Graph 4.1 First-Year Retention Rate 100% 75%

84.94%

90.04%

90.95%

89.58%

87.48%

2015

2016

2017

2018

50% 25% 0

2014

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Goal 5 Foster a productive, inclusive, creative, and positive university environment for all constituents.

Arrows = involvement & collaboration pathways

Board of Directors

President

President’s Cabinet

Colors = decision making authority Purple = Decision making authority (financial policy/ criteria making) Blue = Decision making authority (policy/criteria making); Formulates recommendations for policy/ criteria changes

Student Body

Administrative Team

Faculty/Staff Council

Student Council

Standing Committees & Ad Hoc Workgroups Ed Tech, Curriculum, Diversity & Inclusion, etc.

As we share FNU’s strategic plan, it is important to understand FNU’s organizational structure. FNU implemented a model of shared governance, the purpose of which is to facilitate the involvement of its members in supporting FNU’s mission. FNU’s structure is focused on communication, joint planning, shared authority, and collaborative responsibility for decision making. The organizational structure of the shared governance model is composed of the faculty/staff at large, student body, academic and institutional standing committees, student 18

| 2019 PRESIDENT’S REPORT

Yellow = Decision making authority for committee level work; Formulates recommendations for policy/ criteria changes Green = Participates through established pathways

Faculty/Staff At Large

council, faculty/staff council, president of the university, and the board of directors.

“Through shared governance, we attempt to ensure transparency by communicating effectively and following our established guidelines,” said FNU President Dr. Susan Stone. “The overarching goal is to establish a partnership among all factions of the university, leading to well informed joint decision-making.”

In the shared governance model, Dr. Stone is the direct liaison between FNU’s faculty/staff council, faculty and staff at large, and the board of directors. It is the president’s responsibility to bring any shared governance matters that may affect the FNU policy to the board.

The faculty and staff at large makeup the academic and institutional committees. The student body at large makes up the student council with representatives from each track of each entering class. The responsibilities of the student council include matters related to student needs for the successful completion of FNU’s programs. Students appointed to the faculty/staff council and various FNU standing committees have a voice but no vote.

The faculty and staff at large, the academic and institutional standing committees, and the student council contribute members to the faculty/staff council. The faculty/staff council is responsible for issues related to the curriculum, student affairs and policies, administrative policy, human resources, academic, and institutional standing committees, and ad hoc workgroups. The faculty/staff council reports to the president of the university who is the direct liaison between the council and the board of directors. The faculty/staff council is composed of the chairs of each standing committee, the Dean, the Associate Dean of Academic Affairs, Department Chairs, Program Directors, VP of Finance, COO, Director of Development, plus two elected staff representatives and two elected faculty representatives. One student council representative is included as a member of the faculty/staff council with a voice but no vote.

The responsibilities of shared governance take into account many different aspects including matters pertaining to faculty/staff policy as well as matters pertaining to fiscal accountability. Another function of shared governance is the making of decisions related to the admission, progress, retention, promotion, and graduation of students as well as the decisions related to educational policies, curricula, programs, program evaluation, and learning resources of FNU. Shared governance also functions to provide support for the professional and personal development of faculty, staff, and students and their scholarship and clinical practice activities.

Shared Governance Goals

2

Clearly delineate the University President’s leadership roles including voice and veto ability in Faculty/Staff Council business and directly communicating shared governance matters that may affect FNU policy with the Board of Directors.

1

Continue to have administrators participate in university decisions while increasing the participation of faculty and staff voices in those decisions.

3

Ensure that the opportunity to participate in committee work is available to all members by requiring rotation of committee membership and leadership roles.

4

5

6

7

Ensure that shared governance members are able to make knowledgeable, informed decisions.

Develop a communication model to be used for shared governance business.

Efficient use of members’ time with a clear communication pathway.

Provide a clear pathway for forming and dissolving standing committees, subcommittees, and ad hoc committees.

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Goal 5 President’s Cabinet The President’s Cabinet is composed of the senior university administrators who report directly to the President.

The President’s Cabinet provides advice and counsel to the President, leveraging its collective knowledge and expertise to advance the University’s mission. They work closely together with the President, Board of Directors, and University leadership to provide advice, develop and implement university-wide initiatives and policies, and oversee the operation of the university.

Susan Stone DNSc, CNM, FAAN, FACNM President

Shelley Aldridge BA Chief Operations Officer

Angela Bailey MA, CFRE Chief Advancement Officer

Joan Slager CNM, DNP, FACNM Dean of Nursing

Michael Steinmetz CPA, CMA, CSCA Executive Vice President for Finance and Facilities

Geraldine Young DNP, APRN, FNP-BC, CDE, FAANP Chief Diversity and Inclusion Officer 20

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FNU Board of Directors and Foundation Board of Directors

Michael Carter Chair

Mike Rust Vice-Chair

Emma Metcalf Treasurer

Wallace Campbell Secretary

Carlyle Carter

Peter Coffin

Eunice (Kitty) Ernst

Nancy Hines

Phyllis Leppert

Marcus Osborne

Kerri Schuiling

Peter Schwartz

Nancy Woods

May Wykle

Derek Bonifer

Jean Johnson

Maria Small

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Goal 6 Provide faculty development opportunities designed to assure success in their roles as teacher, practitioner and scholar.

TeamSTEPPS Implementation

by Rachel Mack, Ph.D., DNP, APRN, C-FNP, CNE, Associate Dean of Academic Affairs FNU’s Quality Enhancement Plan (QEP) is focused on enhancing healthcare team communication utilizing the TeamSTEPPS framework, which is an evidence-based, comprehensive teamwork training system to improve quality and safety in healthcare and is rooted in more than three decades of research.

TeamSTEPPS was developed by the Agency for Healthcare Research and Quality (AHRQ), which will help students at FNU become better team members and communicators.

FNU's Faculty Innovation Coach trained all the RCFs during the Spring 2019 term to administer the Team Performance Observation Tool (TPOT). Baseline data was collected from Summer 2019 through Spring 2020. A plan was also developed to ensure the TPOT was utilized at all mid-clinical site visits and the TPOT form was linked into RCF 101 and on the FNU Portal page for easy access.

During the Summer 2019 term, the QEP Implementation Steering Group members During the Spring 2019 term, a system was and Associate Deans completed Innovation created for data tracking and analysis, and the 101: From Imagination to Simulation. The QEP Implementation Steering committee was Faculty Innovation Coach and Curriculum and formed. The committee has 10 volunteers Course Design Coach created and assembled with representation from each department. materials for all students for orientation Rachel Mack, Ph.D., DNP, APRN, C-FNP, The volunteers include Course Coordinators, bounds (Frontier Bounds and Crossing CNE, Associate Dean of Course Faculty, Clinical Bound Faculty, Clinical Academic Affairs Bounds) to introduce TeamSTEPPS beginning Bound Team Leaders, and Regional Clinical the Winter 2020 term. The Teamwork Faculty (RCFs).

Attitudes Questionnaire (T-TAQ) form was created in Survey Monkey for all students to complete Also during the Spring 2019 term, the Academic Affairs starting in Winter 2020. department introduced the curriculum mapping process to faculty and the curriculum map was complete by the end TeamSTEPPS training occurred at the on-site Faculty of the Summer 2019 term. One thread that was mapped Meeting in September during the Fall 2019 term and an was any existing healthcare team communication and escape room was created for faculty participation during teamwork content, activities, and assessments. Based on the breakout session at the Faculty Meeting, which allowed the curriculum mapping results, courses were identified participants to apply the knowledge learned from the where TeamSTEPPS content, practice, and evaluation training to escape from the room in teams. New faculty should be implemented. orientation was revised to include TeamSTEPPS virtual training. Virtual TeamSTEPPS training will continue to occur for new faculty hires in August each year. Three course coordinators completed Innovation 101: From Imagination to Simulation during the Fall 2019 term for course content implementation in Spring 2020.

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The Center for Innovative Teaching and Learning Implementation of the TeamSTEPPS content into the curriculum began in Winter 2020 and the content was placed in three courses for the Spring 2020 term. The course coordinators who have implemented content into their courses showcase their TeamSTEPPS content creation during the monthly Curriculum Committee meetings.

Faculty Development

49

In 2019, 49 faculty members became Certified Nurse Educators In 2019, 49 faculty members participated in the FNU Research Symposium

FNU launched its Center for Innovative Teaching and Learning (CITL) in 2017. Funded in part by the generosity of Dr. Alan Howard, the purpose of the CITL is to improve instructional practices and delivery methods for FNU students and faculty.

The CITL offers professional development opportunities for faculty to help them deliver the best possible instruction to students. Via instructional coaches, library resources, and technical assistance, the CITL equips faculty with support and guidance and provides assistance with course design, development, and alignment. Faculty can also receive assistance and share ideas on a variety of other topics, such as simulations and time management tips.

The CITL has a dedicated online presence on the FNU portal where faculty and students can share ideas and questions. Additional communication comes via monthly newsletters, one month focusing on studentspecific topics, and the next focused on facultyspecific content.

“Communicating with your course coordinator or course faculty is the single most important tip for students,” said CITL Instructional Designer Ally Williams, M. Ed. “No matter the circumstance, your course coordinator or course faculty should be in the loop. The worst thing you can do as a student would be to just fall off the face of the Earth and not tell the course coordinator or course faculty. No one but you knows what you are going through.”

The CITL helps open the lines of communication between students and faculty within a forum designed for questions and the sharing of ideas, information, and best practices.

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Goal 7 Ensure the effective use of administrative and technical systems to improve service.

FNU’s History as a Pioneer in Distance Learning When Mary Breckinridge recognized the difficulty of providing healthcare to people in the rural Appalachian region of eastern Kentucky she founded the Frontier Nursing Service (FNS) in Hyden, Ky., in 1925. FNS introduced the first nurse-midwives to the United States.

Riding horses up mountains, through fog, flood, or snow, the FNS nurses brought modern healthcare to one of the poorest and most inaccessible areas in the U.S. The impact of FNS led to the founding of Frontier Nursing University as the Frontier Graduate School of Midwifery in 1939 as part of FNS’ demonstration project in the care of the mother and child in rural areas of Kentucky.

Fifty years later, Frontier leaders once again recognized a nation-wide need and created a solution to the problem.

FNU recognized a national shortage of nurse-midwives and understood that there were nurses living in rural and underserved areas who would pursue graduate education if they were given the opportunity without a requirement to leave their home community. It also stood to reason that educating students within their communities would result in a higher proportion of clinicians who stay and serve those communities. Because of this FNU launched an innovative hybrid model of distance learning for midwifery education in 1989. In the 30 years since FNU has transformed from a small certificate program to one of the largest and most successful graduate schools of nursing in the United States.

“The stories of the success of our graduates in providing health care services including maternity care around the world is the true measure of our success,” said FNU President Dr. Susan Stone.

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The overall student experience is a hybrid model of two campus experiences, combined with didactic coursework online and community-based clinical practicum in students’ home communities. The FNU network consists of more than 150 didactic faculty and Regional Clinical Faculty (RCF) located nationwide, alumni and clinical preceptors in every state, and a dynamic online presence for academic and peer support.

While didactic faculty design and delivery in-line courses, the RCFs guide and assist students in the areas in which they live and assist students with clinical placement in their communities. RCFs are responsible for evaluating both the clinical site and preceptor to ensure it will meet programmatic needs before students begin the clinical experience. RCFs remain in regular contact with both preceptors and students as they proceed through their clinical practicum. They participate in discussions with preceptors, help resolve any issues regarding clinical sites, organize regional gatherings, and share clinical wisdom and experience. They visit the site prior to the student starting the experience and at least once during the student experience.

Building the IT Infrastructure on the Versailles Campus All students begin their FNU experience by traveling to campus in Kentucky for a 3-day orientation. Students are welcomed into the Frontier community and solidify their commitment to improving healthcare for the families they will serve. Students return to their home communities to complete didactic courses over the next approximately 18 months. All students return to campus for the fiveday Clinical Bound session where they demonstrate their physical assessment skills and participate in simulations designed to prepare them for their clinical experience.

Students complete the clinical experience in community sites such as hospitals, clinics, and birth centers located in or near their own communities.

Marc Weitlauf FNU Director of Information Technology

FNU’s distance learning model comes with an inherent emphasis on technology that is safe, fast, reliable, and adaptive.

Ensuring that students, faculty, and staff all over the country have access to the resources, communications, and opportunities they need to succeed is essential.

As FNU prepares to open its campus in Versailles, Kentucky, great effort and planning have gone into providing a state-ofthe-art technological infrastructure that will pair appropriately with the needs of both those on campus as well as the students and faculty members across the country. In addition to delivering high-speed, quality communications, the campus technology also includes 87 security cameras, all of which will be monitored by around-the-clock security guards. Information will be disseminated via digital signage on monitors mounted in many of the campus buildings. A mobile app is being developed to allow on-campus students to stay informed about campus events, schedules, and additional information. An SMS texting system is also in development to allow for emergency communications to those on campus.

“Delivering information safely and efficiently is our top priority,” said Marc Weitlauf, FNU’s Director of Information Technology. “We are excited about the many new opportunities the campus brings and look forward to delivering excellent IT service to all members of the FNU community.”

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Goal 8 Develop and implement programs designed to secure resources to support programs and operations.

A key component of FNU’s success is due to its financial security. Its financial leadership and low overhead (see story on page 31) provide a sound financial base for FNU’s operations. Working hand-in-hand with the university’s financial experts is FNU’s advancement team. Led by Angela Bailey, who became the Chief Advancement Officer in 2019, the advancement team leads the university’s fundraising efforts, alumni and donor relations, as well as assisting the marketing department with communications and public relations.

Central to these fundraising efforts is the generation of scholarships and financial support for FNU’s students. Even though FNU’s low tuition rates compare favorably to other institutions and the university places a priority on affordability, most students still Angela Bailey incur an average of $60,000 in MA, CFRE Chief Advancement student loan debt. In 2019, 84% Officer of all students received federal student loans. The majority of FNU students are working adults with families, making the cost of higher education and the subsequent loan payments a potential financial strain.

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The advancement team seeks to address this need for scholarship funds and to help reduce student loan debt via donations, bequests, grants, and other funding sources.

“Because so many of our students rely on student loans and scholarships to support their pursuit of postgraduate degrees, it is imperative that we operate efficiently,” said Chief Advancement Officer Angela Bailey. “We have to keep costs down while maximizing the amount of support available to our students.”

In 2019, Linda Barnes joined the team as the Senior Development and Alumni Relations Officer. It was a year of great change and growth that included updating systems, procedures, team composition, and job duties to further the support of the University.

Emergency Scholarship Fund FNU donors have helped establish more than 25 scholarships available for students based on varying criteria. One of the special scholarship funds offered by FNU is the Student Emergency Scholarship Fund, which was established by Alan Howard in 2016. The purpose of this fund is to assist students who are experiencing a financial need due to an unforeseen emergency. The Student Emergency Scholarship has assisted students with financial needs due to situations such as domestic violence, medical needs, death of a spouse, and natural disasters. More than 200 students, such as the one who shared her gratitude in the following quote, have been assisted by the Student Emergency Scholarship Fund since 2016.

8%

In 2019 FNU’s fundraising increased by 8%, which exceeded the national average of 0% change as reported by Giving USA.

“I am writing to express my deepest gratitude to the FNU Emergency Fund Committee. My journey to becoming a Certified Nurse-Midwife through Frontier has had many highs and lows. Requesting additional financial assistance to help me get through what has become the hardest year of my life was not easy, but necessary. Your generous support will be used to pay doctor bills that are close to collections and my electric bill this month. I hope one day when I have completed my education and am fully employed I can return the favor so another FNU student can reach their goal of becoming an advanced practice provider.”

Table 8.1 Year

Donor Funded Scholarships

Federal Grants & Scholarships

Total Scholarships & Grants

Average Loan Debt of Graduates

Percentage of Students Using Loans

2016

$82,650

$350,000

$432,650

$57,161

82%

2017

$189,925

$115,000

$304,925

$62,618

80%

2018

$122,225

$227,508

$349,733

$66,448

85%

2019

$386,310

$772,000

$1,158,310

$67,851

82%

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Goal 9 Continuously improve and maintain facilities to meet the needs of students, faculty, and staff.

On October 13, 2017, Frontier Nursing University finalized the purchase of property in Versailles, Kentucky, that would become the site of FNU’s new campus. FNU has maintained a campus in Hyden, Kentucky, since its founding in 1939, but determined that the move to the Versailles campus, which is set to be completed in the fall of 2020, will allow FNU to better serve students and continue its longstanding commitment to the mission of educating nurse-midwives and nurse practitioners to provide healthcare to women and families with a focus on those in diverse, rural, and underserved populations.

“Change is necessary to continue advancing our ultimate mission of improving healthcare for families everywhere,” said FNU President Dr. Susan Stone. “This campus will make room for the growth needed to establish Frontier as the leader in advanced nursing and midwifery education.”

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The campus is located in a beautiful rural setting but is also less than 10 minutes from the Lexington Bluegrass Airport and accessible from major highways. The campus promises to allow for increased accessibility, cutting-edge teaching, and learning facilities and enhanced lodging and services for students and faculty. FNU’s vision is that the opening of the Versailles campus will permanently establish the university as a leader and national model of excellence for distance learning for advanced nursing and midwifery education.

The move to the new campus allows FNU to potentially expand enrollment -- currently over 2,300 students -and also improve program offerings in order to meet the growing demand for access to quality healthcare nationwide, especially in rural and underserved areas. FNU will continue to recruit, educate, and graduate nurses to increase access to quality healthcare for rural and underserved communities.

The Versailles Campus includes 18 buildings that will enable FNU to maintain and expand its programs and activities. The Community Center will host campus-wide events, lectures, workshops, and seminars. The auditorium, which accommodates up to 120 people, will be used for larger group presentations and Frontier Bound orientation sessions. Four breakout rooms surrounding the auditorium

will serve as smaller meeting spaces. A large lobby will be used for social gatherings and light catering. The Learning Center is a two-story, 8,382 square foot building that has two classrooms, two large laboratory/clinical practicum rooms, a birth center simulation room, a labor and delivery simulation room, a group therapy simulation room, PMHNP counseling or telehealth simulation rooms, and exam rooms for clinical instruction and simulations. Both the Community Center and the Learning Center are equipped with stateof-the-art telecommunications equipment which will enable remote participation in sessions and events.

The Library and Student Services building will house the library and staff that directly support students. The library, which includes a small physical collection of books, journals, and archival materials, will remain virtual so students and faculty located across the United States will continue to access the library resources via login to our online library portal. The Library and Student Services building also has a lounge, two small conference rooms, and workstations for staff to meet with students.

The Administration Building will offer more space to house the administrative and leadership staff, with a capacity of approximately 17. There will also be several common areas and two small and one large conference rooms.

The Welcome Center is situated in front of a large parking area. Students will be able to park their cars, enter the Welcome Center, and walk through to the main campus to spend the rest of their time gathering with classmates, faculty, and staff. The Welcome Center is a large room will be used for student check-ins and meetings.

The Versailles Campus includes three Student Lodges with 51 individual rooms and a combined total capacity of 97 students. Each Student Lodge is two stories and includes a common living and learning area with a kitchenette and a large bathroom per floor.

Additional residential space will be provided by the Faculty and Staff House, which will have 11 individual rooms for visiting staff and faculty members; the Dean’s House, with three individual bedrooms for the Dean and Department

Chairs; and the President’s Cottage, with three individual bedrooms for the President and visitors.

The only new building on campus is the Dining Hall. This 6,815 square foot building has a lower level with a Fitness Center and Gift Shop. The main level has a large industrial kitchen and dining space for 120. There is also a large outdoor patio area to accommodate outdoor dining.

The President’s House, a historic home that has been meticulously renovated, will be used to house university guests and host special events. On the upper level, there are four bedrooms with private bathrooms and a sitting area. The main level has two parlors, a large dining room, a catering kitchen, and another sitting area that leads to an outdoor patio.

Two additional buildings are located on the far side of the campus. One is a two-story building that will be used for additional office space. The other contains five small apartments that will be used for housing students who bring an infant and caregiver with them to campus.

In Development: While the Versailles campus is set to open in 2020, these additional projects will be featured in the next phase of development: Spiritual space: An existing building on campus will be renovated for use as a spiritual space. Students will have a quiet space dedicated to prayer, meditation, and reflection.

Walking trail: Incorporated into the 67-acre campus will be a three-mile walking trail.

Outdoor pavilion with bell tower: FNU students have a long tradition of ringing a bell to indicate their readiness to begin a new journey. A new bell, donated

by FNU Dean Dr. Joan Slager, will be placed by the pavilion to continue this tradition.

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Goal 9 Versailles Campus at a Glance

Learning Center

Student Lodges

Library & Student Services

● 1 Birthing Simulation Room Labor and Delivery Unit

● 3 residence halls (total capacity of 97 students)

● IT Center

● 1 Birthing Simulation Room Home or Birth Center

● 51 individual rooms

● Library

● 2 classrooms to accommodate up to 18 students for specialty track instruction and lectures.

● 1 Living and Learning common area with kitchenette in each residence hall

● 28 workstations ● Lounge ● 2 small conference rooms

● 2 simulation labs will house state of the art simulation labs for all specialty tracks. ● 12 individual exam rooms will provide for simulated patient encounters and small group instruction for nurse-midwifery and nurse practitioner students.

Community Center

Administration Building

● Large auditorium for campuswide events, lectures, workshops, seminars which will accommodate up to 120 people

● 6 private offices

Welcome Center

● 4 breakout rooms accommodating up to 26 persons in each room

Dining Hall

Faculty and Staff House

● Capacity of 120 ● Outside patio ● Gift Shop ● Fitness Center 30

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● 11 individual rooms

● 10 shared offices ● 9 open workstations ● 2 small conference rooms ● 1 large conference room

Additional Structures ● Pavilion and Bell Tower ● Walking Trail ● Spiritual Center

Goal 10 Develop a long-range financial plan to support the strategic planning process.

Efficiency and low overhead lead to lower costs without lower quality.

Michael Steinmetz CPA, CMA, CSCA Executive Vice President for Finance and Facilities

Not only does FNU’s model of distance and face-to-face education serve students who want to continue working in their communities while they pursue their advanced degrees (see story on page 24 for more information), it also enables FNU to maintain a low overhead. FNU keeps operational costs low while providing high-quality education demonstrated by our graduates who regularly exceed the national licensing pass rate averages.

The quality of instruction is attributable in large part to the distance learning model that allows for a diverse and talented faculty that is not constrained by geographic boundaries and do not require significant office space.

“We frequently compare our tuition rate to other institutions,” said Executive Vice President for Finance and Facilities Michael Steinmetz. “FNU’s tuition rate per credit hour is 55% that of comparable institutions. That is an important part of our service to our students.”

Steinmetz’s financial department and Chief Advancement Officer Angela Bailey’s advancement team work closely to monitor the financial standing of the university, implement strategies to maintain and expand its financial stability, and ensure that the institution is acting as excellent stewards of all financial resources, including donor funds. Both report quarterly to the FNU Board of Directors.

In addition to raising funds, the finance and advancement departments focus on efficiency and cost savings. These efforts include periodic bidding processes for vendors and carefully tracking return on investment.

“We take great pride in keeping our tuition rates as low as we can,” Steinmetz said.

“Our Board of Directors fully endorses this strategy and has tremendous oversight and input into our financial structure and planning. Their support and understanding of our mission are what allows us to operate with high efficiency, high impact, and low overhead.”

That leadership and financial oversight are evident in FNU’s planning for the future. As FNU identifies potential needs or changes in the university’s structure, facilities, or curriculum, it analyzes projected expenses. This process is very similar to the data-driven decision making that leads FNU to identify necessary changes in curriculum. Working with its financial advisors, board members, and investment managers, FNU creates a plan to generate the funds necessary to implement initiatives outlined in the strategic plan. By understanding both the needs of the students and the cost to meet those needs, FNU is able to maximize efficiency and maintain a sound financial standing.

“The Advancement Team and the Finance Department are two sides of the same coin. By working together we ensure accountability, credibility, and protect the investment of all donors,” said Chief Advancement Officer Angela Bailey.

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2020 Strategic Plan Even as FNU entered into the final year of its 2015-2019 strategic plan, work on the next plan was already beginning.

The process began at the FNU Board of Directors retreat in April 2019. The board brainstormed ideas for what, at that time, was intended to be another five-year plan. From the retreat came a list of broad-based themes and ideas which were then presented to focus groups consisting of FNU faculty and staff.

The focus groups, which were created by the President’s Cabinet, met during the summer of 2019 to build upon the

themes identified at the Board of Directors retreat. Minutes from those summer meetings were then used to help create the initial draft of strategic goals.

The next step in the process was to survey FNU staff, faculty, and student council representatives to gain additional feedback and suggestions regarding the proposed strategic plan goals. As part of this process, the community also voted to change the strategic plan from five years to three, allowing FNU to have more flexibility to adjust to changing times and needs rather than being locked into

Strategic Plan 2020-22 Strategic Plan Goals Goal 1: Continue to develop, evaluate, and improve programs and services that further our mission.

Goal 2: Create an environment

that promotes diversity, equity, and inclusion and promotes the success of all community members.

Goal 3: Build strategic relationships and partnerships with clinical sites and preceptors, focusing on rural areas.

Objectives

Objectives:

Objectives:

● Develop a plan for pathways to the DNP for potential implementation for 2022.

● Increase the percentage of students, faculty, staff, (preceptors), Board of Directors, and administrators from racially and other underrepresented groups and rural communities.

● Develop a plan to educate health care sites and systems about the benefits of taking students.

● Assess the sustainability of the Bridge program by winter 2020.

● Integrate Diversity, Equity, and Inclusion as core values throughout the community.

● Create a positive environment for preceptors.

● Assess the alignment of the Women’s Health Nurse Practitioner program with our mission by the end of 2020.

● Ensure a diverse and inclusive curriculum with a focus on health equity and the factors that impact it.

● Increase the DNP Plan of Study (POS) by 2 credits to address gaps in the program.

● Implement strategies to retain at least 85% of enrolled students. ● Increase faculty and staff satisfaction and retention with a focus on underrepresented groups.

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● Increase the number of alumni preceptors.

goals that could be outdated by year five of a particular strategic plan.

“Adapting to the changing needs of our communities has been a part of our history since our founding,” said FNU President Dr. Susan Stone. “Our faculty, staff, and students recognized that and felt that a three-year plan would better enable us to develop actionable goals while continuing to evaluate the changing needs of our university and the communities our students and graduates serve.”

Once the 2020-2022 goals were approved by the community and the Board of Directors, the goals were expanded upon by the development of actionable and measurable objectives for each overarching goal.

Throughout the year, progress toward these goals and objectives are reported upon by department leaders.

All progress is shared in quarterly meetings with faculty, staff, and the Board of Directors, ensuring accountability and continued commitment to the goals and objectives established by the FNU community.

Goal 4: Continuously improve and maintain facilities to meet the needs of students, faculty,

Goal 5: Use technology to ensure improvement and attainment of service excellence

Goal 6: Ensure the financial strength and growth is sufficient to meet the needs of

and staff.

to the community.

the university.

Objectives

Objectives

Objectives

● Complete the reconstruction and furnishing of the Versailles Campus

by August 1, 2020.

● Begin the process to choose a new Student Management System with RFP rollout in January 2021.

● Implement operations of the Versailles Campus (food service, security, maintenance, janitorial, etc.).

● Assess and implement technology needs for new campus buildings.

● Evaluate the feasibility of alternate revenue streams, existing as well as potential opportunities with the new campus.

● Implement facility support for Program management on the Versailles Campus (e.g., logistical support, transportation to campus and on-campus [golf carts, trams], appropriate room assignment, equipping of rooms, room access, dorm room assignment). ● Seek and finalize a plan for transitioning the Hyden Campus to new owners for positive new use. ● Create a facilities master plan for the Versailles campus which includes future development and capacity planning.

● Implement Security Enhancements.

● Establish a periodic vendor review process to ensure optimal operating efficiencies. ● Develop, implement, and evaluate procedures and processes for all aspects of fundraising. ● Evaluate the Courier Program and implement appropriate improvements for successful alignment with the mission and program goals. ● Increase the public knowledge and understanding of the definition and scope of practice of the CNM/CM.

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2019 Events and Honors 852 Graduates Honored at First Commencement Ceremony in Lexington, KY Graduates, family, friends, faculty, and staff gathered in Lexington, KY to celebrate commencement on Saturday, Sept. 28, 2019, honoring 852 graduates. A total of 265 graduates attended the event, accompanied by family, friends, and more than 200 FNU faculty, staff, and board members. This graduation was the first to ever be held outside of Leslie County. The new location at Rupp Arena in Lexington, KY was not only close to our Versailles Campus but also allowed for larger attendance and greater comfort for those in attendance.

“As our enrollment and thus graduates continue to grow, it was essential that we find a facility that would accommodate these larger numbers,” said Dr. Susan Stone, FNU President. “The new venue not only allowed for more family and friends to attend graduation but also provided greater access to accommodations for those traveling to graduation and enhanced capabilities for sharing the commencement ceremony virtually.”

Degrees were conferred on graduates who completed the Doctor of Nursing Practice degree, Master of Science in Nursing degree, or Post-Graduate Certificate. To accommodate the nearly 2,000 attendees, the ceremony was moved from its traditional location in Hyden, Ky., to Lexington Center’s Bluegrass Ballroom in Lexington, Ky.

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An annual highlight of the commencement ceremony is the awards presented to faculty and students who showed exceptional performance and leadership: Doctor of Nursing Practice Leadership Award: Heather Haslun, DNP Nurse Practitioner Leadership Award: Kristin DeArruda Wharton, MSN, FNP Kitty Ernst Leadership Award: Heidi Phillips, MSN, CNM DNP Exemplary Project Award: Carla Bray, DNP Student Choice Academic Faculty Award for Excellence in Teaching: Janet Engstrom, PhD, APRN, CNM, WHNP-BC, CNE Student Choice Regional Clinical Faculty Award for Excellence in Teaching: Nancy Pesta Walsh, DNP, FNP

Former U.S. Surgeon General Dr. Joycelyn Elders Addresses Graduates FNU was honored to welcome Dr. Joycelyn Elders, M.D. as the keynote speaker at the 2019 commencement ceremony. In 1993, Dr. Elders was appointed as the 15th Surgeon General of the United States, becoming the second woman and the first African American to serve in the role. Dr. Elders shared her inspiring journey of rising from her upbringing in rural Arkansas through the medical and governmental ranks. Throughout her career, she achieved ground-breaking success in her office practice, medical research, and education leadership. Now retired, she still plays an active role in public health education in her Arkansas community.

“It was a tremendous honor to have Dr. Elders join us as the keynote speaker for our 2019 commencement ceremony,” said FNU President Dr. Susan Stone, who joined FNU Board of Director chair Dr. Michael Carter in awarding Dr. Elders an FNU honorary doctorate. “We are so thankful and proud that she shared her story with our graduates and their families.” In her commencement address, Dr. Elders spoke about the important role the graduates will play in the health care of the country.

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2019 Annual Awards Every fall, Frontier Nursing University presents its annual awards for service. The following alumni, volunteers, and supporters were selected as the 2019 honorees: Distinguished Service to Alma Mater - Nurse-Midwife: Stephanie VanderHorst Distinguished Service to Alma Mater - Nurse Practitioner: Danny Shane Webb Distinguished Service to Society - Nurse-Midwife: Mary Kay Miller Distinguished Service to Society - Nurse Practitioner: Jessica Lynn Smith Courier Program Unbridled Spirit Award: Carlyle Carter Mary Breckinridge Lifetime Service Award: Margaret Voorhies Haggin Trust

FNU President Dr. Susan Stone Inducted into National Academy of Medicine

Frontier Nursing University President Dr. Susan Stone, DNSc, CNM, FACNM, FAAN, was inducted into the National Academy of Medicine (NAM) Class of 2018 at the organization’s annual meeting on October 19, 2019, in Washington, D.C. Of the 85 new inductees, Dr. Stone was one of only two nurses in the NAM Class of 2018 and was the only inductee from Kentucky in the class.

“The National Academy of Medicine offers an incredible opportunity to work collaboratively with leaders from a wide range of medical professions and disciplines,” Dr. Stone said.

“It is a tremendous honor to join this organization which is so deeply committed to improving health care.”

The election of Dr. Stone into the NAM membership was based on facts that she has reached distinguished professional achievement in the field of medicine and health, has demonstrated and continues her involvement with issues in healthcare, disease prevention, education, and research, along with showcasing skills and resources likely to contribute to the Academy’s mission and finally, has proven a willingness to actively participate in the work of the Academy.

Established originally as the Institute of Medicine in 1970 by the National Academy of Sciences, the National Academy of Medicine addresses critical issues in health, science, medicine, and related policy and inspires positive actions across sectors. Election to the Academy is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service. Members are elected by current members through a process that recognizes individuals who have made major contributions to the advancement of the medical sciences, health care, and public health. NAM’s total membership is more than 2,200, with only three members being from Kentucky, including Dr. Stone.

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Dr. Michael Carter Presented Dean’s Distinguished Alumnus Award

The University of Arkansas for Medical Sciences in Little Rock held a 50th reunion for the classes of 1969. FNU Board Chair Michael Carter, DNSc, DNP was presented with the high honor of Dean’s Distinguished Alumnus by Dean Patty Cowan of the College of Nursing. Dean Cowan presented him with a bowl made by the glass artist James Hays. Dean Cowan said that the wavy pattern of the bowl represented the waves that Michael had made in the practice of nursing both nationally and internationally.

Among Dr. Carter’s many impactful accomplishments, in 2013 he was invited by the Western Australia Department of Health and Curtin University in Perth, Australia as a Visiting Professorial Fellow to help create nurse practitioner practices in primary health care for the state. The Australian Commonwealth Department of Health asked him to assist developing new regulations based on an article he published concerning changes needed to promote nurse practitioner practice in the country to help address the shortage of general practitioner doctors. In 2018, he returned to Australia and began working with a group of very isolated nurse practitioners in a sparsely populated part of the country to evaluate their practice.

In addition to his work with FNU, Dr. Carter is currently appointed a Distinguished Professor and Dean Emeritus at the University of Tennessee Health Science Center in Memphis and is an Adjunct Clinical Professor of Geriatric Medicine of the University of Arkansas for Medical Sciences.

Dr. Kerri Schuiling Selected as a Crain’s Notable Women in Education Leadership Honoree FNU alumna and Board of Directors member Dr. Kerri Schuiling, WHNP, CNM, Class 01, was recognized as a Crain’s Notable Women in Education Leadership 2019 honoree in September.

Published by Crain’s Detroit Business, the Crain’s Notable Women Series honors women leaders in various occupations in Michigan. Dr. Schuling is one of 35 women who were featured in the 2019 Notable Women in Education Leadership report. The honorees were selected by a team of Crain’s Detroit Business editors based on their career accomplishments, a track record of success in the field, contributions to their community, and mentorship of others.

Dr. Schuiling is the provost and vice president for academic affairs at Northern Michigan University (NMU). Dr. Schuiling holds a Ph.D. from the University of Michigan, a master’s degree from Wayne State University, and a baccalaureate degree from NMU. She is certified as both a women’s health nurse practitioner and nurse-midwife. Dr. Schuiling is the coeditor of the International Journal of Childbirth, the official journal of the International Confederation of Midwives, and has published more than 42 peer-reviewed papers and book chapters. Her book Women’s Gynecologic Health has received two books of the year awards.

FNU Alumni Cruise More than 150 FNU alumni, leadership, and staff mmbers enjoyed the FNU Alumni cruise to the Bahamas on March 2428. Among the many events, the cruise featured a catamaran excursion, a group cocktail party, and two pharmacology CE sessions.

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