www.jtln.org

Student-to-faculty ratios, teaching loads, and salariesin associate degree nursing programs in thecentral United States

Donna Jones MSN, RNa,*, Barbara Caton MSN, RNa, Joyce DeWitt MSN, RNa,Nancy Stubbs MSN, RNb, Esther Conner MSN, RNc

aDepartment of Nursing, Missouri State University-West Plains, West Plains, MO 65775, USAbDepartment of Nursing, Texas County Technical Institute, Houston, MO 65483, USAcPhysicians Group Practice Project, St. John’s Health Plans Medical Management, Springfield, MO 65807, USA

1557-3087/$ – see front matter D 2007 N

doi:10.1016/j.teln.2006.10.004

* Corresponding author. Tel.: +1 417 2

E-mail address: donnajones@missouri

KEYWORDS:Nursing education;

Faculty workload;

Costs

Abstract While much can be found in the literature about what constitutes quality teaching and

learning, little published research addresses how to structure faculty workloads to maximize faculty

productivity without jeopardizing program quality. This descriptive study provides an initial look at

issues of program structure (student-to-faculty ratios in class and in clinical settings, teaching loads for

the director and the faculty, and salaries) that most affect the cost of delivery for associate degree

nursing programs.

D 2007 National Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights

reserved.

1. Introduction

Current socioeconomic trends have identified that a

shortage of both nurses and nursing faculty will persist

and is likely to worsen over the next 20 years. All nursing

programs are seeking ways to increase enrollment, attract

faculty, minimize costs, and increase quality. While much

can be found in the literature regarding what constitutes

quality teaching and learning, little published research

addresses how to structure faculty workloads to maximize

faculty productivity without jeopardizing program quality.

This descriptive study provides an initial look at these issues

ational Organization for Associate Deg

55 7245; fax: +1 417 255 7246.

state.edu (D. Jones)

of program structure (student-to-faculty ratios in class and

inclinical settings, teaching loads for the director and the

faculty, and salaries) that most affect the cost of delivery for

associate degree nursing programs.

2. Literature review

Few studies regarding cost strategies that are related to

implementing an associate degree nursing program have

been published. One apparent reason noted in investigating

cost-effectiveness for clinical education in 2-year colleges is

that few programs are required to perform cost analysis, and

correspondingly, there is a lack of cost–benefit tools (Jones,

Murtaugh, Durkin, Bolden, & Majewski, 2000).

Teaching and Learning in Nursing (2007) 2, 17–21

ree Nursing. Published by Elsevier Inc. All rights reserved.

Table 1 Student-to-faculty ratios

Total no.

of schools

Total no.

of students

Total no. of

FT faculty

Total no. of

PT faculty

Student-to-FT-

faculty ratios

Student-to-PT-

faculty ratios

Student-to-total-

faculty ratios

All schools surveyed 36 4,793 305 163 16:1 29:1 10.2:1

Schools with

b100 students

19 1,399 98 51 14:1 27:1 9.4:1

Schools with

N100 students

17 3,394 207 112 16:1 30:1 10.6:1

D. Jones et al.18

Cahill et al. (1998) addressed curriculum changes that

used community-based learning strategies and preceptors

within community clinical facilities. The students had weekly

written assignments and weekly conferences with an instruc-

tor and could contact an instructor via telephone or pager. The

authors did not specifically address cost-effectiveness.

Community partnerships are being used to help fund

nursing education. Peterman (2000) provided examples of

such partnerships—a nursing home providing facilities for

a basic nursing skills laboratory with students assisting in

basic patient care as part of their education and a county

hospital providing funds for a nursing coordinator, supplies,

and a classroom as part of a branch campus for a nursing

program. Although these partnerships provide funding for

schools of nursing, they do not address the problem of how

to structure an educational program to get maximum benefit

from available funding.

Farrell (2004) points out that the shortage of qualified

nursing faculty is exacerbated by poor salaries, with

professors in nursing making less than some other disci-

plines and less than clinical nurses. Farrell also reports that

public institutions often place more emphasis on degrees

earned and publication in academic journals than do bfor-profitQ colleges.

Table 2 Faculty load

All

schools

Schools with

b100 students

Schools with

N100 students

3. Methodology

A survey tool developed by faculty was mailed in the fall

of 2004 to 106 associate degree nursing programs in the

central United States. To the extent possible, the programs

selected came from public institutions that have fewer than

5,000 students. Thirty-six programs (34%) returned the

survey forms. The survey tool was coded to allow for

follow-up contact to clarify the descriptive data sought. If

returned data were unclear, the program director was

contacted to help clarify the data. Eighteen schools were

contacted to clarify data.

Contact hours for

nursing faculty are

greater than those

for other faculty

14 7 7

Contact hours for

nursing faculty are

equal to those for

other faculty

21 11 10

4. Summary of results

4.1. Student-to-faculty ratios

The schools surveyed reported an average student-to-

full-time (FT)-faculty ratio of 16:1 and an average student-

to-part-time (PT)-faculty ratio of 29:1 with an average

student-to-total-faculty ratio of 10.2:1. Smaller schools

(b100 nursing students) tend to use more faculty (both FT

and PT). These schools had average student-to-FT-faculty

and student-to-PT-faculty ratios of 14:1 and 27:1, respec-

tively, and an overall ratio of 9.4:1, whereas for the schools

with more than 100 students, the corresponding figures were

16:1 and 30:1, respectively, with an overall ratio of 10.6:1

(see Table 1). Clinical group sizes ranged from 8 to

12 students, and class sizes for the nonclinical instruction

ranged from 10 to 80 students.

4.2. Faculty loads

The difficulty in determining teaching load for nursing

faculty was strongly demonstrated by the survey data. Using

credit hours to determine load was often meaningless for

nursing programs because of the high percentage of time

spent in the clinical setting, which is always converted from

credit hours to contact hours (actual hours per week spent in

class/clinical setting) by a factor of 2 or 3 to allow for the

needed time for experiential learning. Six schools reported

discounting the contact hours in the clinical setting, when

counting those hours toward faculty load, by multiplying

those hours by some factor that varied in the survey results

from 0.5 to 0.8. One school reported discounting the contact

hours in the clinical setting by a factor of 0.3 but set a lower

credit hour load for nursing faculty than for other faculty on

campus. Many schools reported departmentally determining

nursing load based on contact hours per week.

Because of the differences in calculating faculty load

between and even within schools, it was determined that the

most reliable way to analyze the data on the survey was to

compare contact hours per week (time spent in class,

Table 3 Director position in months per year

Months per year

9a 10–10.7 11 12

All schools 1 9 3 23

Schools with b100 students 1 5 1 12

Schools with N100 students 0 4 2 11a Paid overload pay for summer work.

Table 5 Summary of salary data

Average salary

for MSN or

unspecified

degree (US$)

Range for FT

faculty (US$)

Range for

PT, faculty

(US$ per hour)

All schools 34,628 27,000–77,536 16.33–36.50

Schools

with b100

students

33,419 27,000–67,000 16.33–29

Schools

with N100

students

36,079 27,848–77,536 19.40–36.50

Student-to-faculty ratios, teaching loads, and salaries 19

laboratory, or clinical setting) of nursing and nonnursing

faculty. Of the 36 schools reporting, one school contracted

out general education courses and, therefore, could provide

no data on load for nonnursing faculty. Nonnursing faculty

load ranged from 12 to 28 hours per week. Nursing faculty

teaching load ranged from 10 to 28 hours per week. Twenty-

one of the 35 schools (60%) reported contact hour loads that

were essentially equal between nursing faculty and other

faculty in the school, and 14 schools (40%) reported contact

hours that were greater for nursing faculty than for other

faculty. There was no difference noted between smaller and

larger schools (see Table 2).

4.3. Student fees

Three schools surveyed reported charging significant fees

(US$125–450 per semester), in addition to the usual tuition

and university fees, for all clinical courses. This money was

used directly to cover the high cost of instruction for nursing

clinical courses.

4.4. Committees outside the nursing department

Committee work can significantly alter the workload of

faculty members. Schools reported that faculty served on up

to 4 committees outside the nursing department, with the

average being 1.5 committees. The directors served on as few

as 1 committee and as many as 12 committees outside the

nursing department, with the average being 5 committees.

4.5. Director position description in monthsper year and director teaching load

Twenty-three of the 36 schools (64%) surveyed hired the

director or administrator of the program for a 12-month

period. The other schools reported a variety of contracts for

the director, which varied from 9 to 11 months. Most of the

schools that did not employ the services of the director for

12 months (9 out of 36; 25%) identified the position as a

10 to 10.7 month position (see Table 3).

Table 4 Director teaching load

Contact hours per week

0 1–3 4–6 N6

All schools 14 17 3 2

Schools with b100 students 7 8 1 2

Schools with N100 students 7 9 2 0

In 83% (30 of 36) of all the schools reporting, the

director teaches three contact hours per week or less, with

14 (39%) of those schools reporting that the director has no

teaching responsibilities. There was little difference noted

between larger and smaller schools (see Table 4).

Fourteen programs reported that the director shared the

administrative duties of the program with, or received

assistance from, some other person. Of those reporting this

sharing, 10 (71%) hired the director for a 12-month period

and 11 (78%) required 0–2 contact hours of teaching from

the director.

4.6. Salaries

Average starting salary (fall of 2004) for a new FT

faculty person with a master’s degree in nursing (MSN) was

US$34,628 for all schools reporting: Salaries within the

nursing department varied from US$27,000 to US$77,536

(see Table 5).

PT faculty salaries varied from US$16.33 to US$36.50

per hour, with a variety of payment methods. Some schools

paid per contact hour; some paid per credit hour; some

paid per hour worked; and still others paid a percentage

of the FT salary. No single payment method dominated.

There was also variety as to what a PT person received

payment from a school for grading time, meeting times,

travel, and meals.

5. Discussion

Larger schools tend to have higher student-to-faculty

ratios, suggesting that there is an economy of scale for the

delivery of nursing education that favors larger schools. A

number of factors can be proposed to explain this outcome.

Smaller schools may need to maintain a certain minimum

number of faculty to be able to have sufficient manpower to

cover all specialty areas in nursing. Larger schools may

operate with larger clinical facilities that can accommodate

slightly larger clinical groups.

Historically, nursing education is based on an appren-

ticeship model, with students spending a great deal of time

D. Jones et al.20

in and actually staffing hospitals under the supervision of

experienced nurses. Gradually, this evolved into hospital-

based schools in which classroom and clinical experiences

consumed nearly 40 hours per week, with students

continuing to spend a minimum of 20 to 24 hours directly

involved in patient care in the hospital. In the mid-1900s,

nursing education began to lean toward academic settings,

attempting, as well as emphasizing the need, to fit experien-

tial learning in a classroom model. Today, the remnants of

this apprenticeship model continue in nursing programs

as nursing education continues to struggle to fit into the

academic model.

Clinical practicums continue to be a major avenue for

teaching critical thinking skills and for helping students

integrate theoretical concepts into actual nursing practice.

These clinical practicums offer a great financial challenge to

academic institutions. Student-to-faculty ratios must be kept

low to ensure patient safety, making faculty costs higher for

nursing programs than for most other academic programs

and forcing directors and faculty of nursing programs to

face the constant challenge of justifying the cost of nursing

education programs to university/college administrators.

Yet, there is little research concerning the cost-effectiveness

of clinical education (Jones et al., 2000).

Clinical practicums may account for more than 50% of

the actual contact hours of the nursing curriculum, and

most schools maintain a 10:1 or at most a 12:1 student-to-

faculty ratio in the clinical setting. Some states, including

Arkansas, Texas, Mississippi, and Illinois, have set a

statutory limit of 10:1 as the maximum student-to-faculty

ratio in the clinical setting. Because credit hours are nearly

always converted to clinical hours by multiplying the

former by a factor of 2 or 3, students pay one credit hour of

tuition and often receive 2 or 3 hours of time from a faculty

member in the clinical setting. Only three schools reported

charging fees to cover the cost of clinical instruction to help

control these costs, whereas 40% of the schools surveyed

required that nursing faculty commit more hours per week

to teaching than are required from other faculty in the

school. This practice of requiring higher contact hour loads

from nursing instructors is often justified by equating

clinical to internship and laboratory experiences in other

disciplines. However, a clinical practicum is not the same

as an internship in which the student works in an agency

and is supervised by an employee of that agency; nor is it a

laboratory experience in which the student is given

instructions for a project by the instructor and then the

student works on the project while the instructor remains

available to answer questions and supervise student safety.

In the clinical setting, the safety of both the patients and the

students depends on the availability and the knowledge of

the instructor.

Further study concerning cost-effectiveness of clinical

education is needed. Can students gain the same skills they

have traditionally learned in a clinical setting from

simulations, laboratory projects, or other exercises? Can

partnerships with clinical agencies allow for true clinical

internships in nursing? What other strategies can be

designed to teach the critical thinking skills students gain

from clinical settings in other settings? Some allied health

programs rely heavily on preceptorships for the education of

students in clinical settings. Can such practices work for

nursing? If nursing programs were to continue to rely

heavily on the traditional model of clinical instruction,

nursing educators will have to document the cost-effective-

ness of this approach. Such studies would need to document

that traditional clinical instruction produces greater/better

learning than less costly methods of instruction. Also, an

analysis with regard to the job complexity of being a clinical

instructor will be needed if programs are to protect nursing

faculty from increasing faculty loads.

Most schools studied hired the director for a 12-month

period and required a teaching load of less than three contact

hours per week. This suggests that most schools consider

the work of administering the program of nursing to be a FT

job. Interestingly, the similarity between smaller and larger

programs in the data implies that the work of a program

administrator/director is not greatly affected by the size of

the program. The survey did not compare the director’s

work requirements to the expectations of other departmental

or program administrators within the schools surveyed,

although such data would be of interest.

Salary data obtained by this survey demonstrate strongly

that nursing education salaries are far smaller than the

salaries of those from clinical practice. New graduates with

an associate degree in nursing in the rural Midwest started at

US$31,000–32,000 per year in 2004. The schools respond-

ing to the survey paid master’s-prepared nurse educators an

average starting wage that is only slightly more than that of

new associate degree nursing graduates. If the expected

shortage of nursing educators is to be averted, careful

examination of salary structures will be needed to attract

qualified nurses to education.

6. Conclusion

The survey data presented here provide an overview of

how associate degree nursing programs structure the work-

loads of both the faculty and the director of the program.

The data have provided evidence to support or justify

needed program changes (additional faculty or changes in

workload policies) for the schools to which the data have

been previously made available.

Although data were collected on National Council

Licensure Examination pass rates (a quality measure) and

faculty turnover (a measure of faculty satisfaction), the

survey was too small to demonstrate correlations between

these measures and student-to-faculty ratios or faculty

workload. A larger study is needed to demonstrate the

effect that program structure may have, if any, on the quality

of nursing programs or on the satisfaction of faculty.

Student-to-faculty ratios, teaching loads, and salaries 21

This study suggests the need for further research into the

cost-effectiveness of clinical instruction. Nursing educators

tend to intuitively know that students can be taught about

nursing in the classroom but are taught to be nurses in

clinical settings. However, the small student-to-faculty

ratios of supervised clinical instruction are significant

factors in the cost of nursing education. If nursing educators

expect college administrators to understand that students or

taxpayers must bear that cost, they will be called upon to

demonstrate the effectiveness and need for these experi-

ences within nursing education.

Lastly, the survey clearly documented the need for

a closer look at the salaries of nursing educators. The

average starting salary for master’s-prepared nurses with

experience who choose to enter teaching was only slightly

higher than that of associate degree nursing graduates

of the programs in which they would be teaching. The

shortage of nurse educators will certainly persist if nothing

is done to bridge the salary gap between nursing educators

and clinical practitioners.

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Jones, B., Murtaugh, M., Durkin, Z. A., Bolden, M. C., & Majewski, T.

(2000). Clinical education in two-year colleges: Cost–benefit issues.

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