Award Date

5-15-2026

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Committee Member

Angela Silvestri-Elmore

Second Committee Member

Garrett Chan

Third Committee Member

Nancy Spector

Fourth Committee Member

Joseph Morgan

Number of Pages

168

Abstract

Ongoing concerns regarding the fitness and readiness for practice of new graduate nurses have intensified scrutiny of prelicensure nursing education and regulatory oversight in the United States. Nursing education consultants (NECs), employed by boards of nursing, play a critical yet understudied role in evaluating nursing programs and supporting public protection. This two-part national study examined how NECs conceptualize and operationalize fitness and readiness for practice within regulatory oversight of prelicensure nursing education.

Part one consisted of a national descriptive survey of NECs spanning 25 jurisdictions within the United States (U.S.), designed to characterize NEC demographics, professional preparation, regulatory responsibilities, and approaches to evaluating readiness for practice. Part two consisted of a qualitative narrative inquiry to further explore how NECs interpret regulatory expectations, apply evidence-based practice, and navigate contextual factors influencing determinations of fitness for practice. Descriptive statistical analyses were used for the survey data, and narrative thematic analysis was used to analyze the qualitative data.

Findings indicate that NECs constitute a highly educated and experienced regulatory workforce with extensive clinical and academic backgrounds and broad oversight responsibilities. However, preparation for the NEC role varied considerably across jurisdictions and was largely influenced by employer-based orientation and self-directed learning rather than standardized preparation pathways. Participants described variability in role expectations, alignment with job descriptions, and evaluative approaches to determining fitness and readiness for practice. NECs consistently emphasized the importance of integrating fitness for award, fitness for practice, and fitness for purpose when evaluating nursing program outcomes, reflecting a multidimensional understanding of readiness for practice that extends beyond licensure examination performance.

Collectively, these findings advance the understanding of NEC practice and regulatory decision-making while highlighting opportunities to support more consistent oversight through clearer role expectations, more structured orientation and training processes, and the future development of competency frameworks. Strengthening these areas may enhance alignment across nursing education, regulation, and practice in service of public protection and patient safety.

Keywords

Boards of Nursing; Fitness for Practice; Nursing Education Consultant; Nursing Regulation; Prelicensure Nursing Education

Disciplines

Education | Higher Education | Nursing

File Format

PDF

File Size

1295 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

Available for download on Tuesday, May 15, 2029


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