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Creating a faith-integrated Bachelor of Science nursing program: an innovation model

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Creating a faith-integrated Bachelor of Science nursing program: an innovation model

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Content Running head: CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 1

CREATING A FAITH-INTEGRATED BACHELOR OF SCIENCE NURSING PROGRAM:
AN INNOV ATION MODEL

by

Wei Li

A Dissertation Presented to the
FACULTY OF THE USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION

August 2019

Copyright 2019 Wei Li

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 2
DEDICATION
To my fellow-creatures with goodwill:
Especially the nurses, patients, educators, students, leaders, followers, and
those who courageously dedicated their lives in the pursuit of God, truth, healing, and love,
past, present, and future.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 3
ACKNOWLEDGMENTS
A transformed person can transform the world. A healed person can heal the world.
This doctorate is a process of healing and empowerment. “The thief comes only to steal
and kill and destroy. Jesus came that we may have life and have it abundantly” (John 10:10,
ESV). As an ICU nurse, I witnessed much sickness and suffering. Some were healed, while
others were not. It is my deepest desire for everyone to experience love, healing, and abundance.
Mom and Dad, thank you for loving and supporting me unconditionally. I will never
forget where I come from. You help me to see that the gospel really does change everything.
I thank the best dissertation committee for which one could ever ask, especially for
allowing me to conduct this research topic as a chief interest of mine. These remarkable people
are willing to set aside their own beliefs and commit themselves to my learning while promoting
truth-seeking and mutual understanding. Especially I thank Doctor Mark Power Robison for
admitting me into this global program. His sincere trust and appreciation in seeing something
special in me, and his strategic vision that has guided me every step of the way. Dr. Jen
Crawford, as my dissertation chair, provided the organizing framework along with her cheering
spirit that helped me to overcome difficult times. Dr. Cathy Krop and her leadership course freed
me to dream uninhibitedly. She sees me as a servant leader and encourages me to think and
create. I am grateful for Dr. Maddox and many teachers who demonstrated care and excellence.
I thank my countless mentors and true friends, who trusted me before I even trusted
myself. Thank you, Pastor Ivan Fox, Bernie Ooley from Bethel, Dr. John Jackson, and Dr.
Robert Osburn for shaping and pushing me to become whom I am made to be.
I thank the university and its leadership for allowing me to conduct this study.
I thank all my students who are always a source of life and inspiration.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 4
ABSTRACT
The shortage of nurses has become a global issue (ICN, 2019). At the same time, faith-based
schools worldwide provide both opportunities and challenges to address this worldwide nursing
shortage. The organizational context is a private Christian university in California that remains
anonymous in this study. By fall 2020, the university will create a new faith-integrated Bachelor
of Science (BSc.) in Nursing program. They aim to establish a program consistent with Hasker’s
(1991, p. 235) recommendation that “faith integration is best pursued at the level of particular
academic disciplines.” Clark and Estes’ (2008) gap analysis KMO framework was used to
identify the knowledge, motivation, and organizational resources necessary to achieve the
organization’s performance goal of establishing this new faith-integrated nursing program. A
rigorous qualitative approach was adopted, using semi-structured interviews that sought the
individual perspectives and experiences of six (n=6) senior leaders. Interview data were analyzed
using thematic content analysis. Data showed both promising and challenging aspects related to
the establishment of this new faith-integrated BSc. in Nursing program. The data underlined the
ultimate philosophy of Christian education and the importance to the design of the nursing
program: knowing God, His Word, and love personally, and continuously growing in Him so
that the love and power of God will be evident in transformed lives to fulfill His plan and
purpose in this world. The researcher discussed in great detail the promising patterns, insights,
and concepts related to faith-integrated education and its implications for nursing education and
health care reform. Successful implementation of the new program may need to embrace a
broader account for the institutional environment beyond the university itself.
Keywords: nursing, Christian faith, faith-integrated education

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 5
TABLE OF CONTENTS
Dedication 2
Acknowledgments 3
Abstract 4
List of Tables 9
List of Figures 10
List of Matrices 11
Chapter One: Introduction 12
Background of the Problem 14
Importance of Addressing the Problem 15
Organizational Context and Mission 16
Organizational Performance Need 18
Organizational Performance Goal 19
Description of Stakeholder Groups 20
Senior Leadership and the New Steering Committee 21
Internal Stakeholders 21
External Stakeholders 21
Aspiring Nurses 22
The University Community 23
Nursing Employers 23
Patients and Families 23
Stakeholder for the Study and Stakeholder Performance Gap 24
Purpose of the Study and Questions 25
Conceptual and Methodological Framework 26
Definitions 26
Organization of the Study 27
Chapter Two: Review of the Literature 29
The Nursing Workforce 29
The Nursing Shortage 31
Faith-Based Christian Education 33
Historical, Social and Cultural Context of Faith-Based Education 33
Definition, Conception and Guiding Principles for Christian Education 36
Challenges and Controversies Facing Faith-Based Education 36
Current Practices and Trends for Faith-Integration 38
Curriculum, Classroom Practices, and Leadership Development 38
Governance and Policy Implications 39
Faith-Integrated Nursing Education 41
History and Origin of Nursing – The “Faithful” Past 41
Medical Model Care and Modern Nursing Education – The “Challenging” Present 42
Holistic Nursing Care and Faith-Based Nursing Education – “Back to The Future” 44
Stakeholder Knowledge, Motivation, and Organizational Influences 46
Knowledge and Skills 46
Motivation 53
Organizational Influences 56
Conclusion 59
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 6
Chapter Three: Methods 61
Research Questions 61
Research Setting 61
Methods 62
Participating Stakeholders 63
Interview Sampling Strategy and Rationale 65
Interview Sampling Criteria and Rationale 66
Data Collection and Instrumentation 67
Pilot Study 67
Interviews 68
Data Analysis 70
Presentation of Data 71
Matrix Display 71
Summary of the Thematic Analysis 72
Direct Quotes 72
Credibility and Trustworthiness 73
My Role 73
Ethics 74
Limitations and Delimitations 75
Chapter Four: Results and Findings 77
Purpose of the Study 78
Overview of Results and Findings 80
Results and Findings for Knowledge Influences 83
Assumed knowledge influence #1: Accreditation 86
Assumed Knowledge Influence #2: Best Practices in Nursing Education 89
Assumed Knowledge Influence #3: Principles of Faith-Integrated Education 99
Assumed Knowledge Influence #4: Differences for a Faith-Integrated Nursing Program 106
Assumed knowledge influence #5: Recruiting faculty. 115
Assumed knowledge influence #7: Metacognitive. 122
Summary of Knowledge Findings 124
Results and Findings for Motivational Influences 125
Assumed Motivational Influence #1: Utility Value 127
Assumed motivational influence #2: Self-efficacy. 129
Additional Motivational Influence #3: Goal Orientation 132
Summary of Motivation Findings 135
Results and Findings for Organizational Influences 135
Assumed Organizational influence #1: Governance Alignment 138
Assumed Organizational Influence #2: Culture of Trust and Openness 141
Assumed Organizational Influence #3: Funding and Resources 143
Assumed Organizational Influence #4: Strong Institutional Identity 147
Summary of Organization Findings 149
Summary of Results and Findings 150
Chapter Five: Solutions, Implementation and Evaluation 151
Organizational Context and Mission 152
Organizational Performance Goal 152
Description of Stakeholder Groups 152
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 7
Purpose of the Project and Questions 152
Recommendations for Practice to Address KMO Influences 153
Recommended Solutions 158
CCNE Standard I Program Quality: Mission and Governance 160
Recommendation 1: Develop a Congruent Nursing Program Mission 160
Recommendation 2: Develop a Congruent Nursing Program Vision 162
Recommendation 3: Create Structure for Governance Alignment 163
Recommendation 4: Create Congruent Nursing Program Policies 164
CCNE Standard II Program Quality: Institutional Commitment and Resources 165
Recommendation 5: Obtain Funding and Resources 165
Recommendation 6: Create a Business Plan With Budget 166
Recommendation 7: Establish Internal Support 167
Recommendation 8: Establish External Clinical, Educational and Church Partnerships 168
Recommendation 9: Recruit Qualified Nursing Leadership 169
Recommendation 10: Recruit Qualified Nursing Faculty 170
CCNE Standard III Program Quality: Curriculum and Teaching-Learning Practices 170
Recommendation 11: A Faith-Integrated Curriculum at the Subject Level 171
Recommendation 12: Curriculum Co-Created by Nursing and Theology Faculty 172
Recommendation 13: Curriculum reflects Professional Nursing Standards and Healthcare
Guidelines 173
Recommendation 14: Align Learning Activities and Delivery Methods 174
CCNE Standard IV Program Effectiveness: Assessment of Program Outcomes 174
Recommendation 15: Clearly Articulate and Measure Expected Student Outcomes 175
Recommendation 16: Systematic Plan of Evaluation 176
Recommendation 17: Enhance Self-Efficacy Among University Leaders 177
Recommendation 18: A Faith-Integrated Model for Nursing 178
Recommendation 18. 1: Identify One’s Center 181
Recommendation 18. 2: Apply Faith-Integration to the Nursing Curriculum. 181
Recommendation 18. 3: Apply Faith-Integration in the Classroom 184
Recommendation 18. 4: Apply Faith-Integration in the Clinical Practice 187
Summary of Recommended Solutions 190
Integrated Implementation Plan 193
Solutions to Implement 193
Key implementation Action Steps 193
Resources Requirements and Building Capacity to Implement 193
Timeline 194
Key Indicators, or Measures of Successful Implementation 194
Integrated Evaluation Plan 201
Reactions 201
Learning 202
Behavior 202
Results 202
Limitations 208
Future Research 208
Implications for Practice 209
Implications for Nurses 209
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 8
Implications for Education Institutions 209
Implications for Healthcare Organizations 209
Implications for Churches 210
Conclusion 210
References 214
Appendix A: Invitation Letter 236
Appendix B: Information Sheet 238
Appendix C: Informed Consent for Non-Medical Research 242
Appendix D: Interview Protocol 246
Appendix E: Kmo Influencers and Interview Protocol 251
Appendix F: An Overview of Themes, Categories and Sub-Categories 255

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 9
LIST OF TABLES
Table 1: Stakeholder Groups’ Performance Goals 24
Table 2: Assumed Knowledge Influences 48
Table 3: Selected Differences Between Secular and Faith-Based Education (Ekeland & Walton,
2018) 50
Table 4: Assumed Motivational Influences 56
Table 5: Assumed Organizational Influences 58
Table 6: Participating Stakeholders 64
Table 7: Description of Participants (N=6) 79
Table 8: Overview of KMO Influences Chart 80
Table 9: Assumed Knowledge Influences Summary Chart 84
Table 10: Assumed Motivational Influences Summary Chart 127
Table 11: Assumed Organizational Influences Summary Chart 137
Table 12: Matching KMO Influences with CCNE Nursing Accreditation Standards 154
Table 13: Recommended Target Solutions by Gaps in KMO Influences 191
Table 14: An Overview of Proposed Implementation Plan 195
Table 15: An Overview of Proposed Evaluation Plan 204

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 10
LIST OF FIGURES
Figure 1: Undergraduate student body ethnic profile (NCES, 2019). 18
Figure 2: Qualified Nursing Applicants Are Turned Away (AACN, 2019) 33
Figure 3: SWOT Analysis 124
Figure 4: Program organization structure. 164
Figure 5: A multi-level funding strategy for the new nursing program 166
Figure 6: Faith-integrated model for nursing. 179
Figure 7: Arab Baptist theological seminary curricular lenses (Shaw, 2014, p. 3) 182

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 11
LIST OF MATRICES
Matrix 1: Have a Working Knowledge to Fulfil All Accreditation Requirements 86
Matrix 2: The University Needs to Know the Best Practices and components in Nursing
Education 89
Matrix 3: Have a Shared Knowledge of Faith-Based Principles for This Faith-Integrated
Nursing Program 99
Matrix 4: Senior Leadership Needs to Know the Differences for a Faith-Integrated Nursing
Program 107
Matrix 5: Important Criteria for Use in Recruiting Faculty 116
Matrix 6: The Senior Leaders Need to Know How to Develop a Business and Implement
Plan 121
Matrix 7: Senior Leadership Needs to Know How to Reflect on Their Own Beliefs and Goals 123
Matrix 8: Utility Value 128
Matrix 9: Self-Efficacy 130
Matrix 10: Goal Orientation 132
Matrix11: Governance Alignment 138
Matrix 12: Culture of Trust and Openness 141
Matrix 13: Funding and Resources 144
Matrix 14: Strong Institutional Identity 147

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 12
CHAPTER ONE: INTRODUCTION
The nursing shortage has become a global issue. According to the International Council
of Nurses (ICN, 2019) and the American Nurses Association (ANA, 2019), most countries in the
world today are suffering from shortages of qualified nurses. Buerhaus (2009) projects that the
U.S. nursing shortage will grow to 260,000 registered nurses by 2025. This shortage will affect
every state in the United States. The U.S. Bureau of Labor Statistics (2018) projects that another
439,300 new nursing jobs will be created by 2024. This 16% growth rate is much faster than the
average for all occupations.
With the nursing shortage and plenty of people wanting to become nurses, according to
the American Association of Colleges of Nursing (AACN, 2019a), U.S. nursing schools turned
away 68,938 qualified applicants from bachelor’s and graduate nursing degree programs as these
schools “do not have enough faculty, clinical sites, classroom space, and clinical preceptors”
(AACN, 2019a). The National League for Nursing (NLN, 2018) estimates that 34,200 new
nursing faculty will be needed by 2022 to meet the increased demand for nurses and to replace
nurses who are retiring.
Historically, Christian faith-based institutions played essential roles as pioneers in the
early development of nursing education (Haho, 2006). Personal religious belief often provided
needed motivation for nursing students and staff, and the spiritual dimension was a central part
of nursing curricula and practices (Sarkio, 2007).
In recent years, the identity and place of faith-based higher education institution have
been unclear in an academic world often described as postmodern, pluralist, or secular (Karvinen
et al., 2018; Norris & Inglehart, 2007). In order to adapt to diversity in academia and the
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 13
competitive market of higher education, many faith-based institutions have downplayed their
religious roots (Benne, 2001a).
In the 21
st
century, the added value and social importance of religious faith, including its
organizational potential, access to endowment funds from religious donors, as well as the
intrinsic qualities of faith-inspired service, have been increasingly recognized (Calhoun,
Juergensmeyer & Van Antwerpen, 2011). Christian faith-based healthcare professionals whose
faith values and traditions align well with caregiving are sometimes described as more “loving,”
“caring and compassionate,” “joyful,” “reliant on God for strength,” “having a strong work
ethic,” “saturate work with prayers,” “ready to pray aloud with patients,” “called to represent
God in word and deed,” “give non-discriminatory care (treat patients as equally valued by God),”
and “give personal, spiritual, physical and emotional care” (Haldeman, 2006).
However, according to the directory of Nurses Christian Fellowship (NCF, 2019), there
are only 20 nursing schools in the United States that maintain their religious affiliations and
provide a Christian perspective on nursing education, out of more than 996 baccalaureate
programs in the United States (American Association of Colleges of Nursing [AACN], 2019b).
Sometimes, faith-based schools suffer from a lack of prestige, evident in the fact that there are
only 25 Christian universities are in the top 130 of the best universities in the United States
(Council for Christian Colleges and Universities [CCCU], 2018a).
In summary, historically religious institutions/faith-based organizations have taken on the
role of training nurses, with important interconnections with healthcare. However, they have
moved away from that role over time. But there is a renewed potential for faith-based
educational institutions to re-enter this healthcare space, possibly in new ways to address the
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 14
above-mentioned nursing shortage, increased healthcare demands, and need for access to quality
education.
This innovative study explores how Christian faith and nursing science might be
integrated at a private Christian liberal art university so that it serves both the above-mentioned
needs and possibilities.
Background of the Problem
Interconnections between faith and healthcare sectors are multifaceted and have existed
for centuries (Levin, 2016). In the United States, faith-based healthcare accounts for a significant
portion of overall healthcare revenue. Religious groups run much of the U.S. health care system,
with the Catholic Church accounting for one in six hospital beds in the U.S. (United States
Conference of Catholic Bishops, 2009).
According to the American Hospital Association, there are 6210 registered hospitals in
the United States (American Hospital Association [AHA], 2019a) which is an increase from
2016 when the AHA reported a total of 5534 hospitals. The growth is attributed to a shift in
AHA hospital classifications rather than new facilities opening. Nevertheless, according to the
data, the number of U.S. hospitals under faith-based ownership increased from 585 in 1995 to
726 in 2016 (AHA, 2019a; Statista, 2018). Faith-based medical services represent some of the
most sustainable networks for care delivery and social services, both here and around the world
(Faiz, 2014).
The synthesis of religious practice and healthcare has a long history. Physical and
spiritual domains were integrated in order to promote health and prevent diseases (Levin, 2014).
For centuries, hospitals were conceptualized, constructed, and administered by religious
institutions and clergy who served as healthcare practitioners. In the contemporary world, the
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 15
integration of faith and healing, along with religiously affiliated hospitals, and congregational
health ministries such as parish nursing, is increasing in diverse contexts (Chatters, 2000).
Faith integration is not a new concept for professional nurse education. Methods of faith
integration in nursing curricula have differed across time, influenced by evolving understandings
about the nature of being and ways of understanding human experiences that include, for
example, diseases, illness, suffering, socioeconomic status of clients, scientific and technological
growth (Risse, 1999). During the early years of Christianity, a nursing tradition developed as
churches cared for the sick, caring for widows and orphans, feeding the hungry, clothing the
poor, and offering hospitality to strangers. Christian nurses focused on the physical,
psychosocial, spiritual and cultural attributes of clients in order to provide holistic care based on
the belief about the supremacy of human beings as having been made in the image of God
(Genesis 1:27-30, NIV). This is sometimes difficult in a world with diverse ideas about the
nature of God, humanity, health, and illnesses.
Importance of Addressing the Problem
For most schools with rich religious affiliations and histories, the answer to growth with
the times and the culture seemed to involve leaving behind their religious legacy and embracing
as a sole value, tolerance. As public intellectual Stanley Fish (2004) said in “Why we built the
Ivory Tower,” it is impossible for universities to engage in moral education because to do so
requires “deciding in advance which of the competing views of morality and citizenship is the
right one” (p. 1). If institutions and educators are unwilling to make commitments to a consistent
vision and morality, the situation is like “a race for sprinters in which everyone is encouraged to
run off in any directions they desire” (Ream, Herrmann, & Trudeau, 2011, p.13). However,
hundreds of colleges and universities have not left behind their biblical foundations and have
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 16
often had great success. Examples include Notre Dame, Georgetown University, Boston College,
and Davidson College, all of which have appeared in the top 25 of the Forbes Top College
(2016) ranking with number 13, 21, 22 and 25, respectively. Faith-based higher education
institutions enroll about 2 million students each year, and their students pay a combined $46.7
billion in tuition (Grim, 2016). Even as the country grows more secular, just above half (53%) of
Americans say religion is “very important” in their lives. The percentage of Christians who
report the same stands at 68%. Enrollment at the top faith-based schools has increased over 8%
in the last 20 years, from an average of 4,800 in 1994 to 5,200 in 2014 (Grim, 2016).
Many of today’s hospitals and long-term care facilities are run by faith-based
organizations (AHA, 2019a). Although faith-based hospitals went through a period where they
embraced corporate operation and bottom-line mentality, as opposed to a mission-driven
operation, many healthcare centers still have their roots in religious organizations or have a faith-
based rationale for their existence. These faith-based healthcare institutions are not likely to
reject, as potential employees, safe and competent healthcare professionals who did not attend
faith-based institutions. Nevertheless, instruction in and commitment to a moral and religious
tradition and principles where spirituality and caregiving are intertwined can help one to be more
prepared for the increasing demand of modern healthcare needs, more committed to the
corporate missions, and feel more comfortable in those particular corporate cultures (Benne,
2001b).
Organizational Context and Mission
The setting of this study is a private Christian university in northern California. For the
purpose of this study, the actual name of this university remains anonymous and is referred to as
“the university” from here onwards. With nearly 30 undergraduate and graduate degree
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 17
programs, this private Christian university is founded on the integration of Christian faith and
academia, with the mission that graduates will become transformational leaders in their homes,
churches, and communities by serving with distinction in their chosen careers (The University,
2018). This university desires to develop the whole person by developing skills in
communication, quantitative reasoning, and critical thinking and by exposing students to a broad
cross-section of knowledge in sciences, social sciences, and the humanities, all as global citizens.
The university was founded as a Bible college in 1939 and received regional accreditation
by the Western Association of Schools and Colleges (WASC) in 2002. The name was changed in
2003, and the campus moved to northern California in 2004. Since arriving in northern
California in 2004, the 130-acre campus hosts over 20-degree majors and over 50 programs. The
institution employs a faculty body of 43 full-time professors and 171 part-time professors. In
2017, the university enrolled over 1500 students at the campuses. The student body has doubled
in size in the past three years. The student body ethnic profile is 2% American Indian or Alaska,
5% Asian, 6% Black or African, 19% Hispanic/Latino, 1% Native Hawaiian, 59% White, 1%
two or more races, and 3% unknown (National Center for Education Statistics [NCES], 2019).
Please refer to Figure 1 for the undergraduate student body ethnic profile.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 18

Figure 1. Undergraduate student body ethnic profile (NCES, 2019).
The university is a Christ-centered institution of higher learning dedicated to the holistic
formation of students – their academic, mental, physical, emotional, and spiritual formation. As a
Christian faith-based institution of higher education, concepts related to religion, faith, and its
accompanying commitments are integral to its context and the achievement of its mission.
Organizational Performance Need
In order to fulfill its mission in partnership with the church and producing
transformational leaders for the glory of God, the organization is focused on the creation of a
new faith-integrated Bachelor of Science (BSc.) in Nursing program plan. The new BSc. in
Nursing program addresses a current and growing problem among institutions of
paraprofessional education in California. With the current accessibility of nursing programs
severely limited in contrast to significant applications, every California nursing school is turning
away hundreds of applicants each semester (California Board of Nursing, 2017).
A four-year Bachelor of Science Nursing degree program would allow for the university
to promote a community of clinical scholars (allied health candidates) dedicated to understanding
the significant impacts a faith-based education could have on the healthcare industry. The
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 19
Bachelor of Science Nursing degree program would provide an avenue for committed freshmen
and transfer students to receive a faith-based academic education in didactic and clinical
applications, medical missions, local internships, and partnerships with local hospital and
medical facilities. Other candidates (from high school seniors, transfers from community
colleges, career-changing adults, and more importantly, faith-based healthcare paraprofessionals)
would also gain opportunities to gain the direct academic path in preparation for the nursing
board exams. Up till today, the university has already submitted an Academic Program
Development Précis to its Provost’s Office and Chief Academic Council, with the result that the
new nursing program proposal has been approved by the university (The University, 2018).
Organizational Performance Goal
By Fall 2020, the university’s organizational performance goal is to create a new faith-
integrated BSc. in Nursing program that will be “concerned with integral relationships between
faith and knowledge, the relationships which inherently exist between the content of the faith and
the subject-matter of this or that discipline” (Hasker, 1991, p. 235). In this case, establishing a
faith-based nursing program is consistent with what Hasker (1991, p. 235) articulated that “faith-
learning integration is best pursued at the level of particular academic disciplines.”
This is important for the organization because it is consistent with its theological,
educational, and missional underpinnings. Achieving this goal would enable the organization to
fulfill its mission of “partnership with the church, to educate transformational leaders for the
glory of God” and its learning objective that “desires its graduates to exemplify transformational
leadership in church and society through the integration of their faith, learning, and critical
thought in the arenas of Christian literacy, communication, and intellectual skills, professional
competence, and global citizenship” (The University, 2018).
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 20
This new organizational need is related to the larger problem of growing interest in and
concern for issues associated with the establishment of curricula, core values, and varying
models of provision and practices of faith-based schools (Chapman, et al., 2014). This new BSc.
in Nursing program will: 1) provide a unique opportunity for aspiring nurses to be fully
competent and exceptionally employable professionals as state-licensed registered nurses; 2)
advance the university’s mission and strategic direction to offer a broad liberal arts curriculum
(The University, 2018); 3) help nursing employers and faith-based healthcare organizations on a
local, national and global scale to face the increased demand of healthcare (AACN, 2017); 4)
alleviate the nursing shortage (California Board of Nursing, 2018); and 5) deliver quality and
holistic care model that promotes patients’ outcomes (Zamanzadeh, et. al., 2015).
This dissertation provides a pathway on how a new faith-integrated BSc. in Nursing
program may be created and developed while also offering specific recommendations to senior
leaders at this private Christian university on strategies that build capacity for this new program
to be successfully implemented, and evaluated.
Description of Stakeholder Groups
In order to establish the new program, the most relevant stakeholder groups at this initial
stage are senior leaders and members of a newly established steering committee that will plan
and develop the new program. This steering committee includes members who will be
responsible to set strategies, priorities, education standards, and allocate resources for the
establishment of the new program. Although multiple stakeholders exist for this study, the
following stakeholder groups are identified and considered as fundamental to the overarching
success of this performance goal: 1) the senior leaders and new program steering committee, 2)
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 21
the internal stakeholders, 3) the external stakeholders, 4) aspiring nurses, 5) the university
community, 6) nursing employers, and 7) patients and families, as described below:
Senior Leadership and the New Steering Committee
Senior leadership provides the university with strategic leadership, oversees the
operational and change management processes and represents and upholds the academic
credibility of the university. They lead the university community to advance its missions,
preserve and enhance the university’s identity and reputation as a faith-based institution, and
provide quality and relevant liberal arts education that gives its graduates competitive market
advantages.
This new steering committee members will be selected from senior leadership, the
faculty, staff, and board of trustees who will be responsible for creating the mission, vision,
values, and goals; set strategies, priorities, and education standards; and allocate resources for the
establishment of this new faith-integrated BSc. in Nursing program.
Internal Stakeholders
Internal university stakeholders consist of faculty and staff, academic council, human
resources, finance, marketing, admissions, registrar, facilities, IT, Library, student support. These
internal administrative departments will help to compose a feasible business plan; design nursing
facilities and simulation lab; construct the faith-integrated curriculum; hire relevant faculties and
staff; and establish the relevant policies, structures, and processes to support the establishment of
the program.
External Stakeholders
External agencies like Western Association of Schools and Colleges (WASC),
Commission on Collegiate Nursing Education (CCNE) nursing accreditation, healthcare
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 22
facilities, consultants, and community interest groups will provide consultancy and needed
support for the successful planning and implementation of the program. This program will fulfill
national, state, local regulatory requirements; sign agreements and contracts with local healthcare
facilities for clinical nursing practicum and practices, and raise financial support from external
community interest groups.
Aspiring Nurses
Aspiring nurses are the stakeholders for the new nursing program. In comparison to
significant applications, accessibility of current nursing programs is limited, so that every
California nursing school is turning away hundreds of applicants each semester (California
Board of Nursing, 2018).
Nursing schools provide the necessary training to succeed in a nursing career. Nurses rely
on access to affordable and quality courses to meet state licensing requirements. All states
require licensing for registered nurses to pass the National Council Licensure Examination
(NCLEX-RN) and report the U.S. Bureau of Labor Statistics (2018).
Prospective nursing students are affected stakeholder for a new faith-integrated nursing
program, because it provides them a unique opportunity to become fully competent and
exceptionally employable professionals as state-licensed registered nurses while also helping
them to grow in their faith—to learn the Word of God and to experience and communicate God’s
love to people around them. This program fulfills the university’s vision is that their graduates
will be transformed to help redeem world culture by providing notable servant leaders who
enrich family, church and community life while also serving with distinction in their chosen
vocation (The University, 2018).

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 23
The University Community
The university also has a vested interest in its success. Leaders and administrators will
offer programs that attract students and generate revenue for the university. University leaders,
along with administrators and faculty in the health sciences programs, will also build a quality
faith-integrated program that is recognized by state nursing boards. Faculty prestige and success,
in turn, are based on their ability to attract stellar students and prepare them for careers in
nursing.
The proposed degree program aligns well with university priorities and will benefit other
department programs due to the general education requirements and opportunities for associated
minors. The faculty would benefit from a nursing program because it would attract scholarship
and research that would enhance and expand its current offerings of courses, events, and
symposia. This program would be the precursor to a graduate degree program, such as a Master
of Science in Nursing (MSN).
Nursing Employers
Employers also care about the quality of this nursing program. Hospitals, doctors’
offices, and home care programs rely on well-trained nurses to deliver effective care to their
patients. Some medical practices maintain a close working relationship with nursing programs by
serving as clinical sites where students gain hands-on experience in medical practice. Employers
may then recruit potential employees through partnerships with these programs.
Patients and Families
The populations served by health care practitioners are among those most affected by the
quality of nursing programs and graduates. People struggling with chronic health issues or
coping with traumatic events rely on competent care providers. Students who gain the requisite
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 24
knowledge and skill during a nursing program are more apt to deliver this quality care. Along
with technical, medical skills, nurses also learn the importance of care, compassion, and
communication in making patients feel comfortable.
Stakeholder for the Study and Stakeholder Performance Gap
While the joint efforts of all stakeholders will contribute to the achievement of the overall
organizational goal to create and establish a faith-integrated nursing degree program, three
groups have been delineated as entities of great importance, namely, senior leadership, internal
stakeholders, and external stakeholders. Among those three, it is the most crucial to understand
the needs of the senior leaders to ensure success in creating, planning, and developing effective
processes for implementing this new program. Therefore, the stakeholders of focus for this study
will be all senior leaders and members of the newly established steering committee. Please refer
to Table 1 on the next page for the stakeholder groups’ performance goals.
Table 1
Stakeholder Groups’ Performance Goals

Organizational Mission

Partnership with the church, to educate transformational leaders for the glory of God through
the university learning goal that desires its graduates to exemplify transformational leadership in
church and society through the integration of their faith, learning, and critical thought in the
arenas of Christian literacy, communication and intellectual skills, professional competence, and
global citizenship.

Organizational Goal

By Fall 2020, the university will create and establish a new faith-integrated Bachelor of Science
(BSc.) in Nursing Program.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 25
Table 1, continued

Senior Leadership Goal

By September 2019, the
senior university leadership
will decide to establish a
faith-integrated BSc. in
Nursing program by
adopting the KMO
framework of competences.

Internal Stakeholder Goal

By January 2020, the
internal university
departments will create,
plan, and allocate
appropriate resources
required to the
establishment of the new
nursing program.

External Stakeholder Goal

By March 2020, the external
university agencies will
successfully approve and support
the establishment and
implementation of the new BSc. in
Nursing program that aligned
with professional standards.

Purpose of the Study and Questions
The purpose of this study is to conduct a needs analysis in the areas of knowledge,
motivation, and organizational resources necessary to reach the organizational performance goal
of creating and establishing a new faith-integrated BSc. in Nursing program. In light of this
organizational goal, the performance gap is 100%. The analysis will begin by generating a list of
possible needs and will then examine these needs systematically in order to focus on actual or
validated needs. While a complete needs’ analysis would focus on all stakeholders, for the
purpose of this study, the stakeholder focus in this analysis are all senior leadership and members
of the newly established steering committee at this university.
The study aims are to provide qualitative data that help answer the following questions:
1. What are the senior leaders’ knowledge and motivation related to the university’s
commitment to establishing a faith-integrated BSc. in Nursing program?
2. What is the interaction between the organizational culture and context and stakeholders’
knowledge and motivation?
3. What are the recommended knowledge, motivation, and organizational solutions?

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 26
Conceptual and Methodological Framework
Clark and Estes’ (2008) gap analysis, a systematic, analytical method that helps to clarify
organizational goals and identify the gap between the actual performance level and the preferred
performance level within an organization, will be adapted for needs’ analysis as the conceptual
framework. The methodological framework is a qualitative case study with descriptive statistics.
Assumed knowledge, motivation, and organizational influences will be generated based on
personal knowledge and related literature. These influences will be analyzed and organized by
using semi-structured and in-depth interviews, literature review, and content analysis. Research-
based solutions will be recommended and evaluated in a comprehensive manner.
Definitions
It is challenging to find universally accepted and recognized definitions for some of the
terms used in this dissertation. The following terms are defined for this study:
BSc. in NursingProgram – The Bachelor of Science in Nursing (BSN, BScN) also known
in some countries as a Bachelor of Nursing (BN) or Bachelor of Science (BS) with a major
in nursing is a 4-year academic degree in the science and principles of nursing, granted by an
accredited tertiary education provider.
Christian education – It is an education program built around a completely God-centered
orientation of life that helps students develop a thoroughly Christian and biblical worldview, and
teaches them how to think Christianly. The desired outcome is a disciple of Christ who is “the
salt and light of the earth” (Matthew: 5:13, NIV).
Faith-based organization – Any group/organization created by or for a religious or
spiritual group, including, individual places of worship, groups of community or tribal
elders/spiritual leaders, intra- or interdenominational community coalitions, faith-connected
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 27
health and human service agencies, denominational hierarchies/governance bodies, and religious
orders and schools of divinity.
Faith-integrated learning – A learning curriculum “concerned with integral relationships
between faith and knowledge, the relationships which inherently exist between the content of the
faith and the subject-matter of this or that discipline” (Hasker, 1991, p. 235).
Health – A complete state of physical, mental, spiritual, and social wellbeing and not
merely an absence of disease (WHO, 1948).
Health care organizations – Any entity whose primary purpose is the delivery of health
and medical services, including, individual health care practitioners, group practices,
community-based health centers, home health agencies, free clinics, state and local public health
programs, private clinics, hospitals, vertically integrated health care systems, managed care
organizations, professional associations, and university medical, dental, nursing, and other health
professional schools.
Organization of the Study
This study is organized into five chapters. Chapter One provided the background for the
study and examined the problem in practice and its significance. The organization’s mission,
goals, and stakeholders as well as the initial concepts of gap analysis adapted to needs analysis
were introduced. It also identified the purpose of this study and then provided the reader with the
key concepts and terminology commonly found in a discussion of faith-based or faith-integrated
nursing education. Chapter Two provides a review of the current literature surrounding the scope
of this study. Chapter Three details the assumed needs and influences for this study as well as
methodology when it comes to the choice of participants, methods of data collection, and
analysis. In Chapter Four, the data and results are systematically presented, assessed, and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 28
critically analyzed. Chapter Five provides recommended solutions, based on research data and
literature, for addressing the needs and influences in achieving the organizational goal as well as
an integrated implementation and evaluation plan that is specific for the organizational priority,
needs, and context.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 29
CHAPTER TWO: REVIEW OF THE LITERATURE
A systematic review of the literature concerning the study topic was conducted to enable
coverage of a wide range of publications, provide evidence from a large population base, seek
opinions and research data from as many authors as possible while simultaneously reducing the
risk of publication bias.
A wealth of literature exists in nursing and faith-based education. To conduct a systematic
review of both subjects would be too large a task for this dissertation, so the focus was on
research literature exploring links between nursing and faith-based education.
No method is exhaustive for retrieving all prudent and pertinent articles on any subject,
especially in a facet analysis of “nursing,” “healthcare,” “faith,” “Christian faith” and
“education.” With respect to the present study, over 300 papers and texts were consulted and are
believed a representative sample of research-based and anecdotal studies that exist concerning
the subject. In order to have an in-depth understanding of the pertinent issues in this study,
several themes have emerged from the literature review. Also, an overview of the theoretical
framework proposed by Clark and Estes (2008) in terms of stakeholder knowledge, motivation,
and organizational influences will be discussed and critically examined.
The Nursing Workforce
Nursing is defined as “an integral part of the health care system, encompasses the
promotion of health, prevention of illness, and care of physically ill, mentally ill, and disabled
people of all ages, in all health care and other community settings” (American Nurses
Association [ANA], 2019). Across a person’s entire life and healthcare experiences, whenever
and wherever someone needs care, nurses work tirelessly to promote health, prevent illness, and
care for the ill and disabled people.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 30
Nursing can be described as both an art and a science, and a heart and a mind (Rose &
Parker, 1994). At its heart lies a fundamental respect for human dignity and an intuition for a
patient’s needs (ANA, 2019). This concept is supported by the mind, which utilizes rigorous
science and core learning in order to provide the best nursing care (Ross & Parker, 1994). Due to
the vast range of specialties and complex skills in the nursing profession, each nurse will have
specific strengths, passions, and expertise (ANA, 2019).
The American Nurses Association (ANA, 2019) advocates that the nursing workforce is
key to tackling the problems our health care system faces, and empowers individual nurses to
lead change within their own organizations. In addition, it is clear that the public trusts nurses to
lead changes as nursing has ranked highest in the Gallup’s poll of honesty and most trusted
profession among all the other professions over the last 17 consecutive years (American Hospital
Association [AHA], 2019). A recent annual poll of Americans found that 84% of respondents
rated the honesty and ethical standards of nurses as high or very high, while medical doctors
were ranked second at 67%, and pharmacists third at 66% (AHA, 2019).
Numerous scientific studies point to the connection between adequate levels of registered
nurse staffing and safe patient care. For example, the U.S. Census Bureau (2014) reported that by
2050, the number of U.S. residents age 65 and over is projected to be 83.7 million, almost double
its estimated population of 43.1 million in 2012. With larger number of baby boomers and older
adults, there will be an increased need for quality geriatric care, including care for individuals
with complex diseases and comorbidities.
In an issue of Lancet, Aiken and colleges (Aiken, et al., 2014) discovered that an increase
in a nurse’s workload by one patient increased the likelihood of the patient dying within 30 days
of admission by 7%. The researcher also found that every 10% increase in bachelor’s degree
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 31
nurses was associated with a significant decrease in patient mortality by 7%. Higher patient loads
were also associated with higher hospital readmission rates (Tubbs-Cooley, et al., 2013). In
addition, researchers identified a significant association between high patient-to-nurse ratios and
nurse burnout, along with increased urinary tract and surgical site infections, and decreased well-
being of nurses and decreased the overall quality of patient care (Cimiotti et al., 2012).
The Nursing Shortage
The optimum staffing conditions must first be established, uniting nurses in fulfilling
their professional potential. According to the Bureau of Labor Statistics (2019), Registered
Nursing (RN) is projected among the top job growth through 2026. The RN workforce is
expected to grow from 2.9 million in 2016 to 3.4 million in 2026, an increase of 438,100 or 15%.
It is anticipated that more than 500,000 seasoned RNs will retire in the U.S. by 2022. The Bureau
also projects the demand for an additional 203,700 new RNs each year through 2026 to fill
newly created positions and to replace retiring nurses while also avoiding a nursing shortage
(Bureau of Labor Statistics, 2019).
According to the American Nurses Association (2019), there are currently about four
million nurses in the United States. That means that one in every 100 people is a registered
nurse. The Health Resources and Services Administration (2019) projects that by 2022, the
country will need to produce more than one million new registered nurses to fulfill its health care
needs. By 2022, there will be far more registered nurse jobs available than any other profession,
at more than 100,000 per year (ANA, 2019).
There is tremendous demand from hospitals and clinics to hire more nurses, and from
students who want to enter the nursing programs, but the schools have reached their enrollment
limit. According to the stats from the American Association of Colleges of Nursing (AACN,
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 32
2019), in the year of 2017, nursing schools turned away more than 56,000 qualified applicants
from undergraduate nursing programs. Over the past decade, nursing schools have annually
rejected around 30,000 applicants who met all the admissions requirements (AACN, 2019).
Nursing school enrollment is not growing fast enough to meet the projected demand for
registered nursing services. Though AACN reported a 3.7% enrollment increase in entry-level
baccalaureate programs in nursing in 2018, this increase is not sufficient to meet the projected
demand for nursing services, including the need for more nursing faculty, researchers, and
primary care providers (AACN, 2019). According to AACN’s report on 2018-19 Enrollment and
Graduations in Baccalaureate and Graduate Programs in Nursing (AACN, 2019), the competition
to get into a nursing school right now is intense. U.S. nursing schools turned away more than
75,000 qualified applicants from baccalaureate and graduate nursing programs in 2018 due to an
insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, as well as
budget constraints. Almost two-thirds of the nursing schools responding to the survey pointed to
a shortage of faculty and clinical preceptors as a reason for not accepting all qualified applicants
into their programs. Please see Figure 2 below on the trend of more qualified nursing applicants
are getting turned away in droves.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 33

Figure 2. Qualified Nursing Applicants Are Turned Away (AACN, 2019)
Faith-Based Christian Education
Historical, Social and Cultural Context of Faith-Based Education
The fact that faith-based schools are growing worldwide is a subject of some controversy
(Chapman, McNamara, Reiss & Waghid, 2014). To find out the reason, it is worth attending
carefully to the history of education. Although the history of education all too often receives only
limited attention (McCulloch, 2011), understanding of it helps make sense of issues of school
funding, governance, admissions, and curricular matters.
Before the late 18th century, almost every college established in the United States had a
strong religious character (Dockery, 2000). Until the 1960s, the public school could not be
considered truly secular, with its mandated Bible reading, prayers, and the teaching of Protestant
values. For example, America’s best-known college, Harvard University, was founded on
Christian principles in 1636 to train Christian ministers. It provided a prototype of faith and
learning integration (Ryken, 1990).
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 34
In the beginning, most U.S. universities, like Harvard, were established as institutions of
faith. The colonial colleges like Yale and Dartmouth (Puritan), College of William and Mary
(Church of England), Princeton (Presbyterian) and Rutgers (Dutch Reformed Church) – were all
Christian schools in mission or affiliation (CCCU, 2018b). The kind of teaching that Harvard
sought to provide was spelled out in its Rules and Precepts adopted in 1646, stated (original
spelling and Scripture references retained):
Let every student be plainly instructed, and earnestly pressed to consider well, the main
end of his life and studies is, to know God and Jesus Christ which is eternal life and
therefore to lay Christ in the bottom, as the only foundation of all sound knowledge and
Learning. And seeing the Lord only giveth wisdom. Let everyone seriously set himself by
prayer in secret to seek it of him. (John 17:3; Proverb, 2:3, NIV)
During that early era, Harvard exemplified the cooperative relationship that existed
between church and civil society, in which being simultaneously and fully serving both the
church and society (Marsden, 1994). However, as the state became more secular, this
arrangement was seen as problematic. In addition, by the mid-nineteenth century, with the
rapidly growing and diversifying economy, higher education gradually shifted its focus from
preparing leaders for the church and civil society to become a more utilitarian institution that
prepared students for the technological needs of the society (Marsden, 1994; Veysey, 1965).
The primary model of education at that time was the Scottish universities. They believed
that the existence of a conscience in all humans was universally self-evident and that scientific
inquiry would validate rather than undermine the Bible (Noll, 1994). Fundamental principles like
“verifiable empirical data” and, more broadly, natural sciences were considered an objective
source of truth (Noll, 1994, p. 71). However, the presidents of the College of New Jersey (later
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 35
Princeton) and Yale expressed concerns that moral philosophy, that is, the understanding of
human ethical obligations, was learned not by examining human nature, but by learning the
perfections of God. They argued that Christian education must be theologically distinctive
(Marsden, 1994).
Progressively, a compromise emerged between an education based on the belief in the
scripture and that based on science. Shaping good citizens through character education
eventually became education’s priority (Lucas, 2006). By the mid-nineteenth century, both
denominational institutions and state colleges downplayed their religious distinctiveness and
emphasized broad Christian principles and values as the curriculum that they offered was
primarily training for the professions of medicine, law, engineering, mechanical and agricultural
arts. Simultaneously, there was less interest in training clergies and ministers (Ringenberg,
2006).
By the early twentieth century, the prevailing academic opinion was that the university
was essentially a scientific institution that would provide a neutral arena where all views would
be judged on their intellectual merits alone. For science to advance, both controversial religious
views and most traditional theological doctrines were dismissed as having no intellectual
justification (Marsden, 1994).
After the Second World War, religious practices in public schools were successfully
challenged, based on the Establishment clause of the First Amendment. From then on, religious
practices have been removed from the curriculum and religion has been seldom mentioned even
in subjects like history, literature, art, and music. The public school was effectively censored so
that it only presented a view of reality that religion was irrelevant to the real world (Glenn,
2012).
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 36
Definition, Conception and Guiding Principles for Christian Education
What do we mean by Christian education? According to Lowrie (1984), the core mission
of Christian education is “to give a completely God-centered orientation of life to the student, to
develop a thoroughly Christian and biblical worldview, and to teach students how to think
Christianly” (p.14). The desired outcome is “a disciple of Christ – one that is – the salt of the
earth (Matthew 5:13, NIV) bringing flavor to a lost and hurting world, and one that is the light of
the world (Matthew 5:14, NIV) shining before men to lead them to the Father in Heaven.”
Applying this specifically to higher education, Holmes (1987) declared that “the integration of
faith and learning remains the distinctive task of the Christian liberal arts college (p. 4)” and
Sandin (1982) argued that if faith and learning are not integrated on a Christian campus, “there is
no reason for its existence (p.5).”
Questions related to the guiding principles and values of religious education have a long
history. In the face of greater diversity and globalization, whose values should inform, guide and
shape (Henck, 2011)? Mark Halstead, in “Values and Values Education: Challenges for Faith
Schools,” argues that faith-based schools are well placed to provide their students with primary
values education: moral guidance, an understanding of right and wrong and an introduction to a
core framework of moral values. It is because the core values of faith-based schools are broadly
shared by teachers, parents, and the community they serve. Thus, they can provide a consistent
ethos and a coherent, authoritative approach to teaching values.
Challenges and Controversies Facing Faith-Based Education
The challenges these faith-based institutions face in their struggle to maintain their
identity in times of diversity and pluralism need to be explored. There is an implicit
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 37
understanding that faith-based identities fade away as institutions become increasingly
secularized, pluralist, and permissive (Glanzer, 2008).
According to Feinberg (2014), the U.S. government’s neutral stance on religion, which
makes inclusivity and diversity possible in its educational system, also minimizes the possible
influence of faith-based practices in government-sponsored schools. Since values and values
education is central to what faith-based schools have to offer, they have naturally been
challenged to engage in a process of reflection on the explicit and implicit values which underpin
their work to ensure that it is justifiable, autonomous, in line with contemporary educational
thinking and the best interest of the people they teach (Aspin & Chapman, 2007; Haydon, 1997;
Lovat, Toomey, & Clement, 2010).
An additional challenge facing faith-based education is to identify desired student
learning outcomes that are unique to a particular academic program, that reflect serious faith
integration, and that can be effectively measured. In the United States today, as in many
countries, assessment of academic outcomes is a high priority. Nord et al. (2011), in the federal
High School Transcript Study, found that private school students take more credits, have more
demanding courses, and have higher-grade point averages when compared to public school
students. Another measure of academic achievement is the Scholastic Aptitude Test (SAT), a
voluntary exam that is administered by the non-governmental Educational Testing Service (ETS)
and that is used for entrance to higher education. Here again, private school students outpace
their public-school counterparts in critical reading, writing, and mathematics. University-bound
students in faith-related schools surpassed the benchmark score by a considerable margin.
However, school effectiveness is not measured solely by academic outcomes. Issues such
as school safety, student absence, and tardiness, and overall student behavior can impact student
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 38
learning and development. From a Josephson Institute (2011) study, 88 % of students in the
public-school system believe that physical violence is a big problem at school, while only 8 % of
students at religious private schools believe the same statement. In addition, faith-based schools
have a positive impact not only on students and their families but on entire neighborhoods
(Brinig & Garnett, 2012). Especially when the faith-based education claims to involve the whole
person – the relationship between their beliefs and behaviors – measuring the extent and quality
of faith-integration or assessing of outcomes of faith-based education can be a challenging task
(Noll, 2006).
Current Practices and Trends for Faith-Integration
Curriculum, Classroom Practices, and Leadership Development
Harris (1989) develops the concept of the faith community and asserts that educating the
person includes “coming to understand their gifts, their own talents, and their own powers.”
Education is the community engaged “to recognize and develop this inner power and exercise it
on behalf of the church and the gospel.” Harris (1989, p. 75) declares that “persons are dynamic,
not simply passive receptors. Persons are able to transform and be transformed, and the roles of
teacher and learner are not so separate. Persons, not just concepts, are true ‘subjects’ in
education.” She also identifies five classical functions of interrelated and essential parts of any
curriculum as follows:
• koinonia (community and communion)
• leiturgia (worship and prayer)
• kerygma (proclaiming the word of God)
• diakonia (service and outreach)
• didache (teaching and learning)
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 39
McKinney (2011) argued that the faith and the purpose of the school must be realized in
all of its teaching. He points out that subjects cannot be treated as mere adjuncts to faith; teachers
have to forge a synthesis between their faith and the culture of each school subject. Moreover, as
a civic institution, the school is expected to prepare its students for their future careers. However,
the argument stops at this general level as there is not much detailed discussion on how faith-
based missions are being implemented on a day-to-day base in the classrooms. In addition, how
exactly some of the guiding values and principles are translated into action and interactions
between teachers and students and between students themselves needs further investigation.
Muoneme (2014) used the hermeneutic phenomenological methodology to understand the
phenomena involved in presidential leadership from the perspectives of one Holy Cross and
seven Jesuit priests, and found that their styles “manifested the heart of servant leadership, Level
5 leadership, transformational leadership, and situational leadership” (p. vii). Muoneme’s study
shed light on the interrelationships between the lived experiences of individual leaders and the
shared meanings present in Catholic and Jesuit higher education as a whole, demonstrating that
the phenomenological investigation of individual leader experiences can enhance collective
understandings of mission and identity.
Governance and Policy Implications
It is important to understand the influence of governance and policy for Christian
education. In United States law, the Establishment Clause of the First Amendment to the United
States Constitution, together with the Amendment's Free Exercise Clause, forms the
constitutional right of freedom of religion in which the “Congress shall make no law respecting
an establishment of religion, or prohibiting the free exercise thereof...”.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 40
As was mentioned in the historical perspective, higher education increasingly adopted a
more utilitarian approach with the passage of the Morrill Land Grant Act in 1862. The
government offered financial aid to states to support colleges whose curricula included
agricultural and technical instruction (Lucas, 2006). After the Second World War, religious
practices in public schools were successfully challenged based on the Establishment clause of the
First Amendment. From then on, religious practices have been removed from the curriculum and
religion has been seldom mentioned. The public school was censored in order to present a view
of reality that religion was irrelevant to the real world (Glenn, 2012). According to McEneaney
and Meyer (2000), in promoting a modern education curriculum, the state tends to focus on
universalized models of knowledge at the expense of transcending tradition. Therefore,
traditional literature, classical history, religion, and poetry are all associated with indigenous
culture and tend to be marginalized. State reforms are normally met with varying degrees of
resistance from religious and educational stakeholders with vested interests.
Another relevant policy named the Blaine Amendment refers to the constitutional
amendment proposed on December 14, 1875, by Rep. James G. Blaine in reaction to efforts by
the Catholic Church, to establish parochial schools with public funding. President Ulysses S.
Grant had suggested that an amendment be proposed “making it the duty of each of the several
States to establish and forever maintain free public schools adequate to the education of all of the
children” and “prohibiting the granting of any school funds, or school taxes for the benefit of or
in aid . . . of any religious sect or denomination” (Komer & Grady, 2016, p. 11).

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 41
Faith-Integrated Nursing Education
History and Origin of Nursing – The “Faithful” Past
The definition and role of spirituality, religion, morality, and secularization in nursing
have been discussed and debated internationally for decades (Hussey, 2009; Paley, 2008). Since
the 19
th
century, professional nursing in America has transitioned from alignment with the faith-
based community to secularized training programs in hospitals (Libster, 2018). It appears that the
history and origin story of today’s “modern” professional nursing and its association with faith
communities is all but lost (Violette, 2005).
Many women were identified in their faith communities as nurses who provided healing
and caring skills to community members beyond their families. The religious sisters in the early
and mid-19
th
century were “set aside” or “set apart” as nurses and expert caregivers in the faith
communities where they self-sacrificed and fulfilled their calling to help others (Libster, 2018,
p.48).
The United Society of True Believers in Christ’s Second Appearing, more commonly
known as “Shakers,” immigrated to the United States in 1774 from England under Mother Ann
Lee (Andrews, 1953, pp. 12-13). The believers sought healing from God rather than regular
doctors for most health concerns other than broken bones, injuries, measles, and surgical
procedures (Harvard Shakers, 1843). The Shakers practiced the laying on of hands and the use of
prayer in healing (Whitcher, 1882, p. 1).
The American sisters were trained in nursing according to the Common Rules of
Daughters of Charity (Coste, 1924). The sisters contracted with hospitals to perform the duties of
“corporal care of the sick, spiritual instruction of persons in health and sickness, bleeding, giving
remedies, furnishing a proper diet to the patients, maintaining cleanliness, preparing the sick for
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 42
death, laying out the dead, and providing means for decent burial” (Hannefin, 1989, p. 34). In
addition to the physical needs of the sick, the sisters attended to emotional, mental, and spiritual
needs as well. The sisters believed in “leaving God for God” (Libster & McNeil, 2009, P. 32),
and “to love God and the poor, to make no distinction of persons, and to be indifferent to all
places” (Coste, 1924, p. 474). The American Medical Association (AMA), many of whose
members were Protestant, supported the sisterhoods as “highly educated and refined ladies” who
were “noble and self-sacrificing” (Gross, 1869, p. 163).
American nurses, student nurses, and the general public are exposed to the story of
Florence Nightingale (1920-1910) and she cares for the soldiers in the Crimean War as well as
her Notes on Nursing. The purpose of her book is to “give hints for thought to women who have
personal charge of the health of others” (Nightingale, 1980, p. v). Historian Sioban Nelson
suggests that contributions of women religious in American nursing have been rendered
“invisible” (Nelson, 2001, p. 14). In the late 19
th
century, “modernization” of nursing in America
led to the “secularization” of nursing education reform and “gradually altered those ways” in
history by “attaching secular training schools to their hospitals.” They were referred to as
“trained nurses” (Dock & Steward, 1925, p. 147). For these nursing leaders, modernization
entailed the secularized reform of nursing as what they perceived Nightingale’s work to be
about: “Gone forever, the conception of nursing as a charity, exceedingly meritorious and
desiring of the heavenly reward for its self-sacrificing character”, but nursing shone forth as “the
new ideal,” and “the invincible advance of science” (Nutting & Dock, 1907, p. 168).
Medical Model Care and Modern Nursing Education – The “Challenging” Present
The Institute of Medicine (IOM, 2010) reported that the U.S. healthcare system is
challenged to provide consistent, high-quality care to all people. In recent decades, profound
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 43
changes have occurred in science, technology, patient activism, and the nature and settings of the
nursing practice itself. Nurses needed to be prepared in both character and skill to care safely,
accurately, compassionately in an everchanging and diverse healthcare environment in a global
context (American Nurses Association, 2010; Andrews & Boyle, 2012).
Much of today’s healthcare continues to be based on the traditional “medical model”
where providers are most focused on and comfortable with diagnosing and treating physical
conditions. Nurses are trained scientifically to use their judgment to integrate objective data with
the subjective experience of a patient’s biological, physical, and behavioral needs (American
Nurses Association, 2019).
However, care should be “patient-centered, customized according to patient needs,
values, choices, and preferences” where the “system should anticipate patient needs, rather than
reacting to events” (IOM, 2001, p. 3). From this perspective, nurses are challenged to deliver
care that goes beyond the diagnosis and treatment of biological and physical illness. Rather, care
should incorporate “the spiritual dimension in nursing’s tradition, which cannot be separated
from the science of nursing” (Bradshaw, 1994, p. 169).
Although staff and students without Christian beliefs may share similar values, an initial
dialogue about the foundations of Christian values might be a way for faculty to help students
develop a sense of vocational purpose (Maier, 2014). Vught (2009) argues that scarce resources
and the strong influence of academic norms and values tend to lead to greater uniformity and less
diversity among institutions. Contemporary research suggests that nurses more often demonstrate
“conformist practices” today when dealing with the challenge of ethical dilemmas that can
emerge daily. This compares to an approach that emphasizes “a critical and creative search for
the best caring answer” (Dierckx de Casterle, Izumi, Godfrey, & Denhaerynck, 2008). Instead of
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 44
being driven by a commitment to kindness in the alleviation of suffering that is guided by
“spiritual formation” and “commitment to their faith communities”, spirituality was
differentiated from religiosity then as it is today in nursing and nursing education (Baldacchino,
2008; Libster & McNeil, 2009). Sometimes being accountable to two worlds: faith-based identity
and compromises create a feeling of “walking the tightrope” (Henck, 2011, p. 196).
In the early 20
th
century, American nurses re-aligned their need for belonging, from the
faith community to hospitals (Libster, 2018). The hospitals and administrators may not have
been religious, but they were not secular either. Nurses still had strong faith beliefs that aligned
with their intrinsic desire to undertake benevolent community service to others, and yet spiritual
formation disappeared as a new “training model” with a new set of professional and ethical
standards was imposed externally on the nursing profession and education. The responsibility for
extending self in the care of others in a spirit of love, kindness, peace, hope, and diplomacy
identified with professional roots in faith, may have been lost, resulting in greater manifestation
of burnout, stress, adverse patient events, group suffering, substance abuse, perceived incivility,
lateral violence, and identity crises within the profession (Rassin, Kanti, & Silner, 2005; Clark,
2008; Roberson, 2012).
Holistic Nursing Care and Faith-Based Nursing Education – “Back to The Future”
Health is defined as “the complete state of physical, mental, spiritual and social wellbeing
and not merely an absence of disease” (World Health Organization [WHO], 1948). The concept
of holistic care is introduced as a comprehensive model of caring to be the heart of the science of
nursing (Strandberg, Ingvar, Borgquist, & Wilhelmsson, 2007). The philosophy behind holistic
care is based on the idea of holism which emphasizes that, for human beings, the whole is greater
than the sum of its parts, and that mind and spirit affect the body (Tjale & Bruce, 2007). Holistic
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 45
care respects human dignity (Davis-Floyd, 2001) and cares for the person physically,
emotionally, psychosocially, and spiritually, including all aspects of patients’ thoughts,
emotions, cultures, opinions, beliefs, and attitudes that factor into recovery, happiness, and
satisfaction (Selimen & Andsoy, 2011). Unfortunately, there is compelling evidence that most
nurses have been educated with a biomedical allopathic focus and do not have a good
understanding of the meaning of holistic care (Olive, 2003).
Furthermore, most nurses are not familiar with holistic care, with the result that 76% do
not apply this method: they consider patients’ physical needs only (Waldo, 2011). In this regard,
the patients are considered biological machines and the mental, spiritual, and social needs of
patients are neglected (Porter, 1997). Using the ordinary biological model alone for treatment
exposes patients to severe threats, prolongs hospitalization, and raises treatment cost (Olive,
2003). Holistic nursing has been promoted through a change in nursing education, professional
environments, and personality traits (Zamanzadeh, 2015).
When one approaches nursing from a Christian perspective, we recognize that all people
are created by God in His image (Genesis 1:26, NIV) to live in a loving relationship with God,
self, and others (Deuteronomy 6:4-6; Matthew 22:37-39, NIV). Each person is a physically,
psychosocially, and spiritually integrated being with intrinsic value and significance (Psalm 8:4-
8; 1 Thessalonian 5:23; Hebrew 2:11-17, NIV). Christian nursing is a ministry of compassionate
care for the whole person, in response to God’s grace towards a sinful world, which aims to
foster optimum health (shalom) and bring comfort in suffering and death for anyone in need (The
Nurses’ Bible, 2008).

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 46
Stakeholder Knowledge, Motivation, and Organizational Influences
In this section, an overview of the theoretical framework proposed by Clark and Estes
(2008) will be used to guide the study. Organization performance gaps are attributed to three
primary causes: individuals’ lack of knowledge or skills, lack of motivation, or ineffective
organizational processes or culture. In order to select the right solutions that close performance
gaps, it is critical that organizations analyze and determine the exact root causes. Once solutions
have been identified, it is important for organizations to implement and evaluate in order to see if
organizational goals have been met effectively and adequately. For the purposes of this study, the
gap analytic framework has been modified to a needs analysis. Essentially, in order for the
university to successfully create a new faith-integrated nursing program, the study will explore
the knowledge, motivation, and organizational needs of key stakeholder group: senior leadership,
including the university president, provost, the associate provost, the dean of natural and health
sciences, the leaders who sit on a newly established program steering committee.
This study aims to understand and support stakeholder group’s knowledge, motivation,
and organizational performance influences that are needed to create and establish a new faith-
based BSc. in Nursing program at the university. The framework is designed to channel decision-
making through systematic and concrete steps that mitigate biases and assumptions in the
process of achieving the stakeholder’s goal of creating a new faith-based BSc. in Nursing
program by Fall 2020.
Knowledge and Skills
In order for the university to successfully create and implement a new faith-based nursing
program, a number of categories of knowledge, motivation, and organizational factors need to
come together. According to Clark and Estes (2008), individuals in different role groups may not
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 47
have the specific knowledge and skills needed to accomplish a particular task or goal. For
example, for this study, it is vital to understand whether the stakeholders know how to establish
an evidence-based and faith-integrated program and have the pedagogical framework and skills
to deliver rigorous faith-based curricula to their students. For example, a specific knowledge and
skill deficit may exist that will inevitably affect students from accessing high-quality faith-based
university education.
According to Anderson and Krathwohl (2001), knowledge and skills can be placed into
four different categories: factual, procedural, conceptual, and metacognitive. Factual knowledge
refers to the concrete pieces of information and the ability of an individual to understand the bits
of information related to any given concept. Conceptual knowledge, on the other hand, refers to
the ability of an individual to relate factual knowledge to categories and classifications. This type
of knowledge refers to more complex ideas, mental models, schemas, or theories. Procedural
knowledge involves the knowledge of how to do something. This involves the knowledge of
techniques, sequences, or steps that can range from the routine to rather complex. Procedural
knowledge refers to the ability of an individual to use knowledge to accomplish specific tasks.
For example, although an individual faculty member might have factual and conceptual
knowledge about faith-based education, they may not know how to apply it in education
practices. Finally, metacognitive knowledge refers to “knowledge about cognition in general as
well as awareness of and knowledge about one’s own cognition” (Anderson & Krathwohl, 2001,
p. 27). Metacognition also refers to the ability of an individual to transfer knowledge to a new
context and/or problem-solve (Clark & Estes, 2008). Simply put, metacognition is the knowledge
of one’s own self concerning learning and solving different tasks, including knowledge of one’s
strengths and limitations.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 48
For this study, current literature that focuses on the knowledge-related influences that are
pertinent to the achievement of the stakeholder goal of creating and establishing a faith-based
nursing program are reviewed.
Table 2 below lays out the assumed knowledge influences that impact the stakeholder
group at the university, which is the focus of this study.
Table 2
Assumed Knowledge Influences
Knowledge Type Assumed Knowledge Influence
Declarative
(Factual)

The senior university leadership needs to have a working knowledge to
fulfill all requirements of the national accreditation agency and the state
board for a pre-licensure nursing program.

The university needs to know the best practices, teaching components, and
metrics of a high-quality pre-licensure nursing program.

The university leadership needs to have a shared knowledge of the faith-
based principles and components of this new BSc. in Nursing program

Declarative
(Conceptual)

The senior university leadership needs to know the differences between a
faith-based nursing program and other general nursing programs.

Procedural

The university leadership needs to know the knowledge, skills, and
dispositions of ideal faculty that need to be recruited.

Procedural

The senior leaders need to know how to develop a business and
implementation plan.

Metacognitive

The senior university leadership needs to know how to be self-aware and
reflect on their own beliefs and goals for creating an innovative faith-
integrated BSc. in Nursing program.

Mission, vision, and identity of this new faith-based program are clearly defined.
The senior university leadership needs to clearly define and have a working knowledge of a
faith-based BSc. in Nursing program in terms of its mission, vision, values, and goals. The term
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 49
identity is commonly used to indicate the relatively stable way that the individual relates to
himself or herself and the world outside (Erikson 1968; Rorty & Wong 1990). Who we are and
why we exist is crucial to understand. From the Christian theology point of view, each person is
created uniquely with a unique purpose, background, life experiences, and life stories. On this
view, identity is the way we explain ourselves, the choices we make in our commitments, and
their consistency to others and ourselves.
The differences between a faith-based nursing program and other general nursing
programs are sufficiently identified and clearly articulated. Understanding the differences
between secular and Christian education is critical for all the stakeholders involved to make an
informed decision. Before offering a comparison of the differences in every area of education, let
us investigate some of the commonalities of any nursing education programs. In both types of
nursing programs, nursing students are expected to gain substantial knowledge in many
disciplines that are strictly related to medicine, sciences, and sociology, and to discover a diverse
approach towards the field. Majority of the graduate nurses specialize either in hospitals or
private practices and focus on individuals, families, and communities. The academic program
schedule contains theory classes in health sciences and disease processes; lab skills and
simulation scenarios for a variety of nursing techniques and clinical decision-making skills for
treatments; and clinical practicum components providing opportunities to apply the learned
theories and skills into real-world practice under supervision. Caring, compassion, empathy,
critical thinking, clinical decision-making, psycho-motor skills, leadership, and evidence-based
research are highly important to ensure safety, high-quality patient care, and the most updated
best practices.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 50
The classes nursing students take at a faith-based nursing school are likely to be very
similar to those of a non-faith-based nursing school, with the same academic and professional
requirements (including passing the nursing licensure exam and graduating from an accredited
school). Nevertheless, there is a significant difference in the approach to every aspect of faith-
based education. For example, there are two different philosophies regarding the ultimate source
of truth. Based on Ekeland and Walton (2018), ideally, some of the differences are indicated in
the comparison Table 3 below:
Table 3
Selected Differences Between Secular and Faith-Based Education (Ekeland & Walton, 2018)
Secular Faith-based
Purpose of
Education
To prepare citizens for a humanistic
society that tolerates all lifestyles
To prepare citizens for the Kingdom
of God who are equipped to spread the
Gospel

Content of
Education
Humanism - no values are absolute,
and no truth is final
All of life is studied in submission to
the Word of God and its precepts

Teachers Varied backgrounds - Christianity or
some other religion, humanism
atheism; may be straight or gay

Born-again, committed believers
seeking to model Christ before their
students
Rules Determined by state and federal laws
and guidelines
Determined by God’s Word and its
moral standards

Peers

Varied religious backgrounds, often
receiving little moral instruction or
values at home or church
Students from Christian homes who
are there because of their own or their
parents support for Christian values

The university leadership needs to know the knowledge, skills, and disposition of
ideal faculty needing to be recruited. The call for educators to incorporate spirituality into the
comprehensive college experience is not limited to faith-based institutions (Chickering, Dalton,
& Stamm, 2006). However, the task of faith-integration is a difficult scholarly work that
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 51
demands time and training preparation beyond the necessary efforts required to improve content
knowledge and teaching methods (Hasker, 1992).
The faculty at the faith-based institutions, particularly the member s of the Council for
Christian Colleges and Universities (CCCU), are screened, before hiring, for a suitable match to
member institutions’ stances on the Christian faith, and often evaluated for their ability to
integrate faith issues in classrooms.
The latter fact points to a gap in the vast literature that details the teaching techniques
used by and characteristics of excellent teachers in higher education (Bain, 2004; Palmer, 1998).
For example, faculties can create welcoming classrooms that are safe, open, and hospitable to the
students, and which facilitate significant learning by seeking to understand students’ struggles,
integrating students’ personal and prior learning experiences, inviting appropriate self-disclosure,
and showing concern for students’ well-being and progress (Bain, 2004; Brookfield & Preskill,
2005; Palmer, 1998). Researchers have noticed a positive correlation between faculty members
with a high level of spirituality and the use of student-centered pedagogy, and the receipt of
teaching awards (Lindholm & Astin, 2008). However, little has been reported on the
developmental process of excellent teachers who can meet the additional demands of faith-
integration and spiritual guidance (Chickering et al., 2006).
The senior leaders need to have the working knowledge to acquire, plan and allocate
revenues, personnel, budget, and resources in order to support the new initiative by
developing an accurately scaled business and implementation plan. As the cost of providing
a private school education increases, many private schools are finding it increasingly challenging
to operate based on the income from tuition and philanthropic gifts alone (U.S. Department of
Education, 2008). Based on an opinion survey, 55% of respondents believe private schools
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 52
provide a better education than public schools (Looney, 2009). Despite this, only around 10% of
American parents send their children to private schools each year (Snyder & Dillow, 2011) and
the key reason is that the private schools are simply not affordable (Mitchell, 2009). Compared
to the huge comprehensive and research-focused universities with more enrollment and funding
supports, administrators from private schools, particularly in Catholic and other religious schools
are facing a very real financial challenge that seems to be escalating (Aud et al., 2011).
As the scope of this problem has become more evident, the school leadership must have a
scalable business plan and find creative ways to address this issue.
The senior university leadership needs to know how to be self-aware and reflect on
their own beliefs and goals for creating a faith-integrated BSc. in Nursing program. The
lack of faith-learning integration is an important and complex problem to solve for a variety of
reasons. To measure the extent, effectiveness, and quality faith-integrated education is a
challenging task (Noll, 2006). Chickering et al. (2006) describe the unified efforts required to
integrate spirituality into all aspects of an institution of higher education as a balancing act.
In addition, since faith and spirituality are inner, subjective matters that incorporates
personal values, beliefs, actions, commitments, and a sense of connectedness in this changing
world (Astin, Astin, & Lindholm, 2011), it is critical that the university senior leaders are self-
aware and reflective regarding their own beliefs, goals, and biases that may influence this new
nursing program. In order to explore and address the various issues of starting a new nursing
program, there is a need for the leaders to be open-minded to listen with mutual respect, to
accept alternative points of view, to trust each other, to accept criticism, and to draw a wide
range of insights and experiences for further exploration and analysis, discussion, and debate.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 53
Motivation
In addition to knowledge, motivation is another key influence on performance (Clark &
Estes, 2008). The review of literature will focus on motivation-related influences that are
pertinent to university senior leadership’s capacities to create a faith-integrated nursing program.
The term ‘motive’ name from a Latin root meaning ‘to move.’ It can be seen as the ‘why’
of behavior and is defined as a desire that urges us to do something (Charles & Senter, 1995).
Motivation is an internal state or condition that arouses us to action, directs and persists our
behavior, and engages us in certain activities (Franken, 1994; Kleinginna & Kleinginna, 1981;
Ormrod, 1999).
Motivation influences can present themselves via the three behavioral indexes: active
choice, persistence and mental effort. Optimal performance towards a goal is contingent upon
these three facets of motivation. Active choice is the decision to act and begin motion toward the
accomplishment of a predetermined goal. Persistence is the ability to keep moving toward the
predetermined goal in the face of obstacles and distractions. Mental effort is the ability and
confidence to maintain sustained activity toward the achievement of the predetermined goal
(Clark & Estes, 2008).
Consider the three facets of motivation among the senior leaders in this university. When
they intend to do undertake the new faith-integrated nursing program without actually starting
the effort, they are engaged in the active choice facet of motivation. Though the university may
have other competing goals and priorities, when they still continue to work towards achieving
the goal of creating a plan for this new nursing program in a focused way, they are engaged in
the persistence facet of motivation. Finally, when they choose and persist with the adequate
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 54
effort, the right amount of confidence, and the very hard work needed to complete this
predetermined goal, they are engaged in the mental effort facet of motivation.
Motivation itself is a critical area of study in the area of education. In fact, research points
to the fact that “people who are positive and believe that they are capable and effective will
achieve significantly more than those who are just as capable but tend to doubt their own
abilities” (Clark & Estes, 2002, p. 82). The concept of value pertains to both the leaders’ interest
in the objectives, and the usefulness they associate with the benefits of finishing the goal (Kanfer
& McCombs, 2000). This next section will mainly focus on discussing value theory and self-
efficacy theory and discuss how they relate to understanding the key stakeholder groups’
capacities to create a new faith-integrated nursing program.
Value theory. Task value is reflective of the understanding that motivation, learning, and
performance are enhanced if a person values the task (Clark & Estes, 2008). Since higher levels
of value motivate individuals; consequently, the university senior leadership should place focus
on the values of this new nursing program as part of the strategic planning process. Failing to
value this new nursing program can manifest itself in a number of ways: stakeholders may have a
lack of buy-in to the importance of a true faith-integrated nursing program; stakeholders may
avoid investing that their time, finance, personnel, and resources to establishing this new nursing
program; stakeholders may not meaningfully engage in contractual relationships with the internal
and external partners for funding opportunities and accreditation requirements. This study will
explore the degree to which the senior leadership values this new nursing program in terms of the
following four dimensions: intrinsic value, attainment value, extrinsic/utility value, and cost
value.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 55
Self-efficacy theory. Self-efficacy theory states that motivation, learning, and
performance are enhanced when individuals have positive expectations for success (Clark &
Estes, 2008; Pintrich, 2003). Self-efficacy specifically refers to judgement of one’s ability to
master a specific task and receive the support needed to accomplish it. Self-efficacy is different
from ‘confidence,’ as confidence is often interpreted as a generally optimistic view of one’s
capabilities. Efficacy is specific to the tasks and the belief that not only are we able to
accomplish something but that we will also be permitted and/or receive adequate support to
perform the task. A person could be generally confident but have low efficacy about any given
task or vice versa (Bandura, 1997a).
Competence beliefs are rooted in a focus upon task-specific expertise, and individual
skill that makes one successful (Pintrich, 2003). In the context of this study, in order for the
university to create a new nursing program, the senior leadership needs to believe that they and
the university as a whole are capable of creating a new faith-integrated nursing program through
meaningful engagement with both the internal on-campus stakeholders and external partners.
The Table 4 below shows the key motivational constructs that may impact the
stakeholder group’s ability to create and establish a new faith-integrated nursing program at the
university.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 56
Table 4
Assumed Motivational Influences
Motivation
Construct
Assumed Motivation Influence

Utility Value Utility Value – The senior leadership must feel that their time, and resources
allocated in establishing this new nursing program is a worthwhile endeavor
to further advance the mission and vision of the university and global
learning communities.

Self-Efficacy Self-Efficacy – The university senior leadership needs to believe that they are
competent in creating the new faith-integrated nursing program through
meaningful engagement with both internal on-campus stakeholders and
external partners.

Organizational Influences
The third cause of performance can be attributed to facilitators or barriers that exist
within the organization or its culture (Clark & Estes, 2008). When knowledge, skill, and
motivation gaps are ruled out, it is often organizational influences that can either support or
prevent individuals from achieving optimal performance.
Gallimore and Goldenberg (2001) provided the concepts for cultural models and settings
that facilitate the examination of organizational influences. Cultural models relate to assumptions
that are taken for granted within an organization and only noticed when coming into contact with
other organizations that have markedly different models, such as alternate “shared ways of
perceiving, thinking, and storing possible responses to adaptive challenges and changing
conditions within an organization” (Gallimore & Goldenberg, 2001, p. 47). Out of cultural
models flow cultural settings, “where people come together to carry out a joint activity that
accomplishes something they value” (Gallimore & Goldenberg, 2001, p. 48). Cultural settings
include the visible manifestations of cultural models such as policies, procedures, and those
aspects of organizational performance that are given resources and those that are not.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 57
For this study, the organizational influences that may influence the stakeholders to
perform their roles in the organization and achieve their goals will be explored. These areas of
organizational influences include whether or not the work processes and policies are efficient,
material resources are sufficient, and values are aligned. Barriers within the organization can be
symptomatic of its culture. An organization’s culture dictates how work is accomplished and
describes the core beliefs and values of the organization itself (Clark & Estes, 2008). When
considering creating a new program with a faith-integrated curriculum, it is critical to examine
the culture of the organization to determine whether it is conducive for preparing and supporting
the establishment of this new nursing program.
Governance alignment. An organizational culture of governance that is collaborative
and transparent in decision-making processes is critical throughout the new program creation,
inception, development and implementation stages (Schein, 2010).
For this study, the investigation will be made to explore and understand what support and
check-in progress are in place to help address any actual and potential challenges in the process.
In addition, it is also important to explore to what degree the university currently has a culture of
unity, governance alignment, cooperation, and buy-in within the organization that supports the
establishment of this new nursing program.
Culture of trust and openness. The heart of leadership is to create a culture of trust
among the disparate, sometimes competing, human, systems, and programs factions (Fairholm,
1994). Its task is to generalize the values and principles of actions in ways that all involved will
find acceptable and energizing as an expression of community. Leaders are successful when they
unite individuals in collaborative action without losing too much individual autonomy (Kramer,
& Cook, 2004).
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 58
The school needs to have a culture of trust and openness and a safe and respectful
environment that allows people to voice their feedback, thoughts, and input in order to create a
faith-integrated nursing program. With a culture of trust and openness, the creative ways in
which Christian faith-based learning can be best developed, articulated, and integrated will
emerge through open discussion and debate as this new program is shaped.
Funding and resources. When proposals made for new programs, projects, or activities,
the university should take into account the feasibility of obtaining required funding as well as the
budgetary and other impacts the proposals may have.
The school needs to obtain and provide adequate funding and resources necessary to
support the planning and establishment of this new program to meet the university, state, and
national nursing standards (CCNE, 2018). A lack of resources and capital will be a hindrance as
the university needs to provide personnel, facilities, and structures (i.e., classroom, labs, simulations, and
medical/nursing equipment) for this new program.
Strong institutional identity. The school needs to develop a strong institutional identity
that reflects the mission, vision, values, and goals related to this new nursing program, along
with a clearly defined implementation plan that accounts for the controversy associated with
faith-based institutions. For some people, faith is at the core of their being, while for others, faith
is considered a historical irrelevancy or even harmful (Halstead & Reiss, 2003). Furthermore,
every religion has considerable diversity within it. For example, the language of scriptures and
teaching always require interpretation and can lead to disagreement (Halstead & Reiss, 2003).
The table below shows the key organizational influences that may impact the stakeholder
groups’ abilities to create and establish a new faith-integrated nursing program at the university.
Table 5
Assumed Organizational Influences
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 59
Organizational
Influence Category
Assumed Organizational Influences

Governance
Alignment
The university needs to cultivate a collaborative culture within the
organization that supports the establishment of this new nursing
program.

Culture of Trust and
Openness
The school needs to have a culture of trust, openness, safety, and
respect that allows faculty and staff to voice their input on the creation
of a faith-integrated nursing program.

Funding and
Resources
The school needs to obtain and provide adequate funding and
resources necessary to support the planning and establishment of this
new program in order to meet the university, state, and national
nursing standards.

Strong Institutional
Identity
The school needs to develop a strong institutional identity that reflects
its mission, vision, values, and goals in the implementation of the new
nursing program.

Conclusion
In the current extensive healthcare delivery system in the United States, there is no doubt
that nurses play significant roles in it. The nursing shortage is a global issue. As nurses are
becoming increasingly involved in caring for individuals and families’ healthcare needs, many
have to “wear many different hats.” These demands are enhanced a significant number of nurses
are leaving the profession, adding on the complexity and demands of an aging population are
increasing, and a nursing shortage threatens this country.
There is a tremendous demand from hospitals and clinics to hire more nurses, and more
students who want to enter the nursing programs, but the schools are at their enrollment limits.
Accordingly, education policies have been initiated to adequately address the growing need for
faculty and nurses to serve in primary care and other practice roles, and efforts have been made
to address the nursing shortage by focusing on preparing more nurses at the baccalaureate and
higher degree levels.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 60
Besides, much of today’s healthcare continues to be based on a “medical model” where
providers are most focused on and comfortable with diagnosing and treating physical conditions.
However, care should be “patient-centered, customized according to patient needs, values,
choices, and preferences” (IOM, 2001, p. 3). From this perspective, nurses are challenged to
deliver care that goes beyond the diagnosis and treatment of physical diseases. Instead, care
should involve serving the whole person – the physical, mental, emotional, social, and spiritual
(Puchalski, 2001, p. 352).
American nurses’ professional history and their identity are directly tied to a faith-based
primary healthcare model that has demonstrated inclusion and unity within the broader scope of
diverse healthcare beliefs and practices not to mention global differences in religion. Spirituality
and its roots in the faith-based community endure in the group memory of nurses and educators
who know professional nursing needs to be more than mere science. Therefore, integration of
science, art, and spirituality in professional nursing practice and education is called forth as we
quest for excellence and a whole person approach to nursing.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 61
CHAPTER THREE: METHODS
In this chapter, an overview of qualitative research methodology will be discussed and
followed by detailed descriptions of the specific methods used for data collection and analysis in
this study. This chapter contains the following sections: first, an introduction to qualitative
research methodology, explaining the choice to design this study as a qualitative investigation;
second, an introduction that describes the participating stakeholders and sample population;
third, a detailed description of the data collection method in this study and the instrumentation to
collect my data; fourth, methods in conducting data analysis; fifth, ways to increase and maintain
the credibility and trustworthiness of this study; and sixth, my responsibilities with respect to
involving human subjects, including my approach to informed consent, ensuring participation is
voluntary, confidentiality, and study limitations.
Research Questions
1. What are the senior leaders’ knowledge and motivation related to the university’s
commitment to establishing a faith-integrated BSc. in Nursing program?
2. What is the interaction between the organizational culture and context and stakeholders’
knowledge and motivation?
3. What are the recommended knowledge, motivation, and organizational solutions?
Research Setting
The organization setting is a private Christian University in northern California. The new
organizational performance area is the creation and establishment of a new faith-integrated BSc.
in Nursing program.
This nursing program is invaluable for the organization because this is consistent with its
theological, educational and missional foundations. Achievement in this new performance area
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 62
would enable the organization to fulfill its mission of “partnership with the church, to educate
transformational leaders for the glory of God” through the university’s objective to develop
graduates that “exemplify transformational leadership in church and society through the
integration of their faith, learning, and critical thought in the arenas of Christian literacy,
communication and intellectual skills, professional competence, and global citizenship” (The
University, 2017, p. 1).
Methods
In order to address the aims of this study, a qualitative research methodology was
adopted. Qualitative research seeks to examine a social phenomenon as it is, from the perspective
of the human participants; in rich, thick detail; and in naturally occurring settings (Merriam &
Tisdell, 2016). Qualitative research focuses on quality, especially in terms of nature and essence
(Merriam, 2009). Qualitative researchers are interested in understanding the people and how
people make sense of their world and understand the unique experiences they have in the world
(Preissle, 2006).
Qualitative research design has been chosen rather than a quantitative one, as a
qualitative study can support the development of descriptive data. Through an inductive
approach, this study design aims to use the data collected to augment the understanding of the
senior leaders’ knowledge and motivation related to the university’s commitment to establishing
a faith-integrated BSc. in Nursing program and the interaction between organizational culture
and context and stakeholder group knowledge and motivation.
Semi-structured individual interviews were used because they were suitable for the
exploration of subjective and sensitive issues. Semi-structured interviewing, according to
Bernard (1988), is the best method to uncover rich descriptive data on the personal experiences
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 63
of participants and identification of insights into an issue from the perspectives of participants.
This method offered a balance between the flexibility of an open-ended interview and the focus
of a structured ethnographic survey. By means of methodological analysis and data
interpretation, the information portrayed in themes were carefully identified. Although this form
of descriptive data is not readily changed into numerical figures for statistical analysis and is
sometimes considered to be “soft” data (Morse, 1991, p. 98), it can be “sensitive”, “meaningful”,
“rich” and “deep” (Geertz, 1973, p.20).
Participating Stakeholders
The stakeholder group in this study were from senior leaders at the university who was
responsible for setting strategies, priorities, and education standards, and allocating resources for
the establishment of this new and innovative faith-integrated BSc. in Nursing program. The total
number of participants was 6 (n=6). Data were collected from the interviews (n=6) for over two
months from December 2018 through February 2019. The provost at the university helped to
identify a list of potential research participants according to the inclusion criteria. Letters of
invitation, information sheet, and informed consent were sent (Appendix A, B, and C). A total of
ten senior leaders involved in establishing this new nursing program were identified and
approached from the list. Six of them replied and agreed to take part in a research interview. The
participation rate was 60%. The non-participants were contacted either via emails, phone calls,
and voice messages for at least three times, but no answer was received. All participants were in
high-level executive leadership positions and portfolio, including the chair of the board of
trustees, the university president, the provost, the associate provost, the dean of natural and
applied science, and the dean of students.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 64
Table 6
Participating Stakeholders
Sampling
Strategy
(purposeful
with max.
variation)
Number in Stakeholder
population (A total of
10 senior leaders were
identified and involved
in establishing this new
nursing program)

Number of
actual
participants
from the
stakeholder
population
(n=6)
Start Date
for Data
Collection
End Date
for Data
Collection
Interviews: 10

6 December
7
th
, 2018
February 7
th
,
2019

The specific roles of research participants for this study were as follows: a) The president
of the university who, at the level of administrative leadership, provides both vision, strategies,
and support. Ideally, he or she has an in-depth understanding of the knowledge, motivation, and
organizational influences in order to create and establish this faith-based nursing program, and
connects well with the other leaders, administrators, faculties, and staff, taking their feedback
into account in his or her leadership; b) The provost or chief academic officer of the university
who has the responsibility for the university’s academic and budgetary affairs while
collaborating with the president in setting overall academic priorities for the university and
allocating funds to carry these priorities forward; c) The associate provost who, under the
leadership of provost the president, makes sure that administrative and support operations run as
they need to on a daily basis, including monitoring those processes, resolving personnel matters,
balancing budgets, arbitrating demands for facilities, and overseeing the marketing of business
operations; d) The dean of natural and applied sciences, who is responsible for the academic and
administrative leadership of six departments within the university (biology, chemistry and
biochemistry, health science, kinesiology, mathematics, and this new nursing program); e) The
dean of students, who plans and directs university activities related to student services and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 65
campus life with general responsibility for responding to students’ needs and creating
environments outside the classroom where the students can be developed, challenged and get
connected to the community; and f) The chair of the board of trustees who is responsible to
provide leadership for the university’s 15 trustees who, in turn, provide strategic planning and
oversight to the president of the university. The researcher purposefully chose the chair because
he was directly involved in developing and approving the new nursing school’s mission, strategic
goals, and objectives, and developing policies and relevant services for the new program.
Interview Sampling Strategy and Rationale
Purposeful sampling permits the researcher to consciously select participants who have
experienced the phenomenon to be investigated (Maxwell, 2014). This non-probability sampling
method allows the researcher to select participants for the study based on personal judgment
concerning which participants will be the most productively generate useful data and be
representative of the population to be studied (Maxwell, 2014).
The potential research participants were identified by the researcher from staffing lists
provided by the provost at the university. To gain a broad range of perspectives and in-depth
understanding, the potential participants from the senior leadership and steering committee
members who have been working in the university for at least one year were sent an invitation
letter via email along with an information sheet, which explained the study in detail. Before,
during, and after the study, the researcher was always available to answer any questions the
participants may have. The researcher also assured the participants that data would be treated in a
confidential manner, and anonymity maintained.
Prior to the study commencing, the president and provost of the university were
approached to gain permission to the senior leaders who were interviewed. The president and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 66
provost were also consulted over the design and the details of the research. Written permission to
undertake this research was gained from the Institutional Review Board at both the university
and the University of Southern California. An introductory presentation was given to the senior
leaders and steering committee members whom the researcher intended to interview.
Each participant was invited to join the interview process. In order to maintain
confidentiality, each participant voluntarily consented to participate in the interview. Each one
was assured of confidentiality so as to encourage them to be as honest as possible, thus
increasing the validity of the data. They were assured of anonymity, and their names will not be
associated with any reports or conversations.
Estimating the number of participants required to reach saturation in a study depends on
a number of factors, including the quality of data, the scope of the study, the nature of the topic,
the amount of useful information obtained from each participant, and the qualitative method and
study design used. 8-10 participants were considered necessary to generate enough data and
achieve data saturation. However, interviewing ceased after no new themes emerged from the
data, and thus indicating that data saturation had taken place (Merriam & Tisdell, 2016). The
total number of six participants (n=6) assured that data saturation was achieved.
Interview Sampling Criteria and Rationale
The potential research participants were identified by the provost and the researcher, as
they were the best fit to answer the research questions and were directly involved in setting the
criteria and establishing of this new faith-based nursing program. To gain a broad range of and
deeper perspectives, the following inclusion criteria were used:
Criterion 1. Senior leaders who were working at the university, as this research would
concentrate on internal stakeholder groups within the university only, rather than any other
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 67
external stakeholders, for example, local healthcare representatives, clinical nurse specialists,
external consultants from nursing accreditation agencies and associations, community interest
groups, and leaders and faculties from other universities who were not working at the university.
The senior leaders who were working full-time at the university would have a better
understanding of the organizational culture and context.
Criterion 2. The selected stakeholder participants were members of a newly established
executive steering committee for the new faith-based BSc. in Nursing program. This steering
committee includes members who are responsible to set strategies, priorities, education standards
and allocate resources for the establishment of this new and innovative faith-integrated BSc. in
Nursing program. This criterion ensures that this study examines the knowledge and motivation
of those who are in the senior leadership and key positions and their efficacy and commitment to
establishing this faith-based new nursing program.
Criterion 3. Working at the university for at least one year so that there were necessary
knowledge and insights gained about the working environment, culture, available resources, and
on the job training.
Data Collection and Instrumentation
Pilot Study
The “pilot study is a small-scale version, or trial run, done in preparation for a major
study” (Polit & Hungler, 1999, p. 710). In this study, a pilot study was carried out to assess the
adequacy of the data collection plan, to increase validity, and to check out the recorder as well as
the interview process. Two senior leaders from a similar population (private Christian faith-
based healthcare sector and higher education institution) were subjects for this pilot study. The
individuals in the pilot study were questioned concerning his and her reactions to, and overall
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 68
impressions of the project. After the data from the test run had been collected and scrutinized, the
researcher made minor revisions and refinements that would eliminate or reduce problems that
might be encountered during the main study.
Interviews
Data were collected through semi-structured interviews (n=6) at the university over a
two-month period from December 2018 through February 2019. Semi-structured interviews
allowed the interviewer and respondents to engage in a formal interview. By preparing an
interview protocol with a list of questions and topics that needed to be covered during the
conversation, not only was the conversation focused, but this also provided reliable qualitative
data. The inclusion of open-ended questions provided the opportunity for identifying new ways
of seeing and understanding (Maxwell, 2014).
Interviews with senior leaders and board members who were part of the new program
creation and development were deemed an optimal solution for generating research data. This
enabled participants to articulate their experiences from their own point of view, allowed the
researcher to examine phenomena in context, generated themes from the participants’
perspectives, as well as understanding human behavior from their own framework of reference.
These interviews explored the senior leaders’ and participants’ backgrounds, beliefs and values
and personal and professional experiences, which might logically be argued to have potential to
impact on their perceptions about knowledge, motivation, and organizational culture (KMO)
needed to initiate this new program. In order to maintain confidentiality, each participant was
required to read the information sheet again and voluntarily consent to participate in this study.
Each was assured of confidentiality.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 69
The interview style was conversational and placed emphasis on the respondents’ view of
the issues. Suitable probes and prompts were used to explore interesting themes and their
meaning.
Preplanned interview protocol and topic guides were utilized to ensure that participants
focused on the topics under investigation. These were as follows: a) current knowledge,
motivation, and organizational culture for creating a faith-based nursing program at the
university; b) challenges and opportunities; and (c) proposed recommendations and solutions.
The topics were accompanied by open-ended questions written on the interview protocol. An
interview protocol has been provided in Appendix D, and the topic guide categorized by KMO
influencers can be found in Appendix E.
Observational field notes were kept, which included verbal and non-verbal clues as well
as other events that took place during the interview and may have had a bearing on data
collection. These were written up immediately after each interview since it was found that taking
field notes during the pilot study potentially disrupted the flow of information. Although the
memory recall may not have been entirely accurate, field notes captured salient points and
interactions within the interview between participant and researcher and were used to facilitate
reflection on the interview by the researcher.
All the interviews were conducted by the author herself. The interviews were conducted
via either Zoom or Skype online conference platform. The participants were in a secluded room
in the administrative office at the university, so that minimal disruptions were guaranteed and
that the place was quiet. All interviews were recorded with a digital recording device with the
participants’ consent and transcribed verbatim. The interviews generally took between one hour
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 70
and an hour and a half and were audio-recorded with permission. The interviews yielded a total
of 198 pages of verbatim transcripts.
Data Analysis
In the field of qualitative research, data analysis should be systematic and open to the
difficulties of understanding other people’s perspectives. The first step is for the researcher to set
aside her own preconceived ideas about the phenomenon under investigation (for example, faith
and learning) to understand it through the voices of the study participants – the process of
“bracketing” (Husserl, 1931). A fundamental element to consider when conducting qualitative
research is to discover the interviewee’s own framework of beliefs. The researchers should not
impose their own structure and assumptions on the data analysis (Miles and Huberman, 1994).
For the interviews, data analysis began during data collection. The researcher wrote
analytic memos after each interview and documented her thoughts, observations, concerns, and
initial considerations about the data in relation to the conceptual framework and research
questions. Once the above procedure was completed, interviews were transcribed and coded. The
first phase of analysis was a careful reading of the transcripts of the interviews. The data were
analyzed systematically and transparently. Open coding was used, looking for empirical codes
and applying a priori code from the conceptual framework. The second phase of analysis was
conducted where empirical, and a priori coding was aggregated into analytic/axial codes. Codes
were divided into ones that were common to several interviews and ones that were unique for a
particular interview. In this process, both commonalities and differences were identified with in-
case and between-case analysis. In the third phase of data analysis, the researcher identified
pattern codes and themes that emerged with headings and classifications that reflected the
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 71
original conceptual framework of enquiry and any new themes emerging in relation to the study
questions.
Coding enabled the construction of meaning from a large amount of data. Coding the text
involved categorizing particular text segments by using computer-assisted analysis tool NVivo to
arrange the narrative data. Other persons can then inspect the entire database through electronic
files and portfolio apart from reading the findings. In this manner, the creation of a computer
database markedly increased the reliability of this study.
Presentation of Data
For qualitative researchers, the typical mode of displaying data has been extended,
unreduced text. It is sometimes poorly ordered, bulky and overloading (Miles and Huberman,
1999, p.11). To provide the reader with an immediate impression of the themes, categories and
sub-categories identified, an overview of these findings is presented in Appendix F.
Since good displays permit the researcher to absorb large amounts of information quickly
(Cleveland, 1985) while using only extended text, a researcher may easily jump to hasty, partial,
unfounded conclusions (Miles and Huberman, 1999, p.11). Valid analysis requires displays that
are focused enough to permit the viewing of a full data set and are arranged systematically.
Therefore, for the purposes of this study, three methods of data presentation were employed
jointly in order to make the most of the data.
Matrix Display
A well-designed chart, or matrix, can facilitate the coding and categorization process
(Miles and Huberman, 1994, p93–95). The matrix also condenses data into simple categories,
reflects further analysis of the data to determine validity, identity degree of support, and provides
a multidimensional summary.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 72
A matrix displays data for each individual respondent rather than conflating the findings
in a general statement. It is a helpful way to illustrate how and to what extent each individual
contributed to the individual categories and to ensure the presentation of all raw data. Given the
nature of this research topic, a matrix can recover the wealth of individual variability.
Matrices essentially involve the crossing of two main dimensions with subcategories and
each of the six interview participants to see how they interact. By properly displaying the data
sorted into rows and columns, we were able to see how each participant classifies important
phenomena. Responses were recorded in a visual format, as either positive or negative. If the
participant elicited or expressed any opinion during the interview, a “+” sign was recorded. A “-”
sign indicated that the respondent either did not refer to it at all throughout the interview process
or considered the sub-category unimportant in relation to the specific research questions asked.
Summary of the Thematic Analysis
A summary of the findings is presented, synthesized, and analyzed using the horizontal
and vertical analysis method to note patterns, themes, making a contrast, comparisons,
clustering, and counting. With careful attention to the identification of important text that
suggests a connection between them, direct quotes are included to impart some flavor of the
original text and to represent the opinions of these different stakeholders.
Direct Quotes
Narratives are probably indispensable if we are to understand complex phenomena like
faith, nursing, and learning to their full extent. In each section, direct quotes have been made
from all six interview transcripts with fair and equitable representation where these would
clarify, support, deepen, explain, illustrate, and add to the understanding of a particular sub-
category. Elsewhere, authors within the health and social research spell out how the inclusion of
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 73
excerpts from transcripts help to clarify links between data, interpretation, and conclusions,
discussed within concepts such as validity, reliability, credibility, and auditability (Beck, 1993;
Greenhalgh and Taylor, 1997; Spencer et al., 2003).
Credibility and Trustworthiness
My Role
I was the only researcher to carry out this study, and there was no direct conflict of
interest because I was neither an employee nor consultant of the university. However, as the role
of a researcher, I needed to continually assess how my research design was actually working and
how it influenced and was influenced by the context in which I was operating. I worked to
include all voices and themes from the data represented without preference by adopting an open
and accepting attitude and asking open-ended questions that provoke in-depth conversations.
Upon critical reflection, however, as a Christian and a nursing educator, I was particularly
interested in creating an innovative learning experience for a BSc. in Nursing program with a
foundation based on Christian faith combined with the teaching of nursing knowledge and
technical skills. With this increased self-awareness and self-critique, I was better positioned to
identify between the worlds of the “observer and the observed” (Marcus, 1994, p. 570) and open
the possibility for the study to promote honesty and transparency within the research process.
In addition, although I have had the privilege to be exposed to diverse experiences and
worldviews by living and working in five countries, I still run the risk of being deluded by my
own worldview. In this case, my race/ethnicity/socioeconomic status, and prior personal,
professional and faith experiences, understanding, values, and involvement as a Christian, nurse,
and educator may influence my perspectives and “mode of thinking” (Maxwell, 2013, p. 3).
Therefore, to deepen my understanding of others, it was critical for me to be aware, to stay
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 74
engaged yet distant enough to always actively listen and reflect, not to make assumptions and to
approach the interview questions/answers with an open mind and heart to any new ideas and
possibilities.
In order to increase the credibility and trustworthiness of my study, I adopted bracketing
and reflectivity to refrain myself from judgment. To bracket things is not so much a matter of
doubting their existence but of disconnecting from them: “It is a certain refraining from
judgment” (Husserl, 1931, p. 121).
I am committed to address my assumptions and biases and conduct an objective response
to the phenomena itself by respectfully “listening to what the phenomenon speaks of itself.”
Thus, I note that bracketing achieves an openness to the “experience as it is presented by the
participants” (Theohald, 1997, p. 596). To avoid imposing preconceptions on the phenomena of
the unique life experience, the researcher “shifts her own attitude and puts everything else out of
consideration” (Theohald, 1997, p. 596).
Reflexivity is related and is “associated with the self-critique and personal quest, playing
on the subjective, the experiential and the idea of empathy” (Marcus, 1994, p. 569). The outcome
of this reflexivity opens the possibility for the research product to incorporate many voices.
Ethics
The research was conducted by applying the guiding principles of research ethics by
Merriam and Tisdell (2016). In line with the recommendations from Institutional Research
Board, the potential participants were given written information and participation was
completely voluntary, while also respecting the wishes of individuals who did not want to
participate in the study.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 75
Fundamental ethical principles that govern the research process were followed, including
autonomy or respect for the participants, beneficence or the duty to do good for the participants,
and non-maleficence or the duty not to do harm and justice or fairness (Merrell & Williams,
1995).
The principle of mutual respect and a neutral attitude was adopted throughout the
interview process. The study was not designed to benefit participants directly. However, the
information obtained hopefully would help to supply information, to develop professionals’
knowledge, and to provide a better understanding of the capacity and efficacy needed for the
university to establish such a new nursing program while also enabling senior leaders to meet the
challenge with targeted solutions.
Although the topic under discussion was not a sensitive one, it was important for me to
be adequately prepared. The researcher identified and reduced any potential impact on
participants by spacing between each interview to ensure psychological and emotional rest and
recovery. I supported any individuals who wished to withdraw or not answer questions during
the study. When difficulties, painful emotions, or unanticipated reactions were detected, I
planned to provide support and recommend the participants to the formal support systems
available for them, such as counseling services.
I also ensured that all voice recordings for data collection and field notes were stored in a
locked secure cupboard. I will destroy codes and recordings within one year of completion of the
study.
Limitations and Delimitations
It was not anticipated that this research would represent the perceived knowledge,
motivation, and organizational factors for all of the faith-based nursing programs, as it involves
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 76
an in-depth study of the experience of specific participants and institutions. There are no claims
of a high transfer value of this small-scale study to wider populations. This study may not
necessarily reveal the phenomenon to its full depth, but rather begin to unravel some layers of
knowledge in the understanding of stakeholders’ knowledge, motivation, and organizational
culture in creating a faith-based nursing program.
As no single method of investigation can over-ride all design limitations, therefore a
combination of methods (e.g. use of triangulation) is desirable. The research was done by a
researcher with very modest resources. The timescale for the research was also a limitation and
the researcher’s own workload as a full-time nursing faculty was also a constraining factor. The
interviews were conducted by the researcher herself who may have had an “insider perspective”
in her interpretations. The perspective of the insider is regarded with suspicion on the grounds
that it is likely to be “blinkered” in comparison to that of the informed outsider. However, as
Beck (1994, p.123) argued, “It is impossible for a researcher to be completely free from bias in
the reflection of the experience being studied, but it is possible to control it.”

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 77
CHAPTER FOUR: RESULTS AND FINDINGS
The senior executive leadership at the target university established an organizational goal
to create and implement a faith-integrated Bachelor of Science Nursing program by September
2020. The performance gap is 100%. In order to achieve this goal, the study began by generating
a list of possible needs and then moved to examine these assumed needs systematically to focus
on actual or validated needs. Based on the participants’ responses via interviews, the previously
proposed knowledge, motivation and organizational assumed influences were analyzed and
organized into three categories: namely: assets, gaps, or inconclusive. An asset means that this
knowledge, motivation or organizational support already exists and nothing more needs to be
done to reach the performance goal. A gap refers to a continuing need and area that deserves
attention and solution(s) in order to reach the performance goal. Inconclusive suggests that the
researcher was unable to confidently determine as either an asset or a gap. While a complete
needs analysis would focus on all stakeholders, the stakeholder focus in this analysis was senior
executive leaders, as they were the most relevant stakeholders at the time of data collection and
also pertinent for the purpose of this study.
In this chapter, the findings of the study are analysed and organized into three sections:
The first section of this chapter will look at the assumed knowledge influences. Four out of seven
assumed knowledge categories were assets, while one was a gap, and two were inconclusive. In
the next section, findings related to motivation influences will be discussed. Two assumed
motivation influences were approved as assets (including one new motivational influence
emerged from the interviews). Self-efficacy was considered a gap. The last section of this
chapter will focus on assumed organizational influences. Three out of four influences were
considered assets, while funding/resources was considered a gap in this case study. The results
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 78
and findings will be synthesized, critically analyzed and evaluated without combining
discussions and recommending solutions. By presenting the findings in a purely factual way does
not allow the researcher to stray from the limits of the present data. In addition, as suggested by
Burnard (2004, p.179), this also avoids any possible “bending” of the data by comparing it with
other studies.
Purpose of the Study
The purpose of this study was to conduct a needs analysis in the areas of knowledge,
motivation, and organizational resources necessary to reach the organizational performance goal
of establishing a new faith-integrated Bachelor of Science Nursing program. As such, the
research questions that guide this study are the following:
1. What are the senior leaders’ knowledge and motivation related to the university’s
commitment to establishing a faith-integrated BSc. in Nursing program?
2. What is the interaction between the organizational culture and stakeholders’
knowledge and motivation?
3. What are the recommended knowledge, motivation, and organizational solutions?
In order to address the aims of this study, a qualitative case study research methodology
was adopted. Through an inductive approach and the development of descriptive data, this study
design aimed to understand the senior executive leaders’ knowledge, motivation, and
contextualized organizational culture related to the university’s commitment to and efficacy in
establishing a faith-integrated Bachelor of Science in Nursing Program. Semi-structured, in-
depth interviews that typically lasted between 1-1.5hrs were used to collect the wealth and depth
of individual variability in the context of lived experiences.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 79
Data were collected from the interviews (n=6) for over a two-month period from
December 2018 through February 2019. The cohort of research participants were identified by
the provost at the university. Six out of ten participants from the list replied and the participation
rate was 60%. The non-participants were contacted either via emails, phone calls and voice
messages for at least three times and received no answer. All participants were senior leaders in
high-level executive leadership positions and portfolio, including: the board of trustees,
university president, provosts, and deans. Participants in this study group had started their careers
from a wide range of backgrounds and academic disciplines, including business development
and marking; education administration; pastor and denominational leader; theologian and bible
college professor; biology and natural sciences; and special education and leadership. Table 7
below provides a demographic overview of the participants.
Table 7
Description of Participants (N=6)
Sample Characteristics n
Participants 6
Female 0
Gender
Male 6
Experience in Years at Faith-based Education 1.5 – 35
Education at Doctorate Degree Level 6
Roles and Responsibilities in Executive Leadership 6
Chair of Board of Trustees 1
President of the University 1
Provost 1
Associate Provost 1
Dean of Natural and Applied Sciences 1
Dean of Students 1

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 80
Overview of Results and Findings
This study was guided by Clark and Estes’ (2008) analytic framework, which required
the validation of knowledge, motivation, and organizational influences that could potentially be
barriers to achieving the organizational goals. Based on the findings from the interviews, Table 8
presents an overview of the key findings, and then compares them with the assumed knowledge,
motivation, and organizational influences in order to determine and validate assets, gaps or
inconclusive results. In addition to the presumed influences the researcher discovered an
additional influence which is also discussed below.
Table 8
Overview of KMO Influences Chart
Knowledge
Category
Assumed Knowledge
Influences Assets Gaps Inconclusive
Additional
Influences
Factual
The university senior
leadership needs to have a
working knowledge to fulfil
all requirements of the
national accreditation
agency and state board for a
pre-licensure nursing
program.

Yes
Factual
The university needs to
know the teaching strategies,
interventions, tools, and best
practices of a high-quality
pre-licensure nursing
program.

Yes
Factual
The university senior
leadership needs to have a
shared knowledge of faith-
based principles and
components of this new BSc.
in Nursing program.

Yes

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 81
Table 8, continued
Knowledge
Category
Assumed Knowledge
Influences Assets Gaps Inconclusive
Additional
Influences
Conceptual
The university senior
leadership needs to know the
differences between a faith-
based nursing program and
other general nursing
programs.

Yes
Procedural
The University leadership
needs to know the
knowledge, skills and
disposition of ideal faculty
to be recruited.

Yes
Procedural
The senior leaders need to
know how to develop a
business and implementation
plan.

Yes
Metacognitive
The university senior
leadership needs to know
how to be self-aware and
reflect on their own beliefs
and goals for creating an
innovated faith-integrated
BSc. in Nursing program.

Yes
Motivation
Category
Assumed Motivation
Influences Assets Gaps Inconclusive
Additional
Influences
Utility Value
The senior leadership must
feel that their time, and
resources allocated in
establishing this new nursing
program is a worthwhile
endeavor to further advance
the mission and vision of the
university and global
learning communities.

Yes

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 82
Table 8, continued
Motivation
Category
Assumed Motivation
Influences Assets Gaps Inconclusive
Additional
Influences
Self-Efficacy
The university senior
leadership needs to believe
that they are competent in
creating the new faith-
integrated nursing program
through meaningful
engagement with both
internal on-campus
stakeholders and external
partners.
Yes

Goal Orientation
The university senior leaders
believe that creating and
establishing this new faith-
integrated nursing program
will exert influence in areas
including education,
healthcare, church and help
missionary endeavors in
society.

Yes Yes
Organizational
Category

Assumed Influences Assets Gaps Inconclusive
Additional
Influences
Governance
Alignment
The university needs to
cultivate a collaborative
culture within the
organization that supports the
establishment of this new
nursing program.
Yes
Culture of Trust
and Openness
The school needs to have a
culture of trust, openness,
safety and respect that
allows faculty and staff to
voice their input when
creating a faith-integrated
nursing program.

Yes

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 83
Table 8, continued
Organizational
Category

Assumed Influences Assets Gaps Inconclusive
Additional
Influences
Funding and
Resources
The school needs to obtain
and provide adequate
funding and resources
necessary to support the
planning and establishment
of this new program in order
to meet university, state and
national nursing standards.

Yes
Strong
Institutional
Identity
The school needs to develop
a strong institutional identity
that ensures their mission,
vision, values and goals are
implemented in the plan for
the nursing program.

Yes

Results and Findings for Knowledge Influences
The first section of this chapter will look at the assumed knowledge influences and
confirm that all seven assumed knowledge influences on performance were found to be either
assets, gaps or inconclusive as presented in Table 9 below. As was described in the previous
section, an asset means that nothing needs to be done to reach the performance goal; a gap
suggests that a solution is needed in that area; and inconclusive means the researcher is unable to
determine if the influence is either an asset or a gap. Four out of seven assumed knowledge
categories were assets, while one was a gap, and two were inconclusive. Using Anderson et al.’s
(2001) expansion on Bloom’s taxonomy, knowledge needs were identified and categorized into
factual, conceptual, procedural, and metacognitive dimensions. Based on the results of the
interviews, what follows is a very high-level summary and synthesis of the findings related to the
assumed knowledge needs.

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Table 9
Assumed Knowledge Influences Summary Chart
Assumed
Influences
Assets Gaps Inconclusive Summary of Interviews
K1:
Accreditation

Yes The university senior leaders are experts
with WASC accreditation. However, the
interviewees mentioned they have no prior
knowledge of nursing accreditation
standards, as it is “new territory”.
K2:
Best practices

Yes The respondents asserted that teaching
strategies, interventions, and tools used in
other existing programs are “transferrable”
to the new nursing program. However,
“evidence-based, theory-practice
integration” and “industry standard best-
practices for didactic, lab, clinical, and
spiritual” instructions should be co-created
by the nursing experts and instructors. This
was considered with gaps in knowledge due
to the fact that the university neither has an
extant nursing program nor personnel with
experience in the design, implementation or
administration of this academic discipline.
K3:
Principles of
faith-based
education

Yes All six interviewees embraced strong
institutional identity, mission, commitment,
and principles as they “go through the
university process of” creating this new
Christian faith-based nursing program.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 85
Table 9, continued
Assumed
Influences
Assets Gaps Inconclusive Summary of Interviews
K4:
Differences of
Faith-based and
non-faith-based
nursing programs

Yes Based on the data, all participants
unanimously agreed on the importance of
building the program with a “spirit of
excellence”, “best quality and practices”,
“academic rigor” and caring virtues
commonly shared in other nursing and
scientific programs. However, when
asked to “envision and paint an ideal
picture of a fully faith-integrated nursing
program,” raw data uncovered a great
deal of individual variability.
K5:
Recruiting faculty

Yes All six individuals demonstrated shared
knowledge about hiring ideal faculty who
embody dual dispositions: both “deeply
rooted in God’s love and internalized
Christian faith” and “proven experts in
the nursing field,” as well as “able to
teach”. They clearly articulated the
“steps”, “processes involved,” and firmly
support a “personal statement of faith”.
K6:
Developing
business plan and
implementing
strategies

Yes The institutional administration possesses
significant expertise in the planning and
implementation of new programs,
including “recent additions at the
Bachelors’ and Masters’ levels in areas
such as psychology, accounting, criminal
justice, MBA, etc.
K7:
Self-reflection
Yes All six executive leaders who were
interviewed confessed explicitly their
personal understanding and devotion to
Christ and expressed their commitment to
being self-aware and self-reflective on
their own beliefs and goals for creating a
faith-integrated BSc. in Nursing program.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 86
Assumed knowledge influence #1: Accreditation
The first assumed factual knowledge influence, “the university senior leadership needs to
have a working knowledge to fulfil all requirements of the national accreditation agency and
state board for a pre-licensure nursing program” was inconclusive, based on the interviews. The
university senior leaders are experts with WASC accreditation. However, the interviewees
acknowledged that they have no prior knowledge in the state board and nursing accreditation
requirements as it is “new territory”.
As the researcher engaged in discussions about presumed declarative knowledge for
preparing and creating a faith-integrated BSc. in Nursing program, a variety of themes emerged
from senior university leadership that validated their need to know and establish an alliance with
multiple organizations in order to accredit nursing higher education programs. Answers to this
question about accreditation requirements for a pre-licensure nursing program elicited a response
in which all of the six leaders mentioned the importance of WASC accreditation, while four out
of the six mentioned both the California Board of Nursing and nursing program accreditation.
The responses are further divided in the following three sub-categories shown in Matrix 1 below:
Matrix 1
Have a Working Knowledge to Fulfil All Accreditation Requirements
Categories and Subcategories
K1: Accreditation
Respondents
1 2 3 4 5 6
WASC + + + + + +
California Board of Nursing + + + - + -
Nursing Program Accreditation + + + - + -
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

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WASC Senior college and university commission. The university is in the state of
California and is fully accredited by the WASC Senior College and University Commission
(WSCUC). All participants emphasized the importance of fulfilling regional accreditation
requirements as evidence they provide quality education. For example, one participant
commented: “I’ll start on the WASC side first because, of course, there’s the regional accreditor
set of requirements that the institution and the program have for quality education.” This is a
statement to the broader community and the stakeholders that the university is a trustworthy
institution for student learning and committed to ongoing quality improvement.
A majority of the senior university leaders asserted that they developed their expert
knowledge and competencies for accreditation through their successful track records with
WASC accreditation, and subsequent reaffirmations of accreditation. One leader recalled that:
“We’ve been through accreditation dozens of times so that’s not unfamiliar territory for us. We
pretty much know exactly how to write up a proposal, how to prepare for it…The kinds of
documentation market analysis, academic program creation, or learning outcome assessment,
structure, we know how to do that.”
In addition, the leaders demonstrated their declarative knowledge by stating the need for
substantive institutional changes approval prior to starting a new on-site nursing degree program.
One leader offered a typical response as follows: “The first set of screening forms with WASC
has to do with letting them know we intend to develop a particular program.” According to
another participant: “Just because of the nature of a nursing program being enough of an
advancement in departure from the core programs that we have already, it’s not preordained.
They (WASC) could decide otherwise but I fully expect that they (WASC) will tell us, ‘You
need to go through a full proposal and program approval process with them.’” These remarks
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confirm that the leaders are fully aware that just because the education institution has been
approved by the Commission to offer programs at a degree level – in this case, Bachelor’s - it
does not necessarily have blanket authority to initiate additional new programs at that degree
level without prior approval.
California Board of Registered Nursing. The university’s executive leaders raised
concerns about the requirements for any pre-licensure registered nursing program in California to
be approved by the California Board of Registered Nursing, a division of the California
Department of Consumer Affairs. Four out of six leaders understand the purpose of approval is
to ensure the nursing program’s compliance with statutory and regulatory requirements.
However, it is worth noting that, comparing to WASC accreditation, some of the reasons cited by
participants as to why they feel less certain and knowledgeable about the board of nursing
process is that “it is a new territory.” They still asserted that “nonetheless, both the people
involved in championing this program and our structure will help to guide them.” Further, the
leaders acknowledged that, currently, there is no nursing leader or faculty involved internally
within the university to provide relevant nursing expertise in this process.
Nursing program accreditation. Four out of the six executive leaders mentioned that
“particularly, the regulatory bodies advise us in terms of any of the regulatory steps it needs,
while at the same time the champion is connecting with the appropriate regulatory bodies to
make sure that we are aligning our multiple compliance processes with the project.” Although
there was no direct mention of any specific nursing program accreditation throughout the
interviews, the researcher was unable to verify from the data if the leaders clearly ascertained
that approval by a state board of nursing does not mean that the school is accredited by a national
accrediting organization like the Accreditation Commission for Education in Nursing (ACEN).
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 89
Assumed Knowledge Influence #2: Best Practices in Nursing Education
Emerged from the data, the senior leaders in this cohort identified the following six
themes as some of the identified best practices, teaching strategies, intervention, tools, and
components for this new nursing program: theory and practice integration; academic and practice
partnerships; evidence-based best practices; holistic admission with diversity; advanced
technologies and strong Christian mission and identify (presented in Matrix 2).
Matrix 2
The University Needs to Know the Best Practices and components in Nursing Education
Categories and Subcategories
K2: Best Practices in Nursing
Respondents
1 2 3 4 5 6
Theory & practice integration + + + + + +
Academia & practice partnership + + + + + +
Evidence-based best practices - + + + + +
Holistic admission with diversity + + + - + -
Advanced technologies - + + - + +
Strong Christian mission identity + + + + + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

The second assumed factual knowledge influence, “the university needs to know the
teaching strategies, interventions, tools, and best practices of a high-quality pre-licensure nursing
program,” was found to have gaps in knowledge in this area.
The findings elicited the importance for the university nursing leaders and future nursing
faculty to know the components and best practices of a high-quality pre-licensure nursing
program. The respondents asserted that the teaching strategies, interventions, and tools for other
existing programs can be “transferrable” to the new nursing program. However, “evidence-
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 90
based, theory-practice integration” and “industry standard best-practices for didactic, lab,
clinical, and spiritual instructions should be co-created by the nursing experts and instructors
when they are hired in the future.” Therefore, this knowledge influence was considered a gap in
knowledge due to the fact that the university neither has an extant nursing program nor personnel
with experience in the design, implementation or administration of this academic discipline. The
six major themes that emerged from this knowledge category will be explained more specifically
in turn below:
Theory and practice integration. Although none of the senior leaders have a nursing
background, a majority of the participants agree that since theory provides the basis for
understanding the reality of nursing, it would seem reasonable to assume that the content studied
in the classroom correlates with what the student experiences in the clinical settings. The
following comments encompass the participants’ opinions of the theory-practice connection:
I’ll tell you some things, again from my perspective, I’m obviously not a nurse myself,
I’m not registered in that area. It’s not my area of discipline. To me, the balance here is:
Nursing programs, of course, they tend to be very labor-intensive. By that I mean, you
can spend only so much time learning nursing out of the book, but you have to start
practicing it. You actually have to start manipulating things with your hands, touching
them, feeling, them, looking at them, investigating with them because that’s how you're
going to learn more effectively than just reading a book, reading a book, and reading a
book.
Likewise, all of the executive leaders conveyed a similar idea that integration of nursing
theory and knowledge into practice is a crucial component in a nursing education program:
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 91
Yeah. so again, with the disclaimer that I’m not a medical professional, and I have great
honor and respect for medical professionals, one of the things I believe in many areas of
professional training is that we are not early enough to incorporate the experience of
theory and practice consistently together. So what I can imagine or what I envision is
after ensuring a baseline, let’s say, for example, it is the first six months of the program,
after ensuring a baseline of theory and framework, I can imagine a nursing school that is
very distributed early on and has nursing students working in these clinics, working in
these healthcare arenas, and doing so in a safe and supervised way.
As indicated above, all of the interviewees believed that students should be able to
practice and demonstrate what they learn in the classroom in real life scenarios. Therefore, this
finding coincides with numerous nursing education and practice literature that confirms the
importance of theory and practice integration in nursing education (Ahmad, Mohannad, & Rami,
2015; Hatlevik, 2011; Corlett, 2000) and strategies to address the theory-practice gap with
evidence-based practice and the role of nursing educators (Hussein and Osuji, 2016).
Academic and practice partnerships. An academic and clinical practice partnership is
developed between a nursing education program and a clinical care setting so as to achieve
educational and career advancement goals (AACN, 2012). All six participants emphasized that
building strong academic and practice partnerships are an important mechanism to strengthen
nursing practice and help nurses become well positioned to lead change and advance health.
Such intentional and formalized relationships established at the senior leadership level are based
on mutual goals, respect, and shared knowledge. Based on the interviews, the university has
initiated conversations “with the chief medical officers and the nursing directors” from the “large
healthcare providers that are all based within short driving distance of campus.” “They are all
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 92
very keen to partner with us,” and “they want to get their hands on these nursing students as soon
as they can!”
Based on the interviews, another facet of academic and practice partnership is to expand
opportunities for the university to develop collaborative improvement efforts that build
proficiency in relevant ways. This can be best illustrated through the following quote:
Very important to me, in doing faith-integrated education, is that we also be very
connected to the employment and social services community of our region. We’re very
rich in that, in the Sacramento region, in that we have at least five current major
healthcare systems. It would be very important to me, as a best practice before we
launched a nursing school, to ensure that we had communication and coordination with
those five entities, and that we invited both input from those entities and perhaps even
some participation in helping to shape the program. They know the needs in their
hospitals and in their clinics and in their doctor’s offices, and we would want to hear
from them.
The above leader acknowledged that an academic-practice partnership is a mechanism to
not only promote effective nursing education, but also play an important role in advancing
nursing practice to improve the health of the public. Therefore, such intentional and formalized
relationships shall be based on mutual goals, trust, respect, and shared knowledge and
commitment.
Evidence-based best practices. All participants across the board mentioned the phrase
“evidence-based practices” as the principle for a high-quality nursing education. Upon close
examination, they may represent slightly different perspectives. For example, one stated: “It’s
going to be evidence-based teaching, where we are going to be using practice evidence, we’ll be
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 93
using patient preferences and clinical expertise to make a gateway for the evidence-based
instruction.” In this case, evidence-based teaching refers to effective educational strategies
supported by evidence and research as the key component for best practices to support the
students’ individual learning needs.
The leaders also consult national data sources, regional forecasting sources, and
healthcare policies to inform best practices and predict industry trends. “We always try to solicit
the right blend between the academicians, with the technical specialist in the academy, and then
the practitioners in the field – I think there is a good convergence, that is a healthy balance if we
can do that together.” This is another common strategy when the evidence in question consists
largely or entirely of data, academic research, or scientific findings that educators can compile,
analyze, and use as objective evidence to inform the design of an academic program or guide
modifications and decision-making.
Within this emerging theme, the researcher learned that five out of the six leaders
articulated that establishing both external academic partnerships and internal interprofessional
collaboration are central to institutional engagement and collaborative education practice for the
university. Here is an example of benchmarking and how the university promotes external
collaboration to leverage support, partnerships and shared resources:
I also think in terms of best practices we would want to examine other educational
institutions both proximate to us, for instance UC Davis, Sacramento State University,
the community colleges in the area, as well as universities maybe more distant from us.
But that would be what I would call benchmarking.
This leader perceives benchmarking as a best practice which involves, first and foremost,
a search and identification of the best practices – the most effective and model solutions that gain
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 94
the best results by learning from other universities and benefiting from their experiences. This
coincides with the definition by Pieske (1994) which highlights the most important pillar of
benchmarking: learning. This executive leader also emphasized that continuously learning best
practices is very important in order to be competitive.
Another leader articulated how the university builds new programs around internal
interprofessional and collaborative practices in order to first establish, strengthen, and extend the
collaboration needed within and across disciplines and so as to guide coordinated planning.
Let me begin with some of the premises on which we develop all academic programs.
First of all, we work very interdisciplinarily – it’s important to us. We believe the
creativity and innovation emerged out of interdisciplinarity. So, we want people from a
variety of different disciplines to be engaged in the conceptualization and eventually the
formation of this new nursing degree programs.
Traditionally, well-intentioned yet one-dimensional approaches present university
education as a siloed and isolated professional skill development rather than the cultivation of a
fully comprehensive scope of practice (Salari, Klapman, Fry & Hamel, 2017). Optimal client-
centered care requires healthcare professionals to work as a cohesive team (Abu-Rish, Kim &
Choe, 2012). Interprofessional education requires purposeful integration among the disciplines
(WHO, 2010). As articulated above, when nursing students are thrust into the complex
environment of healthcare, they are expected to navigate the boundaries of various healthcare
members’ roles in addition to adjusting to the responsibilities of patient care, Interdisciplinary
collaboration must be well-integrated into this new nursing program and throughout the
curriculum in order to empower each individual to contribute his or her expertise regardless of
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 95
job title or degree, to promote creativity and innovation, and to allow seamless collaboration at
the university.
Holistic admission process with diversity in students’ body. Over half of the cohort
clearly stated that future nursing student policies and admission procedures should be in
compliance with university as well as state non-discriminatory policy, and should be consistently
applied. The university leaders believe admission processes and strategies have significant
implications for the healthcare workforce and believe that their practices are aligned with
institutional mission and goals.
One reported that “we are not going to restrict us in Christian applicants…… So, you can
actually look at this application as an opportunity for us to be missional in nature, where we want
to take in the best applicants with the best academic, experiential experiences and the best needs
– we are looking for diversity.” As stated, this holistic admission process aims to increase the
diversity of their student populations and, by extension, that of future professionals. It provides
flexible, individualized ways of assessing applicants’ experiences, attributes, and academic
metrics, and how those individuals might contribute value as students and future health
professionals. When applied consistently across an entire applicant pool, it can help the
institution to achieve its mission over time.
Other executive leaders added that an innovative admission strategy is a “highly
individualized, holistic review of each applicant’s file…giving balanced consideration by setting
up minimums in academics, but we also take in consideration experiential background,
missionary experiences where there are opportunities for students who have served in a
healthcare and missional capacity to bring in field experiences that you just cannot get out of the
classroom. We want to weight those accordingly in our application process.” The participants
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acknowledge that nursing shortages exist, patient populations are becoming more diverse, and
global health needs are growing more complex. Thus, as leaders of healthcare professional
schools, they assume responsibility to prepare students with the right combination of skills,
qualities, background, and experiences to succeed in the workplace and meet the needs of the
diverse global communities they will serve.
University leaders also value this new program as a privilege and opportunity to lead
education and healthcare equity for all by “giving opportunities to the underprivileged and
underserved applications because the competition is so extreme out there for nurses.” The leaders
made it clear that they do not want “just the top 1% academically,” but prepared graduates who
possess the personal qualities, professional skills, and experiences needed for the workforce and
communities they serve. For example, “we want diversity, not just academically, spiritually,
experientially, but also social-economically.” “We want to give those people opportunities to
have impact in their lives, and maybe they can go back to their communities that are underserved
and become a significant cultural changer for the local community.” This statement further
demonstrates how university leaders stay true to their mission “to educate transformational
leaders for the glory of God” by deeply committing themselves to serve the under-represented,
socioeconomically disadvantaged, first-generation college students. The university under
research extends a special concern for “the poor” and “the marginalized” by promoting the
dignity, equity, rights and responsibilities of all people. What the students are taught and learn
during their university years will mean something for themselves, their families, and the wider
communities they come from and return to serve in the future.
There appears to be a tension or even potential conflict between the university’s desire for
“diversity and inclusion” in admission, and the institution’s strong Christian identity and mission
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 97
statement. The presence of diverse religions in pluralistic societies and educational field raises
the following questions: How can Christianity be predominant at the university while
simultaneously respecting the different religions and cultures represented in the school
environment and in society?
Although the study did not focus on addressing the issue of diversity in this specific
educational context, it was evident throughout the interviews and subsequent sections that the
participants’ individual identities and their institutional identity as Christians are not a set of
propositions, religious rules, and movement focused on proselytism; rather, this university is an
evangelical Christian community of disciples and scholars who seek to serve God in a much
broader perspective by engaging all people in relationships, and advancing the work and the
Kingdom of God in the world through a Christian perspective of truth and life. Faith-integrated
education indeed means some kind of public identification with Jesus, but in such a way that a
coworker or student might want to know more about Him without feeling coerced.
As also stated in the Community Covenant (The University, 2019), “those members of
the university community who do not share the Christian faith are asked to affirm this Covenant,
not as a statement of personal spiritual conviction but as an affirmation of our community vision
and agree to abide by its principle.” The Covenant invites everyone who voluntarily chooses to
be part of the community to broadly embrace the Great Commandments: “Love God and love
your neighbor as yourself” (Matthew 22: 36-40).
Furthermore, all six senior leaders in this cohort demonstrated their commitment to
pursue the concept of diversity from a biblical perspective by affirming that diversity is an
expression of God’s image, love, and creativity. Therefore, “God-honoring” diversity is
something they value that pushes beyond political correctness or financial benefits, and aim
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 98
instead to create a learning environment that respects and honors each individual’s uniqueness
while celebrating collective commonalities in the spirit of love, compassion, empowerment,
humility, and eternal diversity in the Kingdom of God. The issue of diversity will be further
discussed and addressed in Chapter 5.
Advanced technologies. While myriad forces are changing the face of contemporary healthcare,
over half of the school executive leaders argue that nothing will change the way nursing is
practiced more than current advances in technology. One supported this by saying: “We are
finding that technology is becoming so advanced in the healthcare field, that we want to give the
students the technological training to be prepared for some of the things that are going to be
coming out in the next 2-3 years.” The school leaders have begun thinking now about how
emerging technologies will change the practice of nursing and therefore how to best integrate
technology into this future nursing program: “We want to bring in a technological specialist into
the training for our nurses that we allow them to be prepared for some of the requirements and
the hospital facilities or medical facilities when they go into them.” Indeed, technology is
changing the world at warp speed and nowhere is this more evident than in healthcare settings.
These university leaders recognize that technologies will change the practice of nursing and thus
they must prepare nurses with skill sets to develop, use and integrate these technologies.
Strong Christian mission and identity. All participants unanimously articulated that the
mission of this new nursing education program should be congruent with the university’s
mission/goals and reflect the governing organization’s core values: “One of our missions here –
the Christian mission - is to form and educate transformational leaders. We do not actually just
want world changers, but we want environmental changers, we want societal changers, we want
people to have a significant effect on wherever they are going to be.” As is evident throughout
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the interviews, there is an overwhelming sense of unity and commitment amongst executive
leaders to identify with and advance the university mission and vision by staying true to its
Christian identity without wavering. The more specific principles of faith-integrated education
discovered at this university will be explored in the next section.
Assumed Knowledge Influence #3: Principles of Faith-Integrated Education
Matrix 3 below demonstrated that all six senior leaders embraced similar principles of
faith-integrated education as “God-centered,” “respect personal choices,” and appreciate each
student according to their “intrinsic values as individuals” or the “image-bearer of God.” Five
out of six leaders emphasized the importance of “building relationship” and “building
communities” set apart by faith and for faith. It reflects their best collective self and the vision of
community they want to affirm and build. A majority of the leaders mentioned the importance of
a “science and faith unity” that is first grounded in the person of Jesus Christ, and, secondly, in
the natural sciences that reveal “the eternal power and divine nature” of its creator (Romans
1:19-20, NIV).
Matrix 3
Have a Shared Knowledge of Faith-Based Principles for This Faith-Integrated Nursing Program
Categories and Subcategories
K3: Shared Principles for Faith-
Based Education
Respondents
1 2 3 4 5 6
God-centered + + + + + +
Respect personal choice + + + + + +
Intrinsic value as individuals + + + + + +
Build relationships & community + + + + + -
Pro-science and excellence + + + - + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 100
The third factual knowledge influence, “the university leadership needs to have a shared
knowledge of the faith-based principles and components of this new BSc. in Nursing program,”
was found as an asset throughout the interviews.
The mission statement of the university is clear: “In partnership with the Church, the
purpose of the university is to prepare Christians for leadership and service in Church and
society, through Christian higher education, spiritual formation, and directed experiences” (The
University, 2019). According to the participants, the university was birthed in the heritage of the
independent Christian Churches and identifies itself as non-denominationally Christian. The
University is committed to teaching theology from an evangelical perspective and providing a
distinctively Christian environment. Although many meaningful themes and sub-themes emerged
from this knowledge influence category, seven are primary and cited below.
God-centered. When the participants were asked to define the meaning of Christian
faith-based education, it became evident they meant “God-centeredness” and the “integration of
Christian principles into every area of life” as found in the Bible and reflected in the life and
teachings of Jesus Christ. One leader offered a typical answer:
I think that faith is fundamental and foundational for life, and whereas some people view
faith as a compartmentalized activity or experience, the fundamental tenet of a place like
our University is that we are faith integrated. And what that means is, if you think in
concentric circles, the core of the core is our vibrant faith relationship with God through
Jesus Christ. And that influences every other concentric circle.
To further illustrate the essence of “God-centeredness” in faith-education integration and
in life, the respondent further explained:
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 101
So rather than having faith be a pillar holding up maybe a large roof that might be higher
education, instead we are concentric circles, and faith affects every discipline. It affects
the humanities, the social sciences, the natural applied sciences, business, education.
Every domain of knowledge and inquiry here is integrated with our spiritual lives. And
that's the way we understand faith. Faith is not a separate compartment; it is a
fundamental reality in every dimension of life.
According to the university mission statement, “in partnership with the church, the
purpose of university is to prepare Christians for leadership and service in church and society,
through Christian higher education, spiritual formation and directed experiences” (The
University, 2019). The virtues of “pursuing God for who He is,” “His way and truth,” and
“bringing life in harmony with what God intended for each of us” and “to be in harmony with
Him and His love” and “to be loving to people” are central to the purposes of Christian education
(Pazmino, 2008). As an example, another leader stated:
You know, there’s only one truth. And we think of truths as being represented by,
ultimately, God Himself. Jesus said, ‘I am the way, the truth, and the life’ And all life,
all… proceeds from God. If we want to have an educational experience that’s alive with
truth and that it is aligned with the truth, it must be faith-based because it should say that
we know Christ. That's the Christian perspective. And so, there is no part of the
believer’s life, the Christian life that should be separate from the Lordship with Christ. If
we have a discipline called, say, mathematics or literature or whatever the varied
disciplines are, they should be in harmony with the ultimate truth.
Although this “ultimate truth” statement may not be commonly understood or agreed
upon by the wider society, there is staggering evidence in this theme that each individual
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participant in this cohort study is deeply committed to personal beliefs which are congruent with
the organization’s official mission and identity.
Respect personal choice. Next to “God-centeredness”, allowing students to exercise
their free will to “internalize Christian faith through personal choice”, rather than through
indoctrination of religious doctrines remains an important principle in faith-based education for
all six interviewees. For example, one argued that one of the key variables for student identity
formation and development “is their faith, and understanding what they believe, and why they
believe it, for themselves, perhaps for the first time, making that their own.” A different
interviewee further explained this:
We do not feed our students on anything particular or personal believe systems. We do
present a worldview that they are going to be facing as they graduate from here and go
out. We want them to have a strong foundation in their faith, but we want it to be their
own faith, that they understand what’s their own position in the world, academically,
personally, spiritually, and so on.
All six interviewees believe that supporting and challenging students to think deeply and
critically about complex, timeless and contemporary issues is paramount. The students are
encouraged to probe, reflect and openly debate challenging ideas, concepts, and theories in order
to have a deeper understanding about the nature of their faith, truth, and how they apply that
truth to their everyday lives. Another added:
We admit students who are Muslim. We have had Buddhist students. We have Christian
students, of course. We have many, many students who have no faith orientation
whatsoever. But we think part of the educational process is that students become aware of
what the tenets of Christian faith are, and what it looks like and it feels like. But students
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learn about their own faith perspectives, which in and of itself is part of our learning
outcome, a student learning outcome process that they’ll learn about their own faith
orientation perspectives as part of the educational experiences.
So, rather than being threatened by students’ involvement in different faith backgrounds
or by those who tested the limits on lifestyle issues, university senior leaders appear to embrace
the goal of training citizens for “the whole world” who related to those outside the Christian
community as “fellow creations of God.” In this respect, all of the participants affirmed the
“evangelical” desire to interact with culture rather than retreat from it, but they did so by
emphasizing that this activity can only bear fruit if it is rooted in the freewill of each individual.
Value individuals as God’s unique creation with varied gifts and abilities. A
consistent theme found in the study is that all six participants view individual students as “image
bearers” with intrinsic value as God’s creation, uniquely gifted with God-given talents and
purposes. One interviewee said: “I think as the faith-based institutions, we provide a significant
connection with our students where they feel that they have value, and once they feel valued,
they are going to be involved, basically more committed to their studies and their academic
goals. “
The mission of student life at the university is to “champion the student learning
experience by creating holistic programming and Christ-centred learning environments” in which
“every student will succeed and thrive”, “ every student will encounter Christ in a community of
faith, hope, and love,” and “every student will leave ready to lead and serve with a sense of
vocational calling and purpose” (The University, 2019). Anderson (2014) has drawn attention to
the concept of “image bearer” as made in the image of God. “It changes everything when you
view people this lens” (Norsworthy & Belcher, 2015, p.8) . It makes all the difference in terms of
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how teachers’ roles, curriculum, policies and purposes of education are understood and
embodied (Litfin, 2004).
Building relationships and building community. A similar theme was mentioned by
five out of six participants who acknowledge the importance of relationship, responsibility, and
community building. All participants reported that making a priority of building relationships
and covenant community ensures that the school remains a safe place for students to be seen and
known as they sincerely express who they are and explore struggles with grace, truth, and
support.
Our mission in student life is to champion the student experience through holistic
programming and Christ-centered learning environments. There are two ways that we
create the student experience or champion their experience, and that's through the
programs and the experiences that they're having, both in and outside of the classroom,
and then the environments in which that's taking place. Are they fostering a sense of
community and feeling connected?
Indeed, the nature of community reminds us that we are not alone. We are likely to
achieve more together than we could in isolation. In recent years, community building has
become an important and effective pedagogical tool for working with millennial college
students, who are relational learners (Howe & Strauss, 2007). Another member of the executive
leadership also observed:
Students commonly report that they feel safe here and known here, welcomed, that they
can be themselves. It's by no means a perfect place, but our goal is to see every student
succeed and thrive, and everybody be able to encounter Christ in a community of faith,
hope, and love.
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While building community has been shown to promote knowledge acquisition and the
development of higher order thinking skills (Johnson & Johnson, 1999), community is even
more critical to this university’s vision of character formation and the development of more
holistic persons. According to the participants, in this university community, students and faculty
are able to “encounter the challenges necessary for growth and to receive supports needed to
meet those challenges.” The university strives to become what Oldenburg (2000) called a “third
space” where one is known, feels safe, and can engage with others in ways that expand one’s
understanding of self, others, the world, and God.
Pro-science and excellence. All of the executive leaders in the study consistently strive
to establish top-quality, evidence-based programs, continuously measuring the quality of all
critical program areas, in hopes that this will restore respect for Christian faith in the marketplace
and transform the culture with excellence and influence. One leader provided some historical
background:
We got to have the science programs first, so we’ve started biology, physics, physiology,
we are getting ready to launch engineering… Now we’ve got the building, the analysis of
time that we have all of the foundational programs that we needed in order to start what
we think will be a very high-quality nursing degree program.
The emphasis on excellence in scientific programs is vital to this university. The same
leader asserted that “because we’re small, we can’t afford any bogus degrees. We just can’t start
a degree and hope to maintain any kind of reputation if it’s not really, really good! So, we really
have worked hard at creating and visioning a really high-quality nursing degree program.”
Historically, Christian institutions were negatively stereotyped as “anti-intellectual” and
“world-denying” (Olson, 2011). Another participant argued against this critique: “It is also not
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the case that a desire for science cannot coexist with the pursue of God and faith… For me, that’s
specific to a Christ-centred faith. All truth is God’s truth. There’s a mistake thinking the science
would conflicts with faith. It doesn’t. They’re just, they’re not at all in conflict.” During
continued conversations with the leaders in this cohort, phrases like “educating the whole
persons” and “devoted heart and a keen mind” that seek to integrate sincere faith and quality
academic learning were mentioned as ways to serve the common good.
Assumed Knowledge Influence #4: Differences for a Faith-Integrated Nursing Program
There were very mixed views among senior leaders when they were asked about the
differences between a faith-integrated and any other nursing programs. The data yielded the
following six themes as listed in Matrix 4 below. All participants unanimously agreed that
building the program with a “spirit of excellence”, the “best quality and practices”, “academic
rigor,” and “love and caring virtues” are commonly shared in other nursing and scientific
programs. However, when asked to “envision and paint an ideal picture of a fully faith-integrated
nursing program,” there was great individual variability and uncertainty. Some said that there is
no difference, as “they should all train up safe, compassionate and competent nurses.” Some
mentioned the need for a faith-integrated curriculum, while others felt strongly about adding
various added student learning outcomes related to faith-formation, identity and character
development as a response to God’s love and grace, becoming more fully formed into the
likeness of Christ, ways of fulfilling the Great Commission to disciple the nations, and fulfilling
the specific calling of nurses by praying for the sick and healing the earth.

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Matrix 4
Senior Leadership Needs to Know the Differences for a Faith-Integrated Nursing Program
Categories and Subcategories
K4: Key differences
Respondents
1 2 3 4 5 6
Philosophy of education + + + + + +
Goal of education + - + + + +
Faith-integrated curriculum + + + + + +
Integral student learning outcomes + + + - + -
Experience express love of Christ + + + + + +
Prayer and healing - - + - + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

The fourth conceptual knowledge influence, “the university senior leadership needs to
know the differences between a faith-based nursing program and other general nursing
programs” was considered inconclusive due to vast individual differences in responses and
emphases.
Philosophy of Christian education. All executive leaders agreed that the fundamental
distinctive of Christian education is its educational philosophy. For example, one said that this
university fulfills its mission with an emphasis that “prepares Christians for servant leadership
through the church, commissioned by God to fulfil His plan in the world” and that “such an
emphasis mandates a curriculum which prepares people who are thoughtful, compassionate,
culturally sensitive, and capable of integrating personal faith and vocation in all avenues of
society.” The question of who determined what mattered in education, what kind of content we
should be covered and what kind of human being would be produced especially piqued the
participants’ interests.
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Romans 12:2 instructs Christians to “not conform to the pattern of this world, but be
transformed by the renewing of mind. Then you will be able to test and approve what God’s will
is – His good, pleasing and perfect will” (Bible, NIV, 2019). This underlines the ultimate
philosophy of Christian education: knowing God, His word and love personally, and growing in
Him continuously to fulfil His plan and purpose in this world.
Goal of Christian education. Despite their differences, religious and secular schools are
often busy with the mechanics of delivering prescribed curricula, with little attention given to
discerning the end toward which they labor. There is widespread agreement on the university’s
desire for its graduates to “exemplify transformational leadership in church and society through
the integration of their faith and learning.” However, based on the interviews, there is no clear
indication or consensus on how the two should be best related.
For this cohort, “faith-learning integration” seemed to encompass almost every aspect of
academic and student life. Terms like “love,” “faith,” “hope,” “trusting God,” “learning theology
and reading of Bible,” “reason and debate through intellectual inquiry,” “pursued at the subject
level of particular academic disciplines,” “professional competence and excellence,” “able to
defend Christian faith,” “relationship and community building,” “mentorship and role
modeling,” “fostering humility and openness to correction,” and “experiential learning and
services” showed up during the interviews.
The overall impression from this cohort is that the goal of education is so much more
than merely meeting prescribed goals and objectives, but a process of holistic formation that
concerns growth through the encounter between life and transcendent purpose.
A faith-integrated curriculum. Four out of the six participants mentioned that an
innovative faith-integrated curriculum supports accreditation requirements and the achievement
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of end-of-program student learning outcomes. They agreed that this is crucial for the new
nursing program. One quote illustrated this:
The Board of Registered Nurses has a specific curriculum requirement, that we do have
to provide, to be approved. But the application of those particular courses and curriculum
can be modified and/or adapted to a faith-based environment. So, we’re looking forward
to bringing in the faith-based component in the curriculum. We want to give them the
didactic, the clinical, and the spiritual.
According to this leader, their nursing faith-integrated curriculum must integrate good
science, professional practices, and concern for the spiritual dimension of life. Based on this
understanding of the curriculum, another leader provided an example of how faith is integrated
into the discipline of marketing:
For example, I mean my minus was marketing so over the years when I’ve gone through
a lot of exercises which look at: Does it make any difference at all about how I would
practice marketing if I I’m a Christian versus as a non-Christian? Not just I’m going to
be a better person, not just I’m not going to lie, not just I’m going to be more ethical -
wonderful things, but that’s not what we are talking about. We are talking about the fact
that why being a Christian has actually changed how we interact with the theory that
drives marketing, drives the precepts that the general public uses to make marketing
decisions. That’s a different conversation.
For the participants, faith-based education is more expansive than that found in linear
curricula that not only do not reference the spiritual dimension but that also involve a technical,
top-down model of predefined content transferred to students utilizing objective knowledge and
scientific control. The coherent theme among the interviewees is the desire to challenge the
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story and social constructs we are live in. However, how exactly teachers can meet the additional
demands of faith-integration at the subject level was not clarified by the interviewees.
Integral student learning outcomes. Upon careful analysis of the interview scripts,
there are some distinct differences between faith-integrated and secular education with respect to
student learning outcomes. For example, in addition to the traditional measurements of cognitive
learning outcomes, interviewees said that “we want our students to be able to learn about their
own faith orientation,” and “explain their faith within their respective disciplines as a result of
their educational experience.” Another said that “they do not have to become people of faith, but
they need to understand what the parameters of faith look like.”
Apart from this above-mentioned ability to articulate their own faith, another student
learning outcome pertaining to faith-integrated education is to provide transformational
leadership through laying solid spiritual and academic foundations:
Probably to meet the university mission and vision of developing and promoting and
making excellent employees that will provide transformational leaderships. The best way
we see to do that is to lay that spiritual and academic foundations, but they also have
strong conviction and commitment in their faith, when you put them into an outside,
external environment, they are not going to be intimidated by life’s experiences…and we
believe that accommodation is going to make them stronger, not only individually, but
it’s going to make them more employable and, in application, it’s going to improve their
lifestyle, it’s going to improve their purpose that we will hopefully instill in them when
they graduate. And to take that into their career and into the next steps, which will be into
their healthcare environment as a nurse.
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According to this participant, Christian education helps students to develop through a
transformative pilgrimage that, when grounded in practices, satisfactorily meets the tests of real
life. Historically, the dominant educational metaphor was industrial. Educational institutions
were factories, with production lines (Quiggin, 1999). In this light, education was the vehicle of
economic uplift through an efficient process of transferring “knowledge, understanding, skills
and dispositions” (ACARA, 2012) that shaped the learners as effective consumers (Graieg, 2017,
p. 28) with segmented curricula (Huebner, 1999) and prescribed outcomes (Dewey, 2004). By
contrast, the faith-integrated education described by this cohort considers the human to be much
more than a student, and education much more than meeting prescribed objectives. However,
while interviewees offered no measures for faith-related learning outcomes, they did clearly
articulate that education must be concerned with growth through the encounter with real life in
its complexity.
Experience the love of Christ and share it. In the current cohort of leaders, the primary
theme for faith-learning integration is to express “godly love and care”. One leader explained it
this way:
No, you absolutely don’t actually have to be a Christian to come, but you know we are
going to bathe you in Christ’s love for four years, if you’re here as an undergraduate. We
would love to have you come to Christ, if you’re not a believer right now, we would love
that as an outcome. But we’re all okay if that doesn’t happen.
Expressing “love-integration” seems to be more visible and tangible than “faith-
integration” because it merges knowledge and practice, faith in action, and demonstrates care for
God, self and others. The Bible says: “Love is patient, love is kind. It does not envy, it does not
boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no
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record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects,
always trusts, always hopes, always perseveres. Love never fails” (1 Corinthian 13, NIV, 2019).
According to John Wesley (1781) love is “a calm, generous, disinterested benevolence to every
child of man,” and “an earnest, steady good-will to our fellow-creatures” (Outler, 1987).
Envision a full faith-integrated nursing program. When asked to envision and paint
the ideal picture of a full faith-integrated nursing program, this executive leader expressed
concerns about the accessibility and affordability of current healthcare in the United States. He
forecasted that:
I think we’re gonna see basic healthcare centers set up at drug stores across the country
and we’re going to see, I think, practitioners move. We’ve talked to hospital
administrators who tell us that nurses, nurse practitioners, physician's assistants will do
more and more of what I would describe as baseline care into the future…I foresee
churches and clinics being able to be married together so that one of the things that’s on
my heart is I would love for medical missionary outposts to be established in
communities across the country where basic – level of healthcare could be provided in
medical clinics located on churches across the country.
Recently, interest and research in faith-based care has increased (Westberg, 2019). Some
hospitals were among the first to form partnerships with churches through faith community
nursing programs. Known as parish nursing, these programs improve the health of vulnerable
communities by leveraging the influence of pastors and congregations through health education,
onsite screenings, referrals to services, and by supporting ministers in situations requiring
expertise in healthcare system. The U.S. Department of Health and Human Services (HHS,
2019) has recognized the role of faith communities in population health and well-being,
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especially in the areas of mental health, addiction, public health services that reach people that
need their services the most, and delivering transitional care to reduce readmissions and lower
the cost of care.
In contrast to the first respondent, another leader imagined this new nursing program
from a different perspective:
Probably it’s going to look like other programs… It’s like when you are looking from
outside a beautiful building, it looks beautiful if you like that type of architecture, but
until you walk into it, let’s say someone’s home, and actually feel the love and warmth of
that building. So this nursing program is very experiential, very engaging, very
connecting… the students are being cared for, that they are being poured into, they are
valuable, and so when they graduate, they are going to take that same concept, the same
love and peace, grace, into a very difficult environment that they may run into in the
medical facilities where people are sick.
Essentially, at the heart of Christian education, love results in “whole-person education
that prepares students to restore their relationship with God, with self, and neighbors permeates
the entire learning community” (Gehrz, 2014, p. 76). According to the participants, love offers a
focal point. The type of love described above should be “heartfelt,” “experiential,” and “not an
ideology or a set of beliefs.” Methodologies that both meet scientific rigor and inspire nursing
students to respond to God’s love, and to desire a personal and experiential knowledge of Him
are facilitated. Students who are exposed during their four-year academic formation will
facilitate a life-long commitment to enter the workforce with professional competencies, and an
inspired value system and eternal virtues. This experience will add meaning to the delivery of
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compassionate and competent nursing care while also enriching the lives of patients who receive
such care.
Prayer and healing. The cohort across the board shared beliefs about healing power
through prayers. When it comes to providing guidelines for nursing students to express their faith
through prayers in this fully faith-integrated nursing program, the senior leaders appear to have
slightly different perspectives and emphases on healing and prayer. One leader cared about
students’ own faith journey and calling as a minister and explained:
So when students are people of faith, and they do come in to the nursing school and they
see their nursing training as part of their mission and their ministry, and they will feel
called as ministers in the same way that somebody who’s gonna preach in a pulpit. I will
want to be able to pray over and commission them to be able to pray for patients to be
healed…And that’s my hope, is that we will carry the presence of Christ into hospital
rooms, and into churches, and into whatever God allows us to send nursing students.
Since not all students are Christians at the university, the leaders made abundantly clear
that they will respect everyone’s beliefs and personal choices. Others think that unless the
patients request prayers, nurses should not pray for them. The leader went on to explain how he
views the relationship between prayers and healing:
If a doctor asked me, as a nurse, to provide an antibiotic to a patient, I would want to
provide the antibiotic, and I would want to pray over that patient to be healed. The doctor
might think that it was the antibiotic that did the work. I’m going to pray that God
intervenes in a supernatural way and brings healing to these patients based on the touch
and presence of Christ in that room, that the nurse carries with them.
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There is a growing body of literature that supports the hypothesis that patients intensify
the expression of their religious beliefs and experiences when they are faced with serious illness
and hospitalization, and that they desire direct physician and nurse involvement in spiritual
issues as well as their medical ones (Bearon & Koening, 1990). Physicians and nurses have
implicitly and often explicitly been taught to avoid the religious dimension in working with
patients, thus leaving healthcare professionals unequipped to address these issues in a sensitive,
empowering manner (Wright, 1999).
Assumed knowledge influence #5: Recruiting faculty.
The fifth procedural knowledge influence, “the university senior leadership needs to
know the knowledge, skills, and disposition of ideal faculty to be recruited,” is affirmed as an
asset, based on the interviews.
As is shown in Matrix 5, all six individuals shared a desire to hire faculty with, ideally,
dual dispositions: both “deeply rooted in God’s love and internalized Christian faith” and
“proven experts in the nursing field” as well as “able to teach.” They all agreed on the
importance of authentic personal faith, a sense of calling from the Lord to be a nursing faculty,
as well as being a role model in words, deeds, character, integrity, and humble services in action.
Each also clearly articulated the “steps” and “processes involved,” and firmly supported
“personal statements of faith” signed by each new faculty member.

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Matrix 5
Important Criteria for Use in Recruiting Faculty
Categories and Subcategories
K5: Faculty Disposition Criteria
Respondents
1 2 3 4 5 6
Authentic and personal faith + + + + + +
Calling + + + + + +
Nursing expertise + + + + + +
Teaching skills + + + + + +
Role modeling + + + + + +
Faith integration with subjects + + + - + +
Local and global services + + + + + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

Authentic and personal faith. A consistent theme found in the study about the
knowledge, skills and disposition of ideal faculty to be recruited is their personal faith. The
university is “very serious about... hiring faculty – both full-time and part-time – (who have a)
relationship with Jesus Christ. That is vital, and thriving is the number one qualification.” A
different leader stated that “faculty (must) have a personal active faith in Christ, and they (must)
practice their faith rather than grew up with it. Then it’s a historical faith, you fill in the blank –
that’s not who we are.” Another elaborated: “If you do not have a person who not just
understands the Christian faith, but is living it to the best of their ability today, then you do not
have a hope of integrating anything that makes any sense!” According to other participants, “our
faculty signs a statement of faith” and “we have what we call a cascading interview process –
very rigorous six-tier hiring process that deal with issues of personal faith.” In this university,
expectations for educators to teach from their authentic selves, while also considering, seeking to
understand, and appreciating individual differences, are prominent. Palmer (1998) asserts that
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regardless of their style, “good teachers share one trait: a strong sense of personal identity infuses
their work” (p.10).
Calling. All of the participants described that working as faculty at a faith-based
education institution, compared with other institutions, is “a calling” rather than merely a way to
lucrative financial rewards. For example: “It’s true in education, whether it’s public or
private…a practicing physician can make $300,000 in a year. Why would they go to Stanford
and make $150,000 as a faculty? So, we have to find people with a commitment and a calling to
higher education.” This is a remarkable statement. This cohort is recovering the idea that work is
not merely a job, but as a mission of service to something beyond one’s own interests. “A job is
a vocation only if someone calls you to do it and you do it for them rather than for yourself”
(Keller, 2012). This cohort of participants refers to “calling” as a transformative connection
between Christian faith and the workplace.
Nursing expertise and teaching skills. The university strives for excellence by seeking
to hire faculty who balance the mastery of nursing discipline-specific content with an ability to
teach and motivate students. One stated that “we have to have faculty members that are experts
in their respective fields of endeavor, as well as people who are committed to the role and vision
and the mission of the institution.” Another affirmed that “we are looking for commitment to
Christ, excellence in their field, commitment to academics, and then maybe the final thing would
be a love for our area and a love for the geography.” These responses confirmed that the
university aims to hire future faculty who have expertise in both healthcare and pedagogy. They
must be committed to the academic realm.
Role modeling. “Are you living out what you say you should be living out if you believe
your mission statement?” is the critical question asked of new faculty hires at the university. One
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participant illustrated this by saying: “WASC is agnostic, WASC does not care (about) us being
a faith-based school. That is not good or bad. What they care a lot about is how do you know
you are actually achieving those (faith-based learning outcomes)… Faculty members showing
each student the kind of caring Christian attention is exactly the model you want to adopt if you
are going to become a caring nurse.” Another added: “Faculty have modeled for them the kind of
care and love, faculty members who will pray with them if they are having a tough day. All that
kind of staff they (the students) see it and experience it firsthand.” Bandura (1997b) discovered
that behaviors are learned through observations of role models. It is a form of silent
communication where instructions are more caught than taught. According to the participants, a
great deal of what students learn comes from observing the lives of people they respect, starting
with their parents, and then extending to community leaders and teachers. When teachers model
corrupt behavior, even though they teach moral behavior, students take note of the hypocrisy.
From the perspective of the interviewees, the biblical teaching that all humans are corrupt sinners
in need of an incorruptible savior has special relevance at this very point.
Subject level faith-integration. In this study, the expectation for good teaching is tied
together with an expectation of spiritual guidance and an integration of faith in the curriculum at
the subject level. For example:
Raw material is a key starting point. We build every course. We have a series of rubrics
that we go through with every syllabus that’s designed. It helps that faculty member who
is designing the course and then ultimately delivering it, it helps them understand, okay,
alright if I’m a Christian in this discipline.
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This statement briefly describes the development and implementation process for a faith-
integrated curriculum that parallels discipline-specific content throughout the course. Another
said:
How do I need to engage the students so they can piece that a part and begin to
understand it from their own perspectives? Because again it’s not just learning the theory
that the world has from that body of knowledge but how do I use that theory as a
Christian or do I interpret that theory somewhat differently as a Christian?
This quote further illustrated how Christian academics connect major disciplines to students’
personal worldviews, values and faith perspectives, thus preparing students to be effective
professionals in their discipline while also developing an understanding of the nature of their
discipline.
Chickering, Dalton, and Stamm (2006) describe the efforts required to integrate
spirituality into all aspects of an institution of higher education as a balancing act. To achieve
learning outcomes that include spiritual development and a realization of faith-integration,
faculty must look beyond a set of successful techniques used to acquire cognitive competencies
(Chickering, Dalton, & Stamm, 2006). While the interviews emphasized the characteristics
embodied in faith-based education. How exactly teachers can meet the additional demands of
faith-integration at the subject level were not discussed.
Local and global services. As globalization and comprehensive international
programming across higher education continues to respond to the demands of global citizenship
and civic engagement, university leaders have developed and incorporated both internal and
international dimensions to academic curricula through local and global outreach opportunities in
globally aware campus communities:
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I think there’s a lot of strategic partnership opportunities, most within the university.
Every student here also receives a Bible minor, so students are going to have a lot of
exposure to the content, but then also practice. We require, from our area in student life,
spiritual formation credits. There are lots of local and global outreach opportunities.
Indeed, academic and practice partnerships are an important mechanism to strengthen
nursing practice and help nurses become well positioned to lead change and advance healthcare.
Effective partnerships will create systems for nurses to achieve educational and career
advancement, prepare nurses of the future to practice, lead, and provide structure and
mechanisms for lifelong learning in order to meet the increased demand and challenges for the
future of nursing and healthcare industry.
Assumed knowledge influence #6: Business plan. The sixth procedural knowledge
influence, “the senior leaders need to know how to develop a business and implementation plan,”
was demonstrated to be an asset throughout the interviews.
The institution’s administration includes significant expertise in the planning and
implementation of new programs, including “recent additions at the Bachelor’s and Masters’
levels in area such as psychology, accounting, criminal justice, MBA.” Matrix 6 illustrates that a
majority of the senior leaders were concerned with the importance of a feasible business plan
that includes sound market analysis. They also often referred to the “APD Precis,” – a well-
established Academic Program Development approval process communicated internally. This
process is meant to ensure that all new programs or initiatives are properly designed, targeted
and adequately planned for successful implementation.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 121
Matrix 6
The Senior Leaders Need to Know How to Develop a Business and Implement Plan
Categories and Subcategories
K6: Business Plan
Respondents
1 2 3 4 5 6
Market analysis + + + - + +
APD Precis process + + + + + -
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

Market analysis. The expectations for current industry trends and the market is strong,
as was indicated throughout the interviews. To create a Bachelor of Science in Nursing (BSN)
degree program “to launch in Fall 2020 will help expand the much-needed courses in nursing
and an opportunity to significantly contribute to the ever-increasing demand for available
academic and clinical nursing programs in the northern California region.” The university
leaders are aware of the limited accessibility of nursing programs that cannot enroll all qualified
applicants. “The average wait time is over a year or more” and “every nursing school is turning
away hundreds of applicants each semester.” Therefore, it is very likely that this new program
will be over-subscribed.
University leaders are familiar with business plans and implementation processes, as it
has successfully launched multiple degree programs, including biology, kinesiology, theater,
aviation, environmental science, multiple degrees over these last several years. Another leader
commented that the provost’s office has developed processes and checks to analyze market
properly and “build a business plan that is reasonable balance of risk, market analysis is in need
bur still leaves room return for the institution.” Another also mentioned that enrolling new
students could bring financial gain to the school.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 122
ADP precis process. According to the respondents, there are well-established internal
processes and procedures in place to create new programs and initiatives at the university. This
internal approval process starts from where the idea come from, all the way through to the
program launch. Then “it comes back and does a post-analysis within three years of
implementation.” Every detailed proposal must satisfy the WASC requirements as well as have
the internal business plan approved by the academic counsel:
There’s all these checks and balances are built into what we call the ADP process,
‘Precis’ – the Academic Program Development process. And that is our best way of
making sure that a business plan gets built, not only a proper plan, but actually addresses
the questions of the institution before the program is approved.
According to the university leaders, this new nursing program has already gone through
the ‘Precis’ stage, and the dean of natural health and sciences “has the green light to invest
resources in developing the detailed proposal because the institution is willing to support going
down this path.”
Assumed knowledge influence #7: Metacognitive.
The seventh metacognitive knowledge influence: “the senior leadership needs to know
how to reflect on their own beliefs and goals for creating a faith-integrated BSc. in Nursing
program,” was affirmed as an asset throughout the interviews. Matrix 7 illustrated that to create
and sustain a transformative learning community, all are accountable, and each plays a vital role
in fostering self-reflection, humility and openness to correction.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 123
Matrix 7
Senior Leadership Needs to Know How to Reflect on Their Own Beliefs and Goals
Categories and Subcategories
K7: Metacognitive
Respondents
1 2 3 4 5 6
Reflect on own beliefs and goals + + + + + +
SWOT analysis + + + + + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

Reflect on own beliefs and goals. Metacognitive knowledge refers to the understanding
and awareness of one’s own thinking process and the ability to reflect through self-assessment
and regulation, or, simply, thinking about thinking (Anderson, et. al., 2001). All six executive
leaders interviewed confessed explicitly their personal understanding and devotion to Christ, and
expressed their commitment to be self-aware and self-reflective on their own beliefs and goals
for creating a faith-integrated BSc. in Nursing program.
SWOT analysis. This SWOT analysis was summarized and synthesized by the
researcher based on the interview data threaded throughout all of the interview findings from this
cohort. Please see figure 3 below for details:

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 124

STRENGTHS
Institutional philosophy
Aligned with mission
WASC accreditation
Strong science programs
Student population
Faith-integrated
curriculum
Commitment from
leadership

WEAKNESSES
Lack of institutional
expertise
No extant facilities
Institutional infrastructure
Institutional capacities
Funding environment
Faculty shortage
Clinical placement
shortage
OPPORTUNITIES
Favorable market
Shortage of nurses
Engine for enrollment
Revenue
Engine for STEM
Interdisciplinary
collaboration
Community partnerships
Global missions and
services

THREATS
Loss of market demand
Competition from other
nearby universities
Economic movement
Political landscape
Healthcare policies
Figure 3. SWOT Analysis

Summary of Knowledge Findings
To achieve the organizational goal of creating and establishing a faith-integrated
Bachelor of Science in Nursing program at the targeted university in northern California, the
interviews with six senior leaders confirm that four out of seven assumed knowledge categories
are assets, while one is a gap, and two are inconclusive.
The executive leadership team demonstrated an outstanding knowledge of successful
WASC accreditation, principles of faith-based education, ideal faculty to be recruited, business
plan development and implementation process with proven track records, and self-awareness of
education and healthcare trends specific to their own institution and how to reflect on their own
beliefs and goals for creating a faith-integrated nursing program.
SWOT
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These executive leaders include significant expertise in the planning and implementation
of novel programs. They have demonstrated their passion, knowledge, and vast experiences with
vision forecasting. Their commitment to personal Christian faith and student-centered learning
that incorporates love, respect, and excellence, and purposeful work guided by a transcendent
perspective is convergent with the mission, vision, and identity of the institution.
The knowledge gap involves best practices in a pre-licensure nursing program. This is
due to a lack of institutional expertise, as the university has no extant nursing program. In
addition, there are currently no personnel with experience in the design, implementation or
administration of this academic discipline.
Two inconclusive knowledge influences include, firstly, that the interviewees have no
prior knowledge in nursing accreditation, and, secondly, when asked to envision and paint an
ideal picture of a fully faith-integrated nursing program, there was a great deal of individual
variability.
One interesting finding is that the executive leaders entrusted with different roles and
responsibilities at the university bring different knowledge strengths and perspectives to the
program launch process. While at the face level, the interviewer sometimes received very
different answers and approaches when the same interview questions were asked, upon critical
analysis, their contributions seamlessly meshed.
Results and Findings for Motivational Influences
The second section of this chapter looks at the assumed motivational influences and
confirms that two out of three assumed motivational categories are assets, while one is a gap.
According to Clark and Estes (2008), motivation is the force that drives people to actively
choose to engage in activity and to persist in that task. It is the process that initiates and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 126
maintains goal-directed performance. It energizes our thinking, fuels our enthusiasm and
generates mental effort that drives us to apply our knowledge and skills. Underlying the
motivation indicators of choice, persistence, and effort are five basic components of beliefs about
self-efficacy, attributions, interests, values, and goal orientation (Pintrich, 2003).
Clark (1998) suggested that there are three types of motivational factors: (a) active
choice, which involves actively starting to do something instead of merely intending to do so; (b)
persistence, which involves staying focused despite distractions; and (c) mental effort, where
people develop novel solutions. Without motivation, performance gaps exist whenever people
fail to start something new, resist doing something familiar, stop doing something important, and
switch their attention to a less valued task or use old, familiar but inadequate solutions to solve
new problems (Clark and Estes, 2008).
The assumed motivational causes in this study relate to utility value and self-efficacy.
During the interviews, a new motivational factor – goal orientation – clearly emerged as an
additional influence. Evidence from the interviews supports the generalization that active
engagement and persistence in creating the new nursing program is enhanced by these three
factors: utility value, self-efficacy and goal orientation. The following is a summary description
and synthesis of the findings related to the assumed motivational influences.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 127
Table 10
Assumed Motivational Influences Summary Chart
Assumed
Influences
Assets Gaps Inconclusive Summary of Interviews
M1:
Utility Value

Yes Senior university leaders unanimously
agreed, believing that their time and
resources allocated in establishing this new
nursing program is “highly important,”
“useful,” and “a worthwhile endeavor” to
further advance the mission and vision of the
university and global learning communities.
M2:
Self-Efficacy

Yes Although all six individuals expressed the
belief that they are competent in creating the
new faith-integrated nursing program through
meaningful engagement with both internal on-
campus stakeholders and external partners.
However, over half of them did implicitly
express the conditions that they will need
“external nursing expertise,” “funding and
resources,” and “to be guided by faith in
Jesus” “at the right time” in order to fully
launch the program and be successful.
M3:
Goal
Orientation
(newly
emergent)

Yes Senior university leaders unanimously
believed and confessed explicitly that creating
and establishing this new faith-integrated
nursing program will exert influences in areas
of education, healthcare, church, and help the
missionary endeavor in the society.

Assumed Motivational Influence #1: Utility Value
All of the participants in the study, as is shown in Matrix 8, regard their time and
resources allocated in establishing this new nursing program as “highly important,” “useful,” and
“a worthwhile endeavor” to further advance the mission and vision of the university and global
learning communities. Thus, the first assumed motivational influence, “the senior leadership
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 128
must feel that their time, and resources allocated in establishing this new nursing program is a
worthwhile endeavor to further advance the mission and vision of the university and global
learning communities,” was affirmed as an asset.
Matrix 8
Utility Value
Categories and Subcategories
M1: Utility Value
Respondents
1 2 3 4 5 6
Consistent with mission & vision + + + + + +
Affirmed utility values + + + + + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

Task value reflects the understanding that motivation, learning and performance are
enhanced if a person values the task (Clark, 1998; Clark & Estes, 2008). The higher the utility
value, the more people will want to finish the task. According to the data, 100% of senior
university leaders who were interviewed unanimously agreed that to start such a nursing program
“is clearly consistent with our mission and vision” and believed that their time, and resources
allocated in establishing this new nursing program is a worthwhile endeavor to further advance
the mission and vision of the university and global learning communities. One participant
believes that “nursing is a critical component in our development of the natural and applied
sciences at the university. I can’t imagine not doing a nursing program. We have to do nursing
and do it well.” Another interviewee offered another utility-based reflection:
Part of the thing that fits well is that we’re committed to educating transformational
leaders. And I really believe healthcare, which if I’m not mistaken is now one sixth of the
United States economy, healthcare is a tremendous arena for people of faith to be able to
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 129
engage. And we live here in Sacramento region, maybe three million people. Bay Area is
another 10 million people. Very large geographic area that is in desperate need of high
quality conscientious medical service, and if people of faith can go into that field, I think
we can make a huge impact in society.
All the leaders believe that establishing such a new nursing program is important (attainment
value) and that investing time and resources in this is a worthwhile endeavor if light of its
benefits (utility value). Additionally, when asked if they are willing to make time available to be
engaged in the development of this program, all answered positively, thereby indicating that the
program development process is worth their time (cost value.) Not only that, all participants
believe that engagement in the new program, from inception to completion, will enhance their
personal values and faithful commitment (intrinsic value), as well as further advancing the
communal mission and vision (extrinsic value). Leadership highly values the creation of a faith-
integrated nursing program.
Assumed motivational influence #2: Self-efficacy.
Based on the results displayed in Matrix 9, all six individuals claimed the general belief
that they are competent to create the new faith-integrated nursing program through meaningful
engagement with both internal on-campus stakeholders and external partners. But when it comes
down to the specific help and support needed, less than half of the leaders feel confident about
the many conditions that need to be fulfilled in order to successfully establish this new program.
Thus, the second assumed motivational influence, “the university senior leadership needs to
believe that they are competent in creating the new faith-integrated nursing program through
meaningful engagement with both internal on-campus stakeholders and external partners,” was
considered a gap amongst the motivational influences.
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Matrix 9
Self-Efficacy
Categories and Subcategories
M2: Self-Efficacy
Respondents
1 2 3 4 5 6
Generally confident & competent + + + + + +
Need nursing expertise + + - - + -
Need funding and resources - - + + + +
Need right political environment + - - - - -
Need right faith and God’s timing - - - - + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

Self-efficacy reflects the belief in one’s own ability to master a specific task, along with
positive expectations that one will receive the support needed to accomplish the task successfully
(Clark & Estes, 2008). Competence beliefs are rooted in a focus on one’s competence, expertise
and skills (Pintrich, 2003), but self-efficacy is different from confidence. If confidence is a
generally optimistic view of one’s capabilities, efficacy is specific to the tasks necessary to the
accomplishment of goals. According to Bandura (1997a), one can be generally confident but
have low self-efficacy about a given task, or vice versa.
According to the data, respondents unanimously indicated that they are confident that
they possess the skills necessary to carry out the creation and the establishment of this new
nursing program, and have positive expectations of success. However, a couple implicitly
expressed that they will need “external nursing expertise,” “funding and resources,” and “to be
guided by faith in Jesus,” “at the right time” in order to fully launch the program and be
successful. For example, one indicated that: “I’m highly confident. I think we have not yet, in the
state of California, run into any issues. The only thing that perhaps gets in the way is if at some
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 131
point in time California decided that as a state it’s going to be anti-faith-based education more
than it is…” This comment showed concern that the anti-faith environment in California may
become a threat.
Another implied their need of support from external parties: “We haven’t gone external
other than the partners. We’ve had extensive conversations with the partner organizations. We go
to the next step, like we said we’re having the internal group to help. We will need to bring on
board and formalize an external references groups that will have external stakeholders.” Another
interviewee also confirmed that the university is trying very hard to build relationships with four
of the five major healthcare systems in the area: “I’m very confident. Confident that if we are
clear about the direction that we will go, that the healthcare partners in the region will be very
supportive of us both financially, personnel, and every other way.” Respondents universally
indicated that they are confident and have positive expectations for self-regulative success in the
process. Interview data revealed that the dean of natural health sciences will be responsible for
the initial program proposal, establishing clinical partnerships, and overall progress related to the
creation of this new nursing program. However, at the time of interview, milestones and tasks
associated with specific timelines were unclear.
A different leader expressed his faith in Jesus Christ and believed that they will be
successful despite the financial challenge: “Finances and spaces are really challenging. That’s a
big challenge because the nursing schools are very expensive compared to other majors. There’s
a lot of labs required, a lot of special facilities,” he carried on. “The only thing that could be
more challenging than a nursing is probably a medical school.” Nevertheless, “it’s like having a
dream, and you have to pray, and you have to ask God to provide the resources. If it happens,
God has to do it. It takes, I think, like, a supernatural provision of God to do it. And we’ve seen
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 132
lots of supernatural things. The fact that the university exists as it does today (wholly reflects
the) supernatural power of God.” Overall, interview data on self-efficacy showed that high self-
efficacy was mixed with some implicit uncertainties that were offset by hope and trust placed in
God.
Additional Motivational Influence #3: Goal Orientation
As shown in Matrix 10, an additional motivational influence emerged from the
interviews: “senior university leaders believe that creating and establishing this new faith-
integrated nursing program will exert influence sectors such as education, healthcare, and the
church while helping missionary endeavors.”
Matrix 10
Goal Orientation
Categories and Subcategories
M3: Goal Orientation
Respondents
1 2 3 4 5 6
Help institutional mission + + + + + +
Help current US healthcare + + + + + +
Help education system - - + - + +
Help church partnerships - - + - + +
Help local community + + + + + +
Help global health missions + + + + + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

This new motivational influence was proved as an asset. All six participants believed that
the goal of exerting influence as a consequence of this new nursing program is important to the
life and mission of the institution:
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My hope would be the people who graduate from a school of nursing would want to be
involved in the care for people as a reflection and extension of their commitment to
Christ. And they would want to be the hands and feet of Jesus and be part of being
healing missionaries, as somebody I knew once said. Healing ambassadors. And I really
see that as a tremendous opportunity, and one of the reasons I’m excited is that if we had
a hundred or two hundred or three hundred nurses someday who had graduated from our
university and were serving throughout the Sacramento, Bay Area, Northern California
region, and were doing so as healing ambassadors for the cause of Christ, I think that
could be very, very powerful.
Another participant believes that “nursing is a critical component” of the university and
this new program fits not only into the mission of educating people who will be highly
employable in the field of healthcare, but also as a vehicle to serve the local community and
partner with the church:
We always want to partner with the church, and in partnering with the church…it’s very
important for us to be connected to the local community and that (the) local community is
aware of the medical needs. And that vision I gave before of church-based medical
clinics and hospitals. Those are visions I think many more churches will adopt in the
future. So that’s where it fits.
Interviewees cited various factors contributing to healthcare challenges in the US, such as
“rapid medical science and technology advancements,” “growing complexity of care with
chronic diseases and illnesses,” and “changing patient needs.” But then another leader expressed
the hope that a fully faith-integrated nursing program could help save the unsatisfactory
conditions of the healthcare system in the US:
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We honestly believe that development of this nursing program is essential for our current
healthcare crisis we are looking at, where high insurance cost, high medical cost… We
have many difficulties and perspectives on how to do healthcare in America. But I think
if we can begin to put people in the healthcare system that have a strong understanding of
what is required and why it is required, and say that they can make a difference, and
eventually they can impact locally, regionally, and hopefully globally, then we’ve done
our job.
Articulating a desire to save the current healthcare system reflects a goal orientation. In a
recent study, Hero, et al. (2016) discovered that, for decades, public satisfaction with the
healthcare system has been lower in the United States than in other high-income countries, with
11% reporting that they did not get needed treatment in the past year because of cost. The
Institute of Medicine reports that the United States underperforms its peers in terms of cost,
access, and quality, and that Americans are more in favor of major system reform than are people
in other countries (IOM, 2010). In their sentinel event report (a sentinel event is an unexpected
occurrence involving death or serious physical or psychological injury, or the risk of death or
serious injury), the IOM outlined strong evidence that the healthcare system frequently harms
patients and routinely fails to deliver its potential benefits (IOM, 2001; IOM, 2010).
Much of today’s healthcare continues to be based on a “medical mode” where providers
are mostly focused on and comfortable with diagnosing and treating physical conditions (Carr,
2010). At the same time, researchers have discovered that among the 70% of the U.S. population
that identifies with a personal God and the additional 12% who believe in a higher power
(Kosmin & Keysar, 2008), patients and families are particularly inclined to engage in religious or
spiritual guidance during stressful life events, such as healthcare crisis, illness, or death (Koenig,
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 135
King, & Carson, 2012). Undoubtedly, holistic care that is “patient-centered, customized
according to patient needs, values, choices, and preferences” (IOM, 2001, p. 3) is important.
However, core values and principles that “differentiate nursing from other professions may have
been eroded in contemporary practice” (Timmins & McSherry, 2012, P. 953). Therefore,
creating such a goal orientation for better quality patient care enhances motivation (Clark &
Estes, 2008).
Summary of Motivation Findings
To achieve the organizational goal of creating and establishing a faith-integrated
Bachelor of Nursing program at the targeted university in northern California, the findings from
the collected interview data confirm that the executive leaders are a highly motivated group who
possess strong utility values and goal orientation. There seems to be an opportunity to strengthen
self-efficacy, as not all participants projected clear understandings of how they will succeed in
light of potential constraints related to effort, personnel, financial resources invested, and
political uncertainties.
Results and Findings for Organizational Influences
This study has explored the interaction between the organizational culture and
stakeholders’ knowledge and motivation. The third section of this chapter explores the assumed
organizational influences, and confirm that three out of four assumed organizational categories
are assets, while one is a gap.
Clark and Estes (2008) argues that even for people with exceptional knowledge and skills
who are highly motivated, ineffective processes, missing resources, and inadequate support can
prevent the achievement of organizational performance goals (Clark and Estes, 2008).
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 136
Organizational culture is defined as the shared values, beliefs, or perceptions held by
employees within an organization or organizational unit (Robbins & Coulter, 2012). Because
organizational culture reflects the values, beliefs, and behavioral norms that are used by
employees to give meaning to the situation they counter, it can influence the attitude, behavior
and motivation of employees (Scott-Findlay & Estabrooks, 2006). Gallimore & Goldenberg
(2001) provide two key concepts, grounded in cultural models and cultural settings, that facilitate
the examination of organizational performance gaps. Cultural models refer to “shared mental
schema or normative understandings of how the world works, or ought to work,” whereas
cultural settings are defined as “the social furniture” and “the small recurrent dramas of
everyday life played on the stages of home, school, community and workplace” (Gallimore and
Goldenberg, 2001, p. 47).
In terms of organizational influences, the successful creation and implementation of this
new faith-integrated nursing program includes the following elements that stem from cultural
models and cultural settings: 1) governance alignment; 2) culture of trust and openness; 3)
funding and resources; and 4) strong institutional identity. The following is a high-level
summary and synthesis of the findings related to the assumed organizational causes, based on the
interviews.

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Table 11
Assumed Organizational Influences Summary Chart
Assumed
Influences
Assets Gaps Inconclusive Summary of Interviews
O1:
Governance
Alignment

Yes Senior leaders unanimously agreed and
believed that the university needs to cultivate
a collaborative culture within the
organization that supports the establishment
of this new nursing program. Leadership
alignment at the senior executive level must
include board-level support. Data shows
tremendous efforts have been made to
communicate and seek sponsorships by
establishing new external clinical
partnerships. Internally, participatory and
collaborative efforts have involved multi-
disciplinary work teams, including an
academic council (with selected faculty and
staff) at the early stage of program
development.
O2:
Culture of
Trust and
Openness

Yes The interview data confirmed that the
university has a culture of trust, openness,
safety and respect that allows faculty and
staff to voice their input on creating a faith-
integrated nursing program.
O3:
Funding and
Resources

Yes The funding and resources were identified as
gaps throughout the interviews. School
leaders affirmed that they need to obtain and
provide adequate funding and resources
necessary to support the planning and
establishment of this new program to meet
university, state, and national nursing
standards.
O4:
Strong
institutional
Identity

Yes Based on the data, executive leaders
unanimously believed that it is critical to
develop a strong institutional identity that is
reflected in the mission, vision, values, and
goals of the nursing program, despite the
challenges raised by larger political and
financial forces, and the prevalent cultural
environment outside the institution.
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Assumed Organizational influence #1: Governance Alignment
Senior leaders unanimously agreed and believed that the university needs to cultivate a
collaborative culture within the organization that supports the establishment of this new nursing
program. This leadership alignment needs to occur at the senior administrative level, with board-
level support. Tremendous efforts have been made to communicate and seek sponsorships by
establishing new external clinical partnerships. Internally, participatory or collaborative efforts
have involved multi-disciplinary work teams, including an academic council (with selected
faculty and staff), at this early stage of program development.
Matrix11
Governance Alignment
Categories and Subcategories
O1: Governance Alignment
Respondents
1 2 3 4 5 6
We are aligned + + + + + +
“Let everyone know early!” - - - + - -
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

The first assumed organizational influence, “the university needs to cultivate a
collaborative culture within the organization that supports the establishment of this new nursing
program,” was affirmed as an organizational asset, with only one participant voicing the concern
that the senior leadership should promptly inform the faculty and staff about any new progress
early.
The overall impression is that this organization is very unique and dynamic as it
constantly finds a balance between cautious risk-taking and aggressive expansion in this hyper-
competitive marketplace, carefully considering how to enlarge their capacity to ensure success.
Interviews revealed that the university has experienced record growth and has expanded
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 139
aggressively over the last few years: “We tripled the number of degrees,” “from nine degree
programs, we’ve added 24 degrees at the university in a very short span of time,” and “we have
doubled in size the last three years and are on track to double again during these next few years.”
At the same time, the university has clearly defined hierarchies within an
interdisciplinary, team-based collaborative approach, along with a comprehensive and risk-
averse internal process for new program approval. The following statements expand upon this:
Do we have capacity at the university at that time to deliver an excellent project, an
excellent degree program? We look at three different lenses. We look at the degree
program through the vision and mission of the institution, through best practices, and
marketplace opportunities, as well as our own internal capacities. Those three
overlapping circles create what we think of it as the sweet spot.
Additionally, there are strict guidelines for most departments and roles and people in
different departments. They must generally follow established structures and data-driven
decision-making processes. One participant explains the organizational structure and functions of
the board and its focus on strategic instead of operational governance: “Our board is not a hands-
on, program-specific board. They deal with us at the policy level. The policy to the board, that
would govern the board, would be that the university balances its budget on an annual basis. It’s
called Carver policy governance. It’s a government structure that is pretty popular in some
sectors, less well known in higher education.” So rather than “look over the shoulders,” the board
provides guidelines. When it comes to decision-making processes, the same leader explains:
All of that [decision-making] is informed and it’s not just in my office that’s all being
interpreted. It’s being interpreted simultaneously by the executive team, by the formal
governance council to the academic senate reviewing this, as well as our external
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 140
advisory board all reviewing it simultaneously. We aggregate the information and make a
decision following.
As demonstrated above, the respondents were not only able to verbalize the internal
process of approval that includes potential entities involved in the new nursing program, but also
take an interdisciplinary collaborative approach as a team. One respondent reported that “those
are all wired into the main proposal process, signature steps along the way where the right people
see … that involves marketing, it involves enrollment, it involves the registrar, it involves IT.”
When the participants were asked about the discussions on developing a faith-based
nursing program at the university, one leader indicated: “They now know this program is being
developed, they have spoken into it, and nobody is surprised later if it gets approved.” However,
other data indicate that the extensive discussions are primarily at the C-suite level, with the
academic council’s involvement at this stage. The following confirmed this:
Both at the early stage, the precis, extensively at the program proposal stage. They
[academic council] are heavily involved in giving feedback and affirmation and direction
to how that program is being designed to be missionally effective. They go back and they
help, back to your faith integration question, based on other things.
Another leader reiterated the closely held nature of the proposal: “I don’t think it’s been publicly
shared, or even within the community shared yet.” However, one of the six leaders expressed
concern about the process: “I feel like we are always starting some new things. I think there’s
room to perhaps market or posture ourselves in such a way that excitement could be built, rather
than just telling us, ‘It’s happening in a month’ would be great.”
To create a brand-new nursing program is multi-dimensional and will be a major
departure for both the campus and its community of faculty, staff and students, taking on
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 141
institutional, clinical, and cultural implications. It is important that the leadership engage and
educate faculty and staff about the driving forces behind and implementation plans for the
nursing program.
Assumed Organizational Influence #2: Culture of Trust and Openness
The interview data (see Matrix 12) confirmed that the university has a culture of trust,
openness, safety and respect that allows faculty and staff to voice their input on creating a faith-
integrated nursing program. Thus, the second assumed organizational influence, “the school
needs to have a culture of trust, openness, safety and respect that allows faculty and staff to voice
their input on creating a faith-integrated nursing program,” was established as an organizational
asset.
Matrix 12
Culture of Trust and Openness
Categories and Subcategories
O1: Culture of Trust & Openness
Respondents
1 2 3 4 5 6
Trust and openness + + + + + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

Throughout the interviews, senior leaders generously shared their honest points of view,
without any reservation or hinderance concerning progress on the new nursing program. It is
apparent from the interviews that the leaders create a culture of trust and openness by making
sure they engage in transparent business practices. Creating systems and processes for high
involvement in efforts, openly discussing decision-making criteria, applying policies and
procedures fairly, and giving and receiving feedback are all valuable strategies used to increase
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 142
trust and openness. When it comes to reconciling doctrinal differences, one of the executive
leaders emphasized the importance of “agreement on the majors.” For example:
The university also has a community covenant. For instance, if you thought about
different doctrinal or theological differences, the university has done a really good job of
navigating those so that we try not to ever major on the minors. We major on the majors.
And as long as there’s agreement on the majors, we allow for lots of differences and
diversity on that.
When it comes to differences in program direction and resolving conflicts along the way,
senior leaders encouraged the assembly of teams to share information and offer advice for
program formation. This open discussion builds trust, transparency and credibility. One leader
used the following metaphor: “It’s not even wet cement, it's Jell-O for a while where people can
put their hands on it and play in it. Even when it becomes wet cement, if you're part of the
external or internal group that’s speaking into it, it still gets formed and shaped.” This analogy
demonstrated the executive leaders are willing to work diligently to allow people speak into the
program to make them feel like their opinions matter and are welcome and respected. Beyond
this, the leaders expressed that they will always stay open and learn. “So even after we launch
the program, we are not done learning. We’re gonna continue to learn and adapt and develop
over time!” The consensus of interviews was the participants promote team effort both internally
and externally. They are willing to embrace change and encourage continuous quality
improvement through clear communication processes and open feedback. A different leader also
reinforced this assertion by stating that:
In terms of the direction of the program, let’s say we launch the nursing program and
then some people want it to go one direction of emphasis, and other people wanted to go
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 143
another. Those conversations happen all the time in university. We would work with the
team, the provost, the faculty. I would weigh in, if it was appropriate. But for the most
part, I think that we’ve committed to work out any tensions like that.
To further illustrate this point, the same leader went on to give an example of how the
university is committed to overcome challenges through open discussions. In this particular
situation, the university resolved a problem by making environmental science a minor under
biology. “It was (a) challenging conversation, because everybody worries about their role and
that sort of thing, but we actually navigated quite well, and I think it has worked out to
everybody’s satisfaction. We can do that in every area.” The leaders confirmed that they extend
trust to those they lead, where planning and execution come together as process of learning and
transparency reigns in decision-making processes, with the result that everyone contributes to
fostering an environment of trust and openness in which the team thrives.
Assumed Organizational Influence #3: Funding and Resources
Funding and resources were identified as challenging throughout the interviews. School
leaders affirmed that they need to obtain and provide adequate funding and resources necessary
to support the planning and establishment of this new program to meet university, state and
national nursing standards. Thus, the third assumed organizational influence, “the school needs
to obtain and provide adequate funding and resources necessary to support the planning,
establishment of this new program to meet the university, state and national nursing standards,”
was considered as an organizational gap throughout the interviews.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 144
Matrix 13
Funding and Resources
Categories and Subcategories
O3: Funding and Resources
Respondents
1 2 3 4 5 6
From the university + + + + + +
From healthcare system - + + - - -
From Church - - + - - -
From foundations - - + - + -
From donors and sponsors + + + + + +
Wait for APD process + + - - - -
Initiated grant application - - - - + -
Tuition + + - - - +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

When we talked about upfront investment, all the participants confirmed that the
university will need additional funding and resources to support the creation and implementation
of this new nursing program. In terms of sources of funding, two out of the six executive leaders
clearly articulated strategies and sources to obtain funding and resources. One indicated that he
has initiated the process of a grant application for half a million dollars “and currently what
we’re doing is we are establishing the taskforce. We are seeking a process of completing a grant
application through Fletcher Jones Foundation.” However, it is evident from the interviews that
the leaders had not secured the grant or made the actual investments in the program at the time of
interview, as “we are not at that stage yet.” “When we actually have a full proposal, that’s when
we’ll be signing on for additional seed money to start working more intently with partners and to
hire fulltime faculty.”
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 145
Another two out of six leaders referred back to the APD (Academic Program
Development process) as a perfect tool to align the market demand with institutional capacities
and mission and to budget and calculate return on investment. As one leader indicated, “a
significant part of ADP relates to the acquisition and utilization of resources. Revenue can be
generated. I could show you a hundred different proposals. Very few of them have ever been off
the mark by much. We are very conservative about it.” “This is what’s going to take in terms of
the investment by the institution, partners from the other institutions in order for this [new
nursing program] to be successful.”
One leader expressed his concerns for the high upfront investment: “There has to be
really high capital investment upfront by people who have made enough money that they have
that much discretionary income or by people who have left their estates to a cause like that.” He
attributed the school’s success to some very strong financial contributors: “But private schools
like…, who did have some very strong financial contributors, and if it were not those
contributors – Silicon Valley icon types of people, we wouldn’t have been able to have the
school that we have. And the students couldn’t afford to pay for it.” A different leader pointed
out that “tuition can help pay for some degrees, but not all the high costs of labs and spaces.”
However, partnership with the healthcare facilities can help with upfront funding needs: “We
appeal to partners and we have a lot of partners…I just had a meeting with one of the largest
healthcare providers. Their executive team came to campus and said, ‘We’d like to partner with
you.’”
All the leaders cited two or more funding resources simultaneously. All considered the
varying magnitude of funding and resources needed for a new program and the initial financial
demand that could be put on the university. A typical answer summarized the following three
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 146
sources of funding, namely: “the core university budget,” “healthcare system and church,” and
“foundations”:
I’ll cite maybe three sources. Number one, there’s the core university budget where we
would make a commitment. If we do launch a school of nursing that at the time, we
would then make a commitment to how much of the university’s budget would be able to
be invested in that. The second thing is that we have very significant partners in two
areas. Number one would be in the healthcare area. We believe that of the five healthcare
systems that we should see fairly substantial support from our healthcare partners. And I
want to add churches here. We have about a thousand churches that we are in relationship
with. And if we tell the churches that we are starting a nursing program, I believe a case
could be made for very strong support from the churches because they will see this
missional opportunity, particularly if we end up thinking about church-based health
clinics. The third is foundations. We have a relationship with a couple foundations.
We’ve had very specific conversations with them about what it might look like for the
university to launch a nursing program, and them to help fund it.
The leaders unanimously agreed that upon comprehensive program approval, they will
need to concretely obtain, secure, budget, and allocate funding and resources to support the
successful planning and establishment of this new nursing program. They have come up with
creative ways of sharing facilities and lab resources internally and externally, which, according
to their estimates, are the largest two major investments needed for the program. For example,
the participants mentioned that they could share nursing skills laboratories and medical supplies
with other health science programs at the university or with surrounding healthcare facilities; and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 147
also use the computer labs and library space which already fully built, resourced, and equipped at
the university.
Assumed Organizational Influence #4: Strong Institutional Identity
Based on the data (refer to Matrix 14), senior leaders unanimously believed that it is
critical to develop a strong institutional identity that reflects their mission, vision, values, and
goals as the nursing program is implemented, despite the challenges perceived and shared from
the larger political, financial, and prevalent cultural environment. Thus, the fourth assumed
organizational influence, “the school needs to develop a strong institutional identity that reflects
the mission, vision, values and goals related to the implementation plan for the nursing
program,” was evident as an organizational asset.
Matrix 14
Strong Institutional Identity
Categories and Subcategories
O4: Strong Institutional Identity
Respondents
1 2 3 4 5 6
From the top to bottom + + + - + +
Accountability + + + - + +
Humble leadership - + + + + +
God’s grace + - + + + +
“+” = participant elicited or expressed any opinion during the interview
“-” = participant either did not refer to it at all or considered unimportant

Contrary to mainstream postmodern ideas about secularism and pluralism, this cohort of
leaders consistently attempts to identify with its funders’ concerns for Christian education and to
demonstrate that partnering with the church and educating transformational leaders for the glory
of God sustains the life of the university. All six university leaders embraced the mission, which
is enthusiastically shared by the board, educators, and staff.
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When the leaders were asked the question “Who are we as a faith-based institution?”
leaders cited a greater incentive to pursue God through a personal relationship with Jesus Christ
and the importance of staying true to their institutional identity in the face of controversy and
pressure. These themes emerged from this topic: from the top to bottom, accountability, humble
leadership, and God’s grace.
The following leader offered a typical answer when he that there should be strong
leadership alignment from top to bottom: “The number one responsibility of the board of trustees
is to guard the mission of the university. So, I rely heavily on ensuring that the board is in sync
with me to make sure that I lead the university well, to be focused on fulfilling our mission of
being a Christ-centered higher education institution.” Another consistent theme was that
accountability as a faith institution is valued by the leaders. One expressed this as follows:
“Being Christ-centered higher education must mean something, not just being in name only, or
not just being historically.” He carried on: “I personally believe…a very important strategic and
symbolic part of our life as a university (is that) the churches help keep us accountable. If we
drift, if we get off mission, if we somehow are not being faithful, they will let us know. They
will stop sending us students. They will stop sending us finances.”
The majority of interviewees believed that “staying humble” was crucial in terms of the
way in which individuals “respond to God’s grace.” One acknowledged the challenges facing
faith-based organizations and urged people to “never give up” in the
quest for excellence – best defined as that God Himself lives by and holds to – true, holy,
and pure (while) “striving to be godly and loving people, knowing that we are not able to
do it except for God’s grace….If we are able to achieve that, Christ wouldn’t have had to
die on the cross to save us from ourselves and from, you know, the destruction that we
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 149
all, ultimately, face apart from being one with the giver of all life, God Himself, and the
sustainer of all life.
Notably, a majority of the interviewees believed it is God that works through and empowers the
leaders to do anything worthy and good. In the end, they all give the credit back to where it
belongs in order to stay humble:
I think that has to come from God Himself. I don’t think we can empower anyone. We
can try to set a good example, but everyone struggles, including the Apostle Paul in
Romans, the seventh chapter. He’s kind of saying, ‘What I should do, I do not do; but
what I shouldn’t do, I end up doing.’ He finds it very difficult…saying ‘Whoa, who am I?
And how can I actually be who I should be?’ And then he says, you know, it’s by the
grace of God. By God to help them, He has to help us... I think we need to be humble,
understanding that we are not able to live a Christian life. It’s only God who is living in
us that helps us to give ... have the qualities of Christian faith in our hearts.
This cohort of leaders shared their deep concern over challenges to faith-based
institutions seeking to follow the religious commitment at the heart of who they are and what
they do. They are committed to keep their mission and identity front-and-center in everyday
academic and leadership responsibilities. They are committed to “continue to do well and serve
well and the Lord will protect and provide for us in powerful ways.” They have an ability to stay
humble, while communicating their convictions and maintaining a sense of faith, hope, and love.
Summary of Organization Findings
The findings from the collected data confirm that there is governance alignment at the
senior level, including board-level support, organizational structures and processes that ensure
collaboration across internal and external stakeholders, participation of multi-disciplinary work
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 150
teams, and sponsorships by healthcare, church, and academic leaders. Their capacity for creating
and establishing a faith-based nursing program is profound and wide ranging. To succeed, the
interview data reveal that challenges with funding and resources, especially upfront costs for
space, nursing skills labs, and medical equipment. In addition, they must provide clear and
highly supported lines of communication between leaders and faculty/staff throughout all levels
of the organization. It is imperative that the strong institutional identity championed by day-to-
day leaders, educators, and staff must continue to work in complete alignment with the
organizational mission, vision, values, and goals.
Summary of Results and Findings
A qualitative and systematic needs analysis of six senior leaders’ knowledge, motivation,
and organizational context at a faith-based private Christian education institution, using Clark
and Estes (2008) KMO model adjusted for confounding factors, showed both promising and
challenging aspects related to the establishment of a new faith-integrated bachelor of science
nursing program at this education institution. The researcher discussed in great detail an account
of current trends, issues/controversies, promising patterns, insights, and concepts related to faith-
integrated education and its implications for nursing and healthcare reform.
Throughout this section, the ways in which coherence and alignment might be achieved
between key national priorities in education and the identity, beliefs and commitments of
Christian faith-based education are explored. Although this new nursing program starts with the
senior leaders at the local university level, its successful implementation may need to embrace
more broadly the institutional environment beyond the university itself and help to shape future
polities, initiatives and strategies.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 151
CHAPTER FIVE: SOLUTIONS, IMPLEMENTATION AND EVALUATION
The results and findings in the previous chapter have reflected the knowledge and
motivation of a cohort of senior leaders committed to creating and establishing a faith-integrated
Bachelor of Science in Nursing program, with a strong emphasis on their unique Christian faith-
based organizational context. This chapter critically analyses and discusses the most significant
findings of the present study and attempts to make recommendations to close the knowledge,
motivation, and organizational gaps (Clark & Estes, 2018). The ways which the Christian faith-
based learning can be best developed, articulated and integrated in nursing in this local
institutional context through the process of scholarly discussion and best practices will be
critically examined in this chapter.
By comparing and contrasting research evidence with pertinent literature and best
practices, context-specific recommendations are presented with respect to the four nursing
accreditation standards from the Commission on Collegiate Nursing Education (CCNE, 2018),
namely: 1) mission and governance; 2) institutional commitment and resources; 3) curriculum
and teaching-learning practices; 4) aggregate student and faculty outcomes. CCNE is the leading
authority in accreditation for nursing education programs. CCNE supports the interests of
nursing education, nursing practice, and the public. Accreditation is a voluntary, peer-reviewed,
self-regulatory process by which they, as a non-governmental association, recognize education
institutions and programs that meet or exceed standards for educational quality (CCNE, 2018). In
particular, at its initial stage, to assess, plan, implement, and evaluate this new nursing program
according to these above-mentioned standards will not only help to align, monitor, and improve
resources invested, but will also ensure that processes are followed, and results achieved that tie
closely to board of nursing licensing rules and state board examinations.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 152
Organizational Context and Mission
The organization in this study is a private Christian university in northern California.
With nearly 30 undergraduate and graduate degree programs, this private Christian university is
founded on the integration of Christian faith and academia, with a mission to produce graduates
who will become transformational leaders in their homes, churches, and communities by serving
with distinction in their chosen careers (The University, 2018).
Organizational Performance Goal
By Fall 2020, the university’s organizational performance goal is the launch of this new
faith-integrated BSc. in Nursing program.
Description of Stakeholder Groups
While a complete needs analysis would focus on all stakeholders, the stakeholder focus in
this analysis was six (n=6) senior leaders, as they were the most relevant stakeholders at the time
of data collection and most pertinent for the purpose of this study.
Purpose of the Project and Questions
The purpose of this project was to conduct a needs’ analysis in the areas of knowledge,
motivation, and organizational resources necessary in order to reach the organizational
performance goal of establishing the new faith-integrated BSc. of Nursing program. As such, the
questions that guide this study were the following:
1. What are the senior leaders’ knowledge and motivation related to the university’s
commitment to establishing a faith-integrated BSc. in Nursing program?
2. What is the interaction between the organizational culture and context and
stakeholders’ knowledge and motivation?
3. What are the recommended knowledge, motivation, and organizational solutions?
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 153
Recommendations for Practice to Address KMO Influences
In the United States, accreditation focuses on the quality of institutions of higher
education and associated professional programs. The nature of accreditation is a voluntary, self-
assessment process based on best practices and established quality standards. It is considered
best practice for a new nursing program to demonstrate compliance and to exceed these
standards at its conception (Halstead, 2017). Therefore, the recommendations to address KMO
influences are based on actual interview data discussed in Chapter 4. They are prioritized based
on the influences with the highest impact potential for achieving the stakeholder goal, and
organized based on the four standards from Commission on Collegiate Nursing Education
(CCNE, 2018). Recommended implementation and evaluation plans reflect the organizational
context and will follow the discussion of recommended solutions. Table 12 below provides an
overview on how the validated KMO influences in this study match with the relevant CCNE
(2018) nursing accreditation standards.

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Table 12
Matching KMO Influences with CCNE Nursing Accreditation Standards
Knowledge
Category Assumed Influences Assets Gaps Inconclusive
Relevant CCNE
Standards (I-IV)
K1.
Accreditation
(Factual)
The university senior
leadership needs to
have a working
knowledge to fulfil all
requirements of the
national accreditation
agency and state board
for a pre-licensure
nursing program.

Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
K2. Best
practices
(Factual)
The university needs to
know the teaching
strategies, interventions,
tools, and best practices
of a high-quality pre-
licensure nursing
program.
Yes ✓ Institutional
Commitment
and Resources
✓ Curriculum and
Teaching-
Learning
Practices
K3. Principles
of faith-based
education
(Factual)
The university
leadership needs to
have a shared
knowledge of the faith-
based principles and
components of this new
BSc. in Nursing
program.

Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Curriculum and
Teaching-
Learning
Practices
✓ Aggregate
Student and
Faculty
Outcomes

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 155
Table 12, continued
Knowledge
Category Assumed Influences Assets Gaps Inconclusive
Relevant CCNE
Standards (I-IV)
K4. Differences
between faith-
based and non-
faith-based nursing
programs
(Conceptual)
The university senior
leadership need to
know the differences
between a faith-based
nursing program and
other general nursing
programs.

Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Curriculum
and Teaching-
Learning
Practices
✓ Aggregate
Student and
Faculty
Outcomes
K5. Recruiting
Faculty
(Procedural)
The University
leadership needs to
know the knowledge,
skills, and
dispositions of ideal
faculty to be
recruited.

Yes ✓ Mission and
Governance
✓ Aggregate
Student and
Faculty
Outcomes
K6. Developing
business plan and
implementation
strategies
(Procedural)
The senior leaders
need to know how to
develop a business
and implementation
plan.

Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Aggregate
Student and
Faculty
Outcomes

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 156
Table 12, continued
Knowledge
Category Assumed Influences Assets Gaps Inconclusive
Relevant CCNE
Standards (I-IV)
K7. Self-
reflection
(Metacognitive)
The university senior
leadership needs to know
how to reflect on their
own beliefs and goals for
creating a faith-
integrated BSc. in
Nursing program.
Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Curriculum
and Teaching-
Learning
Practices
✓ Aggregate
Student and
Faculty
Outcomes
Motivation
Category Assumed Influences Assets Gaps Inconclusive
Relevant CCNE
Standards (I-IV)
M1.
Utility value
The senior leadership
must feel that their time
and resources are
allocated to establishing
a new nursing program
that is a worthwhile
endeavor for advancing
the mission and vision of
the university and global
learning communities.

Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Curriculum
and Teaching-
Learning
Practices
✓ Aggregate
Student and
Faculty
Outcomes

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 157
Table 12, continued
Motivation
Category Assumed Influences Assets Gaps Inconclusive
Relevant CCNE
Standards (I-IV)
M2.
Self-efficacy
The university senior
leadership needs to
believe that they are
competent in creating the
new faith-integrated
nursing program through
meaningful engagement
with both internal on-
campus stakeholders and
external partners.

Yes

✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Curriculum
and Teaching-
Learning
Practices
✓ Aggregate
Student and
Faculty
Outcomes
M3.
Goal orientation
(Newly
emerged)
The university senior
leaders believe that
creating and establishing
this new faith-integrated
nursing program will
exert positive influence
in other areas, including
education, healthcare,
church, and broader
missionary endeavors.

Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Curriculum
and Teaching-
Learning
Practices
✓ Aggregate
Student and
Faculty
Outcomes
Organizational
Category
Assumed Influences Assets Gaps Inconclusive Relevant CCNE
Standards (I-IV)
O1.
Governance
alignment
The university needs to
cultivate a collaborative
culture within the
organization that supports
the establishment of this
new nursing program.
Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Aggregate
Student and
Faculty
Outcomes

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 158
Table 12, continued
Organizational
Category
Assumed Influences Assets Gaps Inconclusive Relevant CCNE
Standards (I-IV)
O2.
Culture of trust
and openness
The school needs to have a
culture of trust, openness, safety,
and respect that allows faculty
and staff to voice their input on
the creation of a faith-integrated
nursing program.

Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Aggregate
Student and
Faculty
Outcomes
O3.
Funding and
resources
The school needs to obtain and
provide adequate funding and
resources necessary to support
the planning and establishment
of this new program in order to
meet university, state and
national nursing standards.
Yes ✓ Mission and
Governance
✓ Institutional
Commitment
and Resources

O4.
Strong
institutional
identity
The school needs to develop a
strong institutional identity that
reflects their mission, vision,
values, and goals in the
implementation plan for the
nursing program.

Yes
✓ Mission and
Governance
✓ Institutional
Commitment
and Resources
✓ Curriculum and
Teaching-
Learning
Practices
✓ Aggregate
Student and
Faculty
Outcomes

Recommended Solutions
This study has identified and assessed assumed influence for the university to create and
establish a faith-integrated BSc. in Nursing program on the basis of a knowledge and skills,
motivation and organization theoretical framework (Clark & Estes, 2008).
To achieve the organizational goal of creating and establishing a faith-integrated
Bachelor of Nursing program at the targeted university in northern California, findings from the
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 159
interviews with six senior leaders (n=6) confirms that four out of seven assumed knowledge
categories are assets, while one is a gap, and two are inconclusive.
The knowledge gap involves best practices in a pre-licensure nursing program. This is
due to a lack of institutional expertise as the university has no extant nursing program. In
addition, there are currently no personnel with experience in the design, implementation, or
administration of this academic discipline. Two inconclusive knowledge influences include,
firstly, the fact that the interviewees have no prior knowledge in nursing accreditation, and,
secondly, when asked to envision and paint an ideal picture of a fully faith-integrated nursing
program, there was a great deal of individual variability.
The findings from the data confirm that there is a gap in motivation influences related to
the achievement of the organizational performance goal. Senior leaders are a highly motivated
group who possess strong utility values and goal orientation, but there seems to be an
opportunity to strengthen self-efficacy in view of the fact that not all participants projected clear
understandings of how they will succeed when faced with potential constraints related to effort,
personnel, financial resources invested, and political uncertainties.
Along with gaps in knowledge and motivation, organizational gaps also exist that pose a
barrier to creating and establishing this new faith-integrated nursing program. Interview data
reveal challenges with funding and resources, especially upfront costs for space, nursing skills
labs, and medical equipment. They will need to overcome funding and resource challenges by
securing both internal and external funds and establishing external partnerships that promote
excellence in nursing education while also enhancing the profession and benefiting the
community. In addition, senior leaders must provide clear and highly supported lines of
communication between leaders and faculty/staff throughout all levels of the organization. It is
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 160
imperative that the strong institutional identity championed by day-to-day leaders, faculty and
staff continue to work in complete alignment with the organizational mission, vision, values, and
goals.
This study has yielded the following 18 recommended solutions that are based on the
Commission on Collegiate Nursing Education’s (CCNE, 2019) four distinct accreditation
standards (mission, commitment, curriculum and outcomes) and explored the complementary
power of science and faith integration through the lens of the Christian worldview.
CCNE Standard I Program Quality: Mission and Governance
“The mission, goals, and expected program outcomes are congruent with those of the parent
institution, reflect professional nursing standards and guidelines, and consider the needs and
expectations of the community of interest. Policies of the parent institution and nursing
program clearly support the program’s mission, goals, and expected outcomes. The faculty
and students of the program are involved in the governance of the program and in the
ongoing efforts to improve program quality” (CCNE, 2018).
Recommendation 1: Develop a Congruent Nursing Program Mission
Standard I concerns congruency of the new nursing program mission, goals and outcomes
with the mission of the institution. Recognizing that the mission of the university is the primary
lens through which to understand that purpose. The university mission is “in partnership with the
church, to educate transformational leaders for the glory of God” (The University, 2019). The
primary goal of the university is to prepare Christians for leadership and service in church and
society, through Christian higher education, spiritual formation, and directed experiences.
Recommendation 1 is an invitation to vocational faith-integration that connects the
purpose of God’s work with a call upon the student’s life to pursue excellent work within the
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nursing discipline. This concept of a call is distinguished from the concept of a job. It also
resonates with the Great Commandments that are very much at the heart and soul of the
institution: “Love the Lord your God with all your heart and with all your soul and with all your
mind. This is the first and greatest commandment. And the second is like it: Love your neighbor
as yourself” (Matthew 22: 36-40, NIV).
As was critically analyzed and discussed in previous chapters, the university in this study
was birthed in the heritage of independent Christian churches that identify as non-
denominationally Christian. The university is committed to teaching theology from an
evangelical perspective and providing a distinctively Christian environment for its community of
faith (The University, 2019).
The university identifies potential new degree programs based on student demand, the
needs of the communities, and an appropriate “fit” with the university’s mission. The industry
demand for health-related professional degrees, the challenging and unique health needs of the
state, national and global population, and the university’s developing science programs clearly
have identified nursing as a necessary addition to the university’s academic programs.
The establishment of a new faith-integrated Bachelor of Science in Nursing program is
congruent with the university’s academic vision and strategic plan by responding to the
community need, and extending influence in areas including education, healthcare, church and help the
missionary endeavor in the society.
Thus, it is recommended to develop early a separate mission of this new nursing
education unit reflects the governing organization’s core values and is congruent with its
mission/goals. Especially when the participants envisioned this new nursing program from
slightly different perspectives as was discovered and discussed in the findings, developing strong
mission statements can help stakeholders reach a common understanding and agreed-on purpose.
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Recommendation 2: Develop a Congruent Nursing Program Vision
Recommendation 2 involves a conceptual-theoretical faith-integration that helps people
to “think Christianly” (Morrow, 2011). Johnathan Morrow (2011) asserted that the intersection
of faith and culture is a “constant” and “ongoing” event (p. 19). He encourages Christians to
think in a Christian way about the place of religion in the secular culture and cautions against
conforming to the patterns of this world by abandoning the specific Christian perspectives. For
example, he resists the mindset which believes science alone can solve all of society’s problems
or relativism that doubts that there are any solid truths or absolutes.
One way in which this university develops a congruent nursing program vision is by
recognizing that all persons are created in the image of God (Genesis 1:27), and thus deserve to
be honored, loved, and served one another. Likewise, they must support the weak (Micah 6:8;
Isaiah 1:17) by always helping the wounded, the oppressed, and the needy.
Proverbs 29:18 (NIV) teaches us: “Where there is no vision, the people perish.” This new
nursing program must develop and endorse a vision that all recognize in common. While the
mission statement defines what the nursing program does, a vision statement expresses the
ultimate goal of the program. “Vision is knowing who you are, where you are going and what
will guide your journey” (Blanchard & Stoner, 2011). Vision answers “why” the program is
existing and its significance; a clear picture that describes what the end result looks and feels like
and the principles that guide our decisions and actions on our journey.
This should be an internal process of reflection and external assessment and analysis that
include substantive dialogue with all stakeholders involved. When people share a common
vision, they share the same picture of success which creates tremendous amount of power,
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passion and beliefs, creating consistent direction and results in achieving the vision for all
involved.
Recommendation 3: Create Structure for Governance Alignment
The scope for creating a new faith-integrated nursing program is wide and expansive. It
may not happen in a linear, tidy fashion. It will require collaboration, including defined decision-
making roles and processes, between all relevant internal and external stakeholders, necessitating
new organizational structures and governance alignment. This governance alignment must be
consistent with the university’s affirmation of the Lordship of Christ (Acts 2:36) and the
authority of Scripture (2 Timothy 3: 16-17, NIV).
Under the direct leadership of the Dean of Applied and Natural Sciences and the
Provost’s office at the university, a steering committee should recruit members who will
complete a strategic plan for implementation and evaluation. This new steering committee
members will be selected from senior leadership, faculty members, staff, students, and the board
of trustees. They will be collectively responsible to create the mission, vision, goals, strategies,
priorities, education standards, and allocation of resources for the establishment of the new
program. Faculty and student roles in the governance of the program should be clearly defined
and should promote shared governance and participation. The members should be able to bring
critical insights to the table. Please refer to Figure 4 below for the proposed program
organization structure.
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Figure 4. Program organization structure.

Recommendation 4: Create Congruent Nursing Program Policies
This university affirms the teaching of Christ and the Scripture regarding those in
authority, as ordained by God at the university and beyond. By respecting those in authority
(Romans 13: 1-4, NIV) and following program policies created to communicate the desired
outcomes and behaviors, the university is honoring God by affirming God-given authority to the
extent that they are congruent with the government laws, the nature of God and His Word.
Since this is a brand-new nursing program, there are currently no policies and procedures
developed to help govern it. Policies for nursing faculty and staff should be comprehensive,
provide for the welfare of faculty and staff, and be consistent with the university mission and
vision, with differences justified by virtue of the purpose and outcomes of the nursing program
(Laws & Hajer, 2006).
President
Provost Office
Program
Assistant
Clinical Liaison Faculty
Lab and
simulation
Adjunct faculty
Steering
Committee
Dean of Natural and Applied
Sciences
Director of
Nursing
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Academic policies, nursing student handbook, catalogs, and program-specific
publications should be created, all of which should support achievement of the mission, vision,
goals, and expected student outcomes. These policies include fair, equitable and consistent
student recruitment, admission, retention, and progression policies that are published and
communicated. A defined process should be created by which policies are regularly reviewed
and revised as necessary per institution standards. Nursing program faculty should be involved in
the development, review, and revision of academic program policies.
CCNE Standard II Program Quality: Institutional Commitment and Resources
“The parent institution demonstrates ongoing commitment to and support for the nursing
program. The institution makes resources available to enable the program to achieve its
mission, goals, and expected outcomes. The faculty and staff, as resources of the program,
enable the achievement of the mission, goals, and expected program outcomes” (CCNE,
2018).
Recommendation 5: Obtain Funding and Resources
With regard to upfront investment, participants unanimously confirmed that the
university will need additional funding and resources to support the creation and implementation
of this new nursing program. According to the participants, current funding for the new nursing
program comes from a variety of sources including: the core university budget, healthcare
systems, churches, foundations, private donors, and student tuition.
At the same time, from a faith perspective, there is overwhelming sense of trust and
assurance amongst all cohort leaders that when they commit their work to the Lord, His plans
will be established (Proverbs 16: 3). That is, if they are responsible to follow God’s will and
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when their work aligns with God’s will, He will “establish” the plan and “bring about” the
required funding and resources in God’s way and timing.
From a practical perspective, upon comprehensive program approval, the university will
need to obtain, secure, budget, and allocate funding and resources to support the successful
planning and establishment of the nursing program. Financial, physical, and learning resources
need to be sustainable and sufficient to ensure the achievement of the end-of-program student
learning outcomes and nursing program outcomes (ACEN, 2017; CCNE, 2018).
In most cases, the university should seek funding sources that match its mission and the
needs or problems to be addressed. The better the match between the funder’s rationale for
funding and the university’s mission and program, the more likely the program will be funded
and successful. Please refer to Figure 5 below for the proposed multi-level funding strategy for
the new program.

Figure 5. A multi-level funding strategy for the new nursing program
Recommendation 6: Create a Business Plan With Budget
A budget expresses the cost of creating and running the new program. Decision-makers
use budgets to help counteract short-term thinking in decisions that have long-term consequences
(Heath & Heath, 2013). A well-planned budget is important to an education institution by
ensuring that the new program is implemented according to set plans and objectives, facilitates
Physical
Infrastructure &
Simulation
Healthcare
System;
Church
$500,000
Director &
Faculty
Recuitement
Title III DOE
$330,000/yr
for 3 years
Lab & Nursing
Equipment
Private
Donor
$300,000
Program
Development
Private
Grants
$150,000/yr
for 3 years
Outreach &
Pipeline
University
Fund
TBD
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proper administration of revenues and other university resources, and offers a systematic plan for
evaluation (Odden & Picus, 2014).
This approach to budgeting is consistent with a faith-integrated principle illustrated in
Luke 14:28 when Jesus said: “For which of you, intending to build a tower, does not sit down
first and count the cost, whether he has enough to finish.” There is great value gained in having
the end in mind before we start. “Counting the cost” may mean that organization leaders stick
with their plans even when things get tough or prioritization and sacrifices are required.
Recommendation 7: Establish Internal Support
Interview data indicates that extensive discussions are primarily at the C-suite level,
along with the input of the academic council. It is important that the leadership engage and
educate faculty and staff about the implementation plan for the nursing program. Based on the
Commission on Collegiate Nursing Education standards (CCNE, 2018), academic support
services (e.g., library, information technology, student life, tutoring, counseling and disability
services, research support, financial aid, admission, and advising services) should be adequate
for nursing students and faculty to meet program requirements and to achieve the mission, goals,
and expected program outcomes. Program academic services should be regularly reviewed and
improved as appropriate. For example, student satisfaction surveys can be scheduled and
completed annually to solicit feedback in an effort to improve the students’ academic experience
going forward.
It is crucial to establish internal support when creating and establishing this new program
for “if a house is divided against itself, that house will not be able to stand” (Mark 3: 25, NIV).
The principle illustrated here is that sustainability and growth rely on unity and congruency,
whereas division and disunity will weaken the “house” (a person’s soul, a family, a team or an
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organization) and make it vulnerable to external competition or attack. The university also values
and pursues peace with others and is deeply committed to reconciliation (2 Corinthians 5: 18-19)
by expressing grace and forgiveness in conflict.
Recommendation 8: Establish External Clinical, Educational and Church Partnerships
As discussed in Chapter 4 knowledge findings, one aspect of the needs assessment
process involves one-on-one listening visits and discussions with key healthcare personnel and
educational institutions in surrounding areas of California. Leaders should continue to develop
these relationships in hopes that these collaborators will provide supporting letters of
collaboration for the new nursing program.
Clinical and educational partnerships with nursing education institutions, hospitals, and
church organizations can serve many purposes and can be creatively structured in many ways
(DeBourgh, 2012). These partnerships can take many forms and serve multiple functions. For
example, some collaborations could function to enhance the nursing education program in the
areas of institutional mission and commitment, educational benchmarking and excellence,
healthcare partnerships, clinical rotations, clinical development, and community outreach and
relations. Other collaborations can help increase student enrollment and retention or increase the
number of qualified nursing faculty. Still others could share costs, expertise, physical resources,
and infrastructure with schools, churches, and healthcare facilities as means for overcoming
limitations in student enrollment, clinical settings, classrooms, labs, and simulation spaces.
Historian Richard Hughes (1997) asserted that to the extent Christion higher educators
contributes to Christian mission, they must “draw upon their historical or identities or church
connections” (p. 4). This recommendation coincides with the biblical principle, “Just as each of
us has one body with many members, and not all members have the same
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function, so in Christ we who are many are one body, and each member belongs to one another”
(Romans 12: 4-5, NIV). In short, synergistic partnerships that value differences and creative
collaborations which are built on strengths will make the whole greater than the sum of its parts.
Recommendation 9: Recruit Qualified Nursing Leadership
As was pointed out before, the university has no extant nursing program and there are
currently no personnel with expertise and experience in the design and implementation or
administration of this academic discipline (Cronenwett, 2007). However, institutional leaders
possess significant expertise in the planning and implementation of novel programs. Of greatest
concern is the lack of nursing expertise, which will be addressed in two ways prior to the
inception of the program.
First, as described previously, the Dean of Natural and Applied Health Sciences has
recruited a steering committee to guide the development of the nursing program in the early
stage prior to the recruitment of specialized nursing faculty.
Second, dedicated nursing leadership should be carefully recruited. This person must be
experientially qualified, meet governing organization and state requirements, and be familiar
with the role, capable of overseeing a completely new program. This person will also be an
effective implementer of the program vision established by the steering committee during the
planning process.
When referencing leadership, Jesus used “servant” as a synonym for greatness: “Whoever
wants to become great among you must be your servant” (Mark 10:43, NIV). Contrary to the
popular opinion about leadership, the Bible teaches that a leader’s greatness is measured by a
total commitment to serve one’s fellow human beings. Jesus even demonstrated what servant
leadership is by washing the feet of his disciples, as recorded in the Gospel of John.
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Recommendation 10: Recruit Qualified Nursing Faculty
The faculty is the heart and soul of any nursing program. A top priority and consistent
theme found in this study about the knowledge, skills, and dispositions of ideal faculty members
is that they must possess a vital personal faith. Not only will they “understand the Christian
faith,” but they must also “live it out.” In terms of analyzing and applying the intersections
between Christian beliefs and practicing faith-integrated nursing, the nursing faculty are standing
in tension with many paradigms, assumptions and values of the nursing discipline. “Not many of
you should become teachers, my brothers, for you know that we who teach will be judged with
greater strictness” (James 3:1, NIV). The Bible makes it clear that teaching is not a role that
should be taken lightly, but that teachers will not only be held accountable to live by the truth
they teach, but they must not also lead people away from God’s truth by their words or actions.
This theme also reflects the idea that being a as a faculty member is a confirmation of
vocational calling and life mission (Blackburn & Lawrence, 1995). Therefore, because “we teach
who we are” (Palmer, 1998, p.1), the institution should hire faculty with authentic personal faith
who are also academically and experientially qualified to teach in their respective areas of
nursing expertise. They must also assist in the achievement of the organization’s mission, goals,
and expected student outcomes.
In addition, this nursing program should encourage and support faculty instructional
development, professional development on faith-integration, and scholarship and service to the
university, the nursing profession, and to local, regional, national, and global communities.
CCNE Standard III Program Quality: Curriculum and Teaching-Learning Practices
“The curriculum is developed in accordance with the program’s mission, goals, and expected
student outcomes. The curriculum reflects professional nursing standards and guidelines and
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the needs and expectations of the community of interest. Teaching-learning practices are
congruent with expected student outcomes. The environment for teaching-learning fosters
achievement of expected student outcomes” (CCNE, 2018).
Recommendation 11: Develop A Faith-Integrated Curriculum at the Subject Level
According to this cohort of leaders, a faith-integrated nursing curriculum must combine
scientific expertise with professional practices and dynamic Christian faith. The university must
fulfill its mission with an emphasis on education that prepares Christians for servant leadership
through the church, the one institution commissioned by God to fulfill His plan in the world.
Such an emphasis mandates a faith-integrated curriculum which prepares people who are
thoughtful, compassionate, culturally sensitive, and capable of integrating personal faith and
vocation in all sectors of society (The University, 2018).
At the core of a faith-integrated curriculum, the university leaders believe that all truth
are God’s truth and all beauty and sciences are reflections of the ultimate beauty and infinite
nature of a Creator, as the Bible proclaims that “one God and Father of all, who is over all and
through all and in all” (Ephesian 4:6, NIV).
“Integration is concerned with integral relationships between faith and knowledge, the
relationships which inherently exist between the content of the faith and subject matter” and such
connections do not have to be “invented” or “manufactured,” but they need to be “ascertained”
and “developed” (Hasker, 1992, p. 235). Thus, the integration of faith and learning should be
facilitated by a curricular and learning environment that offers an appropriate balance between
courses in theology, the liberal arts, and nursing professional studies by seeking to eliminate any
artificial and unnecessary barriers between these areas of study. Thus, the proposed curriculum
should promote a well-conceived system of values and beliefs in relation to personhood,
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health/wellness, disease/illness, healing, and nursing. The resulting personalized education
process will celebrate and honor all cultural groups and emphasize the priority of relationship-
building throughout university learning experiences.
Chickering, Dalton, and Stamm (2006) describe the efforts required to integrate
spirituality into all aspects of an institution of higher education as a balancing act. To achieve
learning outcomes that include spiritual development and the realization of faith-integration,
faculty must look beyond a set of successful techniques used to acquire cognitive competencies
(Chickering, Dalton, & Stamm, 2006).
Recommendation 12: Curriculum Co-Created by Nursing and Theology Faculty
As a best practice, the faith-integrated nursing curriculum should be co-created by both
the nursing and theology faculty (Hulme, Groom, & Heltzel, 2016) and regularly reviewed to
ensure integrity, rigor, and currency. Theology faculty are best able to marshal their expertise in
a Christian worldview and to, in conjunction with the nursing faculty, recognize profound
intersections between theological and professional nursing knowledge. The curriculum should
be planned and evaluated by both subject matter experts based on the mission, philosophy, and
program outcomes of the new program.
In addition to the theologians and nursing educators, curriculum experts should also be
consulted, along with external consults, community interest groups, and members of the steering
committee. As Christian nursing faculty and theologians working together, they will enrich the
faith-integration in the interest of synthesis between both philosophy and practice (Meneses,
2000; Hasker, 1992). Meneses has argued that the “revelatory knowledge about the nature of
humanity and the purpose of history cannot be accessed or critiqued with anthropological
epistemologies and methodologies” as theoretical underpinnings that are not shared with non-
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Christian scholars (as cited in Gehrz, 2015, p. 72). The Bible claims a different reality about such
knowledge “the knowledge of the mysteries of the kingdom of heaven has been given to you, but
not to them. Whoever has will be given more, and he will have an abundance. Whoever does not
have, even what he has will be taken away from him” (Matthew 13: 11-12, NIV).
Recommendation 13: Curriculum reflects Professional Nursing Standards and Healthcare
Guidelines
The curriculum should also incorporate established professional nursing standards,
guidelines, and competencies and should clearly articulate end-of-program student learning
outcomes, and be consistent with the policies of the university, current standards and
competencies for nursing practices, and laws governing the practice of nursing.
As suggested earlier, multiple sources should be used in the program design and
curriculum development. Baccalaureate program curricula should incorporate The Essentials of
Baccalaureate Education for Professional Nursing Practice (AACN, 2018), the U.S Institute of
Medicine (2003) report entitled Health Professions Education: A Bridge to Quality, as well as
guidelines from the International Council of Nurses (ICN, 2019) and the American Nurses’
Association Standards (ANA, 2019).
The Bible offers a complementary perspectives on nursing standards and healing
guidelines when it declares that God is the great Physician who always initiate restoration:
“Behold, I will bring health and healing; I will heal them and reveal to them the abundance of
peace and truth” (Jeremiah 33:6, NJKV). From a biblical perspectives, health and healing must
begin with a full appreciation of the nature of God, sin and its consequences, and the life and
death of Jesus Christ. According to a Christian worldview, the path to healing can be rooted in
the forgiveness of sins and the restoration of broken relationships with God through prayers
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(James 5: 13-15, Matthew 28: 18-20, NIV), confession (James 5: 16, NIV), ordinances of
humility (John 13: 9-10, NIV), baptism (Galatians 2:20, NIV), gift of healing (John 17: 21-23,
NIV), deliverance (Galatians 5:19-21, Luke 8: 30-31, Ephesians 6:12, NIV) and respect for the
Sabbath (Ezekiel 20: 12; Mark 2: 27-28, NIV).
Recommendation 14: Align Learning Activities and Delivery Methods
Christian higher education is concerned with both the academic as well as the spiritual
life, thus aiming to cultivate the “whole person”. Traditionally, the experiential learning is the
task of student affairs, student life organizations, and campus ministries that compartmentalize
students’ university experiences in a highly bifurcated fashion. A balance of multitasking is not
the concept of faith-integrated learning. Rather, true faith-integration seeks to discover the
“relationship between living a vibrant faith and academic inquiry” (Gehrz, 2015, p 38).
The curriculum should include learning activities and instructional processes that reflect
the best of educational theory, interprofessional collaboration, research, and current standards of
nursing practice. The faith-integrated curriculum should also incorporate culture- and ethnic-
specific knowledge, and may also include experiential-learning and service-learning activities
from regional, national, or global perspectives (Mitchell, 2008). Additionally, the program
learning activities, instructional materials, and evaluation methodologies should be appropriate
and varied for all delivery formats and consistent with the end-of-program student learning
outcomes (ACEN, 2017).
CCNE Standard IV Program Effectiveness: Assessment of Program Outcomes
“The program is effective in fulfilling its mission and goals as evidenced by achieving
expected program outcomes. Program outcomes include student outcomes, faculty outcomes,
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and other outcomes identified by the program. Data on program effectiveness are used to
foster ongoing program improvement” (CCNE, 2018).
Recommendation 15: Clearly Articulate and Measure Expected Student Outcomes
According to the university (2019), the students will be equipped to have a grounded
Biblical worldview and be able to “articulate the relevance of Jesus Christ, His teachings, and a
biblical worldview to their personal and professional lives.” This objective aligns with the
scripture in which “if anyone is in Christ, the new creation has come: The old has gone, the new
is here!” (2 Corinthians 5:17). As the university practices holiness (Hebrews 12: 14; 1
Thessalonians 4:3) and embraces purity (Philippians 4: 8-9), this vision for redeemed humans as
new creations extends to words, thoughts, and deeds.
As is evident from the research data, the university desires its graduates to exemplify
transformational leadership in church and society through the integration of faith, learning, and
critical thinking in the areas of literacy, communication and intellectual skills, professional
competence, and global citizenship (The University, 2018). The proposed nursing curriculum
should not only clearly articulate the expected student learning outcomes, but also assign
evaluations and measurements that are aligned and targeted specifically to support the
achievement of end-of-program student learning outcomes and program outcomes.
The 2008 White Paper produced by the American Academy of Religion and the Teagle
Foundation (2007) provided a critical framework for thinking about faith-based student learning
outcomes. It suggested that faith and biblical studies courses are in flux, and lacks a clear space
in liberal arts curricula. Administrators and faculty might be tempted to accommodate
accreditation demands for student learning outcomes by developing “students will…” at the face
value without pondering how and why we teach.
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According to King, Brown, Lindsay & Vanhecke (2007), liberal student learning
outcomes should take an integrated approach that develops wisdom, one’s responsibilities as a
citizen, and a commitment to community. They have synthesized these themes into seven
outcomes reflective of effective student learning and development: “Integrity of learning,”
“Inclination to inquire and lifelong learning,” “effective reasoning and problem solving,” “moral
character,” “intercultural effectiveness,” “well-being,” and “leadership” (p. 5). In addition, like
any student learning outcome, successful faith-integration should be demonstrated in the
outcomes.
Recommendation 16: Implement A Systematic Plan of Evaluation
Understanding the big picture of a true and living faith, the community should pursue
spiritual formation (2 Corinthians 5: 17) by willingly engaging in spiritual disciplines and
activities that draw students and faculty closer to Christ while at the same time avoiding
practices that hinder that relationship. At the same time, professional competence as nurses must
be a top priority as well. Evaluating students and program outcomes in both spiritual and
professional dimensions needs to be taken seriously.
It is recommended as a best practice (CCNE, 2018) that the nursing program evaluation
should systematically demonstrate that students’ achievements of end-of-program student
learning outcomes as well as program outcomes. The systematic plan of evaluation should
contain specific, measurable expected levels of achievement for each end-of-program student
learning outcome and each program outcome. Appropriate assessment methods should be
adopted for each end-of-program student learning outcome and each program outcome. Proper
analysis of assessment data should inform program decision-making for the purpose of
continuously improving the nursing program.
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Recommendation 17: Enhance Self-Efficacy Among University Leaders
Findings from the collected data confirm that the university’s senior leaders are a highly
motivated group who possess strong utility values and goal orientation. There seems to be a need
to strengthen self-efficacy, as not all participants possessed clear understandings of how they will
succeed in light of potential constraints related to effort, personnel, financial resources invested,
and political uncertainties.
The more the leaders believe they will be able to plan and do what is necessary to
succeed at a specific task, the more they are motivated to persist in the face of distractions. The
more eager they are to tackle challenging tasks with the project, the more quickly they will
recover from failures, accepting corrective feedback and taking responsibility for mistakes. From
a Biblical faith point of view that “I can do all things through him who strengthens me
(Philippians 4: 13, NIV). That biblically informed confidence will be critical to their success.
In a similar way, Eccles and Wigfield (2002) have argued that our values exert a major
influence on our decision to engage and persist in activities in the face of distraction. Motivation
researchers suggest that values combine with expectations of success (self-efficacy) in order to
determine what we will choose to do. When we value an activity and believe that we can
succeed, we are more likely to pursue that activity.
Clark and Estes (2008) describe a number of ways to increase efficacy: a) Provide coping
models who are perceived as both effective and similar to the learner and where the models
“think out loud” so that learners are able to mimic their thought processes as well as their
behaviors; b) Focus learning and performance feedback on people’s successes both present and
past, rather than on their failures or mistakes; c) Attribute the cause of success and mistakes to
effort, not to experience, aptitude, or intelligence, and suggest that people will succeed if “you
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invest more effort;” d) In all communications with learners, project the clear expectation that
they will succeed, and avoid expressions of sympathy when they fail or make mistakes because
sympathy is often interpreted as “Sorry, you best is not good enough;” and e) Assign specific,
short-term, and challenging learning goals since long-term, “stretch” (impossible to achieve)
goals can also damage motivation.
Recommendation 18: A Faith-Integrated Model for Nursing
The university values all persons as created in the image of God (Genesis 1:27) and thus
cannot love God and hate their neighbours whom they believe possess a God-given purpose,
value, and destiny (1 John 2: 9-11, NIV). “Truly I tell you, whatever you did for one of the least
of these brothers and sisters of mine, you did for me (Matthew 25:40, NIV).
There is substantial research evidence, both from the literature and this study, that
healthcare today is expected to provide care that goes beyond the traditional medical model or
even the so-called patient-centred model that meets biological, physical, and behavioural needs.
Despite a strong historical, scientific, and theological foundation that care should incorporate the
spiritual dimension in nursing for spirited human beings (Bradshaw, 1994; Puchalski, 2001; 1
Thessalonians, 5:23; Job 32:8; 2; Corinthians 5:17, NIV), nurses struggle to care for themselves,
as evidenced by record high rates of burnout, stress, fatigue, substance abuse, depression and
anxiety, along with bullying and other abusive behaviours (Abellanoza, Haas, & Gatchel, 2018;
Bavier, 2018; Brandford & Reed, 2016; Thew, 2017; Smith, 2018). These pressures make the
challenge of providing holistic care that much more difficult.
Therefore, the research findings suggest the need for a new faith-integrated model for
nursing that is grounded in biblical principles, and a Christian perspective on God, ourselves, our
colleagues, patients and families, and challenges in healthcare and life in general. The essence of
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this new nursing model must take an inside-out approach, allowing oneself to receive the
unconditional love from God because God, who is love, first loved us (1 John 4:7-8, 19). We are
only able to give freely to others what we have received freely from God. For if we love God
first, then we can better love ourselves and others (Matthew 22: 37-40, NIV). This can be
illustrated as a concentric circle:

Figure 6. Faith-integrated model for nursing.
This faith-integrated nursing model is embedded within nursing practices by way of a
nurse’s personal Christian faith. It is an ethical obligation of Christian nurses to deliver care as
the heart, hands, and feet of Christ who once did likewise. Incorporating Christ and His love and
healing power into professional nursing practice fosters better patient outcomes, for example,
through the effect of prayers on healing (Brown, 2012; Newman, 2007), but also reflects one’s
commitment as a Christ follower to demonstrate His love. This model coincides with Florence
Nightingale’s own faith perspective as the founder of modern nursing: “If I could give you
information of my life, it would be to show how a woman of very ordinary ability has been led
Love Others
Well
Love Self Well
Love God
Well
God-Centered
by receiving
God's love
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 180
by God in strange and unaccustomed paths to do His service what He has done in her” (Florence
Nightingale, 1860).
According to Miller (2007), “a great historic task – the task of restoring the lost unity
between worship and work,” demands the application of Christian ethics and principles, along
with “inner spiritual renewal and heart transformation” (Miller, 2007, p. 31-32). Yet, as we have
seen, the six senior leaders at the same Christian university recommended various approaches
and emphases and did not agree on what true faith-nursing integration actually looks like: “to do
skilful and excellent work,” “to be loving, caring and joyful in serving God and people,” “to
serve the local and global communities,” “to pray and heal the sick,” “to know God, His truth
and plan through personal relationship with Jesus and His words,” “to be personally
transformed,” – there is at least a measure of biblical warrant for every one of them.
This single case study does not expect to resolve all these differences and complexities
over the question of faith-integration. However, rather than viewing the different perspectives as
contradictory, each of the senior leaders’ recommendations can be seen as a complementary way
to serve God, all dependent on our faith journeys, internal convictions and external influences,
such as situations, contexts, culture, backgrounds, and time.
This nursing model is built to recognize such differences and complexities of faith-
integration by feeding our imagination with the richness of who God is, and what the Christian
faith says about matters of timeless and current import. In the next sub-sections practical ways to
integrate faith and nursing in the classroom, clinical practice, and curricula will be critically
analyzed and applied.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 181
Recommendation 18. 1: Identify One’s Center
Based on the Christian principles, by centering one’s life on God Himself, His words and
attributes, faculty and students create a solid foundation for the development of the faith-
integration. As God’s image-bearers (Genesis 1:26, NIV), humans are designed to love God and
others in the same way that they first received God’s love, grace, and forgiveness. One’s true
identity, security, significance, power and guidance comes from knowing that, unlike other
centers based on self, people, things, or even meaningful work that are subject to frequent and
immediate change. God does not change like shifting shadows and He is the same yesterday,
today, and forever. Thus, humans can depend on Him (Numbers 23:19; Hebrews 13:8; James
1:17, NIV).
It is the spirit of man that is born again as Christ becomes one’s Saviour. The “new
creation” about which the Bible speaks occurs in the human spirit, not in the body (2 Corinthians
5:17, NIV). This is what the Apostle Paul meant when he said, “flesh and blood cannot inherit
the Kingdom of God” (1 Corinthians 15:50, NIV). Therefore, from the Christian perspective,
when nurses receive Christ as Lord and allow Him and the Holy Spirit to flow through, and
empower, and guide them, they are truly able to care for patients and their families.
Recommendation 18. 2: Apply Faith-Integration to the Nursing Curriculum.
Genuine intentionality of faith-nursing integration entails multiple levels. Methods of
faith integration in nursing curricula may differ across time, denominations, and educational
programs. Though applied in a different educational context, Shaw (2014) suggested four helpful
lenses through which context-sensitive and faith-integrated learning can be realized, as illustrated
in Figure 7 below:
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 182

Figure 7. Arab Baptist theological seminary curricular lenses (Shaw, 2014, p. 3)
According to Shaw (2014), a well-integrated curriculum begins with the basic premise
that faith-formation takes place when multidimensional learning is designed and implemented
through a “balanced embrace of the cognitive, affective, and behavioural learning domains” (p.
4). Traditionally, students are trained through “fragmented” faith curriculum. Without critical
application, students remain simply a reflection of the societies in which they live, rather than
acting as “agents” of the Kingdom of God (Hiebert, 1994, p. 75-92).
Applying this model into this new nursing program, the university’s mission and vision:
“in partnership with the church, to educate transformational leaders for the glory of God” along
with that of both the church and the individual in searing God is recognized. Core values are
expressed in nursing education through theologies and theories that describe beliefs of concern to
Christian nurses: identity, discipleship, Kingdom and service. In shaping the modular themes, the
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 183
focus on persons, health, environment, and nursing are studied through each of the four
fundamental lenses: biblical-theological, historical-theological, sociological-cultural, and
personal-ministerial. Emphases vary based on the specific issues at stake. But the student
learning objective is the holistic-formation of transformational leaders – their academic, mental,
physical, emotional, and spiritual formation.
For example, from a biblical-theological lens: many Biblical notions, including biblical
perspectives of man, health, sin, disease, suffering, spirituality and healing inform the Christian
practice of nursing will help to establish a firm foundation to understand the nature of God,
human being and experiences.
In light of a historical-theological lens: as noted by Shelly and Miller (2006) in Called to
care, the early tradition of caring for others included reaching out to the poor, the sick, and the
marginalized has been normative throughout church history and the history of nursing.
A sociological-cultural lens: healing occurs in community, and without community,
healing is incomplete. God gifted His Church with many gifts, including the gifts of healing. He
appointed His Church to be Communities of Healing ministering physical, emotional, social,
religious and spiritual healing.
Finally, a personal-ministerial lens: churches are to be communities that call, equip, or
give vocations to individuals to heal as their ministry.
The goal of curricular faith-integration is built on the solid foundation rooted in Bloom’s
taxonomy (Bloom et al., 1956) that faith integration in nursing moves from essential knowledge
to understanding, then to the more complex thinking associated with analysis, synthesis, and
evaluation.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 184
In tune with the university’s desire for holistic education, additional credits can be
allocated to non-classroom learning activities such as: 1) engagement in local church ministry
and work experiences related to nursing; 2) active involvement in chapel time; 3) scheduled
meetings with an assigned faculty mentors; 4) weekly Bible study with students, staff, and
faculty in small groups; 5) recommended electives such as counseling, inner healing, and
spiritual deliverance; 6) service-learning as a pedagogy for “connecting students and institutions
to their communities and the larger social good, while at the same time instilling in students in
values of community and social responsibility” (Neururer & Rhoads, 1998, p. 321). The faith-
integrated curriculum, however, must not be overloaded as to fail to leave time and space for
reflection on life and learning (Shaw, 2014).
Recommendation 18. 3: Apply Faith-Integration in the Classroom
Before proceeding with this section, it is beneficial to unpack and clarify what faith-
integration in the classroom is not: 1) it does not aim to convert non-Christians nor to argue with
students for the believability of the Christian faith; 2) although students may be introduced to
evidence for the Christian faith while in the classroom, discretion and safe distance should be
used when faith matters emerge in the classroom. The teacher needs to be especially aware of the
power differential that inherently exists with their students; 3) faith-integration in the classroom
is more than merely praying before the class or sharing devotional readings which are “detached”
from the topic of the particular class; 4) faith-integration goes beyond offering spiritual input or
counsel which is best done with trained counsellors and ministry professionals and through
mentoring relationships outside the classroom; 5) reading the Bible along without critical
analysis and theological deliberation falls short of well-developed faith-integration; 6) striving
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 185
for Godliness and excellence alone is not faith-integration, as it requires thoughtful, academically
rigorous engagement with matters of faith and nursing.
Faith integration is the responsibility of all involved at the university. As such, if the
ultimate goal of learning is to lead the students from where they are upon entry to the nursing
program and along a pilgrimage towards the long-term goal of effective Christian leadership, and
“the primary concern is the learners – their needs and hopes” (Vella, 2008, p.33), not to serve the
teacher, the or the organization, what would a faith-integrated learning environment look like
and feel like in the classroom? The next section highlights faith-integration that can tangibly
impact competencies, relationships and community in the classroom setting.
First and foremost, serious consideration should be given to the level of diversity and
commonality in the students. How can we inspire value transformation over information, and
promote sincere questioning and critical thinking? Who are the students? Where are they coming
from and where will they go when they leave the program? Vital questions should be asked
about students’ backgrounds, families, communities, political, educational, and socio-cultural
contexts, types and levels of religiosity, and the sorts of churches they come from, so that
learning tasks, materials, and methods of delivery can be selected that are appropriate for the
individuals in the classroom. As Hardy (2007) suggested, developing a questionnaire and
interviewing a representative sample to regularly assess students pre-learning capacities,
especially in the following three areas, will be valuable: “1) What do they already know? 2)
What do they already know how to do? What skills and abilities do they possess? 3) What kind
of people are they? What do we know about their maturity and character” (p. 134)?
Secondly, in many examples that teachers give of their own good practices, “relationship”
is a key word (Bakker and Ter Avest, 2009, p. 141). Conversion to the love of learning occurs
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 186
when the teacher knows and cares for “the person actually stand in front of him” (Nehamas,
1999, p. 345). The following is an example of how a teacher embodied what she felt was crucial
for her own identity as a Christian in the school setting:
It was to one of the girls in my group that I had to bring the message that her results were
not good enough to pass on to the next group. During the past year I was able to establish
a good relationship with her, and we did discuss the abnormal behavior she displayed as
well as her learning disabilities. At the end of the conversation on her poor results she
was very emotional, she cried and was worried. We repeatedly talked about the situation
and one day she said she felt sad and she said she was afraid. Together we walked down
the stairs and halfway we sat down. I said to her: ‘Whenever I feel sad God is in my mind
and I then talk to him. One day God said to me not to worry about what tomorrow might
bring.’ in reaction to this she hugged me. During the last weeks that she was in my class
she frequently came to me and said: ‘Do you remember, miss?’ After one more year I
again became the teacher of the group she was part of. She often reminded me of that
particular moment, and we liked to keep this a little secret of our own. (Bakker & Ter
Avest, 2009, p. 140)
Such an approach asks the teacher a number of skills in a society and school where faith
and religion are far more individualized and less bound to particular homogeneous school
community. For example, the ability to ask the right questions means having an in-depth
discussion that ends in mutual understanding. It can also mean the ability to change perspectives
by not imposing one’s own solutions, but by listening to students. Such an approach may also
mean the ability to do justice to diversity by drawing attention to different perspectives, the
ability to confront the other without fear, the ability to change and adapt as one learns new things
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 187
from practices, the ability to create an environment of safety, trust, openness and mutual respect
for conducive learning, and/or the ability to model how Christian faith is integrated in one’s daily
life and professional practices.
Thirdly, developing faith-integration in the classroom empowers the cultivation of a
community that builds true knowledge, proficiencies, character, and seeks understanding and
higher levels of thinking through discipline, humility, and openness to correction. The classroom
becomes what Odenburg (2000) called a “third place” that nurtures “whole and holy” lives and
development. Spener (1964, p. 103) reminds us that “growing in learning without growing in
moral behaviour is for naught,” and thus faculty out to serve as mentors and role models,
challenging and encouraging students to “grow in wisdom and in stature” (Luke 2:52, NIV). To
Spener, arrogance is the mark of a “worldly spirit” (p. 45), not of a true Christian learning
community. His vision of the classroom is marked by humility and a willingness to be open to
correction. The strength of the community is increased when members willingly admit error to
others who have their best interests at heart and who offer suggestions that are given in the spirit
of love. Constructive feedback is given to one another in the “pursuit of perfection” (p. 114).
Recommendation 18. 4: Apply Faith-Integration in the Clinical Practice
In this section, engaging methods and interactive teaching strategies to create a faith-
integrated clinical nursing environment will be examined and explored in term of faith-integrated
reflective journal writing and providing prayers and spiritual care to oneself, clinical group, and
patients.
First, reflective journal writing is the purposeful and recursive contemplation of thoughts,
feelings, and happenings that pertain to significant personal experiences (Kennison, 2012). It
requires one to reflect on a personal experience for the purpose of self-awareness and continued
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 188
professional growth (Kerr, 2010). In order to facilitate faith-learning integration, the following
specific questions can be used to structure and guide students’ reflective thinking and learning
processes immediately after clinical experiences:
What?
What happened? Description of the situation – focus on a specific topic, theme or
incident you experienced or observed. What did you learn? What did you do? What
did you expect? What was different? What was your reaction?
So What?
Why is this significant? Why does it matter? What are the consequences and meanings
of your experiences? How do your experiences link to your academic, professional
personal, and spiritual development?
Now What?
What are you going to do as a result of your learning and experiences? What might you
have done differently? What will you do differently? How will you apply what you
have learned?
Reflective writing is an active learning tool that can change one’s ideas and
understanding of the situation and encourage looking at issues from a Christian faith perspective
by scrutinizing values, assumptions, and perspectives (Aronson, 2011).
Secondly, praying with patients serves as part of spiritual care and faith-integration.
According to Shelly and Fish (2009), prayer is an intimate conversation between a person and
God, or in communion with God. Those uncomfortable with reference to God might prefer
concepts like higher power, the holy, the source of energy, or other referents.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 189
Faith-based health care institutions have long emphasized the importance of tending to
the spiritual needs of patients. And praying with patients has traditionally been an expected part
of care in such facilities. In recent years, the importance of spirituality in healthcare has also
gained renewed emphasis. The question is not whether holistic nursing care should include
patients’ spiritual or religious needs like prayer; rather, it is whether and how to include prayer in
ways that are respectful of patients in clinical setting. For example, most healthcare workers
want to offer spiritual care if the patients are open to it (Wilfred, 2006), but doing so may cost a
nurse her job in the UK, for example, where initiating discussion about religion may be
considered unprofessional. However, if prayers are found to be beneficial to health and healing,
should not the nurse offer to pray with patients? And should the nurse participate in forms of
prayer that are contrary to the nurse’s own integrity and belief system?
Thirdly, there is widespread support for preparing nurses to provide spiritual care
(Barnum, 2003). In order to practice holistic care, Keefe (2005) found that patients must have the
benefit of a nurse who is knowledgeable about the spiritual dimension and “strong spiritual
components” of care, such as end-of-life and palliative decisions (p. 41). Pesut (2003) asked:
“Who is qualified to teach spirituality?” and “How can spirituality be defined and learned?”
Researchers acknowledged that spirituality encompasses qualities such as strength, guidance,
peace, hope, suffering, meaning, and a belief system that promotes health. However, the
literature review shows that spirituality was defined very loosely, so that human beings are
sometimes reduced to “energy fields” without intrinsic value, at one extreme, or partake of God’s
divine image, identity, and purpose, at another (Barnum, 2003; Cavendish et al., 2004, Stegmier,
2002).
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 190
However, Salladay (2011) has warned that nursing has experienced a shift in worldviews
away from its historic foundation in Christianity that viewed “nursing (as) a ministry of
compassionate care for the whole person, in response to God’s grace, which aims to foster
optimum health (shalom) and bring comfort in suffering and death” (Shelly & Miller, 2006, p.
68). God’s love and healing power is a fundamental part of his nature (Mark 6: 2, 5; 16:18; Luke
4:40; 13:13; Acts 5:12; 28:8, NIV). When nurses are filled with God’s love, guided by His truth
and empowered by the ultimate healer (God), they can endure pain, quell fear, forgive freely,
avoid contentions, renew strength, and as a result, offer better care for themselves and others.
Summary of Recommended Solutions
The following is a summary of the KMO influence gaps identified in this study (listed in
the left column) and matched with the corresponding recommended solutions related to the
organizational needs. These are based on the CCNE nursing accreditation standards Table 13
below (listed in the right column).

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 191
Table 13
Recommended Target Solutions by Gaps in KMO Influences
GAPS IN KNOWLEDGE
INFLUENCES
RECOMMENDED SOLUTIONS
The university senior
leadership needs to have a
working knowledge of how to
fulfil all requirements of the
national accreditation agency
and state board for a pre-
licensure nursing program.

Recruit nursing leadership. Hire nursing consultant or administrator
who is experientially and academically qualified to meet the
institution and state requirements, and is oriented and mentored to the
role.

Recruit nursing faculty. The university should recruit qualified and
credentialed nursing faculty who are aligned with the institutional
mission and values, and qualified to teach the assigned nursing
courses.

The university needs to know
the teaching strategies,
interventions, tools, and best
practices of a high-quality pre-
licensure nursing program.

Develop a faith-integrated curriculum at the subject level.

Co-creation of the faith-integrated nursing program should involve
nursing and theology faculty, and should regularly be reviewed to
ensure integrity, rigor, and currency.

The curriculum must incorporate professional nursing standards,
guidelines, and competencies, and have clearly articulated end-of-
program student learning outcomes consistent with a faith-integrated
approach to nursing education.

Learning activities, instructional materials, and evaluation methods
are appropriate for all delivery formats and consistent with end-of-
program student learning outcomes.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 192
Table 13, continued
GAPS IN KNOWLEDGE
INFLUENCES
RECOMMENDED SOLUTIONS
The university senior
leadership needs to know the
differences between a faith-
based nursing program and
other general nursing
programs.

Create a mission statement for the nursing unit that is congruent with
the mission of the institution.

Create a vision statement for this nursing unit that is congruent with
the vision of the institution.

Create nursing program policies and procedures that are congruent
with the core values and goals of the institution.

Create governance structures and alignment for the nursing unit that
are congruent with the mission, vision, core values, and goals of the
institution.

Clearly identify and measure expected student outcomes.

There needs to be a systematic plan of evaluation. Nursing program
evaluation demonstrates that students have achieved each end-of-
program student learning outcome and each program outcome.

Leaders need to develop a faith-integrated model for nursing, one that
is grounded in a Christian worldview and which can guide the
formulation and development of the curriculum.

GAPS IN MOTIVATION
INFLUENCE
RECOMMENDED SOLUTION
The university senior
leadership needs to believe
that they are competent in
creating the new faith-
integrated nursing program by
meaningfully engaging with
both internal
on-campus stakeholders and
external partners.

Establish internal support by hiring qualified and credentialed faculty
sufficient in number to achieve the program learning outcomes; Staff
must be available to support the nursing program.

Establish external clinical, educational, and church partnerships.
Establish partnerships that promote excellence in nursing education,
enhance the profession, and benefit the community.

Methods to enhance self-efficacy among university leaders.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 193
Table 13, continued
GAPS IN ORGANIZATION
INFLUENCE
RECOMMENDED SOLUTION
The university needs to obtain
and provide adequate funding
and resources necessary to
support the planning and
establishment of this new
program in order to meet
university, state and national
nursing standards.

Obtain funding and resources. Fiscal, physical, and learning resources
are sustainable and sufficient to ensure the achievement of the student
learning outcomes and nursing program outcomes.

Create a business plan with budget.

Integrated Implementation Plan
Solutions to Implement
Three priority solutions have been chosen to prioritize for implementation: (1) Establish a
new nursing program steering committee to provide a forum for reporting on program
development; (2) Create and establish formal partnerships with external healthcare facilities for
clinical practice placements, as it is a mandatory education component for any pre-licensure
Bachelor of Nursing program in the US; and (3) Fully establish and develop other key aspects of
the new nursing program in order to prepare for the first student cohort in Fall 2020. This third
point includes obtaining needed funding, recruiting a nursing director and key nursing faculty;
developing curricula, and gaining initial approval from accreditation agencies.
Key implementation Action Steps
In order to operationalize each proposed strategic solution, a brief description of related
actions steps needs to be put in place in order to reach the organization’s goals.
Resources Requirements and Building Capacity to Implement
In this section, the resources required for strategic implementation of solutions and
related action steps are identified and briefly discussed, including key personnel and their roles
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 194
and responsibilities, building internal stakeholder capacity and external alliances with external
agencies, and obtaining financial resources and funding to cover the costs.
Timeline
By considering the organizational context and capacity, a timeline associated with the
action steps will help monitor progress with the implementation.
Key Indicators, or Measures of Successful Implementation
Below, a list of key indicators or measures of success will be identified along with any
possible constraints or challenges to effective implementation. Please refer to Table 14 below for
an overview of the proposed implementation plan for this university.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 195
Table 14
An Overview of Proposed Implementation Plan
Proposed Solutions Action Steps Building Capacity & Resource
Requirements
Timeline Indicators, Measures & Constraints, Challenges
Strategy 1:
Successfully establish a
new nursing program
steering committee.
1. Identify and
recruit both
internal and
external key
stakeholders to
establish a new
nursing program
steering
committee.
Under the leadership of the
Provost’s Office and the Dean of
Natural and Applied Sciences,
the purpose of this new program
steering committee is to guide
the development of the new
nursing program in the early
phases and to build institutional
capacity before the recruitment
of specialized nursing
administrators and nursing
faculty members.
In-progress
now. To be
completed
by Sep.1
st
,
2019.
Indicators/Measures:
a. Identify a list of potential internal and external
stakeholders;
b. Shortlist the suitable stakeholders with diversified
knowledge and nursing expertise;
c. Recruit stakeholders who commit to meet once
per month and report quarterly to the Provost’s
office and the Dean of Natural and Applied
Sciences on the progression of the nursing program.

Constraints/Challenges:
The university in this study has no extant nursing
program, and there are currently no personnel with
experience in the design, implementation or
administration of this new academic discipline.
External committee members with specialized
nursing knowledge, vested interest, and significant
expertise in the planning and implementation of this
new program should be recruited.
In addition, the university’s mission is to partner
with the church and to prepare Christians for
leadership and service in church and society,
through Christian higher education, spiritual
formation, and directed experiences. Thus, external
advisors must truly understand and be aligned with
the university’s mission and vision.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 196
Table 14, continued
Proposed Solutions Action Steps Building Capacity & Resource
Requirements
Timeline Indicators, Measures & Constraints, Challenges
2. Host the first
meeting of the
steering
committee.
Under the leadership of the
university, the selected steering
committee members will hold
the first meeting.
To be
completed
by the end
of Sep.
2019.
Indicators/Measures:
Successfully hold the first meeting with majority of
the members present.

Constraints/Challenges:
Conflicting schedules for busy senior leaders.

3. Determine the
goals, specific
roles and
responsibilities,
guidelines,
priorities, review
timeline, and
conduct a
SWOT analysis
with the steering
committee.
All steering committee members
will initially help establish the
organization’s capacities to be
accountable to meet the new
program development goals.
By the end
of Sep.
2019.
Indicators/Measures:
Documented evidence of meeting agenda, minutes,
committee goals, terms of reference, priorities, and
assigned roles and responsibilities.

Constraints/Challenges:
Increased workload for the existing executive
leaders and committee members.

4. Form a
strategic plan
taskforce to
develop a
coherent plan for
implementation
strategy.
Engage all stakeholders
(including executive leaders,
steering committee members,
faculty, staff, and community
groups of interest) that have a
vested interest in the
development of the strategic
plan and have an understanding
of faith-integrated education.

By the end
of Sep.
2019.
Indicators/Measures:
a. Identify a list of names to form a strategic
planning taskforce;
b. Articulate and design strategies for
implementation;
c. Document SMART goals and specific
implementation outcomes.

Constraints/Challenges:
Take account of the practical mechanisms necessary
for effective and timely implementation.
Make sure the expectations concerning the
university’s capacity to implement do not exceed
reality.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 197
Table 14, continued
Proposed Solutions Action Steps Building Capacity & Resource
Requirements
Timeline Indicators, Measures & Constraints, Challenges
5. Implement
the new nursing
program
strategic plan.
Engage all internal and external
stakeholders to build support and
to provide a plan and resources
for successful implementation.

In addition, the university must
demonstrate support by
allocating needed personnel,
time, budgeting, and resources to
implement the new nursing
program.

At the end
of the first-
year cycle,
by the end
of August
2020.
Indicators/Measures:
Those responsible should track all key milestones.
For example, meetings should occur with internal
stakeholders, potential healthcare employers, and
nursing leadership in and around San Jose,
California, along with local/state authorities, other
nursing schools/organizations that have been
visited, and faculty, students, and families who care
about the new program.

Constraints/Challenges:
Based on the OECD policy implementation
framework, education policy implementation is a
complex and evolving process that involves many
stakeholders. If the implementation plan is not well
targeted and revised to adapt to the university
governance system and culture, it may not be
effective and may even result in failure.
6. Continuously
assess, monitor,
revise, and
evaluate every
aspect of the
new nursing
program’s
implementation
plan.
Engage in and support all
stakeholders throughout the
process, knowing that the
strategic taskforce will be
responsible to ensure focused
implementation, monitoring, and
on-going evaluation.
At the end
of the first-
year cycle,
by the end
of July 2020
and beyond,
continuous
monitoring.
Indicators/Measures:
Those responsible should determine indicators and
analyze the process for implementation. For
example, the program implementation plan itself,
the actors involved, the characteristics of the
context, and the needs of the students, employers
and community must be carefully analyzed.

Constraints/Challenges:
Systematic collection and rigorous analysis of the
data derived from the implementation process.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 198
Table 14, continued
Proposed Solutions Action Steps Building Capacity & Resource
Requirements
Timeline Indicators, Measures & Constraints, Challenges
Strategy 2: Create and
establish formal
partnerships with
external healthcare
facilities for clinical
practice placements.

Meet with
university-
designated
personnel to
understand
federal, state and
institutional
policies
concerning
external
partnerships.
Individuals and time to meet. By the end
of October
2019.
Indicators/Measures:
Meeting agenda and minutes.
2. Identify
relevant and
largest
healthcare
employers and
meet with them
to understand
their needs and
expectations
from nursing
students.
Individuals and time to meet to
explore mutually beneficial
strategies for partnership with
clinical placement sites.
By the end
of
November
2019.
Indicators/Measures:
a. Meeting agenda and minutes to discuss the
program inception, potential partnerships, and
clinical availability.
b. Establish a relationship with a local Clinical
Utilization Committee.
c. Administer nursing employer/faculty/staff
surveys to assess perceptions about the new
program.

3. Establish
MOU with
clinical sites,
including acute
hospitals and
ambulatory and
community
healthcare
settings.
The university needs to obtain
institutional- level commitments
from healthcare facilities in San
Jose, California.
By the end
of
December
2019.
Indicators/Measures:
a. Obtain letters of support from clinical sites.
b. Obtain signed MOUs with clinical hosting
agencies for clinical practicum.

Constraints/Challenges:
a. Nation-wide clinical placement shortage.
b. Lack of interest for partnership and
collaboration.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 199
Table 14, continued
Proposed Solutions Action Steps Building Capacity & Resource
Requirements
Timeline Indicators, Measures & Constraints, Challenges
4. Explore the
potential to share
lab spaces and
simulation
facilities with
identified
healthcare
facilities and
educational
institutions.
Since there is a lack of
institutional infrastructure and
lab spaces, this will help
alleviate the significant
investment upfront for physical
lab facilities and equipment.
By the end
of March
2020.
Indicators/Measures:
a. Explore and negotiate potential to share lab
spaces;
b. Obtain letters of support or letters of intent to
collaborate from clinical sites;

Constraints/Challenges:
a. Possible failure.
b. Institutional disruptions.
c. Solutions may be temporary.

Strategy 3:
To fully develop and
implement every aspect
of this new nursing
program by obtaining
necessary approval,
funding, and
accreditation, while
also getting ready for
the first student cohort.
1. Submit the
new nursing
program
proposal
internally to
the Academic
Council for
approval at
the
university.
The university has an internal
process for new programs to
gain buy-in and approval for the
development of specific course
content.
Completed
by the end
of
September
2019.
Indicators/Measures:
Internal approval of nursing program proposal.
Constrains/Challenges:
Possible institutional disruptions caused by other
competing priorities and resources.
2. Submit new
program
proposal to
the California
Board of
Nursing and
submit
institutional
change
application to
WASC.
Under the steering committee’s
vision and leadership, the
director of nursing will work
closely with key stakeholders to
obtain initial accreditation
approval status.
In progress
now and
complete by
January
2020.
Indicators/Measures:
Submit application for provisional status to board of
nursing, significant change report to WASC and
candidacy study to gain initial accreditation.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 200
Table 14, continued
Proposed Solutions Action Steps Building Capacity & Resource
Requirements
Timeline Indicators, Measures & Constraints, Challenges
3. Seek start-up
funding for
new nursing
program.
The university needs to seek
multiple funding sources, such
as grant proposals, asking for
sponsorships and gifts; and seek
federal and philanthropic
funding opportunities that are
focused upon the initiation of
new programs, academics,
student support, and hiring new
personnel.
By the end
of January
2020.
Indicators/Measures:
Obtain funding to provide both start-up costs and an
ongoing fund for program development.

Constraints/Challenges:
One of the major impediments to establishing a new
program is the significant financial investment for
physical facilities and hiring of new personnel.

4. Hire a
Director of
Nursing who
will lead
program,
finalize
curriculum,
and recruit
faculty.
Although the university
leadership has significant
expertise in the planning and
implementation of new
programs, the recruitment of
dedicated nursing leadership
should be prioritized to establish
leadership in building capacity,
overseeing a completely new
program, and serving as an
effective implementer of the
program vision.

By January
2020.
Indicators/Measures:
Recruit a director of nursing who is an expert in
nursing education and aligned with the university’s
mission, vision, values. and goals.

Indicators/Measures:
Recruitment and establishment of a nursing leader
and champion is critical in casting vision, providing
strategic planning, and facilitation for the
development and implementation of the new
program.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 201
Integrated Evaluation Plan
The purpose of this section is to provide and apply a sequential framework and critical
analysis for assessing the new faith-integrated nursing program. This integrated evaluation plan
is based on Kirkpatrick & Kirkpatrick’s (2006) four-level model of training evaluation proposed
in their Evaluating Training Programs: The Four Levels. Each level within the framework is
important and has an impact on the next level. In order to measure the effectiveness and impact
of this new program implementation and to answer the question: “Is what I am doing is
working?”, these four levels of evaluation will be discussed and applied in a sequential way to
evaluate learning effectiveness, namely: reaction, learning, behavior and results. The merits of
how data is collected, analyzed, and fed back to implementation for continuous policy and
program improvement will be critically analyzed.
Reactions
The first level of assessment measures how individuals respond, feel, or react to the new
program implementation, through tests of “customer satisfaction” described by Kirkpatrick’s
(2006, p. 21). It is recommended that the university design basic and simple response
mechanisms before the creation and establishment process. Both informal and formal methods
can be used to assess typical participant reactions and levels of engagement. For example, a
response survey can be designed and administered anonymously among all administrators,
faculty, staff, and students, asking about their perceptions and ideas for the new nursing program.
On that form, one can encourage written comments and suggestions about impressions of the
new nursing program. Reactions can then be assessed, and appropriate actions taken accordingly.
Another approach to this will be to observe attendance, participation rates, and levels of
engagement in active discussions during the steering committee meetings.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 202
Learning
The second level of assessment measures the development of participants’ knowledge,
skills, and attitudes, as well as their confidence and commitment (Kirkpatrick, 2006). Learning
can be measured in different ways, depending on the objectives. For example, a pre/post-test can
be designed to measure the newly formed steering committee members’ knowledge and
understanding of state nursing board and nursing accreditation requirements. Another approach
would involve interviews with university-designated internal personnel who understand federal,
state, and institutional policies concerning external clinical partnerships. In addition, surveys of
key stakeholders about their commitment and confidence in achieving the organization’s goals
will be helpful.
Behavior
The third level of assessment seeks to understand how well people apply their learning
and how it changes their behavior. It also reveals learning strengths and weaknesses and where
people might need help to actually utilize and apply new learning in the program implementation
process, and whether the gains made are lasting (Kirkpatrick, 2006). In this case, the university
will want to understand how, and to what extent, the new learning has helped sustain the
implementation process and resulted in knowledge transfer. For instance, follow-up surveys with
the steering committee members on the progress of their assigned tasks and projects, as well as
follow-up phone interviews with select committee members, will help identify the milestones
that have been achieved and to what they attribute their successes or challenges.
Results
The fourth level of assessment concerns the results or impact that occurred because
recommended solutions were implemented and intended impacts achieved (Kirkpatrick, 2016). A
series of ongoing, systematic, short-term measurements and benchmarks for each timeline and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 203
processes are used to analyze the outcomes. In this case, successfully implemented solutions
could include: 1) obtaining provisional status from the California Board of Nursing and gaining
new program initial accreditation from WASC; 2) successfully recruiting a director of the
nursing program who is an expert in nursing education and aligned with the university’s mission,
vision, values, and goals; and 3) obtaining letters of support from various healthcare facilities
and clinical sites, along with a number of signed MOUs with clinical hosting agencies for
clinical practicum, including hospitals, ambulatory, and community healthcare settings.
According to Howlett, Ramesh, and Perl (2009), policy evaluations can be classified into
three broad categories: administrative, judicial, and political evaluations. In contrast to a process
evaluation, Smith & Larimer (2009) assert that the impact analysis is a specific form of outcome
evaluation that seeks to measure and assess what a policy or program has actually achieved. The
breadth of outcome evaluations can involve both short-term and longitudinal measurements.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 204
Table 15
An Overview of Proposed Evaluation Plan
Intervention
Proposed

How you will assess
satisfaction and
engagement with your
intervention?
(Level 1)
How you will assess learning,
commitment, and confidence?
(Level 2)
How you will assess behavior
change and application of
that which is learned?
(Level 3)
How you will assess
impact?
(Level 4)
1. To establish a new
nursing program
steering committee
and hold regular
meetings.
• Successfully hold
the monthly
meetings with a
majority of the
members present
• Monitor attendance,
participation rates,
and number of
meetings
• Observe the level of
discussion in the
meetings – are the
committee members
all active during
discussions
• Pre/post-test, e.g. with
respect to state nursing
board and nursing
accreditation requirements
• Anonymous survey of
committee members to
assess their confidence in
and commitment to the
new nursing program
• Follow up survey with
committee members on
the progress of their
assigned tasks and
projects
• Follow up phone
interviews with select
committee members to
build relationships,
discuss how they
achieved milestones, and
to what they attribute any
successes or challenges
• Identify and recruit
internal and external
stakeholders
• Recruit stakeholders
who are dedicated to
meet once per month
and to report to the
Provost’s Office on
progress
• Develop a coherent
plan and timeline for
the implementation
strategy
• Draft business plan
• Monitor the progress
of implementation
plan with targeted
milestones: i.e., the
university’s
allocations of needed
personnel, time,
finances and
resources to
implement the new
nursing program

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 205
Table 15, continued
Intervention Proposed

How you will assess
satisfaction and
engagement with your
intervention?
(Level 1)
How you will assess learning,
commitment, and
confidence?
(Level 2)
How you will assess behavior
change and application of
that which is learned?
(Level 3)
How you will assess
impact?
(Level 4)
2. To create and
establish formal
partnership with
external healthcare
facilities for clinical
practice placement.
• Monitor engagement
levels by the number
of appointments
(phone calls, face-to-
face meetings) set up
with local healthcare
facilities and
surrounding
educational
institutions
• Interview with the
university designated
personnel to understand
federal, state, and
institutional policies
concerning external
partnerships
• Interview with local
healthcare employers to
understand their needs
and expectations from
nursing students
• Survey key stakeholders
about their commitment
and confidence in
achieving this goal
• Survey key stakeholders
on their understandings of
mutually beneficial
strategies for partnerships
• Interview key internal
stakeholders on
interdisciplinary
collaboration, program
development, and
teaching
• Interview key external
stakeholders to explore
ideas and innovative ways
of collaborating: i.e.
sharing of lab spaces,
simulation facilities,
equipment, faculty, and
institutional infrastructure
and resources

• Obtain letters of
support from various
healthcare facilities
and clinical sites
• Gain a number of
signed MOUs with
clinical hosting
agencies for clinical
practicum, including
hospitals, ambulatory
and community
healthcare settings

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 206
Table 15, continued
Intervention Proposed

How you will assess
satisfaction and
engagement with your
intervention?
(Level 1)
How you will assess learning,
commitment, and
confidence?
(Level 2)
How you will assess behavior
change and application of
that which is learned?
(Level 3)
How you will assess
impact?
(Level 4)
3. To fully develop and
implement every aspect
of this new nursing
program by obtaining
necessary approval,
funding, and hiring of a
nursing administrator
and faculty, while
getting ready for the
first cohort of students,
• Observe and monitor
engagement level by
tracking the progress
of implementation
plan
• Anonymously
survey all levels of
administrators,
faculty, staff, and
students on their
perceptions of and
ideas for this nursing
program
• Interview
perspective students,
parents, and other
community members
on their perceptions
of and ideas about
this new nursing
program
• Survey key stakeholders
about their self-
assessments of
commitment and
confidence in achieving
the goals
• Focus groups/interviews
and self-reflection
concerning lessons
learned throughout the
program implementation
process
• Benchmarking against
current literature and
accreditation standards on
best practices of various
components for
developing, implementing
and evaluating a new
nursing program (i.e.
mission, faculty and staff,
students, curriculum,
resources and outcomes)
• Engage with other
multidisciplinary teams at
the university for the
successful establishment
of this new nursing
program, for example, the
registrar, admission, IT,
facility, marketing,
library, various student
support services, campus
life, international,
missionary and
community services
• Assess and analyze the
fiscal, physical, and
learning resources that are
sustainable and sufficient
to ensure the achievement
of the student learning
outcomes and program
outcomes of the nursing
program
• Submit the new
nursing program
proposal internally to
Academic Council
and gain approval at
the university level
• Obtain funding for
this start-up nursing
program through
multiple funding
sources, for example,
by submitting grant
proposals, asking for
sponsorships and
donations, and
making application to
federal and
philanthropic funding
opportunities
• Successfully recruit a
director of nursing
program, who is an
expert in nursing
education and aligned
with the university’s
mission, vision,
values and goals
• The director of
nursing will lead the
new program, recruit
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 207
Table 15, continued
Intervention Proposed

How you will assess
satisfaction and
engagement with your
intervention?
(Level 1)
How you will assess learning,
commitment, and
confidence?
(Level 2)
How you will assess behavior
change and application of
that which is learned?
(Level 3)
How you will assess
impact?
(Level 4)
• faculty, and finalize
curriculum design
• Obtain provisional
status from California
Board of Nursing and
gain new program
initial accreditation
from WASC.
•

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 208
Limitations
There are no claims that this small-scale study can be transferred to wider populations.
This study may not necessarily reveal the phenomenon in its full depth, but, rather, has helped
promote the understanding of stakeholders’ knowledge, motivation, and organizational culture in
creating a faith-based nursing program.
As no single method of investigation can over-ride all design limitations, therefore a
combination of methods (e.g. use of triangulation) was desirable. The research was done by a
researcher with very modest resources. The timescale for the research was limited by the
researcher’s own workload as a full-time nursing faculty. The interviews were conducted by the
researcher herself who may have had an “insider perspective” in her interpretations. The
perspective of the insider is regarded with suspicion on the grounds that it is likely to be
“blinkered” in comparison to that of the informed outsider. However, as Beck (1994, p.123)
argued, “It is impossible for a researcher to be completely free from bias in reflection of the
experience being studied, but it is possible to control it.”
Future Research
This study has increased awareness of the issue of faith-based nursing education. The
impact on nursing practice and nursing education, philosophical underpinnings, conceptual
models, practical steps of planning, and implementing and evaluating the new nursing program
has been adequately addressed in previous literature and by this research. However, there is a
need to further explore other faith-based institutions which have successfully established fully
faith-integrated nursing programs, including their best practices, unique characteristics, and
measurable faculty and student learning outcomes.
The generalizability of these results to other populations of nurses and nursing programs
is limited by the single, private Christian faith-based setting and by the unique culture and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 209
longevity of the university in this sample. This study could be replicated with a larger sample on
a larger scale and in a different setting.
Implications for Practice
Implications for Nurses
Faith integration is a privilege and a responsibility. As the nurses become more and more
competent in fulfilling their mission to heal, they will find joy and satisfaction in being skilled at
faith-integration. At the same time, nursing should also assess their patients’ spiritual needs
before engaging in spiritual care in the clinical setting.
Implications for Education Institutions
Organizational culture shapes every aspect of learning. The first step in promoting
intentionality for faith-integrated nursing is developing a shared language and a healthy culture.
Change and transformation can take place when faith-integration is fully embraced and
understood and applied by all staff, faculty and leadership.
The curriculum should be created by a collaborative effort between the academic council
and faculty from across the specific disciplines. The curriculum design and solutions proposed
attempt to balance a conceptual understanding of faith integration with practical tools for
academic professionals looking for resources. The context for which it is written is clearly the
university in this study.
The researcher intends to work on faith integration as it is understood by other Christian
educators, scholars and institutions, while also acknowledging particular recommendations,
implications, and ideas that are relevant for this specific institution context.
Implications for Healthcare Organizations
The relevant faith-based healthcare organizations can work to support nurses in the work
of faith integration. In particular, they need to work in partnership with leaders, policy makers,
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 210
administrators, nurses in practice, and administrators to advocate, develop, and create
meaningful accountability so that the work of faith integration can be undertaken with personal
and professional integrity and accountability.
Implications for Churches
The researcher has the great privilege of living and working in both the “sacred” and
“secular” worlds. As a result of those experiences and the findings from this study,faith should
be at the center, no matter if we are worshipping in church or working at our jobs. Yet it seems
there is still a great divide between the two worlds: the “sacred world” where the people of the
church have a difficult time communicating and applying their faith in their professional callings
and those of the “secular world” who may be considered ‘less sacred’ by faith-based
communities.
This study has captured some fundamental ways of thinking about Christian faith in
nursing and how this affects the work we were created to do. The church can take more active
roles in partnership, training, and guidance on how faith can be integrated in the context of
particular vocations, organizations, times, and cultures.
Conclusion
The purpose of this project was to conduct a needs analysis assessing a specific
institution’s capacities and efficacy in the areas of knowledge, motivation, and organizational
resources while pursuing an organizational performance goal related to establishing a new faith-
integrated BSc. Nursing program.
The literature review provided a fresh, complex, and dynamic look at the coexistence of
Christian faith and nursing. These findings are in contrast to the limitations of prior research
which have focused predominantly on either nursing or faith-based education.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 211
A qualitative and systematic needs analysis of six senior leaders’ knowledge, motivation,
and organizational context at a faith-based private Christian education institution, using Clark
and Estes (2008) KMO model adjusted for confounding factors, showed both promising and
challenging aspects related to the establishment of the new program. The researcher discussed, in
great detail, current trends, issues/controversies, promising patterns, insights, and concepts
related to faith-integrated education and its implications for nursing and healthcare reform.
The knowledge gap involves best practices in a pre-licensure nursing program. This is
due to a lack of institutional expertise as the university has no extant nursing program. In
addition, there are currently no personnel with experience in the design, implementation, or
administration of this academic discipline. Two inconclusive knowledge influences include,
firstly, the fact that the interviewees have no prior knowledge in nursing accreditation, and,
secondly, when asked to envision and paint an ideal picture of a fully faith-integrated nursing
program, there was a great deal of individual variability.
Findings obtained from the qualitative procedures are deep and complex. Notably, both
faith-based and secular higher education co-exist to serve the demand of healthcare everywhere
around the world. Those two types of programs may share lot of commonalities at the surface
level, and these expectations were confirmed. What was unexpected, however, was the fact that
participants reported more emphasis on inner vitality, hope, and meaning in the pursuit of God,
truth, and higher purpose, for the common good and for all people.
The findings from the data confirm that there is a gap in motivation influences related to
the achievement of the organizational performance goal. Senior leaders are a highly motivated
group who possess strong utility values and goal orientation, but there seems to be a need to
strengthen self-efficacy in view of the fact that not all participants projected clear understandings
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 212
of how they will succeed when faced with potential constraints related to effort, personnel,
financial resources invested, and political uncertainties.
Along with gaps in knowledge and motivation, organizational gaps also exist that pose a
barrier to creating and establishing this new faith-integrated nursing program. Interview data
reveal challenges with funding and resources, especially upfront costs for space, nursing skills
labs, and medical equipment. They will need to overcome funding and resource challenges by
securing both internal and external funds and establishing external partnerships that promote
excellence in nursing education while also enhancing the profession and benefiting the
community.
This study has yielded the following 18 recommended solutions that are based on the
Commission on Collegiate Nursing Education’s (CCNE, 2019) four distinct accreditation
standards (mission, commitment, curriculum and outcomes) and explored the complementary
power of science and faith integration through the lens of the Christian worldview.
This study discovered at least three aspects that seem to bring together a range of
insightful contributions to clarify and understand faith-integrated education. Firstly, faith-
integrated education cannot be pursued in a singular or linear way that undermines different,
multiple notions of what it means to teach, learn, and lead faith-based education. Rather, it is a
whole person approach that enhances meaningful ways of human flourishing, and moves towards
more virtuous engagement, growth, and expansion in life.
Secondly, in an attempt to integrate faith and learning, or heart and mind, the research
findings suggest a new faith-integrated model for nursing that is grounded in a Christian
worldview. The essence of this new nursing model is allowing oneself to receive the
unconditional love from God because God, who is love, first loved us (1 John 4:7-8, 19). We are
only able to give freely to others what we have received freely from God. For if we love God
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 213
first, then we can better love ourselves and others. The wealth and sensitivity of the qualitative
analyses reveals the complexity, the context dependent factors, and the reification of reality that
constitute nursing, healthcare, faith-integrated education. The lived experience of how
someone’s faith is embedded in the world of everyday nursing life is subject to each individual
nurse’s appraisal and ability to make applications in different contexts.
Thirdly, significant contributions to nursing education can be developed through well-
developed faith-integration at the subject level. Practical ways to integrate faith and nursing in
the classroom, clinical practice, and in the curriculum have been critically analyzed and applied.
This research highlighted the importance of looking at faith-integrated education as a continuous
process of becoming. This implies that the pursuit of faith-based education and nursing should
remain intentional and open to new insights and research.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 214
REFERENCES
Abu-Rish, E., Kim, S., Choe, L. (2012). Current trends in interprofessional education of health
sciences students: a literature review. Journal of Interprofessional Care, 26(6), 444-451.
Accreditation Commission for Education in Nursing (2017). ACEN 2017 Standards and Criteria
for Baccalaureate. Retrieved from: http://www.acenursing.net/manuals/sc2017_B.pdf
Ahmad, S., Mohannad, E. & Rami, M. (2015). Theory practice gap in nursing education: a
qualitative perspective. Journal of Social Sciences, 11(1), 20-26.
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P. & Busse, R.(2014).
Nurse staffing and education and hospital mortality in nine European countries: a
retrospective observational study. Lancet (London, England), 383(9931), 1824–1830.
doi:10.1016/S0140-6736(13)62631-8
American Academy of Religion and the Teagle Foundation. (2007). AAR-Teagle Working
Group. 2007. The religion major and liberal arts education – A white paper. Religious
Studies Review, October: 21–29.
American Association of Colleges of Nursing. (2012). Guiding principles to academic-practice
partnerships. Retrieved from: https://www.aacnnursing.org/Academic-Practice-
Partnerships/The-Guiding-Principles
American Association of Colleges of Nursing. (2013). Academic-Practice Partnerships/The
Guiding Principles. Retrieved from: https://www.aacnnursing.org/Academic-Practice-
Partnerships/The-Guiding-Principles
American Association of Colleges of Nursing. (2019a). Nursing Shortage. Retrieved from:
https://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-Shortage-Factsheet.pdf
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 215
American Association of Colleges of Nursing. (2019b). Baccalaureate Education. Retrieved
from: https://www.aacnnursing.org/Nursing-Education-Programs/Baccalaureate-
Education
American Hospital Association. (2019a). Fast Facts on U.S Hospitals, 2019. Retrieved from:
https://www.aha.org/statistics/fast-facts-us-hospitals
American Hospital Association. (2019b). Nursing: the most trusted profession. Retrieved from:
https://www.aha.org/news/insights-and-analysis/2019-01-09-17th-year-row-nurses-top-
gallups-poll-most-trusted-profession
American Nurses Association. (2010). Nursing: Scope and standards of practice. Silver Spring,
Md: American Nurses Association.
American Nurses Association. (2019). The Nursing Shortage. Retrieved from:
https://www.nursingworld.org/practice-policy/workforce/
Anderson, H. (2014). Made for more: An invitation to live in God’s image. Chicago, IL: Moody.
Andrews, M. M., & Boyle, J. S. (2012). Transcultural concepts in nursing care. Philadelphia,
PA: Lippincott Williams & Wilkins.
Aronson, L. (2011). Twelve tips for teaching reflection at all levels of medical education.
Medical Teacher, 33(3), 200-205.
Aspin, D. N., & Chapman, J. D. (Eds.). (2007). Values education and lifelong learning:
Principles, policies, programmes. Dordrecht: Springer.
Astin, A. W., Astin, H. S., & Lindholm, J. A. (2011). Cultivating the spirit: How college can
enhance students’ inner lives. San Francisco, CA: Jossey-Bass.
Australian Curriculum, Assessment and Reporting Authority (ACARA). (2012). Curriculum
design paper (Version 3). Sydney, NSW, Australia.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 216
Bakken, K. L. (2015). The journey into God: Healing and Christian faith. Wipf and Stock
Publishers.
Bakker, C., & Ter Avest, I. (2009). Encountering ‘good practice’. Teacher’s construction of
school identity. In S. Miedema (Ed), Religious education as encounter (pp. 129-147).
Munster: Waxmann.
Bandura, A. (1997a). Self-efficacy: The exercise of control. New York: W. H. Freeman.
Bandura, A. (1997b). Social Learning Theory. Englewood Cliffs, NJ: Prentice-Hall.
Barry, C. A., Britten, N., Barber, N., Bradley, C., & Stevenson, F. (1999). Using reflexivity to
optimize teamwork in qualitative research. Qualitative Health Research, 9, 26-44.
Beck, C. T. (1993) Qualitative research: The evaluation of its credibility. Western Journal of
Nursing Research, 15 (2), 263-6.
Beck, C. T. (1994) Phenomenology: Its use in nursing research. International Journal of Nurse
Study, 31, 499-510.
Benne, R. (2001a). A college recovers its Christian identity. The Christian Century, 118(13), 12-
15.
Benne, R. (2001b). Quality with soul: How six premier colleges and universities keep faith with
their religious traditions. Wm. B. Eerdmans Publishing.
Bible (2019). Bible. New International Version. Zondervan Bible Publishers.
Blackburn, R. T., & Lawrence, J. H. (1995). Faculty at work: Motivation, expectation,
satisfaction. Johns Hopkins University Press.
Bloom, B. S. (1956). Taxonomy of educational objectives. V ol. 1: Cognitive domain. New York:
McKay, 20-24.
Braskamp, L., Trautvetter, L. C., & Ward, K. (2008). Putting students first: Promoting lives of
purpose and meaning. About Campus, 13(1), 26-32.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 217
Brinig, M. F., & Garnett, N. S. (2012, June). Catholic schools and broken windows. Journal of
Empirical Legal Studies, 9 (2), 347–367.
Brookfield, S. D., & Preskill, S. (2005). Discussion as a way of teaching: Tools and techniques
for democratic classrooms (2nd ed.). San Francisco, CA: Jossey-Bass.
Brown, C. (2012). Testing Prayer: Science and Healing. Cambridge, Mass: Harvard University
Press. https://doi.org/10.4159/harvard.9780674064867
Buerhaus, P. (2009). Avoiding mandatory hospital nurse staffing ratios: An economic
commentary. Nursing Outlook, 57(2), 107-112.
Bureau of Labor Statistics. (2019). Empoloyment Projections: 2016-2026. Retrived from:
https://www.bls.gov/ooh/healthcare/registered-nurses.htm
Calhoun, C., Juergensmeyer, M., & Van Antwerpen, J. (2011). Rethinking secularism. Oxford,
England: Oxford University Press.
California Board of Nursing. (2017). California Board of Registered Nursing: 2015-2016 Annual
School Report. A presentation of Pre-Licensure Nursing Education Programs in
California. Retrieved from: https://www.rn.ca.gov/pdfs/education/schoolrpt15-16.pdf
Chapman, J. D., McNamara, S., Reiss, M. J., & Waghid, Y . (Eds.). (2014). International
handbook of learning, teaching and leading in faith-based schools. London: Springer.
doi:10.1007/978-94-017-8972-1
Charles, C. M., & Senter, G. W. (1995). Elementary classroom management (2nd ed.). White
Plains, NY: Longman.
Chatters, L. (2000). Religion and Health: Public Health Research and Practice. Annual Review of
Public Health, 21(1), 335–367. https://doi.org/10.1146/annurev.publhealth.21.1.335
Chickering, A. W., Dalton, J. C., & Stamm, L. (2006). Encouraging authenticity and spirituality
in higher education. San Francisco, CA: Jossey-Bass.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 218
Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and
health care-associated infection. American journal of infection control, 40(6), 486–490.
doi:10.1016/j.ajic.2012.02.029.
Clark, R.E. (1998). Motivating performance. Performance Improvement, 37(8), 39-47.
Clark, R. E., & Estes, F. (2008). Turning research into results: A guide to selecting the right
performance solutions. Atlanta, GA: CEP Press.
College Board. (2017). Trends in college pricing 2017. Retrieved from
https://trends.collegeboard.org/sites/default/files/2017-trends-in-college-pricing_0.pdf
Commission on Collegiate Nursing Education. (2018). Standards for Accreditation of
Baccalaureate and Graduate Nursing Programs, Amended 2018. Retrived from:
https://www.aacnnursing.org/Portals/42/CCNE/PDF/Standards-Final-2018.pdf
Corlett, J. (2000). The perceptions of nurse teachers, student nurses and preceptors of the theory-
practice gap in nurse education. Nurse Education Today, 20(6): 499-505.
Council for Christian Colleges & Universities. (2018a). About. Retrieved from:
https://www.cccu.org/about/#heading-what-is-christian-higher-4
Council for Christian Colleges and Universities. (2018b). CCCU tuition survey 2017-2018.
Retrieved from: https://www.cccu.org/wpcontent/uploads/2017/06/CCCU_Tuition_
Survey_17-18.pdf
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., ... & Warren,
J. (2007). Quality and safety education for nurses. Nursing outlook, 55(3), 122-131.
Davis-Floyd, R. (2001). The technocratic, humanistic, and holistic paradigms of
childbirth. International Journal of Gynaecology Obstetetrics, 75(Suppl 1), S5–23.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 219
Debourgh, G. (2012). Synergy for Patient Safety and Quality: Academic and Service
Partnerships to Promote Effective Nurse Education and Clinical Practice. Journal of
Professional Nursing, 28 (1), 48-61. https://doi.org/10.1016/j.profnurs.2011.06.003
Dewey, J. (2004). Democracy and education. New York: Courier Dover.
Dockery, D. S. (2000). Biblical interpretation then and now: Contemporary hermeneutics in the
light of the early church. Miami, US. Baker Academic.
Eccles, J. & Wigfield, A. (2002). Motivational beliefs, values and goals. Annual Review of
Psychology, 53, 109-132.
Fairholm, G. W. (1994). Leadership and the culture of trust. Connecticut, US. Greenwood
Publishing Group.
Faiz, A. (2014). Faith-based healthcare: Discussing the major role FBOs play in medical
delivery. The Presbyterian Record, 138(3), 32-35.
Feinberg, W. (2014). Religious education in a time of globalization and pluralism: The example
of the United States. In International Handbook of Learning, Teaching and Leading in
Faith-Based Schools (pp. 489-499). New York: Springer Netherlands.
Fish, S. (2004). “Why we built the Ivory Tower?” New York Times, May 21, 2004. Retrieved
from: https://www.nytimes.com/2004/05/21/opinion/why-we-built-the-ivory-tower.html
Franken, R. (1994). Human motivation. Pacific Grove, CA: Brooks/Cole.
Gallimore, R., & Goldenberg, C. (2001). Analyzing cultural models and settings to connect
minority achievement and school improvement research. Educational Psychologist,36(1),
45-56.
Garber, S. (2007). The fabric of faithfulness: Weaving together belief and behavior. Downers
Grove, IL: InterVarsity.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 220
Geertz, C. (1973) Thick description: Toward an interpretive theory of culture. In C. Geertz (Ed.)
The interpretation of cultures. New York, NY: Basic Books.
Gehrz, C. (2014). The Pietist vision of Christian higher education: Forming whole and holy
persons. Downers Grove: InterVarsity Press.
Glanzer, P. L. (2008). Searching for the soul of English universities: An exploration and analysis
of Christian higher education in England. British Journal of Educational Studies, 56(2),
163–183. doi:10.1111/j.1467-8527.2008.00404.x
Glenn, C. L. (2012). The American model of state and school: An historical inquiry. New York,
NY: Continuum.
Glenn, C. L., & Candal, C. S. (2012). Balancing freedom, autonomy and accountability in
education. J. De Groof (Ed.). Bezoekadres: Wolf Legal Publishers.
Goodin, R., Moran, M., & Rein, M. (2008). The Oxford Handbook of Public Policy (pp. 1–983).
Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199548453.001.0001
Graieg, L. (2017). Who we are: Curriculum and identity. Christian Teachers Journal, 25(1), 26-
29.
Greenhalgh, T., & Taylor, R. (1997). How to Read a Paper: Papers That Go beyond Numbers
(Qualitative Research). BMJ: British Medical Journal, 315(7110), 740–743.
Grim, B. (2016) The socio-economic contribution of religion to American Society: An empirical
analysis. Interdisciplinary Journal of Research on Religion, 12(3), 1-31.
Haho, A. (2006). The essence of caring: History, theory, and interpretation of nursing to the
arguments of caring. Oulu, Finland: Faculty of Medicine, University of Oulu.
Halstead, J. (2017). The accreditation process in nursing education. In Oermann (Ed.),
A systematic approach to assessment and evaluation of nursing programs
(pp. 79–91). Washington DC: National League for Nursing.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 221
Halstead, J. M., & Reiss, M. J. (2003). Values in sex education: From principles to practice.
London, England: Routledge Falmer.
Harris, M. (1989). Fashion Me a People: Curriculum in the Church Louisville. Kentucky, US:
Maria Harris, Westminister/John Knox.
Hasker, W. (1991). Faith-learning integration: An overview. Christian Scholar's Review, 21(3), p.
231-248.
Hatlevik, I.K.R.(2011). The Theory-Practice Relationship: Reflective Skills and Theoretical
Knowledge as Key Factors in Bridging the Gap Between Theory and Practice in Initial
Nursing Education. Journal of Advanced Nursing, 68(4): 868-877.
Haydon, G. (1997). Teaching about values: A new approach. London, England: Cassell.
Haydon, G. (Ed.). (2009). Faith in education: A tribute to Terence McLaughlin. London,
England: Institute of Education, University of London.
Heath, C. & Heath, D. (2013) Decisive: How to make better choices in life and work. New York:
Crown Business.
Health and Human Services (2019) Programs and services. Retrieved from:
https://www.hhs.gov/programs/prevention-and-wellness/index.html
Heldeman, K. (2006). What’s unique in Christian caring? God is my biggest resource. Journal of
Christian Nursing, 23 (3): 20-21.
Henck, A. F. (2011). Walking the tightrope: Christian colleges and universities in a time of
change. Christian Higher Education, 10(3/4), 196–214.
doi:10.1080/15363759.2011.577711
Hero, J. O., Blendon, R. J., Zaslavsky, A. M., & Campbell, A. L. (2016). Understanding what
makes americans dissatisfied with their health care system: An international comparison.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 222
Health Affairs, 35(3), 502-509,1-22.
doi:http://dx.doi.org.libproxy1.usc.edu/10.1377/hlthaff.2015.0978
Hiebert, P. G. (1994). Anthropological reflections on missiological issues. Baker Academic.

Holcomb, G. L. (2004). Faithful change: Exploring the faith development of students who attend
Christian liberal arts institutions (Unpublished doctoral dissertation). University of
Kentucky, Lexington, KY.
Holmes, A. F. (1987). The idea of a Christian college (Rev. Ed.). Grand Rapids, MI:
Eerdmans.
Howe, N. & Strauss, W. (2007). Millennials go to college: Strategies for a new generation on
campus, 2
nd
ed. Great Falls, VA: Lifecourse Associates, pp. 127-129.
Huebner, D. (1999). The capacity for wonder and education. In V. Hillis & W. Pinar (Eds.), The
lure of the transcendent. Mahwah, NJ: Lawrence Erlbaum Associates.
Hughes, R. T. (1997). Models for Christian higher education: Strategies for success in the
twenty-first century. Grand Rapids: Eerdmans.
Hulme, E., Groom, D., & Heltzel, J. (2016). Reimagining Christian Higher Education. Christian
Higher Education, 15(1-2), 95–105. https://doi.org/10.1080/15363759.2016.1107348
Hussein, M.T. & Osuji, J. (2017). Bridging the theory-practice dichotomy in nursing: The role of
nurse educators. Journal of Nursing Education and Practice, 7 (3): 20-25.
Husserl, E. (1931) Ideas: General introduction to pure phenomenology (Translated by W. R. and
Boyce Gibson). London, England: George Allen & Unwin.
Inglehart, R. & Norris, P. (2006). Sacred and secular: Religion and politics worldwide. Retrieved
from:
https://pdfs.semanticscholar.org/dbc2/b5edb5b09fa92267ee87c73de62f60399506.pdf
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 223
Inglehart, R., & Norris, P. (2007). Why didn’t religion disappear? Re-examining the
secularization thesis. Cultures and globalization: Conflicts and tensions, 253-257.
International Council of Nurses. (2019). Global Nursing Shortage: Priority Areas for
Intervention. Geneva Switzerland. Retrieved from:
https://www.who.int/workforcealliance/knowledge/resources/icn_nursesretention/en/
Joeckel, S., & Chesnes, T. (2009). The challenge of gender equity within the Council for
Christian Colleges and Universities. Christian Higher Education, 8, 115–131.
Johnson, D.W & Johnson, R.T. (1999). Learning together and alone: Cooperative, competitive
and individualist learning, 5
th
ed. Boston: Allyn & Bacon.
Josephson Institute. (2010). Character counts. Largest study ever shows half of all high school
students were bullies and nearly half were the victims of bullying during past year: Study
of more than 43,000 shows high school experience is more glum than glee. October 10,
2010 Issue. Retrieved from http://charactercounts.org/pdf/reportcard/2010/press-
release_bullying-violence.pdf
Karvinen, I., Fanuelsen, O., Van Leeuwen, R., Damsma-Bakker, A., Oosterhoff-Zielman, M.,
Ylönen, M. & Tveit, B. (2018). Defining the Mission – From Policy Statement to
Learning Outcomes. Diaconia, 9:1, 32-52.
Kearney, M. (1995). The local and the global: The anthropology of globalization and
transnationalism. Annual Review of Anthropology, 24(1), 547-565.
Keefe, S. (2005). Infusing spirituality into health education. New England Advances for Nurses,
9, 41-42.
Kennison, M. (2012). Developing reflective writing as effective pedagogy. Nursing Education
Perspectives, 33(5), 306- 311.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 224
Kerr, L. (2010). More than words: Applying the discipline of literary creative writing to the
practice of reflective writing in health care education. Journal of Medical Humanities,
31(4), 295-301.
King, P., Brown, M., Lindsay, N., & Vanhecke, J. (2007). Liberal arts student learning outcomes:
An integrated approach. About Campus, 12(4), 2–9. https://doi.org/10.1002/abc.222
Kirkpatrick, D. & Kirkpatrick, J. (2006). Evaluating training programs: The four
levels (3rd Edition). San Francisco, CA: Brett Koehler Publishers, Inc., pp. 1-114.
Kleinginna, P., Jr., & Kleinginna, A. (1981). A categorized list of motivation definitions, with a
suggestion for a consensual definition. Motivation and Emotion, 5(3), 263–291.
Knight, G. R. (2006). Philosophy and education: An introduction in Christian perspective.
Andrews University Press.
Komer, R. D., & Grady, O. (2016). School choice and state constitutions: A guide to designing
school choice programs (2
nd
Ed). Institute for Justice. Retrieved from: http://ij.org/wp-
content/uploads/2016/09/50-state-SC-report-2016-web.pdf
Kramer, R. M., & Cook, K. S. (Eds.). (2004). Trust and distrust in organizations: Dilemmas
and approaches. Russell Sage Foundation.
Langett, J. (2010). Through the story: Organizational recasting and the necessity of narrative-
driven internal branding. PhD Dissertation, Duquesne University.
Laws, D., & Hajer, M. (2006). Policy in practice. The Oxford handbook of public policy, 409-
424.
Levin, J. (2014). Faith-Based Initiatives in Health Promotion: History, Challenges, and Current
Partnerships. American Journal of Health Promotion, 28(3), 139–141.
https://doi.org/10.4278/ajhp.130403-CIT-149
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 225
Levin, J. (2016). Partnerships between the faith-based and medical sectors: Implications for
preventive medicine and public health. Preventive Medicine Reports, 4, 344–350.
Retrieved from http://doi.org/10.1016/j.pmedr.2016.07.009
Lindholm, J. A., & Astin, H. S. (2008). Spirituality and pedagogy: Faculty’s spirituality and use
of student-centered approaches to undergraduate teaching. The Review of Higher
Education, 31(2), 85–207.
Looney, S. (2009). Trends in demand and affordability. In D. R. Davison Jr. & J. Davison
(Eds.), Affordability and demand (pp. 17-24). Washington DC: National Association of
Independent Schools.
Lovat, T., Toomey, R., & Clement, N. (Eds.). (2010). International research handbook on
values education and student wellbeing. Dordrecht, Netherlands: Springer.
Loewenberg, S. (2009). Medical missionaries deliver faith and health care in Africa. The
Lancet, 373(9666), 795-796.
Lowrie, R. W., Jr. (Ed). (1984). Administration of the Christian school. Colorado, US.
Association of Christian School International.
Lucas, C. J. (1994). American higher education: A history. New York: St. Martin's Press.
MacEoin, D. (2009). Music, chess and other sins: Segregation, integration, and Muslim schools
in Britain. London, England: Civitas.
Maier, C. T. (2014). Pursuing purpose on the Christian liberal arts campus: Dialogic education
and vocational conversations. Christian Higher Education, 13(3), 211–226.
doi:10.1080/15363759.2014.904655
Marcus, G. E. (1994) What comes after ‘post’? The case of ethnography. In N. Denzin & Y .
Lincoln (Eds.), Handbook of qualitative research (pp. 563 574). London, England:
SAGE.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 226
Marsden, G. M. (1991). The soul of the American university. First Things: A Monthly Journal of
Religion and Public Life, 34-47. Retrieved from
http://www.firstthings.com/article/2007/10/005-the-soul-of-the-americanuniversity-1
Marsden, G. M. (1994). The soul of the American university: From Protestant establishment to
established nonbelief. New York, NY: University Press.
Marsden, G. M. (1997). The outrageous idea of Christian scholarship. Oxford, England: Oxford
University Press.
Mason, M. (2006). A better way forward – BHA policy on religion and schools. London,
England: British Humanist Association.
Maxwell, J. A. (2014). Qualitative research design: An interactive approach. Thousand Oaks,
CA: Sage.
McCulloch, G. (2011) The struggle for the history of education. January 2011. 1-144. DOI:
10.4324/9780203828854.
McEneaney, E.H., & Meyer, J.W. (2000). The content of the curriculum: An institutionalist
perspective. In M.T. Hallinan (Ed.), Handbook of the sociology of education. New York:
Kluwer Academic/Plenum.
Meneses, E. H. (2000). No other foundation: Establishing a Christian anthropology. Christian
Scholar’s Review, 29 (Spring), 535.
Merrell, J., & Williams, A. (1995) Beneficence, Respect for Autonomy, and Justice: Principles in
Practice. Nurse Researcher 3(1), 24-34.
Merriam, S. B., & Tisdell, E. J. (2016). Qualitative research: A guide to design and
implementation. San Francisco, US. Jossey-Bass.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 227
Mitchell, M. J. (2009). The affordability conundrum: Tuition, income, and financial aid realities
and strategies. In D. R. Davison & J. Davison (Eds.), Affordability and demand (pp. 109-
138). Washington, DC: National Association of Independent Schools.
Mitchell, T. (2008). Traditional vs. critical service-learning: engaging the literature to
differentiate two models. Michigan Journal of Community Service Learning, 14(2), 50-
65.
Morgan, S., Yoder, L. H. (2012). A concept analysis of person-centered care. Journal of Holistic
Nursing, 30, 6–15.
Morrow, J. (2011). Think Christianly: Looking at the intersection of faith and culture.
Zondervan.
Morse, J. M., & Field, P. A. (1995). Qualitative research methods for health professionals (2nd
ed). Thousand Oaks, CA: SAGE.
Muoneme, M. L. (2014). Hermeneutics of leadership: The meaning and transmission of
leadership and Catholic Jesuit cultural ethos and values through the lenses of seven
Jesuit university leaders’ emeriti and Father Theodore Hesburgh (Doctoral dissertation).
Retrieved from ProQuest Dissertations & Theses. (3580282)
National Center for Education Statistics. (2019). College Navigator for the university. Retrieved
from: Link kept confidential.
National League of Nursing. (2018). NLN Nurse Educator Shortage Fact Sheet. Retrieved from:
http://www.nln.org/docs/default-source/advocacy-public-policy/nurse-faculty-shortage-
fact-sheet-pdf.pdf?sfvrsn=0
Nehamas, A. (1999). Virtues of Authenticity: Essays on Plato and Socrates. Princeton University
Press, Princeton NJ, p. 340-50.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 228
Neururer, J., & Rhoads, R. A. (1998). Community service: Panacea, paradox, or potentiation.
Journal of College Student Development, 39(4), 321-330.
Newman, B. (2007). Prayer and healing. Optometry - Journal of the American Optometric
Association, 78(3), 108–108. https://doi.org/10.1016/j.optm.2007.01.007
Noll, M. A. (1994). The Revolution, the Enlightenment, and Christian higher education in the
early Republic. In J. A. Carpenter, & K. W. Shipps (Eds.), Making higher education
Christian: The history and mission of evangelical colleges in America (pp. 56-76). Grand
Rapids, MI: Christian University Press.
Noll, M. A. (2004). Princeton and the Republic, 1768-1822: The search for a Christian
Enlightenment in the era of Samuel Stanhope Smith. Princeton, NJ: Princeton University
Press.
Noll, M. A. (2006). Introduction: Christian colleges, Christian worldviews, and an
invitation to research. In W. C. Ringenberg (Ed.), The Christian college: A history of
Protestant higher education in America (2nd ed., pp. 1-36). Grand Rapids, MI:
Baker Academic.
Nord, C., Roey, S., Perkins, R., Lyons, M., Lemanski, N., Brown, J., & Schuknecht, J. (2011).
The Nation’s Report Card: America’s High School Graduates (NCES 2011-462), U.S.
Department of Education, National Center for Education Statistics. Washington, DC:
U.S. Government Printing Office. Retrieved from:
http://nces.ed.gov/nationsreportcard/pdf/studies/2011462.pdf
Norsworthy, B., & Belcher, C. (2015). Teachers’ understanding of imago dei. International
Community for Christian Teacher Educators Journal, 10 (2), article 4

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 229
Nurses Christian Fellowship. (2019). Christian Nursing Schools. Retrieved from: https://ncf-
jcn.org/resources/christian-nursing-schools?page=2
Odden, A.R. & Picus, L. O. (2014). School finance: A policy perspective, 5
th
ed. New York:
McGraw-Hill.
OECD (2016). Trends shaping education. Paris: Organisation for Economic Co-operation and
Development, pp. 9-111.
Oldenburg, R. (2000). Celebrating the third space: Inspiring stories about the “Great Good
Places” at the heart of our communities. New York: Marlowe & Company.
Oldfield, E., Hartnett, L., & Bailey, E. (2013). More than an educated guess: Assessing the
evidence on faith schools. London, England: Theos.
Olive, P. (2003). The holistic nursing care of patients with minor injuries attending the A and E
department. Accid Emerg Nurs, 11, 27–32.
Olson, R. E. (2011) Pietism: Myths and Realities, in The Pietist Impulse in Christianity, ed.
Christian, T. & Collins, W. (2011) Eugene, OR: Pickwick, pp. 10-12.
Organisation for Economic Co-operation and Development. (2016). Trends shaping education.
Paris, France: Author.
Ormrod, J. E. (1999). Human learning (3rd ed.). Upper Saddle River, NJ: Prentice Hall.
Outler, A. C. (Eds). (1987). The Works of John Wesley. Bicentennial (Ed). Vols. 1-4: Sermons.
Nashville: Abingdon Press, 1984-1987.
Palmer, P. J. (1998). The courage to teach: Exploring the inner landscape of a teacher’s life. San
Francisco, CA: Jossey-Bass.
Parahoo K. (1997). Nursing research principles, process and issues. Basingstoke: Macmillan.
Pazmino, R. W. (2008). Foundational issues in Christian education: An introduction in
evangelical perspective. Baker Academic.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 230
Pieske, R. (1994). Benchmarking: Learning from Others and Its Limitations, IO Management
Zeitschrift, 6: 19–23.
Pintrich, P. R. (2003). A motivational science perspective on the role of student motivation in
learning and teaching contexts. Journal of Educational Psychology, 95(4), 667-686.
Porter, S. (1997). The patient and power: Sociological perspectives on the consequences of
holistic care. Health Social Care Community. 1997; 5:17–20.
Preissle, J. (2006). Envisioning qualitative inquiry: A view across four decades. International
Journal of Qualitative Studies in Education, 19(6), 685-695.
Quiggin, J. (1999). Human capital theory and education policy in Australia. Australian Economic
Review, 32(2), 130-144.
Rassin, M., Kanti, T. & Silner, D. (2005). Chronology of medication errors by nurses:
Accumulation of stresses and PTSD symptoms. Issues of Mental Health Nursing,
26:873–876.
Ream, T.C., Herrmann, T.W. & Trudeau. C.S. (2001). A parent’s guide to the Christian college:
Supporting your child’s heart, soul, and mind during college years. Texas: Abilene
Christian University Press.
Ringenberg, W.C. (2006). The Christian college: A history of Protestant higher education in the
United States (2nd ed.). Grand Rapids, MI: Baker Academic Press.
Risse, G. B. (1999). Mending bodies, saving souls: A history of hospitals. Oxford University
Press.
Robbins, S. P. & Coulter, M. (2012) Management. 11
th
edition. New Jersey: Pearson Prentice
Hall.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 231
Rose, P., & Parker, D. (1994). Nursing: an integration of art and science within the experience of
the practitioner. Journal of Advanced Nursing, 20(6), 1004–1010.
https://doi.org/10.1046/j.1365-2648.1994.20061004.x
Rosenberg, C. E. (1987). The care of strangers: the rise of America's hospital system (pp. 190-
211). New York: Basic Books.
Ryken, L. (1990). Worldly saints: The Puritans as they really were. Zondervan.
Salari, S., Klapman, S., Fry, B. & Hamel, S. (2017). Interprofessional education: in silo,
ineffective. Medical Science Educator, 27(4):831-833.
Sandin, R. T. (1982). The search for excellence: The Christian college in an age of educational
competition. Macon, GA: Mercer University Press.
Sarkio, M. (2007). The historical development of Finnish nursing textbooks from the late 1880s
to 1967—The training of nursing in the Foucauldian perspective. Helsinki, Finland:
Department of Education, University of Helsinki.
Schein, E. H. (2010). Organizational culture and leadership (Vol. 2). Wiley.
Schuurman, D. J. (2004). Vocation: Discerning our callings in life. Grand Rapids, MI:
Eerdmans.
Scott-Findlay, S. & Estabrooks, C.A. (2006). Mapping the organizational culture research in
nursing: A literature review. Journal of Advanced Nursing, 56(5): 498-513.
Selimen, D., Andsoy, I. I. (2011). The importance of a holistic approach during the perioperative
period. AORN Journal, 93, 482–90.
Shaw, P. (2014) Transforming Theological Education: A Practical Handbook for Integrative
Learning (ICETE Series). Retrieved from:
https://books.google.ca/books?hl=en&lr=&id=YIIuDgAAQBAJ&oi=fnd&pg=PP1&dq=
Transforming+Theological+Education:+A+Practical+Handbook+for+Integrative+Learni
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 232
ng+(ICETE+Series)&ots=0NFHeyePjZ&sig=5Zz-
mpEz_SQbh10QCuEE8cbAIBw#v=onepage&q&f=true
Shelly, J., & Miller, A. (2006). Called to Care: A Christian Worldview for Nursing. InterVarsity
Press.
Snyder, T. D., & Dillow, S. A. (2011). Digest of Education Statistics, 2011 (Publication No. 201-
2001). Retrieved from: http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2012001
Spencer, L., Ritchie, J., Lewis, J. and Dillon, L. (2003). Quality in Qualitative Evaluation: A
framework for assessing research evidence, London: Cabinet Office.
Spener, P. J. (1964). Pia Desideria. Trans. Theodore G. Tappert. Philadelphia: Fortress.
Spring, J. (2014). Globalization of Education: An Introduction. New York, NY: Routledge.
Statista. (2018). Number of faith-based hospitals in the United States from 1995 to 2016.
Retrieved from: https://www.statista.com/statistics/800827/number-of-us-faith-based-
hospitals/
Strandberg, E., Ingvar, O., Borgquist, L., & Wilhelmsson, S. (2007). The perceived meaning of a
(w) holistic view among general practitioners and district nurses in Swedish primary care:
A qualitative study. BMC Family Practice, 8(8),
The Nurses’ Bible. (2008). The Nurses’ Bible. Holman Christian Standard Bible. Nashville,
Tennessee: Holman Bible Publishers.
The University. (2018). An internal document: a new faith-based BSc. in Nursingprogram
proposal. California, U.S.
The University. (2019). Mission, vision, statement of faith, goals and community covenant and
chapters. California, U.S.
Theobald, K. (1997) The experience of spouses whose partners have suffered a myocardial
infarction: A phenomenological study. Journal of Advanced Nursing, 26, 595-601.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 233
Thompson, E. A., Quinn, Q., Paterson, C., Cooke, H., McQuigan, D., & Butters, G. Outcome
measures for holistic, complex interventions within the palliative care setting.
Complementary Therapies in Clinical Practice, 14, 25–32.
Tisdell, E. J. (2003). Exploring spirituality and culture in adult and higher education. San
Francisco, CA: Jossey-Bass.
Tjale, A. A., Bruce, J. (2007). A concept analysis of holistic nursing care in pediatric
nursing. Curationis, 30, 45–52.
Torres, C. A. (2015). Global citizenship and global universities. The age of global
interdependence and cosmopolitanism. European Journal of Education, 50(3), 262-279.
Tubbs-Cooley, H.L., Cimiotti, J.P., Silber, J.H., et.al. (2013). An observational study of nurse
staffing ratios and hospital readmission among children admitted for common conditions.
BMJ Quality & Safety, 22:735-742.
Tveit, B., Karvinen, I., Damsma-Bakker, A., Ylönen, M., Oosterhoff-Zielman, M., Fanuelsen,
O., & Van Leeuwen, R. (2015). Balancing Identity and Diversity in Faith-Based Nursing
Education: A Case Study from Northern Europe. Christian Higher Education, 14(5),
283–297. https://doi.org/10.1080/15363759.2015.1079748
United States Conference of Catholic Bishops. (2009). Ethical and religious directives for
Catholic health care services (5th ed.). Retrieved from http://www.usccb.org/issues-and-
action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-
Health-Care-Services-fifth-edition-2009.pdf
U.S. Bureau of Labor Statistics. (2018). Occupational Outlook Handbook: Registered Nurses.
Retrieved from: https://www.bls.gov/ooh/healthcare/registered-nurses.htm
U.S. Census Bureau. (2014). An aging nation: The older population in the United States.
Retrieved from:
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 234
https://www.census.gov/content/dam/Census/library/publications/2014/demo/p25-
1140.pdf
U.S. Census Bureau. (2015). Religion. Retrieved from:
https://www.census.gov/library/publications/2011/compendia/statab/131ed/population.ht
ml
U.S. Department of Education. (2008). Preserving a critical national asset: America’s
disadvantaged students and the crisis in faith-based urban schools. Retrieved from:
http://www2.ed.gov/admins/comm/choice/faithbased/report.pdf
U.S. Department of Education, National Center for Education Statistics. (2009). Higher
Education General Information Survey (HEGIS). Retrieved from:
http://nces.ed.gov/programs/digest/d09/tables/dt09197.asp
Veysey, L. R. (1965). The emergence of the American university. Chicago, IL: University of
Chicago Press.
Violette, B. (2005). Healing the body and saving the soul: Nursing sisters and the first Catholic
hospitals in Québec (1639-1880). In C. Bates, D. Dodd, & N. Rousseau (Eds.), On all
frontiers: Four centuries of Canadian nursing (pp. 57-72). Ottawa, ON: University of
Ottawa Press.
Wallace, M., Campbell, S., Grossman, S. C., Shea, J. M., Lange, J. W., & Quell, T. T. (2008).
Integrating spirituality into undergraduate nursing curricula. International Journal of
Nursing Education Scholarship, 5(1), 1-13.
White, E. G. (1903). Education. Mountain View, CA: Pacific Press Publishing Association.
Winslow, G. & Winslow, B. W. (2003). Examining the ethics of praying with patients. Holistic
Nursing practice, 17 (4): 170-177.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 235
World Health Organization. (1948). Definition of Health. Retrieved from:
https://www.loc.gov/law/help/us-treaties/bevans/m-ust000004-0119.pdf
World Health Organization. (2010). Framework for Action on Interprofessional Education and
Collaborative Practice. Geneva: World Health Organization, 2010.
World Health Organization. (2013). Global Health Workforce Shortage to Reach 12.9 Million in
Coming Decades. Retrieved from:
http://www.who.int/mediacentre/news/releases/2013/health-workforce-shortage/en/
Zamanzadeh, V., Jasemi, M., Valizadeh, L., Keogh, B., & Taleghani, F. (2015). Effective
Factors in Providing Holistic Care: A Qualitative Study. Indian Journal of Palliative
Care, 21(2), 214–224. http://doi.org/10.4103/0973-1075.156506.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 236
APPENDIX A
Invitation Letter
Institutional Review Board (IRB) Study Reference Number: UP-18-00524
Olivia Wei Li, RN, MSN
3470 Trousdale Pkway,
Los Angeles, CA, 90089
University Name (Remains Anonymous)
Invitation to Research Participants
Dear Participant’s Name,
My name is Olivia Wei Li. I am a doctorate student undertaking a Global Executive
Doctor of Education (Global EdD) program at the University of Southern California.
You are invited to participate in a research study conducted by me under the supervision
of Dr. Jenifer Crawford and my doctorate dissertation committee at the University of Southern
California (USC). The approval of conducting this study from both the Provost office at the
university (name remains anonymous) and the Institutional Review Board (IRB) at USC has
been gained. You are invited because you are a senior leader and stakeholder at the university, or
a designated advisory member helps to create a new faith-integrated Bachelor of Science (BSc.)
nursing program. Participants who have been selected will be asked about your knowledge,
motivation and interactions with the organizational culture context. Your participation to this
study will provide valuable insights, future direction and recommending solutions to successfully
meet your organizational performance goals from personal, managerial and organizational
perspectives.
I would be most grateful if you could assist me by participating in a one-on-one semi-
structured interview for approximately 45-60 mins via online environment (i.e. Zoom video)
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 237
where minimum disruptions can be guaranteed. The interview will be audio recorded. The
researcher will give accurate information to all individuals concerned. Written consent will be
obtained, and verbal information given. The respondents will remain anonymous from others and
the data collected will remain strictly confidential.
You may contact the Principal Investigator via email at wli707@usc.edu or Faculty
Advisor Dr. Jenifer Crawford at jenifer.crawford@usc.edu or 530-519-4085 if you have any
questions or concerns. The interview will be arranged according to your timetable. However, I
am required to collect the data by mid-January 2019, I would really appreciate if we could
schedule our interview at your earliest convenience.
Thank you for your kind consideration. I look forward to hearing your response soon.
Yours sincerely,

Olivia Wei Li, RN, MSN
Global Executive Doctor of Education
University of Southern California

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 238
APPENDIX B
Information Sheet
Institutional Review Board (IRB) Study Reference Number: UP-18-00524
Olivia Wei Li, RN, MSN
3470 Trousdale Pkway,
Los Angeles, CA, 90089
University Name (Anonymous)
Research Participant Information Sheet
Title: Creating a Faith-Integrated BSc. in NursingProgram
You are being invited to take part in a research study. Before you decide whether to take
part or not it is important for you to understand why the research is being done and what it will
involve. Please take time to read the following information carefully. If there is anything that is
not clear or if you would like more information, please do feel free to contact me.
1. Why is the study being done?
The purpose of this project is to conduct a needs’ analysis in the areas of knowledge,
motivation, and organizational resources necessary to reach the organizational performance goal
of establishing a new faith-integrated BSc. in Nursingprogram. The analysis will begin by
generating a list of possible needs and will then move to examining these systematically to focus
on actual or validated needs. While a complete needs’ analysis would focus on all stakeholders,
for practical purposes the stakeholder to be focused on in this analysis are all senior university
leadership and members of a newly established steering committee at this university.
2. Why have I been chosen?
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 239
You are invited because you are a senior leader and stakeholder at the university, or a
newly established committee board member helps to create a new faith-integrated Bachelor of
Science (BSc.) nursing program.
3. Do I have to take part?
No. Involvement in the study is entirely voluntary. If you do decide to take part, you are
still free to withdraw at any time, without giving a reason.
4. What will happen to me if I take part?
You will be asked to sign a consent form, indicating that you agree to participate in the
study, that you have read this information sheet, and have been given opportunity to ask
questions. Please retain a copy of both the information sheet and the consent form.
You will then be contacted by the researcher and asked to take part in an interview with
the researcher only.
Providing you agree, the discussion will be audio recorded. This will ensure that no
aspect of the discussion is omitted or misinterpreted, which could occur when relying on
handwritten notes. It is anticipated that the interview will take approximately 60 to 90 minutes,
which includes time for introductions and refreshments. All audio recordings will be erased
when the study is completed.
5. Where will the interview take place?
The interview will take place either in a secluded room at the university or in an online
environment where minimum disruptions can be guaranteed.
6. When will the interview take place?
The interview will take place at a time that is convenient to you outside shift patterns.
7. What do I have to do?
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 240
You need do no more than participate in the interview and expand fully on the things you
said through the use of open-ended questions. It is suggested that there are no ‘right’ or ‘wrong’
answers because the questions are designed to get people to express their personal views,
opinions and experiences.
8. Will my taking part in this study be kept confidential?
All information collected about you will be kept strictly confidential. However,
confidentiality may be broken, and the circumstance reported if information is given that implies
there has been a departure from professional ethical and/or legal standards. All audio recording
will be destroyed within one year of completion of the study. All participants in the interview
will be asked to maintain confidentiality. You name and address will be removed from the
interview transcripts and will not appear in any reports or published articles.
9. What are the possible benefits of taking part?
The study is not designed to benefit participants directly. However, the information
obtained will help to supply information, add to the current body of literature and help
understanding of your perceived knowledge, motivation and interactions with the organizational
culture context. Your participation to this study will provide valuable insights, future direction
and recommending solutions to successfully meet your organizational performance goals from
personal, managerial and organizational perspectives.
10. What will happen to the results of the research study?
The results will be made available in the form of a dissertation project and maybe through
publications in professional journals without disclosing any individual names.
11. Who is organizing and funding the research?
Student Olivia Wei Li, who is undertaking Global Executive Doctor in Education at the
University of Southern California at 3470 Trousdale Pkway, Los Angeles, CA, 90089.
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 241
12. Who should I contact if I have any additional questions and concerns?
You may contact the Principal Investigator Olivia Wei Li via email at wli707@usc.edu
or Faculty Advisor Dr. Jenifer Crawford at jenifer.crawford@usc.edu or 530-519-4085.
Thank you for reading this and taking part in the study.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 242
APPENDIX C
Informed Consent for Non-Medical Research
University of Southern California
Rossier School of Education
3470 Trousdale Parkway, Los Angeles, CA 90089

Creating a New Faith-integrated BSc. in Nursing Program
You are invited to participate in a research study conducted by Wei Li under the
supervision of Dr. Jenifer Crawford at the University of Southern California, because you are a
senior leader at the university or a designated advisory member helps to create a new faith-based
Bachelor of Science (BSc.) Nursing program. Your participation is voluntary. You should read
the information below, and ask questions about anything you do not understand, before deciding
whether to participate. Please take as much time as you need to read the consent form. You may
also decide to discuss participation with your family or friends. If you decide to participate, you
will be asked to sign this form. You will be given a copy of this form.
PURPOSE OF THE STUDY
The purpose of this project is to conduct a needs’ analysis in the areas of knowledge,
motivation, and organizational resources necessary to reach the organizational performance goal
of establishing a new faith-integrated BSc. in Nursing program. The analysis will begin by
generating a list of possible needs and will then move to examining these systematically to focus
on actual or validated needs. While a complete needs’ analysis would focus on all stakeholders,
for practical purposes the stakeholder to be focused on in this analysis are all senior university
leadership and designated members of the program advisory committee at the University.
STUDY PROCEDURES AND BENEFITS
If you volunteer to participate in this study, you will be asked to participate in interviews.
The potential benefits of this study are contingent on the results. As a participant the study will
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 243
provide direction to your organization on the resources needed for you to successfully meet your
performance goals. The study will benefit society by adding to the current body of literature.
PARTICIPANT INVOLVEMENT – INTERVIEW
If you agree to take part in this study, you will be asked to participate in a 30-45-minute
interview that will be audio recorded. You do not have to answer any questions you don’t want
to. No potential risks to participants have been identified; however, you will have an on-going
option to stop participating at any time.
PAYMENT/COMPENSATION FOR PARTICIPATION
You will not be compensated for your interview or observation participation.
CONFIDENTIALITY
Your decision to participate in the study will be kept confidential. All interviews and
observations will be kept confidential. The data will be stored on a password-protected computer
in the researcher’s home for three years after the study has been completed and then destroyed.
Handwritten observation notes will be scanned into the computer and then destroyed. Digital
recordings will be transcribed by and outside third party to protect your identity then destroyed.
We will keep your records for this study confidential as far as permitted by law. However, if we
are required to do so by law, we will disclose confidential information about you. The members
of the research team and the University of Southern California’s Human Subjects Protection
Program (HSPP) may access the data. The HSPP reviews and monitors research studies to
protect the rights and welfare of research subjects.
PARTICIPATION AND WITHDRAWAL
Your participation is voluntary. Your refusal to participate will involve no penalty or loss
of benefits to which you are otherwise entitled. You may withdraw your consent at any time and
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 244
discontinue participation without penalty. You are not waiving any legal claims, rights or
remedies because of your participation in this research study.
INVESTIGATOR CONTACT INFORMATION
You may contact the Principal Investigator via email at wli707@usc.edu or Faculty
Advisor Dr. Jenifer Crawford at jenifer.crawford@usc.edu or 530-519-4085.
RIGHTS OF RESEARCH PARTICIPANT – IRB CONTACT INFORMATION
If you have questions, concerns, or complaints about your rights as a research participant
or the research in general and are unable to contact the research team, or if you want to talk to
someone independent of the research team, please contact the University Park Institutional
Review Board (UPIRB), 3720 South Flower Street #301, Los Angeles, CA 90089-0702, (213)
821-5272 or upirb@usc.edu
SIGNATURE OF RESEARCH PARTICIPANT
I have read the information provided above. I have been given a chance to ask questions.
My questions have been answered to my satisfaction, and I agree to participate in this study. I
understand that the interview will consist of audio recording. I have been given a copy of this
form.
☐ I consent to participate and be audio recorded.
☐ I do not consent to participate and be audio recorded.

Name of Participant

Signature of Participant Date
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 245
SIGNATURE OF INVESTIGATOR
I have explained the research to the participant and answered all of his/her questions. I
believe that he/she understands the information described in this document and freely consents to
participate.

Name of Person Obtaining Consent

Signature of Person Obtaining Consent Date

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 246
APPENDIX D
Interview Protocol
Thank you for taking time out of your busy schedule to interview with me. I am the
researcher and will be conducting all of the interviews to ensure your confidentiality. Your
answers to the questions will be kept confidential and I will assign a pseudonym to the interview
to keep your identity confidential from the primary researcher.
Today I have a series of questions that may take 1-1 ½ hours to complete. The aim of
answering these questions is to evaluate the knowledge, motivation, and organizational
influences that may impact your capacity and efficacy to create a new faith-based nursing
program. The data will be used to help us develop strategies to support you and enable the
university to accomplish the performance goals.
In the informed consent you agreed to audio recording, please keep in mind that the
digital recording will be transcribed by a third part and destroyed to keep your identity
confidential. Are you still o.k. with being recorded today? Thank you.
Topic Areas to be Explored
Opening Questions
Could you please tell me your position?
How long have you been working at your present position?
Could you tell me a bit of background about your work and experiences in the field of
faith-based education?
What do you particularly like about your work experience?
Please describe your role as part of establishing a new faith-based nursing program at the
university.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 247

Faith-based Education
1. Tell me about what a faith-based education means to you?
2. Why did you choose to work at or contribute to a faith-based institution in the first place?
3. Could you please share some of the current practices/strategies/efforts made to create a faith-
based learning environment?
4. What a typical faith-integrated curriculum looks like?
Faith-based Nursing Education
5. Is there any difference between a faith-based nursing program and other general nursing
programs? If yes, what do you think are the man differences? If not, what are the common
points?
6. Why is faith-integration at the subject level important to you, if at all?
7. If you could envision and paint an ideal picture of a fully faith-integrated nursing program,
what will it be like?
Faculty
8. What criteria are you currently using to select the ideal faculty for the university?
9. How are you currently preparing and evaluating the extent and quality of faculty’s faith-
integration efforts?
10. How will you determine which nursing administrator and faculty to hire for this new nursing
program?
Business Plan and Implementation
11. What are some of the budgetary implications to create a new nursing program?
12. How would you determine which marketing strategies and recruitment plans will be used?
13. What are some of the potential the funding sources for this new nursing program?
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 248
14. How are you going about getting those resources?
15. How will the church and other faith-based community groups support this new program?
16. How will you ensure that the plans and strategies are successfully implemented?
Reflection on Own Believes and Goals
I am interested in what you feel about faith-integrated nursing education. I would like to
tell me about your experiences (prompts may be used to explore issues if informants dries up or
is unsure of what is asked). For example,
17. Why is a faith-based nursing education important to you? If at all?
18. Tell me about the trends in current faith-based education.
19. What are some of the unique challenges and opportunities?
20. What innovative practices/efforts you would like to see the university adopt for effective
faith-integration and why?
21. What are some of the perceived facilitating and hindering factors in establishing this new
program?
22. What do you care the most about creating this new nursing program?
23. What does personal reflection mean to you?
24. Tell me about the last time you reflected and how effective it was.
25. Do you have any concerns, thoughts or additional comments that you would like to add?
Utility Value
26. What has and would motivate you to start this new faith-based nursing program?
27. What are the benefits and drawbacks of having a faith-based nursing program?
28. How relevant is a new nursing program in advancing the mission, and vision of the university
and global learning communities?
29. How does the development of a faith-based nursing program fit into the strategic plan?
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 249
Self-Efficacy
30. How confident are you about achieving your goal of creating this new nursing program?
31. What have you accomplished so far towards achieving this goal? For example, engaging with
both the internal stakeholders and external partners.
32. What factors have influenced your level of confidence?
Governance Alignment
33. Tell me about the discussions on developing a faith-based nursing program amongst the
senior leadership, if any.
34. What is the decision-making process at the university?
35. When you disagree with each other, how are decisions made to ensure buy-in?
36. What are some examples of different things that the university has done to show support for
this new program, if anything?
Culture of Trust and Openness
37. How would you describe the organizational culture here?
38. Could you please give me an example on how you support each other’s work?
39. Could you describe the last time you expressed your thoughts and input openly and honestly?
Did you feel comfortable and respected? Why and why not?
40. How do you feel about being part of this organization?
Funding and Resources
41. Tell me about the funding and resources you have available for developing a faith-based
nursing program.
42. Which additional resources would make you work better?
43. How are you going to obtain those additional funding and resources?

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 250
Strong Institutional Identity
44. Who are we as a faith-based institution?
45. In the face of controversy and challenges, how are we staying true to our identity as a faith-
based institution?
Comments, advice, suggestions
Is there anything else you would like to add or comment on that was not addressed in the
previous questions?
An opportunity to address any further questions, information, thoughts which the
participant may have, will be provided following each interview.
Thank you very much for your participation!
Thank you for time. If you have any questions or think of anything you would like to add
please feel free to contact me directly. Once the audio recording is transcribed and summarized,
would you be willing to check that I have accurately reflected what was said in this interview
and if I may contact you with any follow-up questions?
(If the answer is yes) I will contact you when I have completed the summary and identified
the main themes emerging from the interview.

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 251
APPENDIX E
KMO Influencers and Interview Protocol
Questions for Assumed Knowledge Influences

Assumed Knowledge Influence Knowledge
Type
Knowledge Influence Assessment

The university senior leadership
needs to have a working knowledge
to fulfil all requirements of the
national accreditation agency for a
pre-licensure nursing program.

The university needs to know the
teaching strategies, interventions,
tools, and best practices of a high-
quality pre-licensure nursing
program.

The university leadership needs to
have a shared knowledge of the
faith-based principles and
components of this new BSc. in
Nursing program.

Declarative
(Factual)

Tell me what you know about the
accreditation requirements for a pre-
licensure nursing program.

-Is anything unclear to you about
the requirements of the national
accreditation agency for a pre-
licensure nursing program?

Tell me about the best practices and
components of a pre-licensure
nursing program.

What teaching strategies,
interventions and tools used for other
programs at the university can help
with the establishment of this new
nursing program? Please list.

-Which of these strategies,
interventions and tools would
you consider to be key elements
to the program? Please explain.

Tell me about the best practices and
components of a faith-integrated
nursing program you intend to
establish.

What does it mean (to you) to
establish a faith-integrated nursing
program that committed to Christian
mission and identity?

-If you could envision and paint
an ideal picture of a fully faith-
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 252
integrated nursing program, what
will it be like?
The university senior leadership
need to know the differences
between a faith-based nursing
program and other general nursing
programs.
Declarative
(Conceptual)

How does the development of a faith-
based nursing program fit into the
university mission and vision?

-What are the potential
challenges and opportunities you
face in establishing this new
program?

The University leadership needs to
know the knowledge, skills and
disposition of ideal faculty to be
recruited.

Procedural What knowledge, skills and
disposition do you look for when
recruiting faculty well-suited for
faith-integrated teaching?

-What are the challenges in
doing this?

The senior leaders need to know
how to develop a business and
implementation plan.

Procedural How will you develop a business
plan and ensure that the plans and
strategies are successfully
implemented for this new nursing
program?

The university senior leadership
needs to know how to reflect on
their own beliefs and goals for
creating a faith-integrated BSc. in
Nursing program.

Metacognitive

What are your own beliefs and goals
for creating a faith-based BSc. in
Nursing program?

Questions for Assumed Motivational Influences

Motivation
Construct
Assumed Motivation Influence Motivation Influence
Assessment
Utility Value The senior leadership must feel that their
time, and resources allocated in establishing
this new nursing program is a worthwhile
endeavor to further advance the mission and
vision of the university and global learning
communities.

Do you believe that a faith-
based nursing program is
worthy of allocation of the
university’s time and resources?
And why?
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 253
Self-Efficacy The university senior leadership needs to
believe that they are competent in creating
the new faith-integrated nursing program
through meaningful engagement with both
the internal on-campus stakeholders and
external partners.
How should the university
engage with both internal on-
campus stakeholders and
external partners in creating the
new faith-integrated nursing
program?

How confident are you in the
University’s abilities to do this?

Questions for Assumed Organizational Influences

Organizational
Influence
Category
Assumed Organizational Influences Organizational Influence
Assessment

Governance
Alignment
The university needs to cultivate a
collaborative culture within the
organization that supports the
establishment of this new nursing
program.

What are some examples of
different things that the
university has done to
communicate and show support
for this new program, if
anything?

Culture of Trust
and Openness
The school needs to have a culture of
trust, openness, safety and respect that
allows faculty and staff to voice their
input on creating a faith-integrated
nursing program.

What does the school do to
create a culture that empowers
all involved (leadership, staff
and faculty) to create a faith-
based nursing program?

-What specific opportunities
have faculty and staff been
given to offer their input on
creating a faith-integrated
nursing program?

Funding and
Resources
The school needs to obtain and
provide adequate funding and
resources necessary to support the
planning, establishment of this new
program to meet the university, state
and national nursing standards.

Tell me about the funding and
resources you have available for
developing a faith-based nursing
program.
Strong
Institutional
Identity
The school needs to develop a strong
institutional identity that reflects the
mission, vision, values and goals
How are we staying true to our
identity as a Christian faith-
based institution (in
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 254
related to the implementation plan for
the nursing program.

implementing the nursing
program)?

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 255
APPENDIX F
An Overview of Themes, Categories and Sub-Categories
Knowledge
1. Accreditation
1.1 WSCUC Senior College and University Commission
1.2 California Board of Registered Nursing
1.3 Nursing Program Accreditation

2. Best Practices and Components for a High-Quality Pre-Licensure Nursing Program
2.1 Theory and Practice Integration
2.2 Academia and Practice Partnerships
2.3 Evidence-Based Best Practices
2.4 Holistic Admission with Student Diversity
2.5 Advanced Technologies
2.6 Strong Christian Mission and Identity

3. Principles for Faith-Based Education
3.1 God-Centered
3.2 Respect Personal Choice
3.3 Value Individuals as God’s Unique Creation with Varied Gifts and Abilities
3.4 Building Relationships and Building Community
3.5 Pro-Science and Excellence

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 256
4. Best Practices and Components for a Faith-Integrated Nursing Program
4.1 Philosophy of Education
4.2 Goal of Education
4.3 Faith-Integrated Curriculum
4.4 Student Learning Outcomes
4.5 Experience the Love of Christ and Share it
4.6 Prayer and Healing

5. Hiring Faculty
5.1 Authentic Personal Faith
5.2 Calling
5.3 Nursing Expertise
5.4 Teaching Skills
5.5 Role Modeling
5.6 Faith Integrate with Subjects
5.7 Local and Global Services

6. Develop a Business and Implementation Plan
6.1 Market Analysis
6.2 APD Precis Process

7. Metacognitive
7.1 Reflect on Own Beliefs and Goals
7.2 SWOT Analysis
CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 257
Motivation

8. Utility Value
8.1 Aligned with University Mission and Vision
8.2 Affirmed Utility Values

9. Self-Efficacy
9.1 Generally Confident and Competent
9.2 Need Nursing Expertise
9.3 Need Funding and Resources
9.4 Need Right Political Environment
9.5 Need Right Faith and God’s Timing

10. Goal Orientation
10.1 Help Institutional Mission
10.2 Help Current US Healthcare
10.3 Help Education System
10.4 Help Church Partnerships
10.5 Help Local Community
10.6 Help Global Health Missions

CREATING A FAITH-INTEGRATED BSC. NURSING PROGRAM 258
Organizational Influence
11. Governance Alignment
11.1 We Are Aligned
11.2 Let Us Know Early

12. Culture of Trust and Openness
12.1 Open and Trust

13. Funding and Resources
13.1 From the University
13.2 From Healthcare System
13.3 From Church
13.4 From Foundations
13.5 From Donors and Sponsors
13.6 Wait for APD Process
13.7 Initiated Grant Application
13.8 Tuition

14. Strong Institutional Identity
14.1 From the Top to Bottom
14.2 Accountability
14.3 Humble Leadership
14.4 God’s Grace

Abstract (if available)

Abstract The shortage of nurses has become a global issue (ICN, 2019). At the same time, faith-based schools worldwide provide both opportunities and challenges to address this worldwide nursing shortage. The organizational context is a private Christian university in California that remains anonymous in this study. By fall 2020, the university will create a new faith-integrated Bachelor of Science (BSc.) in Nursing program. They aim to establish a program consistent with Hasker’s (1991, p. 235) recommendation that “faith integration is best pursued at the level of particular academic disciplines.” Clark and Estes’ (2008) gap analysis KMO framework was used to identify the knowledge, motivation, and organizational resources necessary to achieve the organization’s performance goal of establishing this new faith-integrated nursing program. A rigorous qualitative approach was adopted, using semi-structured interviews that sought the individual perspectives and experiences of six (n=6) senior leaders. Interview data were analyzed using thematic content analysis. Data showed both promising and challenging aspects related to the establishment of this new faith-integrated BSc. in Nursing program. The data underlined the ultimate philosophy of Christian education and the importance to the design of the nursing program: knowing God, His Word, and love personally, and continuously growing in Him so that the love and power of God will be evident in transformed lives to fulfill His plan and purpose in this world. The researcher discussed in great detail the promising patterns, insights, and concepts related to faith-integrated education and its implications for nursing education and health care reform. Successful implementation of the new program may need to embrace a broader account for the institutional environment beyond the university itself.

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University of Southern California Dissertations and Theses

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Asset Metadata

Creator Li, Wei (author)

Core Title Creating a faith-integrated Bachelor of Science nursing program: an innovation model

School Rossier School of Education

Degree Doctor of Education

Degree Program Global Executive

Publication Date 08/15/2019

Defense Date 08/14/2019

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag Christian faith,faith-integrated education,nursing,OAI-PMH Harvest

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Crawford, Jenifer (committee chair), Krop, Cathy Sloane (committee member), Robison, Mark Power (committee member)

Creator Email oliviaweili@hotmail.com,wli707@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-215363

Unique identifier UC11663132

Identifier etd-LiWei-7792.pdf (filename),usctheses-c89-215363 (legacy record id)

Legacy Identifier etd-LiWei-7792.pdf

Dmrecord 215363

Document Type Dissertation

Format application/pdf (imt)

Rights Li, Wei

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA