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direction of the Institute of Research and Service in Nursing Education of Teachers College, Columbia University."

The university-centered master's program for graduate nurses is a "Johnnycome-lately" to professional education. Its rapid growth has created special problems for it, such as academic standing, qualified candidates, competent teaching staffs, and last but not least-increasing costs to both student and sponsoring institution.

The provision of Federal traineeships and the increase in the number of foundation-supported fellowships have brought relief inadequate, perhaps, but most welcome in the area of costs to the student. These stipends have been largely responsible for the 158 percent increase in master's degree fall enrollments between 1955 and 1958, and have expanded the proportion of students who are able to devote full time to their studies, thus accelerating graduations. Institutional costs, on the other hand, rising more or less in proportion to the gratifying enrollment increases, have been hard to deal with. One reason is that we simply did not know what these costs were. Most master's and doctoral programs are carried on in conjunction with programs leading to the baccalaureate degree, with little or no budget differentiation. The newness and experimental aspects of some of the courses defy price tags; the fact that part of the programs are largely clinical and others are not varies actual costs widely; the range in enrollments-from several hundred students to three or four-makes comparisons between schools extremely difficult.

Decisive action to meet the rising institutional costs of graduate education for nursing seems imperative. Many of the graduate programs are already face to face with budget imbalances, and major growth lies ahead if the Nation's needs for nurse leaders are to be met.

The extent of the growth that should be sought has been indicated by the statement, "While more graduates are needed from every type of educational program in nursing, the situation in graduate education is the most critical one. Against an estimated need by 1970, for 78,000 to 91,000 nurses prepared as administrators, supervisors, teachers, consultants, research workers, and expert practitioners, there were, in 1956, only 6,400 active nurses who had completed graduate programs.'

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The recent 158-percent enrollment increase looks impressive percentagewise. Yet only 997 nurses received master's degrees in 1957-58, less than one-fourth of the additional administrators, supervisors, and teachers the Public Health Service estimated the Nation should have had in 1959. These estimated needs will rise each year until over 6,000 nurse leaders should be added to the Nation's supply in 1969 alone.

Whatever our financial problems are, they seem bound to grow. Tuition meets little more than a third of the cost to the institution of graduate education for nursing. Tuitions are rising, but how far can they be pushed up without defeating the basic purpose of multiplying the number of nurses preparing themselves for leadership positions? Similarly hazardous to the expansion aim would be widespread adoption of the policy decided on in two institutions to deal with the current financial crisis. They are limiting graduate nurse enrollment to the number of students who can be offered quality education with available funds.

Nurse leaders have long sought more public support for education for the public service that nursing is. A strong plea for tax and other forms of public support for nursing education, both basic and advanced, was made in 1948 by Esther Lucile Brown following the study she made under the auspices of the

1 Mrs. McManus (Massachusetts General, Boston; Ph. D., Columbia) is head of the Department of Nursing Education and director of the Institute of Research and Service in Nursing Education at Teachers College, Columbia University, New York. Mrs. McManus is also chairman of the Conference of Nurse Administrators of Accredited Graduate Education Programs in Nursing.

2 Advisers for the study were: Ruth P. Kuehn, dean of the University of Pittsburgh School of Nursing; Sister Charles Marie, dean of the Catholic University of America School of Nursing; Lulu W. Hassenplug, dean of the University of California at Los Angeles School of Nursing; Marie Farrell, dean, Boston University School of Nursing; and Katharine Faville, dean, Wayne State University College of Nursing all members of the Conference of Nurse Administrators of Accredited Graduate Education Programs in Nursing.

3 "Education for Professional Nursing, 1958," Nursing Outlook 7: 448-455, August 1959. Adams, Apollonia O., "Professional Nurse Traineeships, Pt. I: Report of the National Conference To Evaluate Two Years of Training Grants for Professional Nurses" (U.S. Public Health Service Publication No. 675), Washington, D.C., U.S. Government Printing Office, 1959.

National Nursing Council. A growing recognition of public obligation is implicit in the gratifying extension of the Federal traineeship program, yet the Public Health Service Act, section 307 (successor to title II of Public Law 911), fails to make any financial allowance for administration to the institution that accepts the trainees.

Another reason why tax funds offer no early answer to the dilemma faced by the sponsoring universities and colleges is that graduate education for nursing was pioneered and has had its greatest growth in privately supported institutions, which now enroll 72 percent of the students. Moreover, some of the tax-supported institutions in which the other 28 percent are enrolled lean heavily on special grants from private sources for the development-and even for the establishment-of graduate nursing education programs. Any major shift of responsibility to the taxpayer's shoulders will take time.

Relatively new, and small, among the complex of university graduate schools, nursing sometimes has difficulty in establishing its claim to an adequate share of general institutional funds. By the same token the nursing education programs, with one or two exceptions, are totally without the endowments that give stability and continuity to graduate work in some other fields.

With all these and other factors in mind, the deans, or their representatives, from 25 of the 29 National League for Nursing accredited graduate education programs in nursing met in Chicago on March 15, 1959, to discuss financial and other problems incident to preparing the leadership that the Nation's nursing service requires. Again in Philadelphia on May 10, 1959, the deans met, and the outcome was the organization of the Conference of Nurse Administrators of Accredited Graduate Education Programs in Nursing. It was with the advice and cooperation of the conference that the Institute of Research and Service in Nursing Education of Teachers College supervised the designing and conduct of the study of the institutional costs of a typical master's degree program in nursing reported here. The amount of both time and funds available established the limitations of the undertaking.

Events are pressing the graduate programs too closely to permit waiting for the completion of the 3-year study of the cost of nursing education which NLN is making with financial aid from the Public Health Service. Waiting seemed especially inadvisable because it is a question of how much light the NLN study, with its focus on the diploma and baccalaureate programs, will throw on graduate education problems. However, any new data that may be forthcoming will be definitely in order by the time the NLN study is completed, so rapidly is the graduate situation changing.

The accounting and auditing firm of Peat, Marwick. Mitchell & Co. was retained. Three of its representatives, Howard A. Withey, John C. Overhiser, and George D. Gamble, with the help of Dr. Thad L. Hungate, controller of Teachers College and author of a widely used reference on university accounting, developed computational procedures that would utilize financial data and statistics which are generally available in the records of universities. The aim was to arrive at valid estimates of the cost of a typical master's degree program in nursing without engaging in an extensive investigation and analysis of the financial records of educational institutions.

Mr. Gamble then visited five schools of nursing, selected on three bases: (1) Together they needed to assure a broadly representative sampling of all the graduate programs; (2) it was necessary that the dean of the nursing school and the institution's financial officer be available for consultation at the time Mr. Gamble could make his visit; and (3) records of the 1957-58 program year, which was the one studied, had to be in a form that would not require an impossible amount of research.

The five institutions chosen as meeting in the best way these three requirements have graduate nursing education programs with both large and small enrollments; they include the long established and the relatively new programs; they include publicly supported, privately supported (both with and without endowment), and church supported; they are located in different regions of the United States. Moreover, the five enrolled 39 percent of the graduate nursing education students in the entire country in 1957-58 (three part-time students were counted as one full-time student).

5 Brown, Esther L., "Nursing for the Future," New York, Russell Sage Foundation, 1948. Hungate, Thad L., "Finance in Educational Management of Colleges and Universities," New York, Bureau of Publications, Teachers College, Columbia University, 1954.

WHAT ARE EDUCATIONAL COSTS?

The costs to the educational institution, as determined by the study included both instructional costs and the noninstructional overhead costs which are incurred as a result of educational activities constituting the normal academic program of each participating institution.

Included in the educational cost computed by the study were the costs of the following items:

1. Direct costs of instruction, including an appropriate share of organized activities of the institution related to instruction.

2. Use value of buildings and equipment determined as a percentage of either the insurable value or the recorded costs of those assets. The use of current valuations for such assets was considered desirable where such values could be readily determined.

3. Use value of books.

4. Compensation to student assistants for services related to instructional activities.

5. Payments to other institutions for instruction and facilities for the training of students, which constitute a part of the instructional program of the participating school. (These payments do not necessarily cover all costs to the cooper

ating institutions.)

6. General administration and plant maintenance-net of allocations of a portion of those costs to noninstructional activities.

7. Value of services contributed by religious personnel.

8. Expenditures financed by reserve and other restricted funds for educational purposes as defined.

9. Direct costs of summer sessions if such sessions are part of the normal program year.

Excluded from the computation were the costs of the following items:

1. Organized research, including an allocation of overhead thereto.

2. Auxiliary activities including charges for overhead items as recorded in the accounts.

3. Extension and off-campus services, including an allocation of overhead thereto.

4. Equipment and book acquisitions for which a use-value amount was substituted in the cost accumulation.

5. Stipends to students, other than for services related to instruction.

6. Direct costs of summer sessions, if such sessions were not part of the normal program year.

7. Additions to reserve accounts not identifiable with specific expenditures. 8. Expenses, if significant in amount, allocable to other fiscal periods. The basic computational procedure followed by the accountants was to determine the credit hour components by instructional department, of a typical master's degree program. The total educational cost for each department, determined through adding the items indicated above as "included," was divided by the total number of student credit hours taught by each department to obtain the average educational cost of each student credit hour, by department. By multiplying the departmental costs per student credit hour by the department credit hours in the typical program, and summarizing the results, the estimated educational cost of a master's degree in nursing was obtained.

Direct departmental costs included expenditures for the normal program as defined by each individual institution. (Some institutions exclude the summer session from the normal program year; others consider a full calendar year of four quarters, or three semesters, as normal.)

The content of a "typical" program was determined separately in each institution through consultation between the nursing dean and the accountant, taking into consideration the enrollment in the actual programs offered in each school. The wide variety in master's programs made necessary this school-byschool decision.

Segregation of costs of graduate and undergraduate courses respectively was made within the instructional department classifications for the school of nursing, and for such other departments as sociology and psychology which make significant contributions to the education of nurses.

The total student credit hours taught by each instructional department during the program year were accumulated from records maintained by the registrars. The period for which student credit hours were determined for each partici

pating institution was the same as the period for which departmental costs were assembled.

The estimated cost of a typical master's degree program in nursing in 1957-58 in each of the five institutions, the tuition in each, and the percent of the cost met by the tuition, are presented in table 1 which constitutes the total pertinent study findings. Because of the wide range in the cost figures-from $1,700 to $3,100-and other variations in the graduate programs, the accountants believed the findings did not lend themselves to further statistical analysis.

DEANS SEEK INTERPRETATIONS AND PROJECTIONS

The study findings as they stand constitute information never before available that will be useful in the planning for any separate program.

What specific meanings the tables may have with respect to nationwide plans for graduate education for nursing now, and in the future, seemed to call for joint thinking. Three officers of the conference of nurse administrators and two other deans of graduate programs who were able to meet in New York, on October 3, considered the summary of study findings shown in tables 2 and 3. (In order to express the data in terms of the full-time student cost developed by the study, three part-time students were considered equivalent to one full-time student in making the summaries.)

The deans believed that the weighted average of the cost figures revealed by the study as shown in table 2-$2,115.63-was influenced too heavily by the relatively large enrollment and low costs in institution I to be typical of the country as a whole. They believed that the nonweighted average $2,456.34— was more nearly representative, but wanted to check this opinion again by data from other schools.

A brief questionnaire was formulated and sent to the deans of the 24 accredited graduate programs not included in the sample study. The sheet asked for enrollment and tuition figures, and requested each recipient, after conferring with her institution's financial officer, to check the point (on a cost-range chart provided) that they believed to be nearest the cost to the particular institution of a typical full-time master's degree student in 1957-58. The points on the chart were $250 apart.

While nothing more than guesses were expected, 9 of the 17 replies stated that the cost figure supplied was based on some type of actual cost computation. Table 4 summarizes the cost estimates provided by 17 graduate nursing education programs not included in the sample studied.

TABLE 1.-Estimated educational costs of masters degree programs in nursing education at selected institutions and supplementary information

based on program year, 1957-58

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