Original Story [03/07/2022]
Challenge
Demand is growing for nurses and nursing assistants to serve in the healthcare sector. There has been a nursing shortage for several years, and it’s predicted to worsen as the Baby Boomers age. The COVID-19 pandemic stretched the healthcare workforce and further increased the need for more qualified nursing staff.
Students interested in studying nursing often face financial hurdles, including the high cost of textbooks. This can especially be a problem for students from low-income households. In the Wisconsin Technical College System (WTCS), about 1 in 5 of its nearly 250,000 students is economically disadvantaged, according to the most recent student data fact book.
For students who want to serve in this vitally important field, the financial hurdles are among the highest of any program. The nursing associate degree program ranks as one of the most expensive programs at Wisconsin technical colleges with textbooks costing students an average of $1,307 during the course of their program.
Solution
In 2019, Chippewa Valley Technical College (CVTC) in Eau Claire received a $2.5 million federal grant to develop five OER textbooks and 25 virtual reality scenarios for nursing 
students. The Open RN project solicited input from faculty, nursing students, and industry partners to ensure the materials reflected the most relevant and accurate information. CVTC collaborated with other institutions in the state WTCS consortium to produce the digital textbooks, which were published by Pressbooks, accessible online or in downloadable formats.
Faculty can easily remix the textbooks and customize the material through LibreTexts. For students who prefer print, affordable copies are published by XanEdu and available in college bookstores and on Amazon.
The first OER textbook, Nursing Pharmacology, was completed in fall of 2020; Nursing Skills came out in May 2021 and Nursing Fundamentals in the fall 2021. The final two open textbooks (Mental Health & Community Concepts and Management & Professional Concepts) are slated for release in the fall 2022.
Through a separate stream of grant funding, the OpenRN project is also developing an OER Certified Nursing Assistant (CNA) assistant digital textbook.
Impact
The OER nursing textbooks have been adopted by 67 course sections saving 1,250 students nearly $193,000 through the academic year 2020-21. Once all five books are completed and rolled out in courses across the state, it’s anticipated that students will save $1.5 million each year, according to Vince Mussehl, director of library services and Open RN lead librarian at CVTC.
The CNA textbook is expected to reach as many as 7,800 students, saving them $650,000 a year.
In addition to the financial boost, early indications are that students are performing better using the new digital textbooks and like the quality.
There was a 5 percent improvement in student success in sections of pharmacology courses that used the new OpenRN learning materials, says Kim Ernstmeyer, project director. The first three OpenRN books received OER Awards for Excellence, which helped spread the word internationally about the value of the materials, she says.
A feedback survey showed students liked the OER book’s ease of use, navigation to credible resources, and learning activities that help them apply the knowledge to patient care, Ernstmeyer adds.
To educate faculty about how to create and use open resources, Mussehl launched OER 101 in January 2020. More than 200 faculty from all over the country have participated in the free online course. Surveys of the first year cohort revealed participants were saving their student more than $500,000 a year in textbook cost. “This is making a big difference for everyone, not just nursing students,” Mussehl says. “Because of this effort, other colleges have been saving their students money, learning about OER and understanding the benefits of open education.”
To learn more about Open RN and CVTC Affordable Learning, visit their website here.
April 2023 Update: Progress Continues as Open RN Expands
A new report on the impact of the project shows broad international reach of Open RN textbooks with over 7.5 million page views by over 3 million international users. Also, 58 colleges and universities across the United States have adopted one or more print versions of the Open RN textbooks. As of March 1, there have been 414,901 video views, 4200+ hours of watch time, and 777 subscribers on the Open RN YouTube Channel.
The U.S. Department of Education approved a one-year extension of the Open RN’s Open Textbook Pilot grant. This will allow the project to develop second editions of its five open textbooks and publish a sixth nursing textbook, Advanced Nursing Skills, scheduled for release in June 2023.
The updated textbooks will include questions to better assess clinical judgment in nursing graduates that align with the changes in the 2023 licensing exam for nurses (NCLEX), according to Kim Ernstmeyer, project director of the Open RN project.
A spinoff project, “Next Gen RN,” received a $500,000 consortium grant from the Wisconsin Technical College System. Working in collaboration with LibreTexts, it will customize the learning platform so nursing faculty can create complex style case studies to be shared through a repository of the Wisconsin Technical College System (WTCS). Also, links to public questions will be incorporated into the second editions of the Open RN textbooks as formative assessments that students can complete online independently.
Looking ahead, WTCS has requested $3 million to support the creation of OER in the state’s (2023-25) budget, which Governor Tony Evers has included in this executive budget proposal.
The CVTC Student Government Association has become involved. Students have participated in legislative conferences with their counterparts on other campuses and met with legislators to advocate for OER.
If the additional state funding is approved, the hope is to build on Open RN’s success and add OER to classes in career and technical education, where publisher textbooks don’t always translate well to on-the-job experiences, said Hilary Barker, OER network coordinator for WTCS. “OER gives us the opportunity to best align the content with our course competencies and includes examples that are relevant within our communities and local workforce,” she said.
“It has been so exciting to see how, as the Open RN Project matures, it has inspired so many other pathways to open education in Wisconsin,” said CVTC’s Vince Mussehl, a SPARC Steering Committee member, “Students, faculty, administrators, and now even legislatures are starting to better understand the significance of open learning. It is an honor to share our experiences at a state level and now at a national level as a recent appointee to the SPARC steering committee.”
