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Strength In Numbers: Six Nursing Faculty Embark On A Shared Journey To Doctorate Success, Melissa P. Arthur, Leigh Moore May 2026

Strength In Numbers: Six Nursing Faculty Embark On A Shared Journey To Doctorate Success, Melissa P. Arthur, Leigh Moore

Inquiry: The Journal of the Virginia Community Colleges

Pursuing a Doctor of Nursing Practice (DNP) is a demanding and transformative experience, one that can be both daunting and profoundly rewarding. This article chronicles the journey of six dedicated nursing faculty and administrators from Southside Virginia Community College (SVCC) who undertook this challenge together, turning an academic endeavor into a shared mission of growth, resilience, and collaboration. Originating from a spontaneous suggestion, this collective pursuit of doctoral education evolved into a powerful example of professional solidarity.

As seasoned educators and leaders, the group had previously collaborated on pivotal institutional milestones such as ACEN accreditation, Board of Nursing improvement initiatives, …


Building Resilience: Empowering Baccalaureate Nursing Students For Enhanced Well-Being And Success, Jessica Imrie Dnp, Emily Nowak Phd, Roxanne Wilson Phd May 2026

Building Resilience: Empowering Baccalaureate Nursing Students For Enhanced Well-Being And Success, Jessica Imrie Dnp, Emily Nowak Phd, Roxanne Wilson Phd

InnovateHER Meeting 2026

Providing baccalaureate students with resilience-building modules such as stress management, mindfulness, optimism, socialization, and reflection can increase psychological well-being and success through a nursing program. It can also decrease the number of meetings faculty have with students regarding psychological concerns


The Intersection Of Faculty Perceptions Of Student Evaluations Of Teaching And Nursing Retention: The Challenges Of Undergraduate Nursing Programs In Higher Education Institutions, Melissa Wolff May 2026

The Intersection Of Faculty Perceptions Of Student Evaluations Of Teaching And Nursing Retention: The Challenges Of Undergraduate Nursing Programs In Higher Education Institutions, Melissa Wolff

Dissertations, Theses, and Projects

For over 100 years, higher education institutions in the United States of America have been using student evaluations of teaching (SET) to evaluate course effectiveness and teaching quality. SETs are used to inform faculty about areas where course improvements are needed, if course objectives have been met, and the strength of their teaching ability. Even with the longstanding integration of SETs in higher education their reliability and validity have been questioned. Various factors negatively influence student ranking of faculty including class size, faculty appearance, ethnicity, and gender. SETs also impact faculty’s ability to earn tenure and promotion, which raises concerns …


Perceived Stress Levels Of Prelicensure Nursing Students Over A 10 Week Period, Sara K. Myers Apr 2026

Perceived Stress Levels Of Prelicensure Nursing Students Over A 10 Week Period, Sara K. Myers

SACAD: Scholarly Activities

Abstract

Introduction: Nursing students are held to extremely rigorous academic standards, which often result in severe and chronic stress. This phenomenon creates an array of negative consequences, including mental and physical health issues, reduced academic success, and, in extreme cases, attrition from nursing school or subsequent exit from the nursing profession.

Purpose: The purpose of this study was to identify peak stress levels in a four-semester prelicensure nursing program over a 10 week study period to provide a template for implementation of focused mitigation strategies by nurse educators.

Methods: A longitudinal study design in which the Perceived Stress Scores 10-item …


Integrating Artificial Intelligence Into Fnp/Dnp Simulation To Enhance Clinical Competency, Doris K. Gonzales Mar 2026

Integrating Artificial Intelligence Into Fnp/Dnp Simulation To Enhance Clinical Competency, Doris K. Gonzales

SACAD: Scholarly Activities

Abstract  

This poster presents a theoretically grounded, AI-integrated simulation program design structured across 3-4 semesters of Family Nurse Practitioner (FNP) and Doctor of Nursing Practice (DNP) education. This program is designed to support the development of clinical judgment and diagnostic reasoning among FNP students. Guided by Tanner’s Clinical Judgment Model and Roy's Adaptive Model as Theoretical Framework. The program addresses identified gaps in differential diagnosis and role transition from Registered Nurse (RN) to FNP practice. A needs assessment informed the development of a semester-sequenced curricular framework integrating AI-supported simulation across four semesters. The proposed design illustrates how progressive simulation experiences …


Implementing A Student Standardized Patient Elective To Improve Communication And Confidence In Undergraduate Nursing Simulation, Katie J. Mcqueen Mar 2026

Implementing A Student Standardized Patient Elective To Improve Communication And Confidence In Undergraduate Nursing Simulation, Katie J. Mcqueen

SACAD: Scholarly Activities

Abstract

Simulation plays an important role in preparing undergraduate nursing students for clinical practice by fostering communication skills and building confidence. Currently, simulation experiences often depend on faculty and staff to play the roles of patients or family members. Research shows that nursing students can be effectively trained to serve as standardized patients, creating opportunities for peer-supported learning and improving simulation experiences. This evidence-based practice proposal recommends the implementation of a 1-credit-hour Student Standardized Patient (SSP) elective in the undergraduate nursing curriculum for senior level nursing students. The elective would provide structured training in role portrayal, safety practices, and case …


Early Sepsis-Recognition Simulation Training: An Evidence-Based Initiative, Blanca A. Zavala Mar 2026

Early Sepsis-Recognition Simulation Training: An Evidence-Based Initiative, Blanca A. Zavala

SACAD: Scholarly Activities

Sepsis is a life-threatening condition that requires rapid recognition and intervention to prevent poor patient outcomes. Delays in identification remain a significant concern for patient safety, particularly among nurses and nursing students who may lack confidence and clinical judgment in early sepsis recognition (Marsack et al., 2022). This evidence-based practice project aimed to examine the existing evidence on sepsis education and evaluate the effectiveness of simulation-based learning in improving clinical judgment and sepsis recognition, with the goal of informing a potential sepsis training initiative for nursing students.

A literature review of six peer-reviewed studies (2022–2026) was conducted using the PubMed …


Precision Education In Health Sciences Education: A Call-To-Action For Developing An Interprofessional Strategy, Arvie Vitente, Jennifer Bosworth, Robert Sweet, Rebecca Cozzi, Christopher Galloway, Piotr Szczurek, Melanie Obispo-Young, Eron Bozec, Erica Brkovic, Tina Bobo, Jennifer Lubinski Dec 2025

Precision Education In Health Sciences Education: A Call-To-Action For Developing An Interprofessional Strategy, Arvie Vitente, Jennifer Bosworth, Robert Sweet, Rebecca Cozzi, Christopher Galloway, Piotr Szczurek, Melanie Obispo-Young, Eron Bozec, Erica Brkovic, Tina Bobo, Jennifer Lubinski

Philippine Journal of Physical Therapy

Introduction. Growing learner diversity, expanding biomedical knowledge, and rapid clinical digitization have exposed the limits of on-size-fits-all health sciences training. Competency-Based Education (CBE) has sharpened the focus on outcomes, yet many programs still move learners through fixed sequences, infrequent assessments, and retrospective remediation. Precision Education (PE) offers a complementary, data-enabled approach that uses learning analytics, artificial intelligence (AI), and continuous feedback loops. Embedded within CBE, PE converts competencies from static milestones into dynamic trajectories that can be measured, visualized, and adjusted in real time across the curriculum. This abstract highlights the need for an interprofessional strategy to design, fund, and …


Nursing Students As Advocates: Addressing Social Determinants Of Health Through Service-Learning, Rebekah Mullins Nov 2025

Nursing Students As Advocates: Addressing Social Determinants Of Health Through Service-Learning, Rebekah Mullins

Nursing Theses and Dissertations

Advocacy is at the heart of nursing practice, and advocating for the social determinants of health (SDOH) is crucial when providing care to patients from vulnerable populations. Service-learning is a strategy that can be used to teach students advocacy skills. Chapter 2 of this dissertation portfolio presents a concept analysis that explores the definition of advocacy using the Walker and Avant method (2019). The concept analysis informed the development of the case study presented in Chapter 3 and the research study presented in Chapter 4. The portfolio includes original, qualitative research that was guided by the interpretive descriptive method. The …


Chalkboards To Chatbots: Helping Faculty Harness Ai For The Future Of Higher Education, Justin C. Grace Jan 2025

Chalkboards To Chatbots: Helping Faculty Harness Ai For The Future Of Higher Education, Justin C. Grace

Regis University Student Publications (comprehensive collection)

Integrating artificial intelligence (AI) into nursing education presented significant opportunities yet posed challenges due to varied faculty readiness. This Doctor of Nursing Practice (DNP) quality improvement (QI) project evaluated an educational intervention aimed at enhancing nursing faculty's AI proficiency and confidence at Regis University’s Rueckert-Hartman College for Health Professions. Using a mixed-methods, pre- and post-intervention design, validated surveys assessed changes in faculty perceptions, knowledge, and skills related to AI. The intervention included a digital toolkit with nine instructional videos demonstrating practical AI applications using FreedAI’s large language model, ChatGPT, supported by voiceover narration and closed captioning. Data analysis involved descriptive …


The Ethics Of Student Attrition In Healthcare Education Programs, Kent Haina Jr, Peter A. Depergola Ii Jan 2025

The Ethics Of Student Attrition In Healthcare Education Programs, Kent Haina Jr, Peter A. Depergola Ii

Journal of Health Ethics

Student attrition is a problem in healthcare education programs, but there is little in the literature regarding the organizational ethics of lowering it. Some argue that lowering attrition is unethical, because it would lower academic and professional standards, potentially impacting patient care. Others say students deserve to make decisions about when to leave a course of study. However, these arguments ignore inequities in attrition, as well as the conflicts of interest in, and moral obligations of colleges and universities. Lowering attrition rates in healthcare education programs is inherently ethical because it levels the playing field for underrepresented minorities that disproportionately …


Exploring The Relationship Of The Noncognitive Variables Of Grit And Mindset In Baccalaureate Nursing Students And Their Impact On Academic Success, Alecia Hollis Aug 2024

Exploring The Relationship Of The Noncognitive Variables Of Grit And Mindset In Baccalaureate Nursing Students And Their Impact On Academic Success, Alecia Hollis

Dissertations

The study aimed to evaluate how the noncognitive variables of grit and mindset could impact the academic success of baccalaureate nursing students. With the present and growing shortage of nurses, attrition within nursing programs is cause for concern. Attrition is a multifaceted problem; however, academic failure is one contributing factor. While cognitive factors, such as the standardized aptitude test (SAT), pre-nursing science GPA, pre-nursing GPA, and standardized entrance exams (Al-Alawi et al., 2020; Chisholm-Burns et al., 2021), have traditionally been used for admission criteria, increasing evidence suggests that noncognitive factors, like grit and mindset, play a crucial role in academic …


Impact Of Exercise On Burnout Of Nursing Students, Kelly Foudray Apr 2024

Impact Of Exercise On Burnout Of Nursing Students, Kelly Foudray

SACAD: Scholarly Activities

Background: An important topic as a nurse educator is how to provide nursing students with adequate self-care strategies to help prevent feelings of burnout. Burnout is an issue not only that affects healthcare workers, but also those who are studying to work in the medical field, for example nursing students. Nursing students experience high levels of stress due to the significant workload throughout nursing school. Nursing students also go through a rigorous curriculum that is often inflexible. Many nursing programs have a competitive atmosphere among classmates, and they are also preparing for the NCLEX examination. All these factors can …


Implementation Of A Healthy Skin Committee And Education On The Number Of Hospital Acquired Pressure Injuries, Laura Viana Apr 2024

Implementation Of A Healthy Skin Committee And Education On The Number Of Hospital Acquired Pressure Injuries, Laura Viana

SACAD: Scholarly Activities

Abstract

Over the years, hospital-acquired pressure injuries (HAPI) have emerged as a significant challenge in the healthcare industry. Despite significant advancements in healthcare, pressure injuries continue to be a persistent global healthcare issue, closely linked to the safety of patients, affecting patient outcomes, and increasing healthcare costs (Gaspar et al., 2019). HAPIs are associated with increased morbidity and mortality rates. HAPIs are likely to experience longer hospital stays, increased risk of infections, higher treatment costs, and potentially more significant health complications. HAPIs commonly occur in the hospitalized patient and are costly and preventable. Given the implications of HAPIs, there is …


The Effect Of Simulation On Self-Confidence And Anxiety Related To Clinical Decision-Making In Undergraduate Bsn Students, Vivian Bowman Apr 2024

The Effect Of Simulation On Self-Confidence And Anxiety Related To Clinical Decision-Making In Undergraduate Bsn Students, Vivian Bowman

SACAD: Scholarly Activities

Objective: Nursing students face challenges as they transition to the workplace and juggle the tasks of effective communication, delegation, prioritization, and clinical judgment during stressful situations. Research has shown that simulation is one method to improve clinical decision-making skills, increase confidence, and decrease anxiety. The purpose of this quality improvement project is to measure participants’ perceptions of their levels of self-confidence and anxiety related to clinical decision-making before and after a simulation session at George Washington University (GWU). Method: 21 third-semester Accelerated BSN students enrolled in the Adult-Geriatric Nursing 2 course were recruited for this study. Participants completed the Nursing …


Pharmacological Interventions Versus Non-Pharmacological Interventions On Pain In Chronic Pain Patients, Harley Page, Olivia Mcswain Mar 2024

Pharmacological Interventions Versus Non-Pharmacological Interventions On Pain In Chronic Pain Patients, Harley Page, Olivia Mcswain

SACAD: Scholarly Activities

The study is a comparison experiment that looks at the different types of interventions to treat chronic pain. This study is set at Haysmed Rehabilitation to gather data on adult patients with chronic pain. When studying the interventions used for chronic pain, we found numerous ways of treatment. They are categorized as pharmacological and non-pharmacological interventions. During the study we found, that an understanding of what is causing the pain and the use of both interventions is the best way to go about treating/managing chronic pain.


Use Of An Electronic Health Record System In The Nursing Education Lab & Simulation Setting, Easlyn Koch Mar 2024

Use Of An Electronic Health Record System In The Nursing Education Lab & Simulation Setting, Easlyn Koch

SACAD: Scholarly Activities

Simulation has become a significant component of nursing education in recent years, especially with the increasing demand for high-fidelity simulations. However, nursing education struggles to keep up with the ever-changing healthcare technology, specifically electronic health records (EHR). Integrating EHRs into nursing education in areas such as the lab or simulation settings has the potential to impact overall patient safety, familiarity with similar technology, critical thinking skills, and practice readiness of student nurses. A review of the literature was performed, and it was found that the implementation and integration of an EHR in nursing education has overwhelming effects on overall student …


Hormonal Birth Control Effects On The Neurological And Cardiovascular Systems, Alondra Perez, Paige Fink, Adell Riedel Mar 2024

Hormonal Birth Control Effects On The Neurological And Cardiovascular Systems, Alondra Perez, Paige Fink, Adell Riedel

SACAD: Scholarly Activities

Abstract

The present study theoretically investigated the effects of long-term use of hormonal birth control on the female cardiovascular and neurologic systems. The setting will take place at Fort Hays State University campus. Our participants of the survey will include 200 random females ages 16 to 25. This data will be taken from those women who take hormonal birth control versus those females who do not take it on a daily basis. The long-term use of hormonal birth control is creating changes in the neurological and cardiovascular system. Evidence from previous research shows alterations to both the structure and function …


Flipping The Classroom To Improve Knowledge Retention Among Practical Nursing Students, Paige Cooper Mar 2024

Flipping The Classroom To Improve Knowledge Retention Among Practical Nursing Students, Paige Cooper

SACAD: Scholarly Activities

Typical nursing lectures consist of a power point, and a lecturer discussion of a particular subject, such as a disorders, treatments, or pharmacology (HEW & LO, 2018). Flipping the classroom is a lecture style tailored to a variety of student learning styles, and utilizes prerecorded lectures, and participation in projects or discussions during class time. There are four main learning styles: visual, auditory, kinesthetic, and reading/writing. Each style comes with their own strategies, but all have similar advantages, including the opportunity to learn in the best way for individual students. Flipping the classroom avoids the typical lecture, and implements activities …


The Implementation Of Student Success Coaches At Augusta Technical College To Foster The Development Of Diverse And Competent Nurses, Heather R. Vincequere Feb 2024

The Implementation Of Student Success Coaches At Augusta Technical College To Foster The Development Of Diverse And Competent Nurses, Heather R. Vincequere

SACAD: Scholarly Activities

Abstract

This project explores the implementation of Student Success Coaches at Augusta Technical College (Augusta Tech) and their potential impact on the rates of overall program completion and the rate of diverse student program completion. Framed within the GROW model and Sociocultural Learning Theory, the project aims to determine if coaching interventions address barriers to completion and foster a supportive learning environment. A mixed-methods exploratory approach was employed, combining empirical data such as retention rates and demographics with qualitative information from surveys. Anticipated results suggest an increase in overall completion rates from 55.34% to 80% and an increase in diverse …


The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban Dec 2023

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …


Effects Of Clinical Competency In Nursing Students Following The Implementation Of Student-Led Learning, Cori E. Hack, Jacob N. Hicks Oct 2023

Effects Of Clinical Competency In Nursing Students Following The Implementation Of Student-Led Learning, Cori E. Hack, Jacob N. Hicks

Scholars Week

Research and supporting evidence represent a gap identified in didactic learning between students and faculty. This gap shows emotional factors of the nursing curriculum that may suggest negative impacts on nursing students, but also improvements that can be made to increase students’ clinical competency levels. By adhering to strict definitions of student-led learning theory and clinical competency, we were able to create concrete evidence with measurable data that can contribute to the elimination of this gap in learning. Upon inspection of past text, we identified a need for further research on this topic to bring awareness and encourage this method …


Leadership, Policy Development And Emr Utilization In At Services At Heidelberg University, Matallyn Overmyer Apr 2023

Leadership, Policy Development And Emr Utilization In At Services At Heidelberg University, Matallyn Overmyer

Masters Theses/Capstone Projects

The practicum is being completed with Heidelberg University AT Services. I started January 2023 and plan to finish April 2023. I am working directly with Tyson Depinet, Coordinator of AT Services, to learn more about roles and responsibilities of a collegiate head athletic trainer. Emphasized areas of focus: - EMR Administrative Utilization - Policy Development - Leadership & Managemen


Using Doctoral Education And Research-Based Learning To Advance The Nurse Leader, Kara R. De La Fosse Jan 2023

Using Doctoral Education And Research-Based Learning To Advance The Nurse Leader, Kara R. De La Fosse

The Journal of Advancing Education Practice

Nurse leaders perform in highly autonomous positions in two dimensions; academia, and the clinical setting with the awesome responsibility to serve and protect others. To guide nursing practice, research-based skills are crucial to ensure leadership decisions are founded in evidence-based practice. Random controlled studies are gold-standard in healthcare compared to correlation or descriptive studies and employ a systematic review to strengthen findings (Schmidt & Brown, 2021). Research skills are prominent in numerous components of the leadership scope to perform at a stellar level.


The Impact Of Self-Care On Nursing Faculty Burnout And Worklife, Jennifer J. Harrington Jan 2023

The Impact Of Self-Care On Nursing Faculty Burnout And Worklife, Jennifer J. Harrington

Regis University Student Publications (comprehensive collection)

Nursing faculty are relied upon to prepare the nursing workforce of the future. The stress and pressure felt by nursing faculty impacts their ability to practice self-care, and this threatens their ability to perform optimally. Lack of self-care can lead to diminished quality of life, and ultimately burnout. Feelings of burnout and decreased quality of life, which are precursors to faculty turnover, further perpetuates the nursing shortage. A Quality Improvement (QI) Pilot Initiative, with an evidence-based design methodology was implemented within one university’s nursing department, located in a western state, to address this problem. Using a pre-post survey design and …


Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason Jul 2022

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …


Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley Jul 2022

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …


A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford May 2022

A Qualitative Study On Nurse Facilitators Of Mind-Body Skills Groups, Paula D. Blake-Beckford

Mindfulness Studies Theses

The Center for Mind-Body Medicine (CMBM), founded by Dr. James Gordon, provides communities with evidence-based Mind-Body Skills Groups (MBSGs) that foster self-care, self-awareness, and self-expression. MBSGs range from 8 to 12-week series on various mind-body practices wherein group members meet, practice, and reflect on the impact of mind-body skills in their lives. Research has demonstrated that participants in MBSGs have positive outcomes. Healthcare professionals (HCPs), especially nurses, gain resiliency from MBSGs. As facilitators of MBSGs, nurses develop essential skills transferable to clinical and educational settings. MBSGs are therapeutic for adult participants with chronic stress. Prior to this thesis, only one …


Dnp Final Report: Mission Cyborg: An Ebp Project Integrating Hybrid Learning In An Undergraduate Nursing Course, Mary A. Thomas Apr 2022

Dnp Final Report: Mission Cyborg: An Ebp Project Integrating Hybrid Learning In An Undergraduate Nursing Course, Mary A. Thomas

DNP Final Reports

In modern times it is an expectation of students that technology be incorporated into how they receive their education. The COVID-19 pandemic brought to light how pure reliance on traditional face-to-face (F2F) learning can be detrimental to student learning. Many institutes of higher education had already implemented hybrid/blended learning prior to the pandemic and saw no difference in their NCLEX-RN pass rates. This evidence-based practice project gathered, reviewed, and synthesized evidence in order to determine if implementing different teaching strategies would maintain or improve student performance on both unit exams and end of course exit exams.


Exploring Compassion For The Community And Diversity Through Nursing Experiential Learning, Jaime Sinutko, Nadine Wodwaski, Brooklin Adams Apr 2022

Exploring Compassion For The Community And Diversity Through Nursing Experiential Learning, Jaime Sinutko, Nadine Wodwaski, Brooklin Adams

Experiential Learning & Teaching in Higher Education

Background: The aim of Jesuit education is total growth leading to action (Jesuit Institute, 2014a), plus higher Jesuit education seeks to transform students through examining the world around them. The promotion of experiential learning is noted in Ignatian Pedagogy (2014a) by urging the whole person to enter the learning experience. Nursing education, at a Jesuit University, involves educating the whole person within a service-oriented profession. Thus, experiential learning in a nursing course at a Jesuit University is an active component of Ignatian pedagogy, promoting Jesuit values and Catholic identity. This has been challenging since the COVID-19 pandemic forced universities to …