Policymakers, planners, governmental agencies, regulators, and others use National League for Nursing (NLN) workforce data as they prepare legislation, approve budgets, and formulate long-range plans for workforce development. The 2020 NLN Biennial Survey of Schools of Nursing was conducted to provide such data.

This report is compiled from data provided by 383 schools of nursing, which is 37 percent of 1,049 NLN member schools. Forty-three percent of the responding institutions offer baccalaureate or higher degrees in nursing, and 57 percent offer associate degree, diploma, and practical nursing (PN)/vocational nursing (VN) programs. Following are highlights of the findings. Details are online at http://www.nln.org/newsroom/nursing-education-statistics.

UNDERREPRESENTED STUDENTS

According to the NLN data, the percentage of underrepresented students enrolled in prelicensure registered nursing (RN) programs increased slightly from 30.7 percent in 2018 to 30.9 percent in 2020. Specifically, Hispanic enrollment increased from 9.8 percent to 11.0 percent. African American enrollment decreased from 11.8 percent to 11.2 percent; Asian and Pacific Islander enrollment decreased from 5.4 percent to 4.7 percent; and American Indian enrollment decreased slightly from 0.6 percent to 0.5 percent.

Enrollment of men in basic RN programs remained constant at 13 percent in 2020 compared to 2018. PN/VN programs had the lowest percentage of men enrolled (10 percent). Associate degree in nursing (ADN), master of science in nursing (MSN), and doctoral programs had the highest percentage of men (15 percent) enrolled in each program in 2020. The proportion of doctoral students under the age of 30 years decreased from 22 percent in 2018 to 16 percent in 2020. The proportion over the age of 30 years increased from 78 percent to 84 percent in 2020.

PROGRAMS TURNING AWAY QUALIFIED APPLICANTS

The data indicate that significant numbers of applicants for prelicensure programs continue to be turned away. The percentage of PN/VN, bachelor of science in nursing (BSN), and doctoral programs that rejected qualified applicants increased by 9 percent, 2 percent, and 11 percent, respectively, in 2020 from 2018. However, ADN, diploma, and BSRN (RN to BSN) programs that rejected qualified applicants decreased by 6 percent, 35 percent, and 2 percent, respectively. The percentage of MSN programs that rejected qualified applicants remained unchanged at 40 percent.

The NLN data indicate rejections for PN/VN, ADN, diploma, and BSRN programs decreased in 2020, with the most striking decline in diploma programs. PN/VN programs turned away 25 percent of qualified applications in 2020 compared to 27 percent in 2018. ADN programs turned away 35 percent of qualified applications compared to 38 percent in 2018. Diploma programs turned away 17 percent of qualified applications compared to 29 percent in 2018. BSRN programs turned away 1 percent of qualified applications compared to 4 percent in 2018. The proportion of qualified applications (29 percent) turned away by BSN programs remained unchanged. In contrast, MSN and doctoral programs experienced an increase in the percentage of rejected qualified applications, turning away 12 percent in 2020 compared to 9 percent in 2018, with doctoral programs turning away 23 percent compared to 15 percent in 2018. The proportion of qualified applications turned away from BSN and BSRN programs continue to have implications for the Institute of Medicine's (2011) recommendation that at least 80 percent of RNs be BSN prepared.

COVID-19 AND OBSTACLES TO EXPANSION

For prelicensure programs, the demand for nurse educators continues to exceed supply; 18.1 percent of prelicensure programs cited the faculty shortage as one of the main obstacles impeding program expansion. Lack of clinical placement settings was cited by 46.1 percent of programs as the primary impediment to admitting qualified applicants. Interestingly, these NLN-generated data have not changed over the past 10 years.

To mitigate the obstacles to increasing enrollment in nursing programs and address the faculty shortage, continued support for legislation for Title VIII funding is imperative. Also, since the publication of the 2014 landmark study on use of simulation in nursing programs conducted by the National Council of State Boards of Nursing (Hayden et al., 2014), many nursing programs utilize simulation as an alternative to traditional clinical settings for up to 50 percent of clinical hours in the nursing curriculum. During the COVID-19 pandemic, "in many states, because of executive orders, nursing programs were allowed to use up to 100 percent simulation, including virtual simulation, to replace clinical experiences where students provide direct care" (National Council of State Boards of Nursing, 2020). More than 75 percent of nursing schools that responded to the NLN Deans' and Directors' Survey Regarding COVID-19 (NLN, 2021) provided clinical experiences through virtual simulation because of limited access to clinical agencies during the pandemic. Simulation provides an alternative opportunity for students to experience the complexities of delivering patient care.

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