Although nursing education pathways have expanded access to the profession, fragmentation accompanying these entry points has created uncertainty among students about the desired end point, questionable effi ciency and eff ectiveness of reaching career goals, and unclear merging mechanisms to enable seamless, linear progression. In response to these challenges and in anticipation of greater demands on nurses due to health reform, the Institute of Medicine (IOM) examined the capacity of the nursing workforce and proposed a transformative blueprint for change that relies on an education system to promote seamless academic progression. Despite support for this recommendation, little research exists regarding the best way to achieve the IOM's vision. This study examined the most promising practices in design and implementation of alternative pathways for academic progression in nursing. Four case studies are presented that explore the challenges of designing alternative pathways and identify performance measures to assist with developing such programs.
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