Board staff, researchers debate mobile delivery, question edits for 2026 registered‑nurse survey

The Nursing Education Workforce Advisory Committee met to discuss proposed changes to the Board of Registered Nursing—s 2026 survey of registered nurses, including delivery methods, new question domains and tradeoffs required to keep the questionnaire within a 12‑page limit.

Committee members and contract researchers said the survey typically draws from an 8,000–10,000 person sample and is designed to yield roughly 500 responses in each of 10 regions; most reminders are sent by email and paper booklets remain essential because roughly half of responses arrive on paper.

Why it matters: The survey provides data beyond what license‑renewal questions collect and feeds the board—s workforce planning and legislative reporting. Changes to how the questionnaire is fielded, and what it asks about (remote work, discrimination, student debt, artificial intelligence), will affect comparability with prior years and the board—s ability to track trends.

Survey delivery and reminders Joanne, the survey presenter, explained the standard protocol: an initial email and multiple reminder emails (about five or six), followed by sending paper booklets to identified nonrespondents. "While in theory one might think that we should be able to do this whole thing online and stop doing the paper surveys, it turns out that about half of the respondents still come in on paper," Joanne said.

Board executive officer Loretta Melby clarified legal and administrative constraints around contact data: the board—s records include an address of record; email and phone numbers are not statutory requirements and the renewal system (Breeze) collects phone and email but does not indicate whether a phone is a cellular number. Loretta said embedding QR codes in emails or making the Qualtrics questionnaire more mobile compatible are options to consider.

Text messaging, QR codes and mobile compatibility Committee members asked whether text messages or SMS links could raise response rates. Joanne and Loretta warned that long surveys perform poorly via SMS and that legal considerations (opt‑in/anti‑spam rules) should be checked with counsel. "For a survey this long generally does not do well from a text messaging strategy," Joanne said. Loretta added that the Qualtrics platform can present a mobile format but pages may need redesign so single screens are not too long.

Several members proposed experiments and modest changes: randomize text reminders for a sample subgroup, add QR codes to emails and paper cover letters, or adapt the questionnaire layout for better mobile rendering. Joanne noted institutional review board (IRB) concerns about the volume of reminders and recommended judicious testing.

Question content: remote work, management vs. institution, discrimination, AI and debt Committee discussion also focused on proposed new or revised questions. Topics raised included: - Remote work/hybrid phrasing and intent: a proposed item asks where nurses work and whether they work remotely or "from home." Committee members flagged ambiguity (some nurses work remotely from varying locations vs. a home office) and asked for clearer wording or cognitive testing. Joanne recommended cognitive testing to confirm respondents interpret the terms as intended. - Distinguishing manager vs. institution: multiple members recommended splitting items that currently conflate manager behavior and institutional leadership into separate items (e.g., manager support of professional judgment vs. organizational support). Joanne and members noted that changing stems reduces comparability with prior years but may improve interpretability. - Discrimination items (question 41): the survey added items about experiences of workplace discrimination and harassment. Members questioned specific items—for example, whether religion should be included and whether some items ("watched more closely than others") could reflect non‑discriminatory personnel actions. Joanne and others said the items were drawn from validated scales; the committee suggested cross‑tab analyses (for example, by years since graduation) to aid interpretation. - Artificial intelligence (AI): Joanne presented a set of possible AI questions—awareness of AI, organizational policies/guidance, types of AI used, comfort with clinical applications and training needs—and noted a Canadian nurse AI survey that could inform item selection. The committee agreed domain scope must be narrowed because of page limits. - Student debt and resilience: some members suggested adding two debt items (debt at graduation and current debt) or resilience measures, but Joanne cautioned that any addition requires deletions elsewhere to stay within the 12‑page limit.

Next steps and requests for comment Joanne requested written comments be sent to committee staff (Macaulay) by the date posted; Garrett, the committee chair, asked members and the public to send comments to the board email for NEWAC. Joanne said she and board staff will review 2024 tabulations and consider cognitive testing, randomized experiments for reminder modes, and mobile formatting changes before deciding which items to add or drop.

Ending The committee did not take formal votes on survey changes. Members directed staff and the contractor to explore mobile formatting, QR codes in outreach, a small randomized text‑reminder test, cognitive testing of ambiguous items, and tabulations of 2024 results to inform deletions or additions.