TABLE 14.-Distribution of nurse training schools and pupils according to the educational requirements for admission and the length of course offered.

YEARS IN NURSE TRAINING COURSE.

In view of the fact that practically all courses in nurse training schools maintained in general hospitals have been lengthened from two to three years within almost the last decade, this subject deserves consideration. Altogether, in 1918 the length of course offered was reported by 1,606 training schools in general hospitals, and in 1911 by 688 schools, as follows:

offer

a

In 1918 nearly all of the schools in the 2 to 2.9 years group two-year course, only a few giving a fractional part of a year additional. Similarly nearly all of the schools falling in the 3 to 3.9 years group offer only a three-year course. Only three schools report a four-year course, viz: College Hospital, Talladega College, Ala.; Evangelical Saint Lucas Deaconess Hospital, Faribault, Minn.; and Scudder Infirmary, Alcorn, Miss.

The greater number of schools by far offer a three-year course, 88 per cent of all the training schools in general hospitals falling in this class. Only 10 per cent of these schools offer a two-year course. A decided tendency toward a three-year course is evident when a comparison is made between these percentages and the corresponding ones in 1911. In 1911 a course of three or three and a half years was offered by 73 per cent of the schools reporting, as against 88 per cent in 1918; and a course of two or two and a half years was offered by 27 per cent, as against 10 per cent in 1918. Practically all nurse training schools. have extended their course to three years within the last few years. Long hours of duty, lack of facilities for imparting the technical training which should accompany the practical work of the hospital, or low educational entrance requirements may prevent nurse pupils from receiving the equivalent of a college education. The fact that training courses have been lengthened may partly account for the increased difficulty in getting qualified pupils to staff the hospitals.

In schools maintained in hospitals for the treatment of insane patients only two and three year courses are offered, 34 schools offering a two-year course and 47 schools offering a three-year course.

ENROLLMENT OF PUPILS IN TRAINING SCHOOLS OFFERING THE VARIOUS COURSES.

By assembling the corresponding groups in Table 14 it is found that 7 schools, enrolling 137 pupils, offered a course of less than one year; 15 schools, with 261 pupils, a one-year course; 161 schools, with 3,306 pupils, a two-year course; 1,397 schools, with 47,644 pupils, a three-year course; and 3 schools, with 17 pupils, a four-year course. These 1,583 schools enroll an aggregate of 51,365 nurse pupils. The schools offering a course shorter than one year are fourtenths of 1 per cent of the total, but enroll only three-tenths of 1 per cent of the pupils; those offering a one-year course are 1 per cent of the total, but enroll five-tenths of 1 per cent of the pupils; those offering a two-year course are 10.2 per cent of the total, but enroll only 6.4 per cent of the pupils; but those offering a three-year course are 88.2 per cent of the total and enroll 92.8 per cent of the pupils. It is seen, therefore, that, in general, the larger schools offer the longer course of three years, since these schools enroll a correspondingly larger percentage of pupils than the percentage of schools in this group would indicate.

Reducing these percentages to absolute numbers, it is found that the average enrollment in a training school of less than one year is only 20 nurse pupils; in a one-year school only 18 pupils; in a twoyear school, 20 pupils; but in a three-year school it is 34 pupils. In other words, the schools offering a three-year course enroll 70 per cent more pupils on an average than schools offering only a two-year course. These very great differences are not apparent from a casual inspection of the reports. Two facts appear from these figures: First, that practically all professional nurses are now taking a three-year course of training; second, the larger schools are giving generally a three-year course of training.

MINIMUM EDUCATIONAL ENTRANCE REQUIREMENTS.

By summarizing the corresponding groups in Table 14 it is found that, altogether, 1,592 nurse training schools reported the educational entrance requirement for admission in the year 1918. The following summary compares the requirement of that year with corresponding requirement in the year 1911:

The most usual requirement in 1918 was one year of high-school work. About two-thirds as many schools, however, required a full high-school course for admission. Few schools require three years of high-school work.

Considerable shifting in the educational requirements for admission to nurse training schools has taken place since the year 1911, as will be noticed from the comparable data given above. The percentage of schools requiring a full high-school course for admission has decreased from 40.6 per cent in 1911, to 28.1 per cent in 1918, while the percentage requiring one year of high school has increased from 24 per cent to 42.7 per cent during the same period. During this period the percentage requiring only an eighth-grade education for admission has decreased from 31.7 per cent to 12.1 per cent and the percentage requiring two years of high-school work has increased from 3.3 per cent to 16.5 per cent. It is evident, therefore, that there is a tendency on the part of nurse training schools not to require either the completion of a high-school course or of the elementary grades only, but to require either one or two years of high-school work for admission.

It should be distinctly understood that the minimum educational entrance requirement by no means indicates the average educational qualifications of pupils who are admitted to nurse training schools. Many nurse pupils have a college education, and perhaps most of them the equivalent of a full high-school education. The standard set for admission governs only the admission of nurse pupils who have the lowest educational qualifications which the school will consider. With the rapid multiplication of public high schools

throughout the country there should be in the future little reason for nurse training schools to lower their educational standard for admission. A decided tendency away from only an eighth-grade requirement is evident already. It is to be regretted that so large a percentage of schools have been obliged to retract from the full highschool requirement.

EDUCATIONAL ENTRANCE REQUIREMENTS TO NURSE TRAINING SCHOOLS IN HOSPITALS FOR THE INSANE.

In hospitals for the insane, 42 schools for the training of nurse pupils require the completion of the eighth grade for admission; 30 schools require one year of high-school work; and only 6 schools a two or three year high-school course. No school requires a four-year high-school education. In 1911 it was found that of the 49 schools reporting educational requirements for admission, 38 schools required a "common school" or the equivalent of an eighthgrade education; 6 schools required one year of high-school work, and 5 schools a full high-school course. It is evident here also that there is a tendency away from the requirement of a full high-school course, as no school reporting in 1918 holds to it, and also away from the eighth-grade requirement, as 77.6 per cent of the schools of this class in 1911 held to this requirement and only 53.8 per cent in 1918.

The educational requirements for admission to nurse training schools is summarized by States in Tables 15 and 16. These tables show how many pupils now in training have met these minimum standards and how many graduates completing a nurse training course in 1918 presumably met these requirements when admitted to training. As State legislation often governs the educational requirements for admission, it is thought advisable to summarize these minimum requirements by States.