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regarding the competencies to be developed (Conway, 1983). Graduates of ADN programs, who are on average more mature and experienced at graduation (the mean age was 35.7 years in 1992), have resisted the notion that they were less professional than their younger BSN colleagues (29.2 years old on average). This tension between undergraduate programs is further exacerbated by all of the tensions between community colleges and universities. To the extent that different kinds of RNs are educated in different educational systems, there is little opportunity for learning how to work together.
Matters have been further complicated by the fact that ADN graduates are regarded by the public at large, and especially by many a state legislature, as the success story of community colleges because of their speedy access to a relatively well-paid field. Graduates of BSN programs, in contrast, are regarded as requiring an expensive undergraduate education by universities, which tend to equate professional education with graduate education. Legislators would resist efforts to limit the production of ADN graduates, while some universities may countenance the elimination of BSN programs (as has happened, for example, in the University of California system). The more that RN production is relegated to ADN programs, the more nursing is seen solely in vocational terms by the public, including career counselors, rather than as a career choice for the best and brightest. Nursing is so equated in the public mind with doing procedures and giving medications that nurses who manage complex systems and conduct research are viewed by many as not being ''real" nurses.
What has frequently been confused in ADN versus BSN discussions is the question of whether one is working at the bottom or the top of one's scope of practice. While the ADN and the BSN recipient may look relatively comparable technically and interpersonally at graduation, their progress from novice to competent practitioner, and on to expert, will not be comparable (Conway, 1983). The liberal education that is considered foundational to the development of critical thinking, decision making, and independent judgment in the BSN graduate is likely to facilitate the acquisition of the imaginal and systems skills required of advanced practice (Koerner, 1993). Considerable efforts are under way to articulate a model for differentiated nursing practice; Table 3 provides a schematic synthesis of current thinking based on the recent AACN-AONE Task Force on Differentiated Nursing Practice (1995) and the work of Davis and Burnard (1992) as well as that of Koerner (1992). It should be noted that a characteristic of recent consensus development in this area has been giving up the technical versus professional distinctions of previous ADN-BSN debates, because of the pejorative implications in characterizing ADN graduates as not professional, in favor of distinguishing between practice in structured and unstructured environments.
Celebrating 40 years of ADN education, Simmons (1993) noted that that degree is no longer considered to be "terminal" in nature, but a pathway for career and educational mobility. Nursing education must move to an interconnected system of distinct educational levels with differentiated outcomes (Fagin