Nancy DeBasio, RN, PhD, FAANSusan Fetsch, RN, PhD

Learning ObjectivesExamine ways to share expertise and education between agencies and educationImprove or begin partnerships using clinical staff as clinical affiliates for nursing education Minimize time spent in orientating to multiple clinical sitesImprove preceptor orientation and communication to facilitate best outcomes

Learning Objectives:Increase availability of clinical sites/areas using creative models Utilize best practices for conceptual clinical experiencesMaximize student learning through the creation of timely and valuable clinical experiences

Nursing shortageFaculty shortageTechnologyAging of societyClinical Sites

Insufficient numbers Ineffective use

Remote areas of state Boom and bust cycle Shortfall of 222 nurses annually Predominance of AD education Wyoming Center for Nursing and Health Care Partnerships

RENEW

Shared leadership through education and practice partnership:

Using a shared leadership model that encourages mutual and dynamic partnerships between nursing education and clinical facilitiesThinking big…committing to transformation of nursing in Wyoming

Guiding Principles

Knowledge is shared among partners Collaborative relationships between

academia and practice are established and sustained

Mutual respect and trust are the cornerstones of the practice/academia relationship

A commitment is shared by partners to maximize the potential of each registered nurse to reach the highest level within his/her individual scope of practice

A commitment is shared by partners to work together to determine an evidence basedtransition program for students and new graduates that is both sustainable and cost effective

A commitment is shared by partners to develop, implement, and evaluate organizational processes and structures that support and recognize academic or educational achievements

A commitment is shared by partners to support opportunities for nurses to lead anddevelop collaborative models that redesign practice environments to improve healthoutcomes

A commitment is shared by partners to establish infrastructures to collect and analyze data on the current and future needs of the RN workforce

The Institute of Medicine (2010) report, The Future of Nursing: Leading Change, Advancing Health frames these guiding principles and serves as a platform for all strategies to build and sustain academic-practice partnerships.: January 2012

Evolution of the partnership

Lessons LearnedEvaluation Process

Clinical orientation agreement Common employer surveyClinical faculty academy/Affiliate faculty Preceptor academy

http://www.kchealthcareers.com

Used by:◦17 affiliated nursing programs◦28 healthcare agencies

Maintained by:◦Missouri Hospital Association

Employer Satisfaction Low Response RateCommon ProcessOutcomes

Projected shortage of RN’s at the bedside Inability of area nursing programs to

increase enrollments Lack of sufficient number of qualified faculty

to provide clinical supervision Two day workshop established in 2005 Outcomes

Lack of consistent approach to preceptor education across greater KC area

Mission: Proactive approach to educate and support nurse preceptors

Vision: Foster a collaborative work environment based on values of professionalism, diversity, compassion and integrity

Outcomes

1. What are the greatest needs related to your current academic-practice arrangements?

2. What are potential solutions to these needs?

3. What is different and the same in this environment vs. the Kansas City area?

4. What would be required to implement the solutions identified?

5. How can you enhance more effective academic-practice relationships?

1. Small group sharing on needs and solutions

2. Group preference on pursuing any particular solution(s)?

3. What currently exists that would facilitate accomplishing 1 or 2 of these solutions?

4. What barriers need to be overcome to effectively implement these solutions?

Learning Objectives:Increase availability of clinical sites/areas using creative models (DEUs, simulation, traditional, immersion, other?)Utilize best practices for conceptual clinical experiencesMaximize student learning through the creation of timely and valuable clinical experiences

Curriculum Committee: Develop course structures (clinical and didactic)

Clinical Education Committee: Develop and oversee statewide plan for clinical transformation

What is the purpose of clinical in nursing education?

How is clinical experienced in your environment? # Hours? Structure? Setting?

What guides selection of clinical experiences/settings?

What are the “sacred cows” related to clinical education?

What is working? What is not working?

Lack of quality clinical sites Lack of qualified faculty Size of clinical groups (faculty: student)

Restrictions on numbers of students or limitations imposed

Time consuming nature of learning multiple agency systems (including technology)

Specialty Experiences Dedicated Education Units (DEUs) Interprofessional Education/Simulation

Conceptual Experiences Structure Education Needs in Wyoming

Clinical Hours Pilot Study

 Dedicated Education Unit - A model of clinical instruction that provides nursing students with a positive learning environment using proven teaching/learning strategies while capitalizing on the expertise of both clinicians and faculty.

   

   

Director/Clinical Manager: responsible for the planning, organizing, directing and controlling of patient care unit.

Clinical Faculty Coordinator : faculty representative on the DEU and serves as the bridge between nursing program and healthcare setting.

Clinical Instructors: Staff nurse who performs the delegated activities for student learning with direction, supervision, and assistance from the Clinical Faculty Coordinator

Students: Active, reflective participants in the collaborative relationship

Benefits: Academe and Practice

Josiah Macy Foundation: Alignment of IPE with societal needs

IOM report: 2010

Interprofessional Education Collaborative (IPEC) May 2011

IOM initiates Global Forum on Innovations in Health Professions Education

Random or structuredCompetency or availabilityEducational program or residencySeparation or immersionSpecialty or integratedDirect, indirect, or simulatedInpatient or outpatientDay or nightWeek or weekendPreceptor or faculty

Focused Direct Client Care Experience

Concept-Based ExperienceCase-Based ExperienceIntervention Skill-Based Experience

Integrative Experience

Telemedicine/Telehealth?

Geriatrics?

Other?

What would your preferred future of clinical education look like?

How might your setting begin to think about clinical education differently?

What would have to happen to make such changes in clinical education occur?

Identify and prioritize barriers—consider why you continue to do what is not working?

Small group sharing

What is the most significant take-away from the meeting today?

What is the first thing you will do when you return to your setting to begin change?

Past and current participants/members of Greater Kansas City Collegiate Nurse Educators Kansas City Area Nurse ExecutivesMissouri Hospital AssociationBi-State Workforce Innovations CenterFull Employment Council of Kansas CityColleagues in Caring Project –RWJMSBN

Burman, M.E. and Sholty, M. (2011). Educational transformation in Wyoming master plan: Revolutionizing nursing education in Wyoming (RENEW).

Conference on Interprofessional Education.

(2012). Josiah Macy Jr. Foundation. November 2012.

Dedicated Education Units: An Innovation in Clinical Education. University of Portland School of Nursing. www.nursing.up.edu

Didion, J., Kozy, M.A., Koffel, C, & Oneail, K. (2013). Academic/clinical partnership and collaboration in quality and safety education for nurses education. Journal of Professional Nursing, 29, 88-94.

Fetsch, S. H. & DeBasio, N. O. (2012). Academic service partnerships: Organizational efficiency and efficacy between organizations. Journal of Professional Nursing, 27, e82-e89.

Glasgow, MES, Niederhauser, V.P., Dunphy, L.M., & Mainous, R. O. (2010). Supporting innovation in nursing education. Journal of Nursing Regulation, 1, 23-27.

Guburd-Howe, P. & Schoessler, M. (2008) From random access opportunity to a clinical education curriculum. Journal of Nursing Education, 47, 3-4.

Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

Ironside, P. M., & McNelis, A.M. (2010). Clinical education in prelicensure nursing programs: Findings from a national survey. Nursing Education Perspectives, 31, 264-265.

Jeffries, P. & Battin, J. (2012). Developing successful healthcare education simulation centers: The consortium model. Springer Publishing Company.

Research and Planning—Wyoming Department of Workforce Services (2011). Health care needs in Wyoming: Advancing the study.

Dr. Nancy O. DeBasio nancy.debasio@researchcollege.edu

Dr. Susan H. Fetschsusan.fetsch@avila.edu