State of Wyoming 2013 Nursing Education Summit

1. State of Wyoming2013 Nursing Education Summit Nancy DeBasio, RN, PhD, FAAN Susan Fetsch, RN, PhD

2. Academic-Service Partnerships Learning Objectives • Examine ways to share expertise and education between agencies and education • Improve or begin partnerships using clinical staff as clinical affiliates for nursing education • Minimize time spent in orientating to multiple clinical sites • Improve preceptor orientation and communication to facilitate best outcomes

3. Clinical Education Learning Objectives: • Increase availability of clinical sites/areas using creative models • Utilize best practices for conceptual clinical experiences • Maximize student learning through the creation of timely and valuable clinical experiences

4. Status of Nursing Nursing shortage Faculty shortage Technology Aging of society Clinical Sites Insufficient numbers Ineffective use

5. What is Unique in Wyoming? • 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

6. RENEW Shared leadership through education and practice partnership: • Using a shared leadership model that encourages mutual and dynamic partnerships between nursing education and clinical facilities • Thinking big…committing to transformation of nursing in Wyoming

7. AACN Initiative on ASP 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

8. AACN Initiative on ASP (cont) • 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 based transition program for students and new graduates that is both sustainable and cost effective

9. AACN Initiative on ASP (cont) • 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 and develop collaborative models that redesign practice environments to improve health outcomes

10. AACN Initiative on ASP (cont) • 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

13. The KC ASP • Evolution of the partnership • Lessons Learned • Evaluation Process

14. GKCCNE/KCANE Initiatives • Clinical orientation agreement • Common employer survey • Clinical faculty academy/Affiliate faculty • Preceptor academy

15. Clinical Orientation Agreement http://www.kchealthcareers.com Used by: • 17 affiliated nursing programs • 28 healthcare agencies Maintained by: • Missouri Hospital Association

16. Common Employer Survey • Employer Satisfaction • Low Response Rate • Common Process • Outcomes

17. Clinical Faculty Academy • 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

18. Preceptor Academy • 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

19. Small Group Discussion • What are the greatest needs related to your current academic-practice arrangements? • What are potential solutions to these needs? • What is different and the same in this environment vs. the Kansas City area? • What would be required to implement the solutions identified? • How can you enhance more effective academic-practice relationships?

20. Large Discussion Group • Small group sharing on needs and solutions • Group preference on pursuing any particular solution(s)? • What currently exists that would facilitate accomplishing 1 or 2 of these solutions? • What barriers need to be overcome to effectively implement these solutions?

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

22. RENEW COMMITTEE Charges • Curriculum Committee: Develop course structures (clinical and didactic) • Clinical Education Committee: Develop and oversee statewide plan for clinical transformation

23. Small Group Discussion:Current State of Clinical Education • 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?

24. Barriers to Optimizing Clinical Learning (NLN) • 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)

25. Clinical Models • Specialty Experiences • Dedicated Education Units (DEUs) • Interprofessional Education/Simulation • Conceptual Experiences • Structure • Education Needs in Wyoming

26. ATI Content Mastery and Clinical Hours Pilot Study

27. Specialty Areas

28. DEUs  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.

29. DEUs, cont. • 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.

30. DEUs, cont. • 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

31. Interprofessional Education/Simulation • 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

32. Conceptual Experiences

33. Structure Random or structured Competency or availability Educational program or residency Separation or immersion Specialty or integrated Direct, indirect, or simulated Inpatient or outpatient Day or night Week or weekend Preceptor or faculty

34. Clinical Learning Models (Guburd-Howe & Scholessler) • Focused Direct Client Care Experience • Concept-Based Experience • Case-Based Experience • Intervention Skill-Based Experience • Integrative Experience

35. Educational Needs in Wyoming • Telemedicine/Telehealth? • Geriatrics? • Other?

36. Large Group DiscussionFuture State of Clinical Education • 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?

37. Large Group Discussion • 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?

38. THANK YOU and ACKNOWLEDGEMENT! Past and current participants/members of • Greater Kansas City Collegiate Nurse Educators • Kansas City Area Nurse Executives • Missouri Hospital Association • Bi-State Workforce Innovations Center • Full Employment Council of Kansas City • Colleagues in Caring Project –RWJ • MSBN

39. References • 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

40. References, cont. • 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.

41. References, cont. • 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.

42. References, cont. • 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.

43. References, cont. • 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.

44. Contact Information Dr. Nancy O. DeBasio nancy.debasio@researchcollege.edu Dr. Susan H. Fetsch susan.fetsch@avila.edu