Building New Clinical Education Partnerships Globally: Increasing Teaching Capacity and Enriching Clinical Education

International Collaboration ConferenceKuakarun College of NursingNavamindradhiraj UniversityBangkok, Thailand June 2015

JoAnn Mulready-Shick, EdD, RN, CNE, ANEF College of Nursing and Health Sciences, University of Massachusetts Boston (UMB),USA

Education-Service Partnerships

Academic-Practice Partnerships in Clinical Settings: Dedicated Education Unit

“What do our Global “What Evidence supports

Organizations say?” Best Practices and

Outcomes?”

Challenges and Issues: Education

Adequacy of curriculum and experience

to prepare for teamwork and working in environments with

diverse cultural patterns

Mechanisms to prepare for transition

to service/nursing practice

Availability of internship opportunities

for students and graduates

ICN Regulation Series.(2009). Reducing the gap and Improving the interface between education and service.

Retrieved from http://www.icn.ch/images/stories/documents/publications/free_publications/reducing_the_rap.pdf

Challenges and Issues: Clinical Settings

Availability and quality of clinical placements

Availability and quality of staff nurse instructors or

preceptors to meet student needs

Multiple educational providers dealing with competition for

placements

ICN Regulation Series.(2009). Reducing the gap and Improving the interface between education and service.

Retrieved from http://www.icn.ch/images/stories/documents/publications/free_publications/reducing_the_rap.pdf

Reducing the Gap and Improving the Interface between Education and Service (ICN, 2009)

“A Framework for Analysis

and Solution Generation”

How to Educate a Competent

Workforce for the Future and

Address Successful Transitions

from Education to Practice

from a consultation between

ICN and WHO-Eastern Mediterranean

Regional Offices

Education-Service Framework (ICN, 2009)“Work-life Journey”

Common Frameworks (USA, 2009)J. Warner & D. Burton (2009). Policy and politics of emerging academic-service partnerships. Journal of Professional Nursing, 25, 329–334.

Sigma Theta Tau International

“By partnering with one another, nurses in academe and

in service settings can directly impact nursing education

and practice, often effecting changes and achieving

outcomes that are more extensive and powerful than

could be achieved by working alone.”

J. M. Kirschling, & J. I. Erickson. (2010). The STTI practice-academe innovative collaboration award:

Honoring innovation, partnership, and excellence. Journal of Nursing Scholarship, 42(3), 286–294.

Evidence to Date: Why Clinical Education Must Change (USA)

Obstacles to achieving quality clinical education experiences reported.

Recommendations to optimize clinical learning include:

-Align learning and engagement in clinical practice realities

-Focus on achievement of students’ clinical learning goals

- Address quality and safety improvement

- Develop clinical reasoning and a spirit of inquiry

(Ard & Valiga, 2009; Benner, Sutphen, Leonard, & Day, 2010, IOM-Future of Nursing Report, 2011;

Ironside & McNelis 2010; NLN Think Tank of Transforming Clinical Education, 2008; NLN National

Survey, 2009)

The Future of Nursing Report: Leading Change, Advancing Health (2010)

“The development,

growth, and

evaluation of

academic-practice

partnerships is a

fundamental condition

to advance nursing

practice and improve

the quality of care.”

Toolkit and Guiding Principles for ACADEMIC-PRACTICE PARTNERSHIPS http://www.aacn.nche.edu/leading-initiatives/academic-practice-partnerships

American Association

of Colleges of Nursing

American Organization

of Nurse Executives

Building the Evidence to SupportClinical Education Partnerships and Innovation: Dedicated Education Unitshttp://www.evaluatinginnovationsinnursing.org/

University of Massachusetts Boston conducted a two year funded research study to evaluate a new clinical education – service partnership)

“Partnering for Dedicated Education Unit (DEU)

Development and Quality” (2009-2011)

1. Teaching Capacity2. Faculty Worklife and Productivity3. Educational Quality

Clinical Education Partnership Development

DEU Partnership “Piloted” 2007

Overarching Research Question “How does the DEU intervention-

Develop new clinical instructors (thus building capacity)?

Enhance clinical instructor/preceptor worklife

(thus sustaining recruitment, retention, and productivity)? and

Promote educational quality? while

functioning within a shared DEU partnership structure and

within local contexts, amidst nursing unit similarities and

differences?”

Education Quality Findings

DEU Students Spend More Time in Instruction- Time spent in instruction (2x) greater by staff nurse instructor/preceptor compared to other activities.

Mulready-Shick, J., Kafel, K., Banister, G., Mylott, L. & Curtin, L. (2013). Evaluating dedication educations for clinical education quality. Journal of Nursing Education, 52 (11), 606-614.

Comparison of Quality and Safety Competency Development between DEU & Traditional Students Mean Scores

P<.001 QI, Informatics, Teamwork Confirming Pilot Study Findings

4.6

Visit by Ms. Kay Edgecombe, Flinders University, So. Adelaide, Australia Sept. 2010

Dedicated Education Units- Building a BetterFuture (2014)

“A Philosophy and

Set of Principles”

Australia

New Zealand

Sweden

USA

examples

Dedicated Education Units: An Innovative Model and Solution to Global Issues in Nursing Education and Practice

Global Issues: Shortages of Nurses and Faculty

Continued Theory-Practice Gap

DEU Model Flexibility to fit the context of different practicum settings

Clinical and Academic Staff Capacity Building

Students’ Sense of Belonging on Patient Care Units

Developing Communities of Practice

Dedicated Learning Environment

Evidence to Date: Common Themes in Clinical Education Partnerships

Supportive Relationships Goodness of Fit Flexibility Communication

(Teel, McIntyre, Murray, & Rock, 2011)

What is the nature of your relationships with

your agency partners?

Work Life: DEU Staff Nurse Clinical Instructor-Preceptors exhibit enhanced spirit of inquiry and motivation

DEU Student Presentations and Practice Changes

DEU Students Providing Continuing Education Program for Staff Nurses

Practice Change on DEUs

Reflection

Quality of DEU clinical learning experiences exceeds

traditional clinical education model

Insignificant impact on nurse workload and unit workload

Nurses’ work lives are positively enhanced by the

DEU model (increased satisfaction and professionalism )

Recommendations for transforming clinical education

are met in DEU Partnerships, along with creating positive

changes on patient care units

****************************************************************

DEU Cycle of Sustainability

1. Staff Nurses become

CIs

2. CIs become

more skilled in clinical

instruction with CFC coaching

3. Students, nurses, the

patient care unit

and educational program

benefit

4. DEU students are hired as

RNs on DEUs, supporting the DEU model;

nurses return for advanced degrees

CFC = clinical faculty coordinator; CI = clinical instructor/preceptor; DEU = dedicated education unit.

Mulready-Shick, J., & Flanagan, K. (2014). Building the evidence for dedicated education unit

sustainability and partnership success. Nursing Education Perspectives, 35 (6), 287-293.

Recommendations for Further StudyDeeper dive into-

Unit Sustainability (mix of staff, rotation patterns, CI retention,

maximum number of shifts/students)

Model Fidelity; Instrument Development

Student performance on Quality and Ssafety Competencies

Staff Nurse /Preceptor Development and Clinical Coaching

Transition to Practice (costs analyses and results)

Practice Changes- unit level and patient care outcomes

“International” DEU Conference (USA, 2014)

with Video Presentation from Christchurch, New Zealand about Canterbury DEUs- Strategies for Success

DEU Conference Objectives (USA, 2014)

Describe DEU central elements: collaboration,

optimal learning, and clinical resource efficiency.

Integrate DEU theoretical constructs for effective

clinical teaching, such as “situated coaching”

Discuss strategies for successful DEU implementation

across diverse settings.

DEU Conference Objectives (USA, 2014)

Review findings from DEU research and program evaluation.

Discuss approaches for DEU sustainability and

continuous quality improvement.

Establish a community of DEU scholars, administrators,

and service-academe partners to guide future DEU development

and implementation.

University of Portland, Oregon, USAhttp://nursing.up.edu/default.aspx?cid=13136&pid=205&gd=yes

Where can we find our Global Voice to share our Partnership Efforts and Experiences? ICN Wordle

ICN Nurse Educator Network (ICNEN)

With the new international realities of migration,

advances in communication technology,

and a worldwide nursing shortage,

educating and preparing a diverse nursing workforce

has become a critical priority.

Nursing Education Network Bulletin Issue 4 (December 2014)

ICNEN Steering Committee Members

Chair: Virginia W. Adams,

North America (USA)

Kath McCourt, Europe (UK)

Anne-Maria Kanerva, Europe (Finland)

Sharon Vasuthevan, Africa (South Africa)

Jane Mills, Australasia (Australia)

Lian-Hua Huang, Asia (Taiwan)

Liaison: Jean Barry, (ICN), Switzerland

Welcome to the ICN Education Network Forum:

We welcome your posts and questions to address

key issues related to nursing education globally.

Post: “Thank you for having this forum for educators

from all over the world to share their insights

into the wonderful world of nursing education.”

What are your next steps in building and sustaining partnerships between education and service settings? Thank you!