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The
publication that defines the essential elements of clinical
support for the full spectrum of academic nursing - undergraduate
and graduate education, faculty practice, and research.
The changing
dynamics of health care delivery, especially its financing,
are threatening the conventional means of access to clinical
practice sites and requiring a re-thinking of how nursing
educators will provide clinical learning experiences. This
vital AACN publication describes the facilitators and barriers
to clinical access in nursing education, and recommends strategies
for redefining the relationship between education and practice
to ensure that essential clinical resources are accessible
and achievable.
In the clinical Essentials, you'll find....
- How
the shifting focus of health care delivery has changed the
level of educational support by clinical agencies
- Essential
clinical-site learning experiences for both undergraduate
and graduate nursing students
- Condions
that need to exist in academic and clinical settings for
faculty practice to develop and flourish
- Essential
clinical resources to support the research programs of faculty
- Regulatory,
financial, cultural, competitive, and other barriers impeding
nursing schools' access to clinical training sites
- Creative
models of education-clinical partnerships
And much
more!
Background
In 1997,
the AACN Board of Directors established a task force to develop
a comprehensive statement on the essential elements of clinical
support for nursing's academic mission. The need arose out
of growing concern over changes in health care delivery, as
well as in nursing and higher education, that have significantly
altered the number and types of clinical resources available
for nurse training, faculty practice, and nursing research.
Concern also has grown over the barriers to establishing meaningful
relationships between schools of nursing and the clinical
enterprise.
Learning
to perform as a nurse is predicated on engaging in learning
experiences with actual clients in a variety of settings.
This type of learning opportunity, referred to as a "clinical
practicum," represents a field experience. Although experiential
learning can occur in a number of ways, including computer
and virtual reality simulations, case studies, or interactive
videos, the primary focus of The Essential Clinical Resources
for Nursing's Academic Mission is hands-on direct patient
care - clinical site-based experiences at the baccalaureate,
master's, and doctoral levels necessary for preparing qualified
nursing clinicians and researchers.
In March
1997, an AACN
Issue Bulletin revealed that, while deans reported that
applications remained strong, some schools had deliberately
cut admissions to nurse practitioner programs because of a
tightening supply of training locations. Nursing schools now
must vie for clinical training slots not only with other area
nursing schools, but also with medical and physician assistant
programs that are placing students for primary care experiences
in the same health centers used traditionally for nurse training.
In a 1998
AACN survey, only 16 percent of responding institutions reported
not having any problems with the availability of clinical
training sites or in their ability to place nursing students
at clinical training locations. Indeed, 45 percent of schools
reported problems with a shrinking pool of sites for undergraduate
students, with a similar number citing difficulties in placing
undergraduate students for clinical training.
The
New Dynamics of Healthcare Delivery
Overall,
the health care system is moving from an array of disconnected
agencies to integrated systems run increasingly by the private
sector with an increasing emphasis on cost and the bottom
line. In addition, the system is moving from services centered
around the healthcare provider's needs to a focus on customer/consumer
needs, from specialty to primary care emphasis, and from hospital-
and other institutionally based care to community-based delivery.
Moreover,
as care has shifted from hospitals to more outpatient treatment,
the tremendous cost-cutting and re-engineering of acute care
delivery sites have diminished educational support from these
agencies. Indeed, AACN data show that in fall 1998, nurse
practitioner majors accounted for more than half (60 percent)
of all nursing master's-degree students. The move to nurse
practitioner education and the increased number of NP training
programs has dramatically increased the clinical practicum
hours in graduate programs and boosted the demands on primary
care and other clinical sites for educational support.
The
Essential Clinical Resources for Nursing's Academic Mission
provides direction for the preparation of professional nurses
into the 21st century. It has been produced primarily for
baccalaureate and graduate nurse educators and nurse executives,
but is of interest to others involved in employing nurses
throughout the health care system.
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