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Essential Clinical Resources for Nursing's Academic Mission

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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.