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2011 Innovations in Professional Nursing Education Award Winners

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2011 Winners

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madison

University of Wisconsin-MadisoN
Winner - Academic Health Center

The AACN Innovation in Professional Nursing Education Award on behalf of the University of Wisconsin-Madison School of Nursing under the Academic Health Center (AHC) category.

The Early Entry Option-PhD Program: In an effort to address the need to attract younger, more diverse students into careers in nursing research, UW Madison nursing faculty have developed a pre-baccalaureate entrance into the existing PhD program, known as the “early entry option” (EEO). This option allows academically qualified students who have been admitted to the BS major to be screened and admitted to the nursing graduate program in order to provide seamless progression and preparation for a career in research.

By way of context, the University of Wisconsin-Madison is one of top research universities in the world, with more than $1B in research expenditures in 2009. It enrolls approximately 5000 freshmen each year. The middle 50% of the entering freshman class each year is characterized by GPAs of 3.5 - 3.9, ACT scores of 27-29, SAT scores of 1860-2090, and class ranks in the top 10-15%. The School of Nursing benefits from the academic rigor at Wisconsin, as students apply to the BS nursing major at the end of their second year (or four semesters) of undergraduate study. Admission to the nursing major is likewise highly competitive. In Fall 2010, the School of Nursing screened 371 qualified applications for 154 available slots in the BS Nursing program. The resulting admit class included 58 students with an earned baccalaureate degrees and 10 students with advanced degrees, and the average GPA for the class was 3.5.

Nursing faculty sought to develop a pathway whereby talented students who were already admitted to the BS nursing major and who signaled an interest in nursing science could simultaneously be evaluated for admission into the PhD program. The goals were: 1) to accelerate progression of selected nursing students from the BS through to the PhD, 2) to capitalize on the School of Nursing’s exceptionally strong undergraduate applicant pool and on the rigorous research training model already in place in the PhD program.

The EEO option was launched in 2003. After admission to the BS nursing major, students may then apply to the EEO. Requirements are similar to the graduate school application process on campus (i.e., written application including a statement of career goals and potential research interest, review of test scores and transcripts, references, and interviews with program faculty). Once admitted, EEO students are assigned a three-member advisory committee (undergraduate advisor, faculty advisor, and an assistant dean) who help the student plan their program. EEO students earn a BS (a minimum of 124 credits), an MS or MS/MPH (a minimum of 16 credits) and a PhD (a minimum of 54 credits). Theoretical and clinical course work is consistent with the AACN Essentials for baccalaureate and masters education. The school commits substantial scholarship funding to EEO students during the undergraduate portion of the program, and EEO students receive top priority for available graduate student funding.

The program consists of three integrated components: theoretical courses, early and intensive research training, and clinical practice. Theoretical and clinical course work is consistent with the AACN Essentials for baccalaureate and masters education. Some graduate courses may be substituted for undergraduate courses, if the student is progressing well. Research training is begun early and is integrated through the program. As undergraduates, EEO students participate in the undergraduate honors program and complete an honors thesis. This provides the framework for identifying a faculty mentor and a research focus. During this experience, EEO students are matched with a faculty advisor (major professor). The “goodness of fit” between student and faculty mentor is deemed critical for success. If this match is successful, the faculty mentor typically assumes responsibility for research training throughout the remainder of the program. The EEO student joins the faculty’s research group in weekly meetings, can interact with more advanced doctoral students and witnesses first-hand the challenges of planning and implementing a program of research. As students progress into graduate course work, they begin to refine possible research questions and approaches. They also participate in a weekly research colloquia series that exposes them to the breadth and depth of research in the school. Clinical practice is likewise integrated throughout the first three years, as students complete 12 credits of undergraduate clinical nursing courses and 3 credits of advanced practice clinical coursework. Clinical experiences are individualized wherever possible to support the student’s developing research focus.

Progression guidelines have been developed for each year of the EEO-PhD program; benchmarks and evaluative criteria include performance in required courses, selection of faculty mentor, progress in research (i.e., poster presentations, submission of manuscripts), progress in securing funding (i.e., applications for research funding or fellowship applications). Evaluation of student progress is the responsibility of the advisory committee. Since the program was launched in 2003, 21 students have enrolled, and attrition to date is 48%. We learned some important lessons about student selection in the first four years (2003-2006), as 7 of the first 10 students completed the baccalaureate, but did not continue into the PhD portion. In the subsequent four admit classes (2007-2010), only 3 of 11 have left after completing the baccalaureate degree.

At present, 11 students are in the EEO: five undergraduates (3 first year, 2 second year), and 6 doctoral (1 first year, 2 second year, 1 third year, 1 fourth year, 1 fifth year). Of these 11 students, 8 were ages 19-22 at admission, and 3 were ages 24-27. While this student group is predominantly female (10 female, 1 male), 4 are from underrepresented populations (i.e., Hispanic/Latina, African American, Hmong). Their average admission GPA was 3.6 (range 3.49-3.96) and average composite ACT was 26 (range 20-32).

The first graduate of the EEO defended her dissertation in December 2010, having earned her BS in 2004 and her MS in 2007. She had received an NIH Individual Predoctoral Traineeship, and was a Hartford Building Academic Geriatric Nursing Capacity Scholar. She had 6 publications and 8 research presentations to her credit, and was 28 years old at time of graduation. The next two graduates are progressing beautifully; they are expected to complete in 2014, and both will be under the age of 30.

This model clearly attracts much younger and more diverse students into our PhD program, and it is clear that they can be successfully transitioned from admission to the nursing major through to the PhD. We know from talking with our undergraduate students that the presence of EEO students in their midst has elevated the profile of nursing research and careers in education. The development and implementation of the EEO-PhD has stimulated important faculty discussions about the core of the nursing discipline, how that core is reflected in our BS, DNP and PhD programs and how those programs must connect. It has required faculty in our baccalaureate and PhD programs to collaborate in new ways, and has required our experienced investigators to reach out to a wider array of faculty colleagues across campus in order to support, and literally to keep up with the research interests of this “new breed” of nursing doctoral student.

I believe our innovative EEO-PhD model can be borrowed, replicated and improved upon in any university nursing environment where there are academically strong undergraduates, where faculty can ensure early and continuous engagement of students in research training, and where faculty are prepared to engage the „future of nursing? at very close range by working with doctoral students who are very different from those in our past, but who have enormous potential. My faculty colleagues believe so much in the promise of this model to build the nursing professoriate of the future that we are actively shifting our PhD recruitment to focus to a much greater extent on entering BS students, and to include entering freshmen (major as yet undeclared) at Wisconsin.

I myself have been engaged in doctoral education in nursing for more than 30 years, and am convinced that programs like this one will literally chart new directions for our discipline for decades to come. I hope that your committee shares our excitement, as I know that my faculty colleagues would be most honored to receive this important award. I will look forward to hearing the results of your deliberations, and thank you for your service to AACN.

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wilkes

Wilkes University
Winner, Small Schools

The AACN Innovations in Professional Nursing Education Award on behalf of the School of Nursing at Wilkes University under the Small School category.

Program Description:
In 2009, the Lasater Clinical Judgment Rubric (LCJR) was adopted by the Clinical Nursing Simulation Center (CNSC) at Wilkes University School of Nursing (WU-SON) as the evaluation tool which would be used to measure the development of clinical nursing judgment in undergraduate baccalaureate nursing students.  In an effort to assure quality, efficiency, and accountability in the implementation and evaluation of this tool in the simulation program, a statistical database was created.
 The database is structured to include cases for all students enrolled in the baccalaureate nursing curriculum at Wilkes University beginning with the Fall 2009 semester.  The purpose of the database was to provide a means for the CNSC to:

  • analyze quantitative statistical data on students and student cohorts;

  • access and analyze data in order to objectively evaluate simulation program outcomes;

  • monitor, analyze, and evaluate the development of clinical nursing judgment in the individual throughout program progression; and

  • have access to historical data for longitudinal studies;

This database was initiated in the 2009-2010 academic year to store student data collected during simulation activities and to enable the CNSC to use this data to perform statistical analysis of clinical judgment (LCJR) scores for specific student cohorts. The results of the statistical analysis provided quantitative data which supported the objectives and goals of the simulation program, which was initially integrated into the nursing curriculum at the beginning of the 2008 academic year. The database is currently being expanded so that further statistical analyses can be done to determine relationships and correlations on multiple variables as a means of assuring quality, efficiency, and accountability in the implementation and evaluation in other aspects of the undergraduate nursing curriculum. Data obtained through this database also have been useful in advancing faculty interactions with the CNSC, and vice versa, which have in turn, led to changes in the curriculum and instruction in courses, the clinical setting, and the CNSC.

Mission:
The mission of the Wilkes University School of Nursing is to prepare professional practitioners of nursing who have mastered the core concepts and principles of the discipline, to address ethical issues in practice, to promote lifelong learning and to serve others with intelligence, compassion, and integrity in a constantly evolving, multicultural environment. Consistent with this mission and the vision of the WU-SON, simulation integrated into the undergraduate nursing curriculum is designed to prepare professional nurses for an evidenced-based practice in an increasingly complex healthcare environment.
The role of the simulation program in this curriculum is to create a learning environment in which undergraduate nursing students are exposed to complex clinical situations in a standardized and controlled simulation setting. The goals of the simulation program are to provide a system by which students can develop clinical nursing judgment and to employ a standardized and centralized mechanism by which the development of clinical judgment is objectively evaluated in order to provide feedback to enable curricular changes for continuous quality improvement.

Program and Program Outcomes:
In 2006, Wilkes University began to explore the use of simulation in undergraduate nursing education and, in 2007, the CNSC was established with the intent of integrating simulation into the undergraduate nursing curriculum using the philosophical underpinnings of Benner’s Theory From Novice to Expert. The goal of the simulation agenda is to provide a mechanism by which students are exposed to complex clinical situations followed by a formative debriefing session as a means to assist in the development of clinical nursing judgment. In 2008, an educational session was held on simulation and faculty began integrating clinical simulations into each clinical nursing course. At the end of the 2008 academic year, systematic review of the curriculum and evaluation of the simulation agenda revealed a need for an objective method by which this clinical nursing judgment can be evaluated.
In response to this identified need, the Lasater Clinical Judgment Rubric (LCJR) was adopted as the evaluation tool.  The LCJR was chosen because it is consistent with the philosophy of Benner and it was specifically designed to measure a student’s clinical judgment during performance in clinical simulations in cognitive, psychomotor, and affective domains of learning. The LCJR scoring gives a quantitative measure of a student’s clinical judgment and establishes a level of development for each student as either beginning, developing, accomplished, or exemplary. The LCJR and scoring parameters were distributed to all faculty during an educational session held at the beginning of the 2009 academic year.

In an effort to assure quality, efficiency, and accountability in the implementation and evaluation of the simulation agenda integrated into the nursing curriculum, a SPSS database was also created in 2009 so that data on student clinical judgment can be centralized and used for analysis of both student and program outcomes. Also, because the LCJR was new, the SPSS database included variables to monitor inter-rater reliability.

While the simulation program and database were designed specifically for pre-licensure students, the importance of such a program in the evaluation of students was recognized. The graduate curriculum for Nursing 542: Evaluation in Nursing Education was updated to include the LCJR, its scoring parameters, and the importance of inter-rater reliability. The graduate students enrolled in that course participated in student evaluations using the LCJR in clinical simulations in the CNSC beginning in 2009.

Data collected using the LCJR to evaluate students’ clinical nursing judgment in simulations were entered into the database and analyzed based on student cohorts of sophomore, junior, and senior. Data analysis showed that both mean and median LCJR scores were higher for the junior level cohort as compared to the sophomore level cohort and LCJR scores were higher for the senior level cohort as compared to the junior level cohort. It was also noted that the range of scores for the sophomore level cohort was larger than the range of scores for both the junior level cohort and the senior level cohort. And the range of scores for the junior level cohort was larger than the range for the senior level cohort. An independent-sample t- test comparing the mean scores of the sophomore students (NSG210) and the mean scores of senior students (NSG310) found a significant difference between the means of the two groups (t(88) = -2.684, p <.05). The mean of the sophomores is significantly less (m = 25.98, sd = 6.86) than the mean of the seniors (m = 29.48, sd = 5.27).The results suggest that overall clinical judgment skills improve as students transition through the baccalaureate nursing program and clinical judgment skills become more consistent among students as they approach program completion.

As the simulation program is dedicated to the mission of the WU-SON, the use of the database to demonstrate the development of clinical nursing judgment in the enrolled students supports the School’s mission to prepare professional practitioners of nursing who have mastered the core concepts and principles of the discipline. Curricular changes that resulted from the new simulation program are:

  • The School of Nursing’s philosophy for the undergraduate curriculum was rewritten based on the philosophical underpinnings of Benner,

  • All clinical nursing courses in the baccalaureate curriculum now have an integrated clinical simulation to evaluate the students’ clinical judgment,

  • Nursing 542 in the master of nursing program now includes content and assignments on the evaluation of clinical judgment in pre-licensure students using the LCJR,

  • School of nursing undergraduate curriculum reports and systematic evaluations now include statistical data on student cohorts’ clinical judgment development which support the curricular changes.

The curricular changes that came about from the introduction of the new simulation agenda were well-received by faculty and administration. The program development and results were presented by the CNSC Director at the International Nursing Association for Clinical Simulation and Learning (INACSL) Conference in Las Vegas in June 2010 in an effort to stimulate curricular changes in nursing education that will foster large-scale changes for the integration and evaluation of development of clinical nursing judgment in pre-licensure nursing students.

Data continue to be entered into the database and descriptive statistical data is reported as part of the CNSC’s monthly report. In 2010, WU-SON faculty requested use of the database as a central and standardized method for storing not only information on simulation but also other variables that can help in evaluating the undergraduate nursing curriculum. During the 2010-2011 academic year, the CNSC Director met with the Assistant Dean of Academic Affairs and Assessment and the WU-SON Associate Dean to begin expanding the statistical database to allow for routine analysis of quantitative statistical data on students and student cohorts in cognitive, psychomotor, and affective domains and provide access to this historical data for longitudinal studies. In the Fall of 2011, educational sessions will be held for all WU-SON faculty so that use of the statistical database becomes an integral part of systematic evaluation.

Meeting the award criteria:

  • This program served as a catalyst for change by integrating a simulation agenda into the undergraduate nursing curriculum using the philosophical underpinnings of Benner’s Novice to Expert Theorem

  • This program was implemented in 2009-2010 academic year, was sustained in the 2010-2011 academic year, and is now a part of the ongoing systematic evaluation of the School of Nursing.

  • Information on this program was disseminated via conference podium presentation in an effort to stimulate replication of similar curricular changes in other nursing programs.

  • This program was a collaborative effort by the administration, faculty, and staff of the Nesbitt College of Pharmacy and Nursing.

  • This database reinforces Wilkes University’s dedication to the mission and vision of AACN to continuous improvements in quality, efficiency, and accountability through an evidence-based curriculum which prepares undergraduate nursing students for entry into professional nursing practice and fosters a commitment to life-long learning.

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tcu

Texas Christian University -
Winner, Private School Without an AHC

The AACN Innovations in Professional Nursing Education Award on behalf of the School of Nursing at Texas Christian University (TCU) – Harris College of Nursing and Health Sciences (HCNHS) under the Private School without an Academic Health Center category.
Summary: The purpose of the Baccalaureate Nursing Emphasis in Oncology (BNEO) at Texas Christian University (TCU) - Harris College of Nursing & Health Sciences (HCNHS) is to increase nursing students’ desire and decision to practice in an oncology setting upon graduation. Established in Spring 2008, the programmatic innovation offers baccalaureate nursing (BSN) students the opportunity to complete an emphasis in oncology within their generalist nursing preparation. The program has demonstrated success in recruiting students to oncology nursing after graduation as well as serving as a curricular model for other areas of nursing for BSN students. TCU’s academic partnership with the University of Texas Southwestern Medical Center (UTSW) provides the opportunity for our students to experience oncology clinical opportunities in a National Cancer Institute designated center.

Description of the Programmatic Innovation
There is a dramatic need for oncology-specialized nurses to care for the growing population of people diagnosed and living with cancer, as well as for caregivers of cancer survivors. The Baccalaureate Nursing Emphasis in Oncology (BNEO) is an innovative strategy to promote interest and skill development in oncology nursing among BSN students. The BNEO program used the Oncology Nursing Society (ONS) Standards of Oncology Nursing Education: Generalist Level Education as the framework for the development of the oncology curriculum and collaborative clinical experiences (Jacobs, 2003). Graduates of the program have been well-prepared and motivated to enter oncology nursing practice.

Courses developed or supplemented for the oncology emphasis program are guided by the criteria statement from ONS: “To ensure that the science of and technical skills associated with the physical, psychosocial, spiritual, and cultural care of the patient with cancer necessary when examining prevention, early detection, risk reduction, treatment, rehabilitation, palliation, and/or end-of-life principles are included (Jones, 2003).” Although oncology nursing is an established specialty, many nursing programs lack focused oncology clinical and didactic experiences for students resulting in a failure of students to explore careers in oncology after graduation. The foundation for the BNEO is two upper-division undergraduate courses.

Aspects of Oncology Care is a three-credit course that requires didactic and outpatient rotations coordinated with the Simmons Comprehensive Cancer Center at the University of Texas-Southwestern Medical Center (UTSW). Didactic content is provided in an intradisciplinary approach by oncology clinical experts at HCNHS, UTSW and other oncological resources in the community. Clinical experiences for each student are required and coordinated through the outpatient clinics at UTSW. These include four 8-hour days in these clinics: Bone Marrow, Infusion, Gynecology-Oncology, Surgery, Radiation, & Hematology/Oncology, as well as the Interdisciplinary Care Clinic. Students also join the Oncology Nursing Society and attend local chapter meetings; becoming engaged in the professional aspects of oncology nursing.

The second course, Oncology Residency, is a three-credit hour, precepted internship with an oncology certified registered nurse. Students are placed on the adult general oncology unit, bone-marrow unit or pediatric oncology unit at one of three hospitals associated with UTSW medical system. Students complete nine 12-hour shifts and must demonstrate that they can competently and independently care for up to four oncology patients.

An additional aspect of the program is an Oncology Internship Program coordinated collaboratively with a large local oncology physician group with opportunities for urban and rural settings. BSN students must apply for the Oncology Internship and have successfully completed Aspects of Oncology Care. Interested students submit an essay speaking to their interest in oncology and career goals. A committee of oncology nursing faculty and nurses from the oncology group select participants for the internship. Students selected have experiences in medication administration, intravenous starts and accessing venous access devices, dressing changes, patient monitoring, opportunities to gain an understanding of case management and financial aspects of oncology patient care, and caring for the caregiver and family.

Since inception of the BNEO, 75 students have completed Aspects of Oncology Care (38 have graduated) and 23 students have completed the Oncology Residency (16 have graduated). Twenty-four students have entered oncology nursing upon graduation. Twelve students have participated in the Oncology Internship Program. The practice site for the Oncology Internship has employed one of the participants full-time upon graduation and continues to use three of the program graduates part-time.

As part of the BNEO, professional development opportunities have been offered to all TCU students, members of the entire TCU community (faculty/staff), the community of Fort Worth, and Dallas–Fort Worth professional cancer care providers. These have included continuing education (CE) workshops on radiation oncology; prostate cancer, cervical cancer, breast cancer, cancer prevention for women, and most notably, an annual full-day CE symposium for oncology nurses. These offerings have enhanced the relationships of the TCU–HCNHS reputation for being on the forefront of oncology practice for nursing and served to establish HCNHS as a baccalaureate program for students interested in oncology as a nursing specialty area.

In addition to the standard undergraduate nursing curriculum, assignments and activities in several other standard nursing curriculum required courses have an oncology-emphasis requirement for students participating in the program. With assistance from Community Partners, students participate in expanded didactic and clinical content on long-term effects, caregiver concerns, palliative care, primary, secondary and tertiary prevention, as well as end-of -life care and decision-making. Partners allow students to participate in and experience the valuable role of an interdisciplinary approach to cancer care from diagnosis, survivorship and end-of-life. Graduates of the program have been able to immediately contribute to institutions and communities as knowledgeable health care providers regarding services and needs of cancer survivors along the survivorship continuum.

The BNEO meets award criteria in the following ways:
Catalyst for change within the curriculum and/or educational mission of the institution. The Oncology Emphasis has served as a model for two subsequent initiatives: gerontological nursing course with interprofessional practicum experience and perioperative nursing course. Since initiation of the BNEO there has been a documented increased interest, not only dialogue, among faculty about oncology, but also research and community programming in oncology.

Sustained for at least one year and met outcomes. The program has been sustained since January 2008 and has met outcomes for student participation, faculty collaboration and awareness, and fostering community partnerships. The program has increased enrollment from 10 in year one to 30 this past year; and the number of graduates being employed in an oncology setting has consistently increased with each cohort.

Involved faculty teams. In addition to the standard undergraduate nursing curriculum, assignments and activities within several other required courses within the standard nursing curriculum have an oncology-emphasis requirement for students participating in the program.

Consistent with AACN mission and vision. The innovation is an exemplar of a strategy to meet human and societal needs through nursing. It is a proactive strategy to prepare baccalaureate nurses who are ready to respond to emerging knowledge about cancer and the increasing need to effectively care for survivors and their caregivers in a variety of different settings.

Demonstrates advancement of professional nursing education. The program highlights the role of the baccalaureate nurse in oncology care and demonstrates nursing’s commitment to prepare individuals ready to collaborate with other disciplines and community agencies to meet the needs of persons with cancer, survivors, and their families.

Recent literature documents that a shortage of registered nurses in oncology is a reality that the profession must address, given an aging population, concurrent aging of the oncology workforce, the nature of cancer, and increased number of cancer survivors. Specific to the National Action Plan for Cancer Survivorship, the program supports the prioritized need for the development of specific oncology curriculum, clinical experiences and an externship that students do not currently participate in. However, students have the opportunity to participate in the oncology internship. Curriculum content is aligned with care across the lifespan focusing on the issues of survivorship for cancer patients.

Nursing students frequently see cancer as a fatal condition and believe that oncology nursing lacks the complexity or excitement found in other clinical settings. By providing focused clinical experiences in different oncology settings and oncology-specific curricula, the BNEO has achieved its major aim to increase the number of baccalaureate nursing graduates that select a career in oncology nursing. In addition, the innovative program can be implemented and sustained in other programs of nursing.

References
Centers for Disease Control and Prevention and Lance Armstrong Foundation. 2004. A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies. Atlanta: Centers for Disease Control.
Jacobs, L., ed. 2003. Standards of Oncology Nursing Education: Generalist and Advanced Practice Levels. 3rd ed. Pittsburgh: Oncology Nursing Society.

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udm

 University of Detroit Mercy -
Winner, Private School Without an AHC

The AACN Innovations in Professional Nursing Education Award on behalf of the School of Nursing at University of Detroit Mercy under the Private School without an Academic Health Center category.

Overview:  Dramatic changes in health care, movement towards a global society, continued budgetary restrictions, learning needs of new millennium students and increasing multidisciplinary efforts to accomplish a variety of goals were a few of the reasons the University of Detroit Mercy (UDM), McAuley School of Nursing (MSON) recently initiated an innovative multidisciplinary nursing course into the curriculum.  The overarching goal of the multidisciplinary effort is to train students how to effectively collaborate with members of other disciplines, advance nursing education and improve practice in order to ameliorate care.  The school of nursing has established collaborative relationships and formed strategic alliances with the school of engineering, local health care providers, and the surrounding community and by doing so has advanced baccalaureate nursing education.  Multidisciplinary collaboration in baccalaureate nursing education has the potential to create fertile grounds for learning beyond that of a single discipline approach.  Specifically nursing and engineering faculty have developed a way to inspire and stimulate their students to learn and use the knowledge they’ve gained to provide care to their clients.  This innovative multidisciplinary educational approach effectively meets the learning needs of our current students while helping members of our community.

Introduction:  In 1988, the US Federal Government passed the Technology-Related Assistance for Individuals with Disabilities Act (“Tech Act” 2000). Increasing the availability of assistive technology as well as the capacity to provide technology-related assistive devices were two objectives of the federal act. Accordingly, in 2008, the departments of Nursing and Mechanical Engineering at UDM collaborated to provide unique assistive devices to physically challenged individuals living in the Detroit Metro Area while teaching multidisciplinary collaboration.  Following classroom instruction the student teams, under the supervision of the nursing and engineering faculty, meet people from the local community with a physical disability.  Individuals requiring assistance are identified through a variety of developed partnerships such as Michigan Rehabilitation Services, Veterans Administration (VA) Hospitals, Michigan Spinal Cord Association and personal contacts.    The students interact with the client to assess his or her needs.  Collaboratively, the students and the client determine a device that could be built in order to improve the life of the disabled person.  Nursing students inform the team about the specific physical disability and its implications, help with design ideas and evaluate the device and the client for any potential health related issues. Engineering students design and build the assistive devices identified by the client and make necessary iterations until a satisfactory device is completed. The multidisciplinary student team works together to provide a safe, useful and health conscious device with the goal of improving quality of life.   Nursing faculty and engineering faculty collaboratively teach bi-weekly in the classroom and also facilitate the multidisciplinary student interactions as they build the devices for the clients. 

Description, Outcomes & Title: The title of the program is “Enhancing Education Using a Multidisciplinary Program Building Assistive Devices for Physically Disabled People”.  The goal of this interdisciplinary educational effort is to teach collaboration and team work between disciplines in order to prepare graduates with skills necessary to work in a global society while positively impacting the lives of others.  The collaboration between mechanical engineering and nursing in this manner lends support to Kijima’s (2007) encouragement to advance multidisciplinary work in the systems sciences where one system is mechanical and the other human.  The outcomes for the course are as follows:  1.) Students will have an improved understanding of the roles engineers [nurses] have in the development of assistive technological devices.  2.)  Students will demonstrate improved collaborative and communication skills with members of other disciplines.  3.)  Students will state enhanced understanding of how to apply learned skills to a variety of problems.  4.)  Students will be exposed to needs of people in the community and design strategies to improve those needs.  5.)  Students will state an anticipated enhanced ability to communicate across disciplines in the workplace post-graduation compared to their colleagues without multidisciplinary training.  Pre and post course surveys of students demonstrated that all outcomes have been effectively met.     

Award Criteria: Since the initiation of the multidisciplinary course both nursing students and engineering students have had the unique opportunity to learn collaborative skills which serves as a catalyst for change to nursing curriculum, with the goal of additional multidisciplinary opportunities incorporated into other nursing and university courses.  MSON is advancing professional nursing education by offering this unique type of multidisciplinary education.  In addition, the faculty teaching the multidisciplinary course have disseminated information on how other universities can replicate this program.  The goals, purposes and techniques of this unique learning experience has been presented at the American Association of Colleges of Nursing Baccalaureate Education Conference (November, 2010), the Michigan Academy of Science Arts and Letters Annual Conference (March 2010), the Nurses Trusted to Care Conference (May 2011 – poster), featured on Pubic Network Television (August 2009, http://www.youtube.com/watch?v=DNmE3TxQ828) and published in a pending issue of Michigan Academician (in press).  It is our hope that other colleges and nursing programs will begin to incorporate similar programs into their curriculum with the goal of graduating nurses proficient in applying their nursing skills in expanded ways.  Nurses need to have input when devices, technology and electronics are being designed for patients.  Currently, far too few products being used in clinical settings have been influenced by the expertise of the nurses who will be using them.  It is our goal that nurses lead the delivery of quality health care and help generate new knowledge to improve health and the delivery of care services. In order to accomplish this objective, consistent with the AACN vision, nurses need to be educated to communicate and collaborate with other disciplines in order to enhance technology used in clinical settings and patient lives.

We have just completed our third year of the multidisciplinary nursing/engineering course.  The program is consistent with and fully supports the mission of UDM which states, “The University of Detroit Mercy, a Catholic university in the Jesuit and Mercy traditions, exists to provide excellent student-centered undergraduate and graduate education in an urban context. A UDM education seeks to integrate the intellectual, spiritual, ethical and social development of our students.”  Our program develops students by educating them to use their intellectual skills learned throughout their courses at UDM in order to improve the lives of people living in our urban community with physical disabilities.  The students also include the spiritual, ethical and social aspects involved in providing for the needs of the physically disabled living in an underserved area.   In addition, our multidisciplinary course provides resources which serve the public, is creatively, uniquely and innovatively advancing nursing education and practice to meet the demands of the 21st century health care, objectives consistent with the mission of AACN. 

Our program was recently awarded a NCIIA grant (#8286-10, “Student designed technologies for the disabled”) which will financially contribute to additional and improved devices that our students can build for the physically disabled persons in our urban community.  The multidisciplinary student efforts have produced innovative devices such as:  a hand grasper for a former police officer with right sided hemiparesis from a gunshot wound to the head, an ankle strengthener / exerciser for a man with multiple sclerosis, a torso & triceps strengthener for a paraplegic man, a side sliding crib for a wheelchair bound mother, a motorized wheelchair mover for non-electric wheelchair users, a liquid food feeding tool for burned patient unable to feed himself liquids due to contractures and loss of fingers, a camera stabilizer for a photographer with Huntington’s Chorea, and laundry tub extractor for a woman with Spina Bifida.

Challenges:  We have encountered some limitations in our collaborative course.  For example, scheduling conflicts and time constraints between nursing and engineering students have made team meetings occasionally difficult to schedule.  Also, initial differences in professional language and jargons make communication between disciplines somewhat problematic.  However, the initial language barriers become an outcome met towards the end of the term as each discipline begins to learn and understand how to collaboratively communicate with the other discipline.  The faculty view this phenomenon as meeting course objectives 1, 2 & 5.  An example of this is noted during the stage when a perceived design is presented to the client but revisions are needed.  The engineering students refer to revisions as “iterations”; the nursing students refer to revisions as “alterations to interventions”.  Interestingly, by the end of the term both groups of students understand the others language without explanation.  Another example is the ease that nursing students understand and can explain words like spina bifida, contractures, and hemiparesis to the engineering students but also leave the course understanding words like gantt chart, prototyping, and sequential dependency. 

Conclusion: Despite some challenges to multidisciplinary education, the nursing and engineering students have stated that the course had a positive impact on their realization of the needs of people in the community and how their unique skill sets can be used collectively to ameliorate those needs.  The students have also verbalized an improved understanding of the need for multidisciplinary efforts in the workplace to design equipment built by engineers, used by nurses to improve health care. Both the engineering students and the nursing students have stated an enhanced understanding of the others’ discipline and have expressed a desire to work with other disciplines as a means to improving care.    In addition, lives of physically disabled people in our local community have been positively impacted because two very different disciplines have learned to work together.
Please do not hesitate to contact us if you have any additional questions regarding our awesome multidisciplinary program.  We are very proud of this work and the impact it will have on the future of baccalaureate nursing education.

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ut

The University of Texas at Austin -
Winner, Public School Without an AHC

View innovation summary in PDF

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