Innovations in Professional Nursing Education Award Winners
Academic Health Centers: Oregon Health Sciences University
Small Schools: Illinois Wesleyan University
Private Schools Without an AHC: D’Youville College
- Public School Without an AHC: Texas A&M University-Corpus Christi
Past Award Winners
Oregon Health & Science University
Winner - Academic Health Centers
Faculty and administration of the OHSU School of Nursing provided essential leadership in the collaborative efforts that resulted in creation of the new consortium and nursing education curricula. The consortium was created in 2002 and has served as a catalyst for change in nursing education throughout Oregon and the nation since that time. The Oregon Consortium for Nursing Education1 is a partnership of Oregon nursing programs (9 community college ADN programs and the OHSU BSN program) dedicated to educating future nurses. Faculty members from these partners have created a shared curriculum taught on all consortium campuses. The curriculum was created and continues to be maintained and revised by faculty representing all the partner programs. Through OCNE, students can complete coursework for the Bachelor of Science Degree in Nursing from OHSU without leaving their home community. Students on OCNE community college campuses complete the Associate of Applied Science degree in nursing and are eligible to take the RN licensure exam, then have the option to continue directly to OHSU senior level coursework required for the Bachelor’s degree through various OHSU campuses or through distance delivery of the didactic portion of the courses and local completion of the clinical experiences.
The OCNE curriculum is an innovative design based on a set of core competencies educating a nurse who can provide care to individuals, families and communities in health promotion, acute or chronic illness and at the end of life. The graduate from an OCNE program is skilled in clinical judgment, culturally appropriate & relationship-centered care, systems thinking & leadership, and evidence-based practice.
OCNE is often cited as an initiative primarily focused on increasing access to baccalaureate education, and this has been one of its goals. This goal would be consistent with AACN’s mission and vision as well as the IOM recommendations. However, OCNE actually encompasses multiple initiatives necessary to meet the overarching goal of aligning nursing education with the emerging health care needs of Oregonians:
- Partnerships and Collaboration
- Curriculum Transformation
- Pedagogy Reform
- Clinical Education Redesign
This comprehensive and collaborative effort is unprecedented in the United States and is increasingly viewed by health care and nursing education leaders as a model that could be adapted to achieve similar goals across the country.
Nationally, OCNE has inspired nursing faculty around the country to engage in education redesign in order to align nursing education more closely with emerging health care needs and health care system changes, and to increase educational capacity for baccalaureate education. Through conferences, publications, and webinars, faculty in 12 states have actively deliberated whether to develop programs like OCNE. So far, at least 10 states have seen the greatest effects: components of the OCNE program have been adopted in Massachusetts, Texas, New York, and rural North Carolina, while statewide or regional consortia have been developed in California and Hawaii and continued active planning is occurring in New Mexico, Wyoming, Minnesota, and Maine. My colleague from OHSU and fellow Co-director of OCNE, Paula Gubrud-Howe, recently returned from consulting with nursing educators in Maine at the same time I was consulting with MANE—the Minnesota Alliance for Nursing Education which is developing a new curriculum and relationships along the lines of OCNE.
More information can be found at http:/ocne.org.
Illinois Wesleyan University
Winner - Small Schools
Our curricular advancement entitled “An Innovative Study Abroad Program for Nursing Majors at a Traditional Liberal Arts University” meets the award criteria and is described below. To our knowledge, no other small private liberal arts undergraduate institution offers a semester long study abroad experience for nursing majors embedded within the curriculum; we believe our Spain program, which is entering its third year being open to nursing majors, is truly an innovative approach to establishing cultural competence for undergraduate nursing majors and could serve as a model for other small schools and private universities.
In response to an increased need for Spanish speaking and culturally competent nurses, Illinois Wesleyan University implemented a semester-long study abroad program for nursing majors in Barcelona, Spain, as an innovative strategy to assure the newly revised curriculum meets the changing needs of society. Curricular revision incorporated The Essentials for Baccalaureate Education for Professional Nursing Practice and met the Institute of Medicine’s recommendations for core knowledge needed for all healthcare professionals. Previously, student travel abroad was limited to May Term or summer for nursing majors due to the limitations of delivering a traditional pre-licensure program at a liberal arts university. Nursing majors can now participate in the University’s study abroad program, allowing both the study abroad students and the students who remain on campus to enhance their appreciation for cultural and ethnic diversity. The School of Nursing’s mission, philosophy, and goals are consistent with that of the University’s emphasis on preparing students for democratic citizenship and life in a global society and “extends the University’s liberal arts tradition to prepare exceptional thinkers, compassionate professionals, and leaders for nursing and global healthcare.”
In Spring 2012, five sophomore nursing majors experienced immersion in Spanish language and culture while living with families in Barcelona. The program grew to seven sophomore nursing majors participating in 2013. These pioneers enrolled in two non-nursing classes, at Barcelona International College, including a Spanish language course and a course that met general education credit. Through the use Polycom technology, the study abroad students and the students on campus synchronously completed Pathophysiology and Pharmacology II and the didactic portion of Nursing Foundations II: Health Promotion and Risk Reduction with IWU School of Nursing faculty. Clinical observation experiences in Barcelona assured students could collaborate with other healthcare professionals and patients to provide culturally appropriate health promotion and disease and injury prevention interventions. Demonstration of competency in fundamental nursing skills and completion of 40 hours of direct patient care occurs when the students return to campus in May. Michele Bromberg, Nursing Coordinator, The Illinois Department of Financial and Professional Regulation (IDFPR), described the IWU Spain program as “on the cutting edge of facilitating bilingual healthcare workers in the state of Illinois.”
Qualitative and quantitative data obtained from student participants demonstrate the success of the study abroad program. Feedback from 2012 was used to improve the 2013 program and plans are underway to assure the success of the twelve sophomore nursing majors studying in Barcelona in 2014. Teaching strategies employed for a successful study abroad experience include 1) techniques to create a dynamic classroom learning environment for both students on campus and those abroad (e.g., increasing bandwidth speed; installing more monitors/speakers); 2) ways to assure ongoing communication and academic success (e.g., Skype study session with tutors and faculty); 3) techniques to accommodate different test taking needs (e.g., providing both paper and electronic testing options). Administrative strategies included 1) grant writing to secure and update telepresence technology; 2) an agreement and establishment of a relationship with an international institute of higher learning; 3) multiple site visits beginning 2 years in advance to secure several clinical observation sites to accommodate cultural variations in agency agreements and ongoing visits to assure learning needs are met. Additional lessons learned from the inaugural year that were applied to the seven nursing majors who traveled in 2013 included the need to 1) assure a dedicated study space for students outside of home stays and beyond limited hours of libraries and universities; 2) inform students of the demands of skill-based modules and clinical experiences upon return to campus; 3) delay clinical observation experiences in Barcelona until acclimation to the culture and language skills are more developed; 4) enhance technology support services including the development of more than one contingency plan for technology challenges; 5) pre-departure meetings with returning students, faculty, and staff to prepare departing students for the rigorous demands of the study abroad program for nursing majors; 6) pre-departure planning sessions with the Study Abroad Director (a faculty colleague in Hispanic Studies or other non-nursing discipline) and Internship Coordinator (an international colleague on site in Barcelona) to assure the unique needs of nursing majors are addressed.
In summary, the Illinois Wesleyan University study abroad program for nursing majors in Barcelona, Spain, is an innovative approach to allow cultural immersion and advance cultural competency at a traditional liberal arts university. Sophomore nursing majors can spend the Spring semester immersed in Spanish language and culture while living with host families in Barcelona. As part of the Spain Program, students take language and general education courses offered through Barcelona International College while using PolyCom for synchronous learning of IWU core nursing course content. This approach honors the face-to-face learning environment that defines Illinois Wesleyan’s small private liberal arts residential campus. Students participate in Spanish clinical observation experiences in public and private health care centers and complete direct patient care requirements upon return to campus in May. Participation in the semester long study abroad allows nursing majors to experience the global opportunities available to all University students while allowing the nursing majors, who report having a “life transforming experience” to graduate on schedule with their classmates who remained on campus.
Winner-Private School Without an AHC
During the current 2012-2013 academic year, D'Youville College School ofNursing began an innovative approach to interprofessional education (IPE) in collaboration with the other six health care professions at the college. The objective ofthe D'Youville College (DYC) interprofessional education committee (IPEC) is to develop a working model that meets the core competencies of IPE and fosters patient-centered collaboration across professions. DYC has responded by creating a curriculum containing a four hour simulated patient scenario experience, centered on the IPE core competencies of: values and ethics for interprofessional practice, roles and responsibilities, interprofessional communication, and teams and teamwork. The objective was successfully met with 254 students and 25 faculty members from the seven health care professions participating in the experience.
Faculty created a "Year in the Life of Chris Dulles", 4 authentic fictional patient scenarios that occur throughout a continuum of care settings (Outpatient clinic, CCU and medical/surgical hospital floor). Actors from the on-campus theater were trained as simulated patients/family members. The curriculum strives to ensure practicing health care professionals function as a holistic integrated team delivering high quality patient-centered care. Within the scenarios, undergraduate nursing seniors and graduate family nurse practitioner students and students from multiple health professions are required to work together while recognizing the unique and complementary contributions of members of the health care team. Debriefing sessions provide an opportunity for students to increase their understanding of the IPEC competencies and talk about the experience of working together on a team. The simulated patient experience includes faculty and students from Nursing in collaboration with faculty and students of the other healthcare programs at the college: Chiropractic, Dietetics, Occupational Therapy, Pharmacy, Physical Therapy, and Physician Assistant. Student learning was assessed via pre and post measures for achievement of interprofessional competencies as proposed by the Interprofessional Education Collaborative.
To promote the practice of teamwork and collaboration and the understanding of each other's roles on the health care team, experiences integrated into the curriculum can begin to change the culture of isolated practice. On the college campus the culture change has begun between the faculty and students across the health professions as they work together in the simulated encounters. The experience also supports the D'Youville College mission that emphasizes leadership development of students.
The innovation began in February 2012 and is continuing. The outcome of educating the 7 health professions through the IPE experience was successfully met by refurbishing an off campus location with video, live feed, and simulated patient spaces; creating patient scenarios; training actors as simulated patients; educating faculty facilitators; collecting student assessment data; and successfully bringing 254 students through the experience. The IPEC simulations will be continued in all the health professions curricula in the next school year.
This IPE experience can be replicated. The experience is being disseminated by several members of the IPE faculty who have presented at their respective professional conferences. Moving forward, groups of faculty have begun to work on papers for publication to be submitted in the next year. The scenarios have been placed in a consistent format to be shared. The group has submitted further grant applications to expand space and equipment with intent to expand the experience to additional student cohorts and expand the IPE objectives. The model developed can be replicated by other schools with multiple health professions with which to partner.
All seven ofD'Youville College's health care professional programs are included in each simulation experience. Initially, the organizing faculty committee was comprised of one member of each profession; five faculty members attended the 2012 IPE Institute. The group has expanded to 14 with two faculty members from each professional school plus the 25 trained faculty facilitators from the college some of whom are non-healthcare faculty members. The inclusion ofnon-healthcare professionals in the experience enhances the resources ofthe group and has opened discussion about roles of the college business and liberal arts departments, and the library for future projects.
This initiative supports the AACN's position in the IPEC organization to heighten collaboration among all providers to advance high quality, integrated healthcare delivery. The educational experience supports the Baccalaureate Essential of interprofessional communication and collaboration for improving patient health outcomes by creating an experience where collaboration among health care professionals is learned and not left to happenstance in the clinical setting.
Teamwork and collaboration have been shown to affect safety and quality outcomes for patients. Interprofessional education of our future health care professionals can take this culture change and teamwork example directly into practice to affect patient care outcomes. The faculty committee chose interprofessional simulation encounters with simulated patients as its first initiative to provide deliberate experiential learning about team communication skills and respect for each other's roles. In addition, learners experience shared accountability in striving to improve the quality and safety of patient care.
Texas A&M University - COrpus Christi
Winner - Public School Without an AHC