School of Nursing amp Health Professions Judith F Karshmer PhD APRN Dean amp Professor Common Rules in Nursing Education Dont reinvent the wheel 2 Start clinical experiences with simple patients ID: 598161
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Breaking the Rules: Redesigning the Educational Endeavor for Nursing
School of Nursing & Health Professions
Judith F. Karshmer, PhD, APRN
Dean & ProfessorSlide2
Common Rules in Nursing Education
Don’t
re-invent the wheel
...
Slide3
2
. Start clinical experiences with “simple” patients (i.e., those in long-term care).Common Rules in Nursing EducationSlide4
3. Make patient assignments (instead of “nurse” assignments
).Common Rules in Nursing EducationSlide5
4. Hone the nursing skill-set in
a structured in-patient setting before expanding to the more fluid ambulatory care setting. Common Rules in Nursing EducationSlide6
5
. Affirm that clinical instructors are “faculty”- their relationship with the setting is secondary.Common Rules in Nursing EducationSlide7
6
. Value “breadth” across an array of practice cultures rather than “depth” within one.Common Rules in Nursing EducationSlide8
7. Value “real patient” experiences over simulated
ones.Common Rules in Nursing EducationSlide9
8
. Treat hours of clinical time as equal, regardless of the experiences made available.Common Rules in Nursing EducationSlide10
9
. Supervise students’ “interprofessional communication.”
Common Rules in Nursing EducationSlide11
10. Always require a pre-lab the day before clinical so the student can prepare a well-researched plan of
care.Common Rules in Nursing EducationSlide12
11. Use clinical rotation times that are different from the “work day” of the
facility.Common Rules in Nursing EducationSlide13
12. Focus on “getting the work
done,” rather than on seeking learning opportunities.Common Rules in Nursing EducationSlide14
The Future is NOW
TIME TO
BREAK
THE
RULES… Slide15
“Now” Questions…Where is healthcare taking place
?Who are the patients?What is the reimbursement model?What are the expectations of the patient; the provider?Who is providing it?Slide16
“Now” Answers
Ambulatory, transitional & home care settingsAn educated consumerCapitated = health promotion + keeping the patient at homeAccessibility, connectivity, & dataWho IS providing the care??Slide17
If nursing education does not change and start preparing the nurse for ambulatory & transitional care & the home health and clinic settings it will be:
CHWsTeam-lets Tele-health ConsortiaSlide18
So which rules do we break?
ALL OF THEM!Slide19
We need to re-
invent the wheel...Preparing the nurse must be preparing for the future.Slide20
We need to start students in the settings where they will
practice:Out-patient and community clinicsHome health/hospiceSchools/health departmentsTransitional care programsSlide21
We need to assign students to nurses and other
professionals:Preceptor/apprentice modelIPE joint appointmentsFaculty as coach to provider dyadsSlide22
We need to question the impact of focusing on the skill-set rather than the knowledge base & clinical decision
making.Provide integrated skill development in simulated settings as prep for practiceSlide23
We need to move away from the arbitrary division among the nurse, preceptor, & faculty
roles.Develop academic-practice partnerships in which faculty and staff are one in the same.Slide24
We need to stop moving students from setting to
setting.Expand the academic-practice partnerships so the student is a key part of the Health Care HomeNurses carrying patient panelsSlide25
We need to exploit the power of
simulation.Simulated experiences:Standardized patientsIPEHigh-fidelity simulatorsSimulated systemsSlide26
We must stop treating
hours of clinical time as equal.Competency Based EducationSlide27
We must require
“interprofessional communication” as a standard.IPE simulationsIP practice = requiredSlide28
We can’t continue to set an expectation that nursing practice is
static.Mobile devises for prepPoint of Care learningTreatment & teaching AppsSlide29
We must stop treating the clinical sites like real estate & demanding time to match academic
schedules.Link student time with agency personnel timeUse staff/faculty partnersSlide30
We must stop evaluating students on “getting the work
done.”Focus on demonstrating competencies & learningSlide31
USF Lessons Learned
Transition to Practice (T2P) Programs in Ambulatory Care, Home Health, & School Nursing16-week program: precepted clinical 20hr/week + class & simulation 1day/weekSlide32
USF Lessons Learned
PartnershipsSchool districtsHome health agenciesHospiceCommunity clinics; FQHCsSpecially clinicsTransitional care programsUrgent care centersNew Graduates = Jobs 100+Slide33
USF Lessons Learned
Push Back…What can they do?How much time will they take?How safe are they?State and agency regulations.Slide34
USF Lessons Learned
Success:40+ Partnerships5 (& counting) cohorts100+ jobs for new graduates in these non-traditional settings!Slide35
USF Lessons Learned
BSN collaborative with VA to prepare the nurse of the future.20%-80% not 80%-20%Slide36
USF Lessons Learned
Master’s entry program for CNLs to prepare for ambulatory care & home health.Preceptors = faculty/staffSlide37
Change is easy – it’s keeping the status quo that’s so hard!Slide38
Questions?