Learning-service community partnership model: A pediatric program evaluation

Pediatric clinical learning experiences in which service provision is offered present a challenge to nursing faculty and students. The Learning-Service Community Partnership Model is a framework in which innovative learning and service provision are an integral part of the pediatric nursing clinical experience. This article discusses a program evaluation of a pediatric community-based health promotion program based on this model. The result from this program evaluation shows that a service program can be effectively managed and provided by pediatric nursing faculty and students. This article describes the shift in moving pediatric learning experiences into the community and validates its importance.     

Peanuts,Popcorn, and Pediatrics: School-Based Carnival for Health Promotion

A carnival themed health fair was designed to enhance a pediatric clinical experience through service learning in an undergraduate Associate degree nursing program. The goal of this pilot was to foster pediatric health promotion by connecting nursing students with elementary students classified as a vulnerable population. Senior nursing students created, designed, and implemented an interactive learning activity for 225 children. Kolb's Experiential Learning Theory was the framework utilized for project organization and development. Nursing faculty guided students in identifying issues specific to contemporary pediatric health concepts, but creative and artistic control was given to the student. Students utilized a web-based learning platform to document the journey for the project from inception to informal evaluation. Students achieved pediatric course and program outcomes by working collaboratively with the community in an innovative format. This school-based carnival offers a valued contribution for collaborative connections utilizing innovation and creative methods.     

Combining community health and psychosocial nursing: a clinical experience with the homeless for generic baccalaureate students

A report is made of a teaching approach which combined community health and psychosocial nursing clinical experiences for senior level, generic, baccalaureate nursing students over a period of two academic quarters. An urban community center and shelter for the homeless was the setting for this unique clinical approach. Areas on which the evaluation of the clinical experience focused included the clinical design, student activities, types of clients seen, and student and faculty views. Strengths and limitations of the experience were identified. The progression of the student group in adapting to the homeless population was described in detail. Faculty concluded that by sharing their clinical expertise in this combination clinical setting with the homeless, generic students were able to maximize and coordinate their academic and clinical activities. The homeless setting is demonstrated to be an excellent arena for student learning when faculty provide structure, support, and guidance.     

An Experience in Health Planning for Baccalaureate Nursing Students

A model was developed, using the nursing process, that has been incorporated into a health planning project for a community health nursing course. It is used to assist students to view larger aggregates as the client and to gain knowledge and experience in health planning. Examples of completed projects are presented. Evaluation of the projects by students, faculty, and aggregates supports the use of the model as a framework for nursing intervention within a community for the improvement of client health.     

A unique opportunity for students: long-term therapeutic relationships with chronically ill clients

Because of a number of factors, fewer opportunities are available today for students to have independent clinical experiences with home care agencies. At York College of Pennsylvania, community health nursing faculty designed a home health clinical experience with chronically ill clients that would be meaningful to students, fill unmet client needs, and establish or strengthen the relationship between the nursing department and community/home health agencies. In addition to achieving the stated goals, these clinical experiences offered additional unanticipated benefits that resulted from the long-term nature of these client-student interactions.     

Faculty mentorship: support for nurse practitioner students and staff within the rural community health setting

As pointed out in the introduction, there are certain practical concepts within our base of nursing knowledge that can only be taught through experience. Many things are easier to teach by example. As we turn back the clock in nursing, we can see how Florence Nightingale, Clara Barton, and Lillian Wald were role models to their nursing peers in their era. They taught nursing by example, by role modeling their clinical expertise. Today, this model is still effective and faculty mentoring of nurse practitioner students and CHNs in a compassionate and collegial leadership results in higher quality of health care for our nation's needy clients and their families. But greater yet are the opportunities for flexible nurse practitioner faculty practice and personal interactions on many levels for nursing faculty who wish to share their expertise. Mentorship by nurse practitioner faculty for nurse practitioner students and CHNs in a rural clinical setting has revealed many positive aspects in providing quality care for rural clients and growth for nurses. Exposure to the rural community health system helps us, as nurses, to identify the many strengths it possesses for innovative rural nursing practice.     

The integrative clinical preceptor model: a new method for teaching undergraduate community health nursing

The Integrative Clinical Preceptor Model was designed to provide a framework for undergraduate clinical education in community health nursing. The model is based on reciprocal collaboration between students, preceptors, and faculty. Implementation of the model has resulted in individualized, population-focused experiences for students based on the principles of service-learning, empowered preceptors who are able to increase their scope of service, and increased productivity for the faculty in research and scholarship. The authors describe the collaborative partnership between a school of nursing and nurses in community health settings that has resulted in excellent clinical experiences for undergraduate nursing students.     

Population-focused practice: introduction to baccalaureate-level nursing students

This article describes a clinical nursing experience which introduces baccalaureate students to population-focused practice in the community. The importance of such practice in community health nursing is discussed as is the rationale for including it at the undergraduate level. An overview of how the experience fits within the baccalaureate nursing curriculum is presented. Individual and group student responsibilities are outlined, explaining the structure of this nursing experience. Student projects with two groups--the well elderly and the school-aged are described to illustrate the clinical experience. Finally, an evaluation of the experience is presented which indicates that it has benefits for clients, community health nurses, students and faculty.     

Empowering nursing faculty and students for community service

As the health care delivery system moves from acute care settings to community-based services, nursing education must examine the experiences that increase students' abilities to function within a changing system. Currently, students receive community-based experiences that involve teaching health promotion concepts. However, students are not routinely prepared with specialized screening skills to use in the community. Using a train-the-trainer model, faculty and students were taught four specialized screening skills: Early and Periodic Screening, Diagnosis, and Treatment, Denver II Developmental Screening, vision screening, and hearing screening. Initially, faculty obtained certification as trainers for these specialized skills. Then, faculty educated students and provided enhanced, guided community experiences. Undergraduate, RN-to-BSN, and graduate family nurse practitioner students participated in this community-based experience. Project outcomes were evaluated based on the number of students and faculty who were certified and participated in these community activities.     

Of Lillian Wald, Community Health Nursing Education, and Health Care Reform

Abstract A pilot project is described that was initiated to provide a comprehensive clinical experience for community health nursing (CHN) students despite local cutbacks in field nursing services. The project, entitled the Nursing Elementary Education Outreach Project (NEEOP), is used as a basis for discussion on the CHN role in community-focused health care reform. One-third of the CHN students in one school of nursing during one academic year ( n = 16) participated in the NEEOP. One salaried CHN faculty member assumed primary responsibility, and equipment funding was granted by a local corporation. Collaboration was established with the county's proactive school nurses' association. CHN students developed and conducted health education presentations in elementary schools, worked with school nurses, and participated in other community health activities. Three levels of evaluation were utilized: elementary students to nursing students, nursing students to nursing faculty, and school nurses to nursing faculty. The NEEOP was a success by all evaluation criteria, and plans are currently in progress to expand its focus. Innovative clinical placements such as the one described can promote student understanding of CHN practice with its broad-based emphasis on the promotion of healthier communities.     

Community learning: the Reach for Health Nursing Program-Middle School Collaboration.

Nursing faculty and students have a vital role to play in promoting adolescent health at the community level. However, few nursing education programs have developed programs which provide nursing students with the skills and hands-on experiences they need to work with adolescents in community settings. A successful model for integrating community-based adolescent health promotion into nursing education is described in this article. Developed by nursing faculty from Medgar Evers College Department of Nursing, teachers and staff from a large middle school in Brooklyn, New York serving economically disadvantaged Black and Hispanic youth, and Education Development Center, Inc., the Reach for Health (RFH) Nursing Program-Middle School Collaboration has two mutually reinforcing components: (a) classroom-based health instruction taught by teachers with assistance from nursing students and faculty, and (b) community youth service in which middle school students spend approximately 3 hours per week providing assistance in health-related facilities under the guidance of nursing faculty and student nurse mentors. As part of an evaluation study, the authors conducted focus groups with nursing students involved in this program and administered an identical survey before and after intervention to assess potential benefits of participation. Compared to a control group of nursing students, those who participated in the RFH program reported increased skills and comfort working in school and community settings and with young adolescents, their teachers, and their parents. An example of other benefits was a greater understanding of the health and developmental needs of adolescents. At the same time they provided a service to the community, nursing students gained the skills and experience needed to be effective in community health promotion efforts.     

Service learning: head start and a baccalaureate nursing curriculum working together

Service learning experiences for pediatric nursing students in Head Start programs allow students to achieve the objectives of the pediatric nursing curriculum, model the values of the profession, meet the goals of a community agency, and contribute to the good of society. Students conduct screening tests, present health promotion or safety education projects, develop pediatric-related handouts for the parents and staff, perform assessments of growth and development, identify and research pediatric health issues, and learn the fine art of communicating with preschool children. Head Start schools as clinical sites provide students with ample opportunities to blend nursing theory with application while introducing them to another area of the population. Students, faculty, and Head Start staff agree that this collaboration accomplishes the goals of both organizations.     

Clinical simulations: Let's get real!

Simulations have been recommended when clinical facilities are scarce because they provide a similar experience to that which a student would encounter. Pasco-Hernando Community College nursing faculty designed a role-playing home care simulation for students. The students interact with community theater actors in an improvised simulated home health environment. The home care visit interaction is followed by a debriefing session. Here, students identify concerns in the scenario and verbalize their feelings about the experience.     

Incorporating quality improvement concepts and practice into a community health nursing course

Community health nursing students learned to incorporate continuous quality improvement (CQI) methods in their community health clinical settings. With the help of faculty guides, the students, clinical faculty, and key personnel from the community site collaborated on improvement projects that contributed to the agency's ongoing mission. Successful implementation of the CQI principles improved clinical operations, as well as patient care. In addition, the projects contributed to improved student and faculty satisfaction with the overall community experience. Students completed the projects and their clinical rotation with a sense of making a genuine contribution to the agency, and faculty reflected that the students were more engaged and invested in the project outcomes.     

The clinical home community: a model for community-based education

BACKGROUND: Escalating health care costs, racial inequities and socioeconomic disparities have limited access for many to even the barest of health care services. The paradigm shift to a health promotion, disease prevention, and health restoration model within a community-based framework demands greater integrated learning experiences for nursing students that are centred where clients live, work, and play. AIM: To describe the process of developing, implementing and evaluating a rural New England University's experience of piloting a clinical home community model within its existing baccalaureate curriculum. CONTENT: The model describes how it is possible to break free from traditional acute care settings in hospitals and mental health institutions. Students are provided with maternal-child and adult mental health experiences that are available in a targeted clinical home community setting where consumers are increasingly seeking health care. The concepts that directed curriculum revision from a traditional to a community-based educational framework are discussed. OUTCOMES: Strengths and limitations of the model are presented within the context of student, faculty and consumer partnerships. Implications for global development of the clinical home community model in nursing are proposed.     

Selected factors associated with students' perceptions of threat in the community

This study assessed nursing students' perceptions of threat in the community from the beginning to the completion of their first formal community health nursing course (inclusive of specific community health content associated with relevant clinical experience) and determined how perceptions of threat differed by residential zone and by type of program (generic day, generic weekend/evening, or R.N.). Undergraduate nursing students were sampled from eight National League for Nursing Accrediting Commission (NLNAC) accredited baccalaureate schools. Completed pretest data were obtained for 345 students. Completed post-test data were obtained for 274 students. Paired data were available for 197 students. Generally, students were comfortable when the environment was assessed within the context of daylight before and after the course. Students were not as comfortable with the environment when assessed within the context of nighttime either before they started the community course or after they completed it. Students continue to perceive that the community environment presents limited threats, particularly when viewed from the perspective of time of day. Because the community educational experience is not restricted to baccalaureate education (Cahill et al., 1998), nor is it conceptualized as a singular experience (Mellon & Nelson, 1998), the challenge to faculty is to enhance student learning by preparing them in such a manner that they assess their community environment for threats and practice safely within that environment. The use of the Environmental Comfort Scale III, including the open-ended question, may be one way to achieve this challenge.     

Impact of a service-learning project on nursing students

This article describes the incorporation of a service-learning project in a maternal-infant health course in a baccalaureate nursing program. Partnership goals between university faculty and project Early Head Start were to develop and implement a clinical education experience that not only enhanced services to teenage mothers, but also taught students key elements in the delivery of community services to this vulnerable population. This article examines the impact of the service-learning experience on students' understanding of diversity, perceptions of social responsibility in community service, and health care issues. Implications for faculty investment of time and resources are also explored.     

School Nursing Is Alive and Well in Kalamazoo,Thanks to Nazareth College Nursing Students

Kalamazoo, Michigan, public schools have not had nurses employed by the board of education for over a decade when nurses were cut from the school budget as an austerity measure. Approximately 26,000 school-age children live in Kalamazoo County, including a large inner-city, low-income population, many of whom have meager access to health care. Two part-time public health nurses provide consultation and limited direct services. Nazareth College's commitment to community service has resulted in the placement of nursing students in elementary school settings. The nursing faculty orients the students and takes responsibility for their experience. These students have planned and implemented health-promotion projects that have been well received. Suicide prevention, disaster response, nutrition, and personal hygiene are examples of topics. The challenge for school nursing is as great today as it was in 1902 when Lillian Wald first identified a need for school nurses. Through this program, the students are gaining rich experience, increased independence, and a sense of helping to meet a community need as they meet their own learning needs in community health nursing.     

Learning community health nursing concepts from clinical experience

Clinical faculty often struggle to design competency demonstrations that promote quality learning experiences. A nursing program in Oregon combined mental health and community health nursing practica and required well-planned, integrated competency demonstrations. This requirement became the impetus for students to promote the health of clients and learn clinical concepts that are difficult to experience in a typical term. Faculty coached students to make a significant contribution that would last beyond their clinical practica. A case study in competency demonstration design is described, and implications for curriculum development are presented.     

Collaborative learning among undergraduate students in community health nursing

Teamwork can benefit students, enhancing their ability to think critically, solve problems creatively, and collaborate effectively. We piloted a collaborative learning project with undergraduate community health nursing students (N = 83) that entailed working in teams to explore epidemiologic data, synthesize the literature, and develop an evidence-based plan for nursing intervention and evaluation pertaining to a public health issue. Project evaluation consisted of pre- and post-project surveys by students, peer evaluation, and formative and summative evaluation by faculty. Having students work in teams, while challenging both for faculty and students, may be a viable strategy for preparing the next generation of nurses for inter- and intraprofessional collaboration. Our experience suggests that instituting a collaborative learning experience as part of an undergraduate course in community health nursing can be an effective way to expose students to constructive approaches to teamwork and prepare them for evidence-based nursing practice in the future.