Lessons learned from developing, implementing, and evaluating a model of community-driven nursing

The Helene Fuld Health Trust, HSBC Bank USA,Trustee has made generous contributions to the development of community-based nursing education. As a recipient of funds, faculty at the University ofWisconsin-Madison School of Nursing developed, implemented, and evaluated a pilot curriculum for undergraduate nursing students. The first phase of the project changed the landscape of community-based nursing education through faculty development. Unlike traditional approaches to faculty development, a resident expert model of faculty development based on dialogue was used. The second phase changed the landscape of teaching and learning community-based care through curricular and instructional revisions. Noteworthy changes were the creation of a curriculum responsive to both individual student and community needs, and recruitment of a cadre of teachers to enhance the cost-effectiveness of clinical education. The third phase changed the landscape of community-based nursing education through evaluation research. Several strategies were used to assess the project's usefulness, including interpretive phenomenological study of interview data and review of conventional outcome measures. Each phase of the project contributed to a new vision of community-based nursing education, a vision in which nursing as service is taught and learned.     

Evaluation of the end-of-life nursing education consortium project in the USA

Care of patients at the end of life is contingent on adequate preparation of health care providers. Nursing, as the predominant caring profession in end-of-life (EOL) care, must achieve competence in physical and psychosocial care of patients and families facing terminal illness. Previous research has demonstrated that nursing education has not prepared nurses to provide optimum EOL care. To date, there has not been a unified or organized effort to broadly address the preparation of nurses in EOL care. This article describes one national project, the End-of-Life Nursing Education Consortium (ELNEC), which was developed as a comprehensive effort to improve EOL care by nurses in the United States. The ELNEC project consists of EOL education for various nursing audiences: the undergraduate faculty; continuing education providers; paediatrics; oncology; and the graduate faculty. This organized effort is a major step towards strengthening nursing knowledge in EOL care to improve care of the dying.     

The evolution of a distance education initiative into a major telehealth project

After a five-year collaboration in distance learning, the University of Texas Medical Branch in Galveston School of Nursing and the Lamar University Department of Nursing in Beaumont, Texas, opened discussions during the mid-1990s about working together to establish a cutting-edge telehealth clinic. Other participants in this dialogue were the UTMB Division of Pediatric Special Services (DPSS) and the East Texas Area Health Education Center (ETAHEC). DPSS hoped to provide telehealth services for children who had to commute routinely to receive comprehensive health care. ETAHEC, which specializes in building community-academic partnerships to improve the health of populations in its service region, had already worked with members of the team, providing support for the distance education collaboration between UTMB and LU. Several meetings between representatives from the two universities and ETAHEC resulted in the decision by LU to establish an infrastructure for distance learning that could also support telehealth activities. UTMB, which offered family nurse practitioner education at LU through the earlier distance learning initiative, had extensive experience in both distance education and telehealth. It provided the expertise to ensure that the two types of technology could be provided on the LU campus. Eventually, a third university came on board, and the program expanded to provide services in six public schools. A single telehealth clinic, in operation for two years with over 112 client visits, has grown into a major telehealth initiative linking an academic health science center, universities, and school districts in Texas.     

The Oregon Consortium for Nursing Education: a response to the nursing shortage

The Oregon Consortium for Nursing Education (OCNE) is a statewide coalition designed as a long-term solution to the nursing shortage and in response to the need for a new kind of nurse to care for Oregon's aging and increasingly diverse population. It is an effort to increase capacity in schools of nursing by making the best use of scarce faculty, classrooms, and clinical training resources in the delivery of a standard curriculum on 13 campuses, including 8 community colleges and the 5 campuses of the OHSU School of Nursing. This article describes the development of OCNE, including infrastructure development, creation of the shared curriculum, redesign of clinical education, faculty development, and plans for evaluation. If OCNE is successful in achieving its goals, it holds substantial policy implications for the development of nursing education systems, design of curricula, use of simulation as a component of clinical education, and delivery of clinical education.     

Enhancing cancer nursing education through school of nursing partnerships: the Cancer Nursing Faculty Fellows Program

This article describes the Cancer Nursing Faculty Fellows Program, an innovative program designed to provide nurse educators with state-of-the-art cancer knowledge to enhance their ability to teach cancer content. The Faculty Fellows Program was developed at the University of Louisville School of Nursing and was part of a multifaceted educational intervention to improve cancer nursing education. This intervention included comprehensive curriculum reviews, conferences with national consultants, cancer-specific faculty seminars, and funded instructional projects. The Faculty Fellows Program consisted of a mentored experience attending the Oncology Nursing Society Congress and a month-long intensive program to provide faculty with exposure to cancer experts, researchers, and clinical and community resources. By providing a forum for nurse educators to obtain this knowledge and provide the resources they need to change the way they educate nursing students, the program can significantly affect cancer-related nursing education and, ultimately, the care of patients with cancer and survivors.     

Creating a research base for nursing education: an interpretive review of conventional, critical, feminist, postmodern, and phenomenologic pedagogies

The National League for Nursing Priorities for Nursing Education Research calls educators (1) to increase their pedagogic literacy to meet the challenges of the changing social, health care, and educational worlds and (2) to develop research-based pedagogies for nursing. This interpretive review of conventional, critical, feminist, postmodern, and phenomenologic pedagogies facilitates the pedagogic literacy of faculty members and provides a background for research-based nursing education. An example of a research-based pedagogy, Narrative Pedagogy, which developed through interpretive (hermeneutic) studies of the lived experiences of students, teachers, and clinicians in nursing education, is explicated.     

The Densford Clinical Scholars Program: improving patient care through research partnerships

The Densford Clinical Scholars Program at the University of Minnesota School of Nursing partners advanced practice nurses and faculty members to design and conduct clinical studies for improving patient care. Benefits have included changes in nursing practice and, on occasion, the practice of other members of the healthcare team; enhanced research skills for clinicians; an enriched professional practice environment; access to clinical facilities for faculty; funding for research; and an expanded network for professional development. The authors describe this innovative partnership.     

Navigating the waters of interprofessional collaborative education

The increasing emphasis on interprofessional practice to improve the quality and safety of health care delivery led the nursing faculty of a small liberal arts university to explore a unique collaborative educational initiative with School of Business Administration faculty. As the School of Nursing was developing a master's of science in nursing administration option, the School of Business Administration was creating an undergraduate health care administration concentration. Both disciplines were examined for common competencies, courses that could be shared were identified, and the initiative was launched. The response from students has been overwhelmingly positive. The ability to examine health care issues from both business and clinical perspectives has enriched the learning environment and broadened the views of students in both majors. Challenges faced and lessons learned are discussed. Recommendations for evaluating and strengthening the partnership are identified. Advice and encouragement are offered to others considering similar nonclinical collaborative opportunities.     

The process of becoming: from specialty practice to community-based nursing

This article reports on the experience of the School of Nursing at Creighton University in cross-educating faculty to community-based nursing. In the late 1990's the Helene Fuld Health Trust recognized the importance of preparing nursing faculty for community-based nursing because of changing trends in the health care system. Placed in the historical context of the early beginnings of nursing practice in the community, this renewed emphasis led to seeking grant support from the Trust to strengthen the place of community-based nursing for faculty and students alike to be responsive to future changes in health care.     

Integrating informatics into undergraduate nursing education: A case study using a spiral learning approach

A gap in informatics expertise amongst nursing students, practising staff and faculty has been noted globally, which reduces the potential for nurses to utilise technology to enhance patient care. National nursing education strategies and recommendations from professional associations have identified digital health as an area that needs investment. This case study describes how health informatics is being integrated into a Bachelor of Nursing programme in the United Kingdom. An international collaboration with a US-UK Fulbright Specialist Scholar enabled individual learning units corresponding to key health informatics competencies to be designed and incorporated into a pedagogic framework grounded in the spiral learning approach. This approach is proposed as one way to integrate informatics into nursing education, so students can become competent clinicians that are able to deliver technology enabled care in the health service.     

Madagascar nursing needs assessment: education and development of the profession

Purpose: To address how Madagascar is improving nursing education and the profession to strengthen their nursing workforce. Background: The sub‐Saharan Africa nursing workforce shortage is more than 600 000. Madagascar measures among affected countries. Nursing in Madagascar with reference to the Malagasy Lutheran Church Health Department (SALFA) is examined in this paper. The Malagasy Lutheran Nursing School (SEFAM) was established in 1956 to prepare nurses and midwives. The school recently relocated to better meet SALFA goals to increase nurses in the system and improve nursing education. A US nursing faculty and the SEFAM director proposed to conduct programme assessment to ensure that nursing and midwifery education meet health, social and community needs in Madagascar. Data source/methods: An in‐depth needs assessment of the school programme, facilities and resources occurred. Site visits and informal interviews were held. Field study visits to nursing schools and health‐care facilities in Kenya and Tanzania assisted the authors in learning how nursing developed in those countries. Data analysis included comparison of the authors' comprehensive notes for congruity and accuracy. Outcomes: Strategies are needed to support and maintain quality education, improve quality and quantity of nursing care services in hospitals and dispensaries, and improve conditions for nurses and other health‐care workers. Compared with Madagascar, Kenya and Tanzania have more well‐developed systems of nursing education and professional development. Limitations: There were limited written sources for some information but methods, such as verbal accounts, compensated for this limitation. Implications/conclusions: Implications include advantages, disadvantages, facilitators and barriers to nursing educational and professional development in Madagascar. Development of nursing education, regulation and the profession will continue with support from key stakeholders. Kenya and Tanzania can serve as role models for Madagascar nurses. Countries with similar nursing education and professional development issues can be informed by lessons learned in this project.     

Professional nursing and Operation Smile International.

Operation Smile International (OSI) has a commitment to make a difference in the quality of life for people in third world countries by performing reconstructive surgeries on patients with birth defects and other deformities. Faculty members from the Hampton University School of Nursing and a graduate student were volunteers on two African medical missions. This article focuses on two of these faculty members as they provided nursing care services during reconstructive surgeries in Monrovia, Liberia and as they conducted lecture series, surveys, a research study and a day-long scientific symposium. Additionally, a model for human resource development was established in Monrovia, in conjunction with OSI, to upgrade the level of nursing education for Liberian.     

Perspectives of schools of nursing on nursing regulation

Nursing programs in 34 jurisdictions were surveyed to discover their perceptions of state board of nursing performance. They were asked for their perceptions of the adequacy of current regulation, effectiveness of regulation in protecting the public, perceptions of board communication methods, and satisfaction with services received. Nursing programs were also asked to rate how essential board of nursing involvement is in the approval of nursing programs. Programs reported too much regulation in the area of education program approval and perceive nursing regulation as fairly effective in promoting quality in education, responding to health care changes, and responding to innovation in education.     

Preparing nurses for the new world order: a faculty development focus

The new world order demands nursing faculty members be as competent in teaching and coaching students as they are about the art and science of nursing. The complexity associated with classroom management requires mastery of innovative learning modalities to assist students to think critically using research-based evidence in making patient care decisions. Grand Canyon University has made faculty competence a priority to ensure quality student outcomes. The College of Nursing has embraced a systematic process for creating faculty excellence through a comprehensive faculty development initiative. Developing faculty requires university support through policy and resources that is essential to prepare nurses for the new world order and therefore closing the education practice gap.     

Development and organization of a curriculum for joint theoretical education in geriatric,hospital and pediatric nursing

From November 1996 through April 2001 the first long-term project in nursing education was carried out. The following five institutions participated in this project: the Caritas Cooperation of the diocese of Essen as project leader, the Catholic School of Nursing and the College of the Catholic Clincis of the Ruhrhalbinsel Essen as places of training, the Institute for Nursing Science at the University Bielefeld and the Institute of Gerontology at the University of Dortmund being in charge of the scientific part of the project. In this paper we present the main results of this study project: the curricula for the joint theoretical education in nursing in acute, geriatric and paediatric care. First the process of development is dealt with in a critical constructive manner. Next, the specific construction of the curricula will be justified and the nursing teaching methods are worked out. The third part is dedicated to the rough structure of the curricula and its particular characteristics (see Oelke and Menke, 2002).     

Defining pass/fail nursing student clinical behaviors phase I: moving toward a culture of safety

Achieving safe patient care underlies all of clinical nursing education. Nurse educators are professionally, legally, and ethically expected to anticipate safety risks for patients and prevent students from causing harm to patients in the clinical arena. When a student's behavior or behaviors pose a threat to patient safety, that student may be subject to a failing grade in the clinical nursing course. However, determining what student behaviors will result in failure in a clinical nursing course is challenging for even the most experienced nurse educators. Moving from a culture of blame to a culture of safety is also challenging. The authors developed a multiphase project to facilitate that move. Phase I, the focus of this article, began with a qualitative study. Focus groups of part-time and ranked faculty in baccalaureate nursing programs were conducted. The goal was to begin to identify faculty perspectives regarding nursing student behaviors that result in failure in a clinical course. One major theme (context and patterns) and five subthemes (safety, thinking, ethics, communication, and standards) with clarifiers emerged from this study. Plans for the next four phases of the multiphased project are presented.     

The cluster concept in nursing research

Innovative strategies are needed to promote research development in schools of nursing. At the University of Michigan School of Nursing, using a visiting professor to direct a research cluster project enhanced scholarly productivity among new faculty investigators and graduate students.     

Think globally, learn locally: Multimedia conferencing between two schools of nursing

Three nurse educators, who met at the American Nurses Association Nursing Care in Life, Death and Disaster Conference (Atlanta, June 2007), collaborated on a multimedia conferencing project to teach nursing students about disaster response. This case study examines two outcomes of this project. The project provided students in a disaster nursing course in Indiana an opportunity to meet faculty who helped establish and maintain a special needs shelter in Texas following Hurricanes Katrina and Rita. It also demonstrated, through the use of technology, the ability of nurse faculty to share their expertise with colleagues and students residing in different geographical locations.     

Elder RNs' perspectives on nursing education: lessons learned

Nursing faculty are challenged with recruiting students and preparing graduates to practice in increasingly complex healthcare settings. The nursing shortage compounds the burden faced by faculty in meeting the needs of the profession. A grounded theory study that explores the perceptions of nurses aged 65 years and older regarding the state of the nursing profession in light of the shortage revealed many interesting aspects of "early" nursing education that are worth revisiting. The author describes the research and uses narrative data to describe what brought elder nurses into nursing, the positive and negative aspects of their education, and the lessons we can learn from their wisdom and experience.