Evaluation Outcomes of a Dedicated Education Unit in a Baccalaureate Nursing Program

The Learning Environment of Student Nurses During Clinical Placement: A Qualitative Case Study of a Student-Dense Ward

Introduction

Ensuring the quality of clinical placements has long been a challenge in nursing education. This is partly due to a growing aging population requiring health services, and an increased need for nursing workforce. Both in Norway and internationally, there is a rise in the use of student-dense models, wherein several students are placed together on the same ward at the same time where the supervision of the students is the collective responsibility of the nurses.

Objective

The aim of this study was to explore factors that promote or inhibit learning in a student-dense ward when used as a model for clinical placement in hospitals. We examined how clinical placement is experienced in a student-dense ward, as well as how learning is facilitated.

Methods

A qualitative case study design was used to capture the learning environment on the student-dense ward in a comprehensive way. We used focus group interviews, in-depth interviews, and observations with students and employees at a major hospital in Norway.

Results

Our findings showed that the orientation days and the teaching activities in student-dense wards, the feedback students receive, the clinical facilitator's role and the student community were factors that had particular importance for good learning environments in this placement model.

Conclusions

To ensure the quality of clinical placements, more attention should be paid to these factors in the planning, organization, and facilitation of new and existing student-dense wards. It is paramount to provide students with thorough written feedback and to secure the clinical facilitators with enough time to conduct student supervision when organizing clinical placement as student-dense wards.

'Working as a Real Nurse': Nursing Students' Experiences of a Clinical Education Ward in Psychiatric Care

Although the concept of clinical education wards has shown encouraging outcomes regarding nursing students' satisfaction with clinical placements in somatic care, the existing research in a psychiatric context is sparse. This study aims to explore nursing students' experience during clinical education at a psychiatric clinical education ward. A qualitive descriptive study with content analysis, using interviews with 16 bachelor's degree nursing students was conducted. The results indicated that an enriched and adapted learning environment focusing on psychiatric nursing with peer learning supported independence and progression into the future nursing role.

Characteristics and processes of the dedicated education unit practice education model for undergraduate nursing students: a scoping review

OBJECTIVE

The objective was to review literature related to the dedicated education unit practice education model for undergraduate nursing students, and identify common characteristics and processes for implementing and sustaining this model.

INTRODUCTION

Although practice education is central to undergraduate nursing education, evidence-informed practices for learning in the clinical setting remain elusive. Changes to health care over the past decades related to the role and scope of practice for nurses, gradual shifts to community- and population-based care delivery, and expectations for interprofessional practice require forward-looking education models. The dedicated education unit model was developed in 1997 as a potential solution to globally recognized challenges in nursing education amidst discourses of nursing resource scarcity. Despite more than two decades of innovation and expansion, there is still limited understanding of the effectiveness of the dedicated education unit as a solution to those challenges, or for the anticipated benefits for students and patients, through enhanced evidence-informed health care. This analysis of the characteristics and processes of the model is timely for evaluating and sustaining implementation of the dedicated education unit across nursing practice and education settings.

INCLUSION CRITERIA

English-only publications related to the dedicated education unit practice education model for undergraduate nursing students in baccalaureate and associate degree programs using qualitative, quantitative, or mixed methods research, and quality improvement, program evaluation, and opinion publications were included.

METHODS

Using selected keywords including "dedicated education unit," we searched CINAHL, Google Scholar, MEDLINE, Academic Premier Search, ERIC, Cochrane Database of Systematic Reviews, JBI EBP Database, and ProQuest Dissertations and Theses. Two independent reviewers screened titles and abstracts against inclusion criteria. We reviewed reference lists for gray literature and additional references. Data were extracted from the included articles and categorized for characteristics and processes. Eighty-two publications from January 1997 to May 2020 were included. The findings were presented descriptively with tables and figures to support the data.

RESULTS

Dedicated education unit models were based on five characteristics and four processes. Characteristics of the dedicated education unit model included effective academic-practice partnership, adaptability to diverse contexts, unit culture of educational excellence, responsive and supportive unit leadership, and clarity of roles and responsibilities. Processes included building nurse and faculty capacity, facilitating student learning, communicating regularly at systems and unit levels, and evaluating and sustaining the model.

CONCLUSIONS

Evidence demonstrated that the dedicated education unit practice education model is well-established. However, there were existing gaps in this evidence, specifically evaluation and economic analyses. There was also limited attention to long-term sustainability of the model. The common characteristics and processes identified in this review may be used to support planning, implementation, and evaluation, including development and validation of evaluation tools. Although administrative infrastructure was noted as central to the dedicated education unit strategy, it was rarely acknowledged as part of management and thus also requires further study.

The Impact of Dedicated Education Model on Nursing Students' Outcomes: An Integrative Review

BACKGROUND

Dedicated education units (DEUs) provide an approach to clinical redesign in nursing education. However, the evidence supporting the application of the DEU model has not been systematically reviewed to assess the impact of this model on students' learning outcomes.

PURPOSE

This integrative review analyzed the evidence on the relationship between the DEU model and nursing students' learning outcomes.

METHODS

Electronic databases were searched for articles published between 1998 and 2019. Search terms used were dedicated education unit, academic collaboration, academic-practice partnership, and outcomes. A total of 24 articles informed this review.

RESULTS

Four categories emerged: clinical self-efficacy and confidence, teamwork and collaboration, knowledge and competency, and students' satisfaction.

CONCLUSION

The main findings support a positive relationship between the DEU model and students' learning outcomes. Research is still needed to investigate the impact of DEU models on students' problem-solving and clinical judgment.

An Integrated Mental Health and Acute Care Clinical Rotation on a Dedicated Education Unit

BACKGROUND

Traditional mental health clinical experiences expose students to an environment that may not prepare them to address mental health needs in hospital settings.

PURPOSE

The purpose is of this project was to evaluate the implementation of an integrated mental health and acute care clinical model on a dedicated education unit (DEU).

METHODS

In this pilot project, students provided dually focused medical and mental health care on assigned patients. A preclass and postclass survey measured their perceptions of mental health competency.

RESULTS

There were no statistically significant differences between the 2 groups (integrated model on the DEU compared with a traditional experience on an acute care and inpatient behavioral health unit). All groups reported increased mental health competency.

CONCLUSIONS

Both groups showed similar improvements from the preclass to the postclass survey on perceived competence, suggesting that an integrated acute care and mental health clinical practicum may be equivalent to the traditional model.

A mixed-methods assessment of the transition to a dedicated educational unit: nursing students' perceptions and achievements

BACKGROUND

In 2019, our nursing school shifted clinical instruction from the traditional model to the Dedicated Educational Unit (DEU).

OBJECTIVES

To evaluate the DEU learning atmosphere, instruction quality, clinical instructor's performance and students' grades.

METHODS

A sample of 45 nursing students completed the CLES-T; 10 of them participated in a focus group. Students' grades in the DEU and traditional models were compared.

RESULTS

Students (77.6%) ranked the DEU outcomes as "good"-"excellent;" "nursing care on the unit" and the "clinical faculty's ability to integrate theory and practice" were the highest and lowest ranked categories, respectively. The focus group revealed dichotomous opinions regarding the unit atmosphere and the professional performance of the nurse manager and staff. Students in the DEU framework attained higher grades than did their counterparts.

CONCLUSIONS

Clinical instructors need specific training; the clinical staff and nurse managers should be informed about the unit atmosphere's impact on students' future professional decisions.

Peer learning and collaborative placement models in health care: a systematic review and qualitative synthesis of the literature

AIMS

To summarise the international empirical literature to provide a comprehensive overview of peer learning and collaborative practice placement models in health care and to synthesise their benefits and challenges.

BACKGROUND

Practical placements for students are in high demand due to the need for an increased nursing, midwifery and health professional workforce, thus collaborative placement models are an attractive solution to potentially increase placement capacity and enhance the student learning experience.

DESIGN

A systematic search of the literature and qualitative data synthesis using the PRISMA checklist and ENTREQ guidelines.

REVIEW METHODS

MEDLINE and CINAHL searched in March 2020. Quality appraisal of studies conducted. Collaborative models and empirical findings summarised. Reported benefits, challenges and implementation recommendations synthesised. Two tables developed for data representation.

RESULTS

172 studies were identified by the search strategy. Of these, 47 articles were included for appraisal and synthesis. 30 articles employed qualitative, seven quantitative and ten mixed-methods approaches. Research took place in eight countries. The majority of studies employed focus groups, interviews as well as questionnaire design. The total participant sample was 3462 consisting of students and educators.

CONCLUSIONS

This review confirmed that any peer learning is beneficial in supporting students' confidence and team working skills. It is especially helpful when pairing first year with third-year students. The latter can demonstrate their clinical skills and prepare for working in practice. Simultaneously, expert-led learning is important for role modelling and for the recognition of acquired skills. Evidence on the optimal placement experience is inconclusive; however, it can be concluded that any form of collaborative placement model requires careful planning and continuous preparation for staff and students.

RELEVANCE TO CLINICAL PRACTICE

Decision makers should consider implementing at least some form of peer learning to assist students with peer support, and ideally work towards a collaborative learning environment.

Nurses and undergraduate student nurses' experiences in collaborative clinical placement programs in acute hospitals: An integrative literature review

OBJECTIVES

To identify, and critically review student, nurse clinician and clinical facilitator/educator experiences of collaborative clinical placement models in acute hospitals.

DESIGN

An integrative review that followed Whittemore and Knafl's (2005) framework.

DATA SOURCES

Studies published between 2009 and 2019 were identified via a comprehensive search of the following databases: CINAHL, OVID Medline, EMBASE, EMCARE, PsychINFO, Johanna Briggs Institute, ERIC and SCOPUS.

REVIEW METHODS

The initial search located 2309 Articles. After screening and checking for eligibility 14 articles were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers, the McMaster's Critical Review Form for quantitative papers and MMAT Appraisal tool for mixed method papers. The papers were then analysed thematically.

RESULTS

Thirteen studies met the inclusion criteria for the review (four quantitative, six mixed method, three qualitative). We identified an overarching central theme of sense of belonging and acceptance along with the following four sub themes: familiarity and continuity, confidence and competence, preparedness and lastly supervising relationships and faculty support.

CONCLUSION

This review indicates collaborative clinical placement programs have a positive impact on the student experience. Further research is needed regarding experiences of clinical nurses, health organisation leaders and Faculty to better understand what will improve support of students in collaborative clinical placement programs as there were few research findings found related to these non-student participant groups. Exploring student placement experiences that include both traditional and Collaborative models would provide greater insight into the value of these programs.

The implementation of a dedicated education unit in a public health setting

INTRODUCTION

The dedicated education unit (DEU) is an innovative clinical model that prepares preceptors for success in clinical settings with nursing students. Though the DEU is mostly used in acute-care settings, this project explores the implementation of a DEU in a public health setting.

OBJECTIVES

Better preparation of public health nurses and social workers as clinical preceptors for nursing students with the implementation of a DEU in a public health setting.

DESIGN

IRB approved, pre/post survey with participant comments.

MEASUREMENTS

Clinical Nurse Teacher Survey was assessed pre/post intervention with registered nurses and social work staff (n = 13). Paired t-tests analysis was used to determine significance. The Clinical Learning Environment and Nurse Teacher (CLES+T) scale completed postimplementation by nursing students (n = 8) after the clinical rotation.

RESULTS

Clinical Nurse Teacher Survey mean scores preintervention was 4.56 and increased postintervention to 4.89, though not statistically significant (p-value .11). CLES+T showing 100% fully agree or agree that the Public Health DEU is an effective learning environment.

CONCLUSIONS

The DEU model in a public health setting is an opportunity to improve lived clinical experiences of preceptors and nursing students, which may increase nursing students' positive perceptions of, and increase interest in serving as a public health nurse after graduation.

Evolution of the Canterbury Dedicated Education Unit model

The Dedicated Education Unit (DEU) model of clinical teaching and learning represents a substantial shift in philosophy from the previous preceptorship model in undergraduate nursing education in Canterbury, New Zealand. This research aims to identify the factors underpinning the evolution of the Canterbury DEU model. It utilised a qualitative case study design with inductive and deductive thematic analysis of archival documents and three key informant interviews. Analysis identified centrality of relationships and a progressive culture shift as integral to the development of the Canterbury DEU. The relationships vital to the success of the DEU model are evidenced at varying organisational levels between the health care and education provider and have been essential to the substantive growth of the DEU model in Canterbury, from an initial five pilot sites in 2007 to 47 DEUs in 2017.

The effectiveness of partnership models in clinical nursing education - A scoping review

OBJECTIVES

To examine the effectiveness of partnership models in clinical nursing education with regards to cost effectiveness; student employability, work-readiness, confidence, and competence; and stakeholders' satisfaction.

DESIGN

Scoping review.

DATA SOURCES

Research studies published in English were searched electronically through EbscoHost (CINAHL and ERIC), Scopus, Medline (via Ovid), ProQuest Central, and Web of Science databases. Criteria were developed to guide the selection of original studies published in English before 2019 for review.

REVIEW METHODS

Arksey and Malley's framework (2005) and relevant enhancements guided the conduct of the review. An informal appraisal of selected studies was applied.

RESULTS

Two theses and 31 articles with a variation in methodologies, methods, sample sizes, research populations and quality of evidence were included for review. Four themes were identified: (i) Description of partnership models in clinical education, (ii) length of model implementation prior to evaluation, (iii) positive qualitative findings, and (iv) quantitative findings limited by data collection periods and methods.

CONCLUSIONS

Shared among the reviewed studies is stakeholder view of the positive impacts of partnership models on the clinical learning environment, and the increased level of support and individualised instruction for students. However, the use of not fully validated survey instruments and the lack of description about the implementation period before evaluation in many reviewed studies limit the interpretation of quantifiable effect of the partnership models. This review identifies a lack of attention on student employability, work-readiness, cost evaluation, patient perspective, and partnership models in low-income countries. Future research to address these knowledge gaps using high quality data collection methods and rigorous research design is warranted.

Exploring the Impact of a Dedicated Education Unit on New Graduate Nurses' Transition to Practice

Adequately preparing new graduate nurses for contemporary practice remains a challenge. This innovative mixed-method study explored the impact of a dedicated education unit on new graduate nurses' transition to practice. Results indicated that new graduate nurses with dedicated education unit experience were better prepared for contemporary practice compared to their peers with traditional clinical experiences. This study highlights the positive impact collaborative clinical teaching models can have on preparing new graduate nurses for practice.

Collaborative learning in practice: A systematic review and narrative synthesis of the research evidence in nurse education

Collaborative Learning in Practice is a model of placement learning for student nurses that is currently being implemented in the United Kingdom, apparently originating in Amsterdam. Potential benefits are reported to be increased placement capacity, reduced burdens on mentors as practice assessors, improvements in qualified nurses' job satisfaction, recruitment and retention, and better-developed preparedness for registrant practice amongst student nurses. We conducted a thorough, rigorous systematic review between October and December 2018 of the literature on Collaborative Learning in Practice to discover whether there was a research evidence base for these claims. We found nothing published in English in peer reviewed journals. We found 14 related papers, although these were about the Dedicated Education Unit concept, and we have conducted a narrative synthesis of them. Key findings support the assertions related to Collaborative Learning in Practice, albeit in different models of placement learning. Further research is necessary with Collaborative Learning in Practice stakeholders including staff and students, and regarding patient care metrics, to demonstrate benefits or otherwise and until that research takes place potential gains remain unproven.

Dedicated Education Units: A Unique Evaluation

Background

Traditional models of clinical nursing education do not deliver the most effective learning experiences to undergraduate nursing students. An innovative way to clinically prepare nursing students is the use of dedicated education units (DEUs). This model utilizes staff nurses to provide supervision and hands-on teaching to students.

Objective

The purpose of this project was to evaluate an evidence-based change from a traditional model of clinical instruction to a DEU.

Methods

DEUs were implemented on three adult medical–surgical units. Two unpaired identical pre-DEU and post-DEU questionnaires were used to evaluate the practice change in both nursing students and staff nurse mentors.

Results

A total of 41 students and 22 nurses participated in the project. Students reported feeling comfortable, engaged, and satisfied in their clinical experiences on the DEU. Nurses' responses revealed the DEU to be a rewarding experience and found satisfaction in their role.

Conclusions

The paradigm shift from traditional to DEU models has enhanced the quality of learning experiences for students and improved the professional environment for nurses at large academic medical institutions located in central Ohio.

Implications for Nursing

Implications for future inquiry include standardizing educational training/orientation programs for DEU staff nurse mentors.

Challenges to the provision of clinical education in nursing

Objective: To outline and discuss the challenges inherent in providing clinical education for undergraduate nursing students.Design: Discussion paper.Discussion: The primary goal of undergraduate nursing education is the preparation of graduates able to function as newly registered nurses in acute hospital, primary care, continuing care and mental health settings. Clinical practice is a critical yet complex and challenging component of students' professional development.Conclusions: It is argued that different models for clinical learning are appropriate for different contexts and stages of student development. Nursing needs, however, to be fully cognisant of the importance of collaborative development underpinned by adequate funding and to be aware of the often invisible impacts of neoliberal policies and priorities on health and education.

Mutual benefits in academic-service partnership: An integrative review

BACKGROUND

Academic and service institutions involve with many challenges. Partnership programs are a golden opportunity to achieve mutual benefits to overcome these challenges. Identifying mutual benefits is the cornerstone of forming a successful partnership and guarantee to its continuity. There are definitions and instances of mutual benefits in the literature related to partnership programs, but there is no coherent evidence and clear picture of these benefits.

OBJECTIVE

This study is conducted to identify mutual benefits in academic-service partnership by analyzing the definitions and instances of it in the literature.

DESIGN

An integrative review of key papers regarding mutual benefits in academic-service partnership was undertaken. This review was guided by the framework described by Whittemore and Knafl.

DATA SOURCES

Search of the following databases was conducted: MEDLINE, ERIC, Google Scholar, Emerald Insight and Science Direct. The search terms were mutual benefits, mutual gains, mutual interest, mutual expectations, mutual goals, mutual demand, partnership, collaboration, academic-service partnership and academic service collaboration.

REVIEW METHODS

Cooper's five-stage integrative review method was used. Quality evaluation of articles was conducted. Data were abstracted from included articles. The analysis was conducted based on the qualitative content analysis of the literature suggested by Zhang and Wildemuth.

RESULTS

28 articles were included in this review. Mutual benefits are described in four categories include: synergy in training and empowerment of human resources, education improvement, access to shared resources, facilitate production and application of beneficial knowledge into practice.

CONCLUSION

Mutual benefits in the academic-service partnership include a range of goals, interests, expectations, and needs of partner organizations that is achievable and measurable through joint planning and collaboration. We suggest academic and service policymakers to consider these benefits in the planning and evaluating partnership programs.

"Feeling part of a team" a mixed method evaluation of a dedicated education unit pilot programme

The clinical learning environment is integral to the sustainability of the nursing workforce. Traditionally undergraduate nursing students were preceptored one-to-one with a registered nurse. With an increasingly complex clinical environment and more RNs working part-time, that model has become problematic. The Dedicated Education Unit (DEU) is a model of student learning whereby students are nurtured by all staff in a clinical area, clinical and academic staff collectively support the student and student learning is a collaborative process. In this study, a pilot DEU model in three clinical areas of one District Health Board in New Zealand was evaluated. These DEU are different from others reported in the literature as three unique nursing programmes from two Tertiary education providers (TEPs) in an urban area in New Zealand were involved in the pilot. The approach in this study was a mixed method descriptive evaluation design, undertaken in two phases: phase one was an online anonymous survey completed by 42 nurses and nurse managers employed in three DEUs and 24 undergraduate third year nursing students who were completing their final nine week pre-graduate placement. Phase two was six separate focus groups with registered nurses and undergraduate nursing students. Students (91%) and staff (85%) were satisfied with their participation in the DEU. Students described feeling part of the health care team and staff reported enjoying working with students from different programmes, also noting the supportive DEU structure gave them more opportunity to engage with student learning. Role clarification was an issue which needs to be resolved. Staff from three units at a District Health Board and three unique nursing programmes were able to develop learning partnerships, collaborating together to provide a positive, nurturing learning environment for nursing students and a clinical setting where nurses enjoyed their teaching/coaching roles.

Clinical learning experiences of nursing students using an innovative clinical partnership model: A non-randomized controlled trial

BACKGROUND

Clinical practicum is a major learning component for pre-registration nursing students. Various clinical practicum models have been used to facilitate students' clinical learning experiences, employing both university-based and hospital-based clinical teachers. Considering the strengths and limitations of these clinical practicum models, along with nursing workforce shortages, we developed and tested an innovative clinical partnership model (CPM) in Hong Kong.

OBJECTIVE

To evaluate an innovative CPM among nursing students actual and preferred clinical learning environment, compared with a conventional facilitation model (CFM).

DESIGN

A non-randomized controlled trial examining students' clinical experiences, comparing the CPM (supervised by hospital clinical teacher) with the CFM (supervised by university clinical teacher).

SETTING

One university in Hong Kong.

PARTICIPANTS

Pre-registration nursing students (N = 331), including bachelor of nursing (n = 246 year three-BN) and masters-entry nursing (n = 85 year one-MNSP).

METHODS

Students were assigned to either the CPM (n = 48 BN plus n = 85 MNSP students) or the CFM (n = 198 BN students) for their clinical practice experiences in an acute medical-surgical ward. Clinical teachers supervised between 6 and 8 students at a time, during these clinical practicums (duration = 4-6 weeks). At the end of the clinical practicum, students were invited to complete the Clinical Learning Environment Inventory (CLEI). Analysis of covariance was used to compare groups; adjusted for age, gender and prior work experience.

RESULTS

A total of 259 students (mean age = 22 years, 76% female, 81% prior work experience) completed the CLEI (78% response rate). Students had higher scores on preferred versus actual experiences, in all domains of the CLEI. CPM student experiences indicated a higher preferred task orientation (p = 0.004), while CFM student experiences indicated a higher actual (p < 0.001) and preferred individualization (p = 0.005). No significant differences were noted in the other domains.

CONCLUSIONS

The CPM draws on the strengths of existing clinical learning models and provides complementary methods to facilitate clinical learning for pre-registration nursing students. Additional studies examining this CPM with longer duration of clinical practicum are recommended.

The effectiveness of clinical education models for undergraduate nursing programs: A systematic review

Clinical nurse education is a major part of all undergraduate programs preparing nurses for competent professional practice. While research mostly evaluated specific clinical education models, few studies compared different type of models and limited attention has been given to the effect on student learning outcomes. This systematic review aimed to examine the effectiveness of clinical education models for undergraduate nursing programs. This systematic review utilised the Joanna Briggs Institute systematic review approach (JBI, 2014). A web-based literature search was conducted to identify research studies published from 2002 to 2015 using a three-step search strategy. All selected papers were assessed by at least two independent reviewers for inclusion criteria, methodological validity, and data extraction in the review. This systematic review included nine studies including two pre-post-test studies with a control group totalling 1893 participants including 1286 nursing students. The evidence regarding the effectiveness of clinical education models for undergraduate nursing programs is notably weak; however this review found limited evidence that the clinical facilitator model is preferable to the preceptor model and the Clinical Education Unit (CEU) model provided greater engagement and an enhanced learning environment compared with the standard facilitation model.

From Academic-Practice Partnership to Professional Nursing Practice Model

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "From Academic-Practice Partnership to Professional Nursing Practice Model," found on pages 104-112, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 28, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the benefits and barriers to participation in a community-based academic-practice partnership. Identify three changes in the practice environment that transform the practice of staff nurses working in partnership model clinical units. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. This study used a qualitative descriptive design to examine the role of the expert staff nurse or clinical liaison nurse (CLN) participating in a community-based academic-practice partnership. Little is known about the influence of participation by expert nurses in community hospital settings. Focus groups were conducted with nine CLNs to explicate their experiences in a unit-based leadership practice model. Eight themes were identified: Reciprocal Learning Between Staff Nurses and Students; Reciprocal Learning Between Student and Patient; Working Around the System; Building Relationships; Valuing the CLN Role; Faculty Recognition of CLNs; Transforming Practice; and a variant theme, Recognition That Some Nurses Neither Value nor Enjoy Working With Students. The benefits of developing partnerships in community hospitals can be far reaching and may be of interest to educators and leaders in the profession. When a practice environment focused on evidence and was fueled by student enthusiasm reinvigorates staff nurses, their work world suddenly transforms. J Contin Educ Nurs. 2017;48(3):104-112.

From Student to Practicing Oncology Nurse: A Novel Collaboration to Create a Transition to Practice Program in Ambulatory Cancer Care

BACKGROUND

Healthcare reform and the shift of care to the ambulatory setting has created challenges for preparing nurses to practice in these complex clinical settings. Oncology is an area where dramatic transitions to ambulatory care have occurred, and the ambulatory oncology setting holds great potential for teaching evidence-based care to nursing students.

OBJECTIVES

The article summarizes the collaboration between a baccalaureate nursing program and a cancer clinic to establish a dedicated education unit (DEU).

METHODS

A pilot project was undertaken to create the DEU and residency program.

FINDINGS

The collaboration has provided a clinical setting for baccalaureate nursing students to learn and develop clinical competencies, advance their critical thinking skills, and enhance advanced pathophysiology knowledge. The scope of the program includes a transition-to-practice model which maximizes the use of the DEU as students graduate and are eligible to apply for the oncology residency program. The DEU has created a pipeline for new nurses.

Pursuing Improvement in Clinical Reasoning: Development of the Clinical Coaching Interactions Inventory

BACKGROUND

Clinical coaching has been identified as a signature pedagogy in nursing education. Recent findings indicate that clinical coaching interactions in the clinical learning environment fail to engage students in the higher order thinking skills believed to promote clinical reasoning.

METHOD

The Clinical Coaching Interactions Inventory (CCII) was based on evidence of supervisor questioning techniques, the Tanner clinical judgment model, Bloom's Taxonomy, and simulation evaluation tools. Content validity was established with expert assessment, student testing for clarity, and calculation of scale-content validity index/average (S-CVI/Ave). Reliability was established with Kuder-Richardson Formula 20 (KR-20).

RESULTS

CVI (S-CVI/Ave) was .91, and KR-20 was .70. The CCII identified differences in clinical coaching behaviors in university faculty supervisors and staff nurse preceptor supervisors.

CONCLUSION

The CCII advances the measurement of clinical coaching interactions from qualitative to quantitative. Ultimately, results from use of this inventory may facilitate the design of prelicensure clinical coaching strategies that promote the improvement of students' clinical reasoning skill. [J Nurs Educ. 2016;55(9):495-504.].

Building the evidence for dedicated education unit sustainability and partnership success

AIM

To evaluate the sustainability of dedicated education units (DEUs) within an academic-service partnership.

BACKGROUND

A two-year, multisite, mixed-methods study with a randomized control trial was designed to isolate the effects of the DEU innovation on clinical education quality, teaching capacity, work life, and productivity.

METHOD

Interview data from 34 participants were analyzed for interactions and behaviors that indicated sustainability.

RESULTS

Seven themes portrayed successful participant interactions, revealing shifting roles based on mutual respect and collaboration among engaged partners working within complex adaptive systems. Relationship building and partnership achievements were confirmed as key components in DEU sustainability.

CONCLUSION

Sustainable, mature clinical education partnerships depend on implementing routinizing, reinforcing, recognizing, and rewarding activities. Unit level success relies on foundational structures that support the ongoing development of DEU clinical instructors. DEU sustainability will depend on the continual creation of new meaning for participants and the generation of new resources and results.

Developing a dedicated education unit in long-term care: a pilot project

Within long-term care, the transitional care setting provides post-acute and short-stay rehabilitation to older adults, easing the transition between the acute care hospital and home or long-term care. The current nursing shortage makes it difficult for these facilities to attract and retain qualified nursing staff. In order to meet the rehabilitation needs for this patient population while at the same time addressing the challenge in nursing education of limited clinical placements and severe nurse faculty shortages, an academic-practice partnership was developed to establish a Dedicated Education Unit (DEU). The DEU is an innovative clinical education model in which experienced staff nurses serve as clinical teachers to nursing students. This paper describes the process of developing a DEU using the Partners in Caring Model as the framework. Formative and summative evaluation results and recommendations for program improvement of this pilot project are discussed.