Building Global Clinical Education Partnerships: Increasing Capacity and Enriching Teaching

1. Building New Clinical Education Partnerships Globally: Increasing Teaching Capacity and Enriching Clinical Education International Collaboration Conference Kuakarun College of Nursing Navamindradhiraj University Bangkok, Thailand June 2015 JoAnn Mulready-Shick, EdD, RN, CNE, ANEF College of Nursing and Health Sciences, University of Massachusetts Boston (UMB), USA

2. Education-Service PartnershipsAcademic-Practice Partnerships in Clinical Settings: Dedicated Education Unit “What do our Global “What Evidence supports Organizations say?” Best Practices and Outcomes?”

3. Challenges and Issues: Education Adequacy of curriculum and experience to prepare for teamwork and working in environments with diverse cultural patterns Mechanisms to prepare for transition to service/nursing practice Availability of internship opportunities for students and graduates ICN Regulation Series.(2009). Reducing the gap and Improving the interface between education and service. Retrieved from http://www.icn.ch/images/stories/documents/publications/free_publications/reducing_the_rap.pdf

4. Challenges and Issues: Clinical Settings Availability and quality of clinical placements Availability and quality of staff nurse instructors or preceptors to meet student needs Multiple educational providers dealing with competition for placements ICN Regulation Series.(2009). Reducing the gap and Improving the interface between education and service. Retrieved from http://www.icn.ch/images/stories/documents/publications/free_publications/reducing_the_rap.pdf

5. Reducing the Gap and Improving the Interface between Education and Service (ICN, 2009) “A Framework for Analysis and Solution Generation” How to Educate a Competent Workforce for the Future and Address Successful Transitions from Education to Practice from a consultation between ICN and WHO-Eastern Mediterranean Regional Offices

6. Education-Service Framework (ICN, 2009)“Work-life Journey”

7. Common Frameworks (USA, 2009)J. Warner & D. Burton (2009). Policy and politics of emerging academic-service partnerships.Journal of Professional Nursing, 25, 329–334.

8. Sigma Theta Tau International “By partnering with one another, nurses in academe and in service settings can directly impact nursing education and practice, often effecting changes and achieving outcomes that are more extensive and powerful than could be achieved by working alone.” J. M. Kirschling,& J. I. Erickson. (2010). The STTI practice-academe innovative collaboration award: Honoring innovation, partnership, and excellence. Journal of Nursing Scholarship, 42(3), 286–294.

9. Evidence to Date: Why Clinical Education Must Change (USA) Obstacles to achieving quality clinical education experiences reported. Recommendations to optimize clinical learning include: -Align learning and engagement in clinical practice realities -Focus on achievement of students’ clinical learning goals - Address quality and safety improvement - Develop clinical reasoning and a spirit of inquiry (Ard & Valiga, 2009; Benner, Sutphen, Leonard, & Day, 2010, IOM-Future of Nursing Report, 2011; Ironside & McNelis 2010; NLN Think Tank of Transforming Clinical Education, 2008; NLN National Survey, 2009)

10. The Future of Nursing Report: Leading Change, Advancing Health (2010) “The development, growth, and evaluation of academic-practice partnerships is a fundamental condition to advance nursing practice and improve the quality of care.”

11. Toolkit and Guiding Principles for ACADEMIC-PRACTICE PARTNERSHIPShttp://www.aacn.nche.edu/leading-initiatives/academic-practice-partnerships American Association of Colleges of Nursing American Organization of Nurse Executives

12. Building the Evidence to SupportClinical Education Partnerships and Innovation: Dedicated Education Unitshttp://www.evaluatinginnovationsinnursing.org/

13. University of Massachusetts Boston conducted a two year funded research study to evaluate a new clinical education – service partnership) “Partnering for Dedicated Education Unit (DEU) Development and Quality” (2009-2011) • Teaching Capacity • Faculty Worklife and Productivity • Educational Quality

14. Clinical Education Partnership Development DEU Partnership “Piloted” 2007

15. Overarching Research Question “How does the DEU intervention- Develop new clinical instructors (thus building capacity)? Enhance clinical instructor/preceptor worklife (thus sustaining recruitment, retention, and productivity)? and Promote educational quality? while functioning within a shared DEU partnership structure and within local contexts, amidst nursing unit similarities and differences?”

16. Education Quality Findings

17. DEU Students Spend More Time in Instruction- Time spent in instruction (2x) greater by staff nurse instructor/preceptor compared to other activities. Mulready-Shick, J., Kafel, K., Banister, G., Mylott, L. & Curtin, L. (2013). Evaluating dedication educations for clinical education quality. Journal of NursingEducation, 52 (11), 606-614.

18. Comparison of Quality and Safety Competency Development between DEU & Traditional Students Mean Scores 4.6 P<.001 QI, Informatics, Teamwork Confirming Pilot Study Findings

19. Visit by Ms. Kay Edgecombe, Flinders University,So. Adelaide, Australia Sept. 2010

20. Dedicated Education Units- Building a BetterFuture (2014) “A Philosophy and Set of Principles” Australia New Zealand Sweden USA examples

21. Dedicated Education Units: An Innovative Model and Solution to Global Issues in Nursing Education and Practice Global Issues: Shortages of Nurses and Faculty Continued Theory-Practice Gap DEU Model Flexibility to fit the context of different practicum settings Clinical and Academic Staff Capacity Building Students’ Sense of Belonging on Patient Care Units Developing Communities of Practice

23. Dedicated Learning Environment

24. Evidence to Date: Common Themes in Clinical Education Partnerships • Supportive Relationships • Goodness of Fit • Flexibility • Communication (Teel, McIntyre, Murray, & Rock, 2011) What is the nature of your relationships with your agency partners?

26. Work Life: DEU Staff Nurse Clinical Instructor-Preceptors exhibit enhanced spirit of inquiry and motivation

27. DEU Student Presentations and Practice Changes

28. DEU Students Providing Continuing Education Program for Staff Nurses

29. Practice Change on DEUs

30. Reflection Quality of DEU clinical learning experiences exceeds traditionalclinical education model Insignificant impact on nurse workload and unit workload Nurses’ work lives are positively enhanced by the DEU model (increased satisfaction and professionalism ) Recommendations for transforming clinical education are met in DEU Partnerships, along with creating positive changes on patient care units ****************************************************************

31. DEU Cycle of Sustainability CFC = clinical faculty coordinator; CI = clinical instructor/preceptor; DEU = dedicated education unit. Mulready-Shick, J., & Flanagan, K. (2014). Building the evidence for dedicated education unit sustainability and partnership success. Nursing Education Perspectives, 35 (6), 287-293.

33. Recommendations for Further StudyDeeper dive into- Unit Sustainability (mix of staff, rotation patterns, CI retention, maximum number of shifts/students) Model Fidelity; Instrument Development Student performance on Quality and Ssafety Competencies Staff Nurse /Preceptor Development and Clinical Coaching Transition to Practice (costs analyses and results) Practice Changes- unit level and patient care outcomes

34. “International” DEU Conference (USA, 2014)with Video Presentation from Christchurch, New Zealand about Canterbury DEUs- Strategies for Success

35. DEU Conference Objectives (USA, 2014) Describe DEU central elements: collaboration, optimal learning, and clinical resource efficiency. Integrate DEU theoretical constructs for effective clinical teaching, such as “situated coaching” Discuss strategies for successful DEU implementation across diverse settings.

36. DEU Conference Objectives (USA, 2014) Review findings from DEU research and program evaluation. Discuss approaches for DEU sustainability and continuous quality improvement. Establish a community of DEU scholars, administrators, and service-academe partners to guide future DEU development and implementation. University of Portland, Oregon, USA http://nursing.up.edu/default.aspx?cid=13136&pid=205&gd=yes

37. Where can we find our Global Voice to share our Partnership Efforts and Experiences? ICN Wordle

38. ICN Nurse Educator Network (ICNEN) With the new international realities of migration, advances in communication technology, and a worldwide nursing shortage, educating and preparing a diverse nursing workforce has become a critical priority. Nursing Education Network Bulletin Issue 4 (December 2014)

39. ICNEN Steering Committee Members Chair: Virginia W. Adams, North America (USA) Kath McCourt, Europe (UK) Anne-Maria Kanerva, Europe (Finland) Sharon Vasuthevan, Africa (South Africa) Jane Mills, Australasia (Australia) Lian-Hua Huang, Asia (Taiwan) Liaison: Jean Barry, (ICN), Switzerland

40. Welcome to the ICN Education Network Forum: We welcome your posts and questions to address key issues related to nursing education globally. Post: “Thank you for having this forum for educators from all over the world to share their insights into the wonderful world of nursing education.”

41. What are your next steps in building and sustaining partnerships between education and service settings? Thank you!