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Breaking the Rules: Redesigning the Educational Endeavor for Nursing School of Nursing & Health Professions Judith F. Karshmer, PhD, APRN Dean & Professor.

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Presentation on theme: "Breaking the Rules: Redesigning the Educational Endeavor for Nursing School of Nursing & Health Professions Judith F. Karshmer, PhD, APRN Dean & Professor."— Presentation transcript:

1 Breaking the Rules: Redesigning the Educational Endeavor for Nursing School of Nursing & Health Professions Judith F. Karshmer, PhD, APRN Dean & Professor

2 Common Rules in Nursing Education 1.Don’t re-invent the wheel...

3 2. Start clinical experiences with “simple” patients (i.e., those in long-term care). Common Rules in Nursing Education

4 3. Make patient assignments (instead of “nurse” assignments). Common Rules in Nursing Education

5 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 Education

6 5. Affirm that clinical instructors are “faculty”- their relationship with the setting is secondary. Common Rules in Nursing Education

7 6. Value “breadth” across an array of practice cultures rather than “depth” within one. Common Rules in Nursing Education

8 7. Value “real patient” experiences over simulated ones. Common Rules in Nursing Education

9 8. Treat hours of clinical time as equal, regardless of the experiences made available. Common Rules in Nursing Education

10 9. Supervise students’ “interprofessional communication.” Common Rules in Nursing Education

11 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 Education

12 11. Use clinical rotation times that are different from the “work day” of the facility. Common Rules in Nursing Education

13 12. Focus on “getting the work done,” rather than on seeking learning opportunities. Common Rules in Nursing Education

14 The Future is NOW TIME TO BREAK THE RULES…

15 “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?

16 “Now” Answers Ambulatory, transitional & home care settings An educated consumer Capitated = health promotion + keeping the patient at home Accessibility, connectivity, & data Who IS providing the care??

17 If nursing education does not change and start preparing the nurse for ambulatory & transitional care & the home health and clinic settings it will be: CHWs Team-lets Tele-health Consortia

18 So which rules do we break? ALL OF THEM!

19 We need to re-invent the wheel... Preparing the nurse must be preparing for the future.

20 We need to start students in the settings where they will practice: Out-patient and community clinics Home health/hospice Schools/health departments Transitional care programs

21 We need to assign students to nurses and other professionals: Preceptor/apprentice model IPE joint appointments Faculty as coach to provider dyads

22 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 practice

23 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.

24 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 Home Nurses carrying patient panels

25 We need to exploit the power of simulation. Simulated experiences: Standardized patients IPE High-fidelity simulators Simulated systems

26 We must stop treating hours of clinical time as equal. Competency Based Education

27 We must require “interprofessional communication” as a standard. IPE simulations IP practice = required

28 We can’t continue to set an expectation that nursing practice is static. Mobile devises for prep Point of Care learning Treatment & teaching Apps

29 We must stop treating the clinical sites like real estate & demanding time to match academic schedules. Link student time with agency personnel time Use staff/faculty partners

30 We must stop evaluating students on “getting the work done.” Focus on demonstrating competencies & learning

31 USF Lessons Learned Transition to Practice (T2P) Programs in Ambulatory Care, Home Health, & School Nursing 16-week program: precepted clinical 20hr/week + class & simulation 1day/week

32 USF Lessons Learned Partnerships School districts Home health agencies Hospice Community clinics; FQHCs Specially clinics Transitional care programs Urgent care centers New Graduates = Jobs 100+

33 USF Lessons Learned Push Back… What can they do? How much time will they take? How safe are they? State and agency regulations.

34 USF Lessons Learned Success: 40+ Partnerships 5 (& counting) cohorts 100+ jobs for new graduates in these non-traditional settings!

35 USF Lessons Learned BSN collaborative with VA to prepare the nurse of the future. 20%-80% not 80%-20%

36 USF Lessons Learned Master’s entry program for CNLs to prepare for ambulatory care & home health. Preceptors = faculty/staff

37 Change is easy – it’s keeping the status quo that’s so hard!

38 Questions?


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