Academic-clinical Partnership Research Articles

Triad Mentoring Model: Framing an Academic-Clinical Partnership Practicum.

The triad mentoring model was developed to frame the implementation of innovative student-centered academic-clinical partnerships for online graduate students in nursing leadership and administration practicums. The nurse leader and faculty member jointly mentored each student to achieve the academic program's objectives through clinical learning experiences that were relevant and important to the clinical organization. Partnerships with nurse leaders within the student's locality were sought, and capstone practicum projects were developed and implemented during four courses. Both formative and summative results were obtained from all members of the triad team throughout the practicum courses. The processes undertaken to establish, implement, and evaluate the student-centered academic-clinical partnerships identified project modifications throughout the course of study. Implementation of the triad mentoring model created academic-clinical partnerships that promoted a fusion of evidence-based practice, quality improvement, and clinical knowledge that produced positive outcomes for the health care setting and student learner. [J Nurs Educ. 2019;58(8):463-467.].

A statewide initiative integrating Quality and Safety Education for Nurses (QSEN) through academic-clinical partnerships to improve health outcomes.

The purpose of this article is to describe an innovative project that contributed to the work of Quality and Safety Education for Nurses (QSEN's) second generation which resulted from the original initiative and the awareness that new environments, partnerships, and strategies were needed to improve quality and safety. It is the only known project that served as a pilot model to disseminate the QSEN competencies across an entire state to build academic-clinical partnerships and can be replicable across the country. Findings from the current project highlighted the following: (a) the need for ongoing education for both academic and clinical partners regarding the QSEN competencies as well as ongoing coaching to develop those collaborative relationships; (b) an awareness among the partnerships of the competing time demands with their other work responsibilities to complete their QSEN project; and (c) many unforeseen positive outcomes including the establishment of the QSEN Institute Regional Center at Jacksonville University. Supported by a mini-grant by the Florida Blue Foundation it is the authors' beliefs that we have now moved onto the third generation of QSEN due to the leveraged opportunities to further improve health outcomes.

Nurse Preceptor Perceptions of Nursing Student Progress Toward Readiness for Practice.

New nurses are often perceived as not meeting expectations for safe nursing practice. Nurse educators need to identify student learning and professional development needs as students progress toward practice. The purpose of the study was to determine the strengths and weaknesses of senior-level nursing students related to readiness for practice before graduation. Using a descriptive, exploratory design, nurse preceptors evaluated the degree to which their assigned senior nursing student was meeting expectations for readiness for nursing practice. Survey items were organized into affective, cognitive, and psychomotor domains and general readiness. This evaluation occurred at the beginning of the final practicum to assess student progress toward readiness for practice. Students scored highest in professional attributes but lowest in time management, prioritization, management of multiple patients, and pharmacology knowledge. Results can be used to inform teaching strategies, strengthen academic-clinical partnerships, and promote readiness for entry-level practice.

Creating New Models of Care Through Academic-Clinical Partnership.

There are many documented instances of academic nurses creating faculty practice opportunities to support their faculty and students. Fewer articles have been published about the value of these shared models to clinical partners. Advanced practice nurses from the academic and clinical departments at Emory University and Emory Healthcare codesigned a new model of care that addresses the health system's need to achieve better experiences and health outcomes for patients living with dementia. The nurse-led clinical practice, called Integrated Memory Care Clinic, is an innovative example of joint planning and design by academic and clinical nurses to advance the teaching, practice, and research mission of the School of Nursing as well as help satisfy the health system's ability to achieve the Triple Aim.

Home-based nurse practitioners demonstrate reductions in rehospitalizations and emergency department visits in a clinically complex patient population through an academic-clinical partnership.

The purpose of this pilot study was to describe the impact of one aspect of an academic-clinical partnership that showed how assigning nurse practitioner faculty to deliver home-based primary care services to clinically complex patients would decrease rehospitalizations and emergency department visit rates. Rehospitalizations and emergency department visits of a cohort of 82 patients were recorded from April 15, 2016 to August 25, 2016 and compared with the same cohort during the two pre-home care inception periods (6 months and 1 year) using insurance claims-based data. Compared with the 1-year pre-home care inception period, there was a decrease of 23.7% in emergency department visits and 34.9% decrease in rehospitalizations after the implementation of the home-based primary care program and a decrease of 35.6% in emergency department visits and 59.4% decrease in rehospitalizations compared with 6 months of pre-home care inception. Allowing nurse practitioners with full practice authority to deliver home-based primary health care services to homebound, chronically ill, recently discharged, and/or disabled patients can decrease costs and promote optimum health care in this population. In addition, these programs provide valuable learning experiences for nurse practitioner students and their preceptors.

Status of knowledge on student-learning environments in nursing homes: A mixed-method systematic review.

To give an overview of empirical studies investigating nursing homes as a learning environment during nursing students' clinical practice. A supportive clinical learning environment is crucial to students' learning and for their development into reflective and capable practitioners. Nursing students' experience with clinical practice can be decisive in future workplace choices. A competent workforce is needed for the future care of older people. Opportunities for maximum learning among nursing students during clinical practice studies in nursing homes should therefore be explored. Mixed-method systematic review using PRISMA guidelines, on learning environments in nursing homes, published in English between 2005-2015. Search of CINAHL with Full Text, Academic Search Premier, MEDLINE and SocINDEX with Full Text, in combination with journal hand searches. Three hundred and thirty-six titles were identified. Twenty studies met the review inclusion criteria. Assessment of methodological quality was based on the Mixed Methods Appraisal Tool. Data were extracted and synthesised using a data analysis method for integrative reviews. Twenty articles were included. The majority of the studies showed moderately high methodological quality. Four main themes emerged from data synthesis: "Student characteristic and earlier experience"; "Nursing home ward environment"; "Quality of mentoring relationship and learning methods"; and "Students' achieved nursing competencies." Nursing home learning environments may be optimised by a well-prepared academic-clinical partnership, supervision by encouraging mentors and high-quality nursing care of older people. Positive learning experiences may increase students' professional development through achievement of basic nursing skills and competencies and motivate them to choose the nursing home as their future workplace. An optimal learning environment can be ensured by thorough preplacement preparations in academia and in nursing home wards, continuous supervision and facilitation of team learning.

Rightsizing Projects for Non-Research-Intensive Schools of Nursing via Academic-Clinical Partnerships.

Most academic-clinical partnerships are described as formal agreements between schools of nursing at research-intensive universities and large teaching hospitals. This article demonstrates less formal versions of academic-clinical partnerships established between a small, private liberal arts university school of nursing and 2 regional clinical agencies. In both exemplars, students, faculty, and staff contributed to evidence-based practice projects. Schools of nursing in non-research-intensive environments can develop right-size academic-clinical partnerships that are beneficial for all parties involved.

Developing an infrastructure to support clinical academic careers.

Research and evidence-based practice underpins the delivery of high-quality patient care. Developing the research capacity and capability of nurses, midwives and allied health professionals requires a robust emphasis and the necessary support infrastructure to encourage and develop practitioners to follow a clinical academic career pathway. Clinical academic partnerships between higher education and healthcare institutions can offer a blend of required expertise with mutual benefits. This article reports on a recent Florence Nightingale Foundation and Council of Deans of Health Leadership Scholarship improvement project to establish an infrastructure to support the development of clinical academic roles to enhance the provision of evidence-based patient care in the North East of Scotland.

The Global Health Service Partnership: An Academic-Clinical Partnership to Build Nursing and Medical Capacity in Africa.

The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians) by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals—a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP) is a unique collaboration between the Peace Corps, President’s Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals. Nurse and physician educators are seconded to host institutions to serve as visiting faculty alongside their local colleagues. They serve for 1 year with many staying longer. Educational and clinical best practices are shared, emphasis is placed on integration of theory and practice across the academic–clinical domains and the teaching and learning environment is expanded to include implementation science and dissemination of locally tailored and sustainable practice innovations. In the first 3 years (2013–2016) GHSP placed 97 nurse and physician educators in three countries (Malawi, Tanzania, and Uganda). These educators have taught 454 courses and workshops to 8,321 trainees, faculty members, and practicing health professionals across the curriculum and in myriad specialties. Mixed-methods evaluation included key stakeholder interviews with host institution faculty and students who indicate that the addition of GHSP enhanced clinical teaching (quality and breadth) resulting in improved clinical skills, confidence, and ability to connect theory to practice and critical thinking. The outputs and outcomes from four exemplars which focus on the translation of evidence to practice through implementation science are included. Findings from the first 3 years of GHSP suggest that an innovative, locally tailored and culturally appropriate multi-country academic–clinical partnership program that addresses national health priorities is feasible and generated new knowledge and best practices relevant to capacity building for nursing and medical education. This in turn has implications for improving the health of populations who suffer a disproportionate burden of global disease.

The Hope Research Community of Practice: Building Advanced Practice Nurses' Research Capacity.

Background Clinical nurses have multiple challenges in conducting high-quality nursing research to inform practice. Theoretically, the development of a community of practice on nursing research centered on the concept of hope is an approach that may address some of the challenges. Purpose This article describes the delivery and evaluation of a hope research community of practice (HRCoP) approach to facilitate research expertise in a group of advanced practice nurses in one hospital. It addressed the question: Does the establishment of a HRCoP for master's prepared nurses increase their confidence and competence in leading nursing research? Method Using interpretive descriptive qualitative research methodology, five participants were interviewed about their experiences within the HRCoP and facilitators engaged in participant observation. Results At 13 months, only four of the original seven participants remained in the HRCoP. While all participants discussed positive impacts of participation, they identified challenges of having protected time to complete their individual research projects, despite having administrative support to do so. Progress on individual research projects varied. Conclusion Nurse-led research remains a challenge for practicing nurses despite participating in an evidence-based HRCoP. Lessons learned from this project can be useful to other academic clinical partnerships.

Increasing Research Capacity in a Safety Net Setting Through an Academic Clinical Partnership.

Safety net settings care for a disproportionate share of low-resource patients often have fewer resources to invest in nursing research. To address this dilemma, an academic-clinical partnership was formed in an effort to increase nursing research capacity at a safety net setting. Penn Presbyterian Medical Center and the Center for Health Outcomes and Policy Research located at the University of Pennsylvania partnered researchers and baccalaureate-prepared nurses in an 18-month research skill development program. This article describes the programmatic design, conceptual framework, resource requirements, and effect on the institutional partners and participants.

Exploring Proxy Measures of Mutuality for Strategic Partnership Development: A Case Study.

Partnerships between academic and clinical-based health organizations are becoming increasingly important in improving health outcomes. Mutuality is recognized as a vital component of these partnerships. If partnerships are to achieve mutuality, there is a need to define what it means to partnering organizations. Few studies have described the elements contributing to mutuality, particularly in new relationships between academic and clinical partners. This study seeks to identify how mutuality is expressed and to explore potential proxy measures of mutuality for an alliance consisting of a hospital system and a School of Public Health. Key informant interviews were conducted with faculty and hospital representatives serving on the partnership steering committee. Key informants were asked about perceived events that led to the development of the Alliance; perceived goals, expectations, and outcomes; and current/future roles with the Alliance. Four proxy measures of mutuality for an academic-clinical partnership were identified: policy directives, community beneficence, procurement of human capital, and partnership longevity. Findings can inform the development of tools for assisting in strengthening relationships and ensuring stakeholders' interests align with the mission and goal of the partnership by operationalizing elements necessary to evaluate the progress of the partnership.

Clinical nurse leaders' and academics' perspectives in clinical assessment of final-year nursing students: A qualitative study.

The nature of nursing practice is diverse; therefore, clinical assessment is a complex process. This study explores the perceptions of clinical nurse leaders and academics on clinical assessment for undergraduate nursing education during transition to practice. An explorative qualitative approach was applied. Eight nurse managers, six clinical nurse educators, and eight academics from two tertiary hospitals and a university in Singapore participated in four focus group discussions. Thematic analysis was conducted. Four overriding themes were revealed: the need for a valid and reliable clinical assessment tool, preceptors' competency in clinical assessment, challenges encountered by the students in clinical assessment, and the need for close academic and clinical collaboration to support preceptors and students. Closer academic-clinical partnership is recommended to review the clinical education curriculum. Clinical and educational institutions need to work closely to design a learning program to enhance preceptors' competence in clinical pedagogy and assessment. Furthermore, a stress management program could build students' resiliency in coping with unfamiliar clinical environments. Ongoing support needs to be provided for both preceptors and students to enrich the preceptorship and learning experiences.

Utilizing a Curriculum Development Process to Design and Implement a New Integrated Clinical Education Experience

Background and Purpose. Intentional curriculum development processes have been described in the literature but application of such processes has not been described specific to the clinical education (CE) component of a doctor of physical therapy (DPT) curriculum. The article describes one DPT program's application of David Kern's Six-Step curriculum development approach to the creation of a unique integrated clinical education (ICE) curriculum. The development of the ICE curriculum, a component of a larger curriculum revision of the DPT program, began in 2010. The details of Kern's steps are provided and their application to the development of the new ICE curriculum is described. Method/Model Description and Evaluation. The DPT program used Kern's 6 steps, beginning with a general and targeted needs assessment (Steps 1 and 2). The DPT program collaborated with clinical faculty in these early steps to gather information and feedback. The program consulted with a strategic planning committee and reviewed student and clinical instructor (CI) feedback on the existing ICE experience in the prerevision curriculum. The DPT program also reviewed the literature and consulted with another DPT program during this phase. The needs assessment resulted in the basic structure and design of the new ICE, employing innovative characteristics, such as use of the collaborative model, reimbursement to clinical sites, and early placement in the clinic with a focus on hands-on experience. The DPT program continued with the development process by creating goals and objectives for the ICE (Step 3), followed by educational methods (Step 4) to meet these objectives. The program planned for implementation (Step 5) and evaluation (Step 6) of the new ICE curriculum by following Kern's recommendations to continue to collaborate with key stakeholders in these final steps of curriculum development. Outcomes. The result of this process was the new ICE curriculum implemented in 2014 with 17 clinical sites and 24 CIs participating. Survey data and feedback revealed that students believed ICE was essential to their learning and the collaborative model enhanced overall learning. CIs indicated feeling adequately prepared for the unique experience and described feeling more connected to the DPT program as a result of participation in ICE. Discussion and Conclusion. This curriculum development process highlighted the importance of a strong academic-clinical partnership in the creation of a unique ICE model. Utilization of a systematic approach to development of an ICE curriculum can support DPT programs in meeting the recent call for innovation and partnership in CE. Kern's approach engages key stakeholders—in this case academic and clinical faculty—throughout the development process, which ultimately leads to increased intentionality and quality of the ICE curriculum.

Impact of a physical activity pathway for musculoskeletal conditions: a clinical–academic partnership service evaluation

Impact of a physical activity pathway for musculoskeletal conditions: a clinical–academic partnership service evaluation

Leveraging Resources to Improve Clinical Outcomes and Teach Transitional Care Through Development of Academic-Clinical Partnerships.

Nurse educators need to provide students with clinical experiences that prepare them for our rapidly changing health care environments. This article describes how nurse educators used academic and clinical resources to develop a partnership between a school of nursing and clinical entity to facilitate successful transitions from hospital to home for adult heart failure and pediatric asthma patients.

Reaching their potential: Perceived impact of a collaborative academic–clinical partnership programme for early career nurses in New Zealand

The dynamic nature of healthcare ensures that early career nurses enter an uncertain and complex world of practice and consequently require support to develop their practice, build confidence and reach their potential. The New Zealand Nurse Entry to Practice programme for registered nurses in their first year of practice has been operating since 2005 to enable safe and confident practice, improve the quality of care, and positively impact on recruitment and retention. This academic and clinical programme was offered as a partnership between a university and a clinical provider with postgraduate academic credits gained. The aim of this study was to explore the perceived impact of postgraduate university education for early career nurses in one regional health area of New Zealand. Participants were registered nurses who had completed the early career nurse programme and their clinical preceptors. The research was conducted via an online survey of 248 nurses and three focus groups to explore how the programme was experienced and its impact on knowledge and practice. Early career nurses and their preceptors found that the programme enables improved knowledge and skills of patient assessment, application of critical thinking to clinical practice, perceived improvement in patient care delivery and outcomes, enhanced interprofessional communication and knowledge sharing, and had a positive impact on professional awareness and career planning. This clinical-academic partnership positively impacted on the clinical practice and transition experience of early career nurses and was closely aligned to an organization's strategic plan for nursing workforce development.

Informing innovative models of nurse practitioner education: A formative qualitative study

Despite major changes in health care, the one- to- one model of nurse practitioner (NP) clinical education programs has changed little in 50 years contributing to a lack of preceptors for NP education programs. More efficient models to educate NPs and are needed to ensure a sustainable primary care NP workforce. The purpose of this formative evaluation study was to assess barriers and facilitators to precepting NP students and adopting new models of NP education in clinical academic partnerships. Eight participants provided rich data from which to better understand the barriers and facilitators to precepting multiple NP students. Two major themes emerged; the student-academic-practice partnership and the health care system. Systems factors pertain to those not modifiable by NP programs such as time available, scheduling and space. Implications for development of a NP attending clinical model and academic curricula models are discussed.

Forming academic/community partnerships to help alleviate the clinical placement crisis

Purpose of the article: The finite number of traditional clinical placements in acute care settings is creating pressure for nursing education programs. This article describes the design and successful implementation of a non-traditional, academic clinical partnership established between a faith-based community partner and a baccalaureate nursing degree-granting academic institution. Design/method: The authors lay out a novel partnership-development concept and operationalize that concept through real-world examples. The goal of the collaborative was to screen clients of the community partner to identify cognitive impairment within this population. Additionally, nursing students were exposed to a collaborative, research project between the academic and community partner. Findings: The collaborative partnership met mutual goals. Eighty nursing students contacted over 1,400 clients, completed telephone screening of over 1,000 active clients, and performed over 75 in-home assessments for clients of the faith-based community agency. The tools used identified that approximately 30% of the community partners’ clients were living with some form of cognitive impairment. Conclusions: Both academic and community partners found the partnership effective. Over 80% of students rated the clinical experience 4 or higher on a 5-point Likert scale. Students reported satisfaction and demonstrated increased sensitivity to independent community-dwelling seniors. The community partner was able to incorporate the tools used in the project into their routine screening process for all clients.

The critical elements of effective academic-practice partnerships: a framework derived from the Department of Veterans Affairs Nursing Academy.

BackgroundThe nursing profession is exploring how academic-practice partnerships should be structured to maximize the potential benefits for each partner. As part of an evaluation of the U.S. Department of Veterans Affairs Nursing Academy (VANA) program, we sought to identify indicators of successful partnerships during the crucial first year.MethodsWe conducted a qualitative analysis of 142 individual interviews and 23 focus groups with stakeholders from 15 partnerships across the nation. Interview respondents typically included the nursing school Dean, the VA chief nurse, both VANA Program Directors (VA-based and nursing school-based), and select VANA faculty members. The focus groups included a total of 222 VANA students and the nursing unit managers and staff from units where VANA students were placed. An ethnographic approach was utilized to identify emergent themes from these data that underscored indicators of and influences on Launch Year achievement.ResultsWe emphasize five key themes: the criticality of inter-organizational collaboration; challenges arising from blending different cultures; challenges associated with recruiting nurses to take on faculty roles; the importance of structuring the partnership to promote evidence-based practice and simulation-based learning in the clinical setting; and recognizing that stable relationships must be based on long-term commitments rather than short-term changes in the demand for nursing care.ConclusionsDeveloping an academic-clinical partnership requires identifying how organizations with different leadership and management structures, different responsibilities, goals and priorities, different cultures, and different financial models and accountability systems can bridge these differences to develop joint programs integrating activities across the organizations. The experience of the VANA sites in implementing academic-clinical partnerships provides a broad set of experiences from which to learn about how such partnerships can be effectively implemented, the barriers and challenges that will be encountered, and strategies and factors to overcome challenges and build an effective, sustainable partnership. This framework provides actionable guidelines for structuring and implementing effective academic-practice partnerships that support undergraduate nursing education.