clinical education settings - dedicated education units
In response to a combination of influential factors affecting today’s nursing practice and education such as the current nursing shortage, a shortage of both nursing faculty and clinical placement sites, and the need for an overall transformation of nursing education delivery, new and innovative education strategies must be applied to provide excellent clinical education for pre-licensure nursing students with the limited resources available. The development of dedicated education units (DEUs) is an example of an innovative clinical education strategy in which collaboration of nursing education and nursing practice occurs (Billings & Halstead, 2012; Mulready-Shick, Flanagan, Banister, Mylott, & Curtin, 2013). On DEUs, staff nurses are trained to be the clinical instructors for the nursing students. Rather than one academic faculty member overseeing an entire group of clinical students, interested and trained nursing staff members of the DEU are each paired with one or two students for the length of students’ clinical rotation (Klein-Collins, 2011).
The DEU model has proven to be useful for the clinical learning of nursing students since it places students with nurses who are currently in the practice area thereby allowing for the formation of a collaborative partnership to occur which provides students with greater insight and opportunity to learn first-handedly what the clinical role of the nurse entails. As a result, students are naturally better prepared for the reality of professional practice as a registered nurse (Dapremont & Lee, 2013). DEUs provide the staff nurses (now clinical instructors) opportunities to highlight valuable teaching instances and point out meaningful “aha moments” for students due to the time allotted for instructors to focus solely on one or two students and the cohesive bond that is developed from the close partnership that is shared. Additionally, DEUs have been recognized as communities that provide students with opportunities for greater engagement, integration of various nursing concepts, participation, accountability and identity development that in turn, allow for positive support and feedback from the partnership they share with the staff nurses. These benefits then lead to greater development of students’ clinical reasoning skills, assist with the provision of a sense of belonging, and students become valued as self-directed learners (Mulready-Shick, Flanagan, Banister, Mylott, & Curtin, 2013)
Two innovative and creative student-centered teaching/learning strategies that would be appropriate to apply in this clinical setting include clinical questioning and development of a poster or a pamphlet that describes a topic that is reflective of an issue related to one of the national patient safety goals found in the clinical setting as identified by the student and supported by the staff nurse/clinical instructor. One of the goals of a DEU as described by Mulready-Shick, Kafel, Banister, & Mylott (2009), is to integrate quality and safety competencies at the nursing course and clinical unit levels. To do so, nursing students and their corresponding staff nurse/clinical instructor can collaboratively identify a nursing practice issue present on the DEU that is in need of quality improvement. The student will then take on this project by defining an example, represent the cause and effects of the identified issue, and develop strategies to try and resolve the problem through creative development of a poster or pamphlet. This type of unit-based, quality improvement teaching/learning strategy, as described and supported by Mulready-Shick, Kafel, Banister, & Mylott (2009) fosters the student’s ability to collaborate with others and value the teamwork that is required for successful experiences to occur on DEUs while teaching a valuable lesson on the implications of various quality and safety initiatives.
The second student-centered teaching/learning strategy, clinical questioning, is a valuable tool that can be used to determine a nursing student’s state of knowledge or understanding, readiness for increased challenge, understanding of safety in the clinical setting, strengths, and areas for growth. Furthermore, it is designed for rapid assessment of individual progress and provides insight into a student’s ability to think ahead, think in action, and think back on various patient-care issues (Herrman, 2008). As noticed in the video by Greer Glaser, Dean of Nursing and Health Sciences at the University of Massachusetts at Boston, clinical questioning plays a vital role in the determination of the presence or absence of students’ critical thinking skills as evidenced by the staff nurse/clinical instructor’s inquiry regarding students’ knowledge of what to look for when assessing a patient’s peripheral IV line, for example. With careful, nurturing, and supportive questioning techniques, clinical questioning allows for valuable dialogue to occur between the clinical instructor and the student which further enhances the development of the instructor-student partnership and ultimately enhances student learning (Herrman, 2008).
While the benefits of DEUs are undeniable, nursing education institutions must understand and value the benefits of a variety of clinical sites as they all provide unique learning experiences and add layers of nursing knowledge that cannot otherwise be afforded by the typical acute care setting. It is through the nursing student’s clinical educational experience in which he or she is able to learn what it means to be a licensed registered nurse in a variety of settings. Options of settings in need of nursing care are endless which should encourage students to feel confident in their ability to ultimately choose a setting of practice in which he or she feels passionate about and can easily engage and devote his or her time and effort into. Only through a rotation of various clinical experiences can students truly understand the vastly different yet important all nursing care environments are to the provision of quality health care for all individuals.
References
Billings, D. M., & Halstead, J. A. (2012). Teaching in nursing: A guide for faculty (4th ed.). St. Louis, MO: Elsevier.
Dapremont, J. & Lee, S. (2013). Partnering to educate: Dedicated education units. Nursing Education in Practice, 13(5), 335-337.
Herrman, J. W. (2008). Creative teaching strategies for the nurse educator. Philadelphia: F. A. Davis Company.
Klein-Collins, R. (2011). Strategies to produce new nurses for a changing profession. Council for Adult and Experiential Learning. Retrieved from http://www.cael.org/pdfs/132_innovationinnursingeducation2011-1-.
Mulready-Shick, J., Flanagan, K. M., Banister, G. E., Mylott, L., & Curtin, L. J. (2013). Evaluating dedicated education units for clinical education quality. Journal of Nursing Education, 52(11), 606-614.
Mulready-Shick, J., Kafel, K. W., Banister, G., & Mylott, L. (2009). Enhancing quality and safety competency development at the unit level: An initial evaluation of student learning and clinical teaching on dedicated education units. Journal of Nursing Education, 48(12), 716-719.
The DEU model has proven to be useful for the clinical learning of nursing students since it places students with nurses who are currently in the practice area thereby allowing for the formation of a collaborative partnership to occur which provides students with greater insight and opportunity to learn first-handedly what the clinical role of the nurse entails. As a result, students are naturally better prepared for the reality of professional practice as a registered nurse (Dapremont & Lee, 2013). DEUs provide the staff nurses (now clinical instructors) opportunities to highlight valuable teaching instances and point out meaningful “aha moments” for students due to the time allotted for instructors to focus solely on one or two students and the cohesive bond that is developed from the close partnership that is shared. Additionally, DEUs have been recognized as communities that provide students with opportunities for greater engagement, integration of various nursing concepts, participation, accountability and identity development that in turn, allow for positive support and feedback from the partnership they share with the staff nurses. These benefits then lead to greater development of students’ clinical reasoning skills, assist with the provision of a sense of belonging, and students become valued as self-directed learners (Mulready-Shick, Flanagan, Banister, Mylott, & Curtin, 2013)
Two innovative and creative student-centered teaching/learning strategies that would be appropriate to apply in this clinical setting include clinical questioning and development of a poster or a pamphlet that describes a topic that is reflective of an issue related to one of the national patient safety goals found in the clinical setting as identified by the student and supported by the staff nurse/clinical instructor. One of the goals of a DEU as described by Mulready-Shick, Kafel, Banister, & Mylott (2009), is to integrate quality and safety competencies at the nursing course and clinical unit levels. To do so, nursing students and their corresponding staff nurse/clinical instructor can collaboratively identify a nursing practice issue present on the DEU that is in need of quality improvement. The student will then take on this project by defining an example, represent the cause and effects of the identified issue, and develop strategies to try and resolve the problem through creative development of a poster or pamphlet. This type of unit-based, quality improvement teaching/learning strategy, as described and supported by Mulready-Shick, Kafel, Banister, & Mylott (2009) fosters the student’s ability to collaborate with others and value the teamwork that is required for successful experiences to occur on DEUs while teaching a valuable lesson on the implications of various quality and safety initiatives.
The second student-centered teaching/learning strategy, clinical questioning, is a valuable tool that can be used to determine a nursing student’s state of knowledge or understanding, readiness for increased challenge, understanding of safety in the clinical setting, strengths, and areas for growth. Furthermore, it is designed for rapid assessment of individual progress and provides insight into a student’s ability to think ahead, think in action, and think back on various patient-care issues (Herrman, 2008). As noticed in the video by Greer Glaser, Dean of Nursing and Health Sciences at the University of Massachusetts at Boston, clinical questioning plays a vital role in the determination of the presence or absence of students’ critical thinking skills as evidenced by the staff nurse/clinical instructor’s inquiry regarding students’ knowledge of what to look for when assessing a patient’s peripheral IV line, for example. With careful, nurturing, and supportive questioning techniques, clinical questioning allows for valuable dialogue to occur between the clinical instructor and the student which further enhances the development of the instructor-student partnership and ultimately enhances student learning (Herrman, 2008).
While the benefits of DEUs are undeniable, nursing education institutions must understand and value the benefits of a variety of clinical sites as they all provide unique learning experiences and add layers of nursing knowledge that cannot otherwise be afforded by the typical acute care setting. It is through the nursing student’s clinical educational experience in which he or she is able to learn what it means to be a licensed registered nurse in a variety of settings. Options of settings in need of nursing care are endless which should encourage students to feel confident in their ability to ultimately choose a setting of practice in which he or she feels passionate about and can easily engage and devote his or her time and effort into. Only through a rotation of various clinical experiences can students truly understand the vastly different yet important all nursing care environments are to the provision of quality health care for all individuals.
References
Billings, D. M., & Halstead, J. A. (2012). Teaching in nursing: A guide for faculty (4th ed.). St. Louis, MO: Elsevier.
Dapremont, J. & Lee, S. (2013). Partnering to educate: Dedicated education units. Nursing Education in Practice, 13(5), 335-337.
Herrman, J. W. (2008). Creative teaching strategies for the nurse educator. Philadelphia: F. A. Davis Company.
Klein-Collins, R. (2011). Strategies to produce new nurses for a changing profession. Council for Adult and Experiential Learning. Retrieved from http://www.cael.org/pdfs/132_innovationinnursingeducation2011-1-.
Mulready-Shick, J., Flanagan, K. M., Banister, G. E., Mylott, L., & Curtin, L. J. (2013). Evaluating dedicated education units for clinical education quality. Journal of Nursing Education, 52(11), 606-614.
Mulready-Shick, J., Kafel, K. W., Banister, G., & Mylott, L. (2009). Enhancing quality and safety competency development at the unit level: An initial evaluation of student learning and clinical teaching on dedicated education units. Journal of Nursing Education, 48(12), 716-719.