This project was completed for the Emerging Educational Administration Institute (EEAI) as part of a leadership journey. Clinical education is a key component of nursing career preparation. Benner, Sutphen, Leonard & Day (2009) and others have urged nursing program faculty to place a greater emphasis on the clinical learning environment. The clinical setting is described as an intensive environment for the application of theory to practice. A key resource in this learning environment is the clinical educator, yet due to the nursing faculty shortage, academic nursing programs rely heavily on clinical adjunct faculty members to supervise students’ clinical learning experiences.
The National League for Nursing (NLN) has developed a framework for the advanced specialty role of the Clinical Nurse Educator (Shellenberger, 2019). The Core Competencies descriptions reflect synthesis of research and best practices in the role of the clinical nurse educator and provide guidance for excellence in clinical education.
Aim/Goal/Purpose
The purpose of this project was to establish an evidence-based educational program preparing faculty to facilitate student learning in the clinical environment.
Methods: Project Activities
The project was completed as part of the leadership journey in the EEAI. The leadership journey began with self-assessment of who I am as a leader. I serve as the Director of Veterans to BSN Initiative. I have proven military leadership skills and am internally motivated to address areas where improvements are needed or where growth can occur. In addition, I am a clinical expert with extensive teaching experience. Synthesizing my experiences to support veterans in their ability to achieve success and the breadth of my clinical teaching experience really tells my story of where I am today. I have adopted the Army’s Leadership Model, “Be, Know, Do” as my own.
- My attributes “Be” are my dedication to the profession, our school and our students.
- I “Know” a lot about our school, our students, our community partners and clinical education.
- I recognized my need for professional growth in reference to Nursing Education Administration along with the need for development of our clinical adjunct faculty. Hence the “DO”, the EEAI institute and my project.
There were four phases to the methods for this project.
Phase 1: Assess educational needs of Clinical Adjunct Faculty (Spring 2018 – December 2018)
Activities included: (a) meeting with the clinical coordinators to identify anticipated needs of instructors, (b) aggregating data from students’ evaluations of their clinical instructor, (c) planning logistics of a survey to assess educational competencies of clinical adjunct faculty, and generating survey items from the NLN Clinical Nurse Educator Core Competency task statements associated with “to facilitate learning in the health care environment.” A literature review was completed to determine other evidence regarding best practices for clinical education.
Phase 2: Implement the needs assessment survey to prioritize educational needs. (12/18 – 1/19)
Emails were sent to thirty-three clinical nurse educators hired as “Clinical Adjunct Faculty Members “asking them to complete a survey using Survey Monkey®. The design included mixed methods: quantitative task statements from the NLN core competencies using a 5-point Likert scale, and qualitative statements as participants were asked to provide an example for each of the task statements.
Measures: Project Outcomes:
Twenty-three clinical adjunct faculty completed the survey and quantitative results analysis using Statistical Package for Social Science (SPSS®) indicated overall scores for each of the task statements. Task statements with the lowest confidence score(s) included “Bridges the gap between theory and practice by connecting clinical learning opportunities to course content” with a score of 4.04/5 and “Grounds teaching strategies in education theory and evidence-based teaching practices” with a score of 3.87/ 5. Thirteen participants provided qualitative responses, which were analyzed using thematic coding. One key theme that emerged was faculty giving examples of evidence-based clinical practice when they were asked for examples of evidence-based teaching.
Phase 3: Provide the educational program (1/2019 – 3/2019)
Based on results of the survey, an education program was developed with (2) objectives: Objective 1; Create learning opportunities to help bridge the theory to practice gap for the prelicensure nursing student, and Objective 2: Assess the value and impact of educational theory and evidence-based teaching for its use in the clinical environment. All clinical faculty for the 2018-2019 academic year were invited to the program and 15 clinical instructors attended. CEUs were awarded.
Phase 4: Evaluate and disseminate project (3/2019 – 4/2019)
Participants evaluated the educational event and rated the outcome highly to indicate that the learning objectives were met. A follow-up survey via email asked participants to self-evaluate their progress for each associated task statement from the NLN core competency. Participants were also asked to provide an example in reference to each of the task statements.
Results:
Pre-educational intervention scores on each of the task statements were compared with post-educational intervention scores on the same task statements. Because the educational program focused on only two of the task statements only these quantitative results were compared for pre-intervention and post-intervention. The pre-intervention score was 3.87 and post-intervention 3.69 for the task statement, “Grounds teaching strategies in education theory and evidence-based teaching practices." And the score was 4.04 pre-intervention and 4.08 post-intervention for the task statement, “Bridges the gap between theory and practice by connecting clinical learning opportunities to course content”. Qualitative results indicated better understanding regarding use of educational theory and evidence-based teaching and with no change noted regarding bridging the gap between theory and practice. Examples of qualitative comments from educational offering:
- “I think it was very helpful for faculty to get together and share ideas about what worked well and what didn’t in the clinical setting. While it was helpful to the theory behind successful clinical teaching experiences, there were quite a few discussed and might be helpful for the future to choose a few of the most relevant to discuss.”
- “The suggestion and discussion about approach to teaching in clinical, problems that arise and ideas and examples of how to handle was wonderful. The active engagement of all present itself, provided ideas of how to further engage the students. Thank You!”
Discussion:
The project was disseminated to nursing administration, colleagues, and stakeholders. Organization effects were positive, as this project involved a collaborative effort of many within the organization concerning the role of clinical education in the program. Planning and conducting the training brought a lot of energy and ideas of how to continue to build on the training, including the use of simulation. Recommendations included:
- Continue educational offering at least once a year
- Focus on different clinical core competencies each time offered
- Make it mandatory
- Continue to award CEUs
- Seek funding support for those clinical faculty desiring certification as Clinical Nurse Educator
As an EEAI scholar I achieved growth as a leader and had several achievements. To begin, honing my skills in communication, as this was vital to leading a project and working with administration to get the resources required for the project to improve the clinical adjuncts’ competencies. I was able to introduce Clinical Nurse Educator Competencies to all clinical adjunct participants, creating a collaborative learning environment for those who participated in educational offering. My journey for this project made me acutely aware of all the valuable resources that our school has from the human resources to the technology resources. I will continue to develop as an educational administrative leader within my role as the Director of the Veterans to BSN Initiative and an Assistant Professor within the School of Nursing.