Educating Nursing Students as Change Agents: A Case Study

In 1996, the Institute of Medicine Committee on Public Health proposed a model of engagement and collaboration of public health, community, and hospital partnerships to improve population health. Nearly seventeen years later, supported by aspects of the Affordable Care Act (ACA), this initiative requires a nursing workforce with leadership capabilities to transcend boundaries between the two sectors. At our college of nursing, faculty who teach public and community health nursing collaborate with the university medical center and community based organizations to develop caring and responsible nurses with clinical reasoning who are patient advocates and innovators capable of problem-solving and development and implementation of changes that improve outcomes in complex health care systems.  Using the Model of Situated Learning in Leadership as a framework, students at Rush University College of Nursing (part of a large academic medical center with Magnet® recognition for excellence in nursing practice) are educated as change agents. Students to work with community partners, conduct a community assessment, identify areas of need, and gather data to support and evaluate the changes. Faculty coached students lead the needed changes, integrating coursework including organizational leadership, health care policy, epidemiology, biostatistics, and finance with project experiences. A case-study of using this model for education in leadership is nursing student involvement (with faculty guidance) in ongoing efforts at the medical center to improve the care of patients with intellectual disabilities and developmental disabilities. The experience provides real-life lessons in leadership to strengthen care coordination between regulatory agencies, family, and community supports and to bridge the gap between inpatient care and public health to improve the quality of care for an at-risk group of patients.