Dedicated Education Units and Traditional Units: A Comparison of Learning Outcomes

Friday, 20 April 2018: 10:35 AM

Deborah A. Raines, PhD, EdS, RN, ANEF
School of Nursing, University at Buffalo: SUNY, Buffalo, NY, USA

Designing a quality clinical learning experience for undergraduate nursing students is challenging. Reports by the Carnegie Foundation, Institute of Medicine (IOM) and Robert Woods Johnson Foundation call for nurse leaders to improve how nurses are prepared and educated by reducing the gap between classroom and clinical teaching. In addition, the IOM’s Future of Nursing report encourages collaboration among organizations to better prepare nurses to deliver high-quality care.

The Dedicated Education (DEU) Model of nursing practice education is one strategy to bridge the gap between classroom and clinical teaching and to enrich the quality of students’ learning opportunities.

A DEU model changes the traditional role of the faculty and the unit staff in their provision of clinical education to students. In a traditional model, a school of nursing faculty member has primary responsibility for a group of 8 to 12 students, and each student is assigned to specific care delivery activities by the faculty member who also supervises the delivery of care. The involvement of unit-based staff in a student’s provision of nursing varies based on the relationships established by the individual faculty member. In some settings unit-based staff may have limited awareness of students’ clinical expectations, their designated learning objectives, or their prior knowledge. In a DEU, each nursing student is paired with a unit based nurse for the duration of the clinical rotation. The student and the nurse care for an assignment of patients together, with the student assuming increasing responsibility over time.

The purpose of this study was to evaluate student confidence in performing nursing role responsibilities and to measure learning of specific nursing skills performed during a clinical learning experience.

This was a quasi-experimental study using a pre-test/post-test survey design. Students are randomly assigned to a clinical setting by a coordinator. Students completed a survey to measure level of comfort and skill performance before and after the clinical rotation. A total of 96 students, 48 in a DEU and 48 in a traditional unit, completed both surveys. The survey included the Casey-Fink Nursing Student Transition Survey and 15 Likert scale items focused on self-perceived comfort in performing specific nursing procedures, specific to the clinical course objectives. Two item collect data on the participant’s prior work experience in health care and their desire to work in this setting after graduation.

The analysis examined the magnitude of the change in level of comfort and skill performance before and after the clinical experience. The data revealed that students in the DEU performed a greater number of skills, reported a higher level of comfort and confidence in skill performance and had a greater magnitude of change in pre and post clinical scores on the Casey-Fink Student Transition Survey.

This study provides a beginning body of evidence that the DEU is a positive factor in student learning in the clinical area. Future studies need to examine the impact of DEU experiences on the students’ transition to new RN employee in the practice organizations.