It is difficult to correlate a particular educational activity and it’s relation to achieving competency, especially with an intangible concept such as nursing leadership (Abdrbo, 2012). Learning in the clinical setting is a common and valued component to nursing education as is simulation. Research shows both environments provide effective learning and are essential to nursing education, not only with fundamental clinical skills but with nursing leadership skills (Chunta & Edwards, 2013; Gore, Johnson, & Wang, 2015; McGrath, Lyng, & Hourican, 2012).
A southeastern university’s school of nursing defines leadership skill as a core curricular outcome and component within their conceptual framework. Two critical factors identified in their mission are to exemplify excellence in teaching and to ensure graduates are prepared to assume leadership roles in the provision of nursing care. The following is an excerpt from their Conceptual Framework/Vision and Mission Philosophy:
Leadership skills include ethical and critical decision making, mutually respectful communication and collaboration, care coordination, delegation, and conflict resolution. These skills are built on an awareness of complex systems and the impact of power, politics, policy, and regulatory guidelines on these systems. Professional nurses must have a solid understanding of the broader context of health care, including the organization and financing of patient care services and the impact of regulatory guidelines on practice and reimbursement. Professional nursing also requires knowledge of health care policy. Moreover, professional nurses practice at the microsystem level within a constantly changing health care system. Professional nurses apply quality improvement concepts to minimize risk of harm to patients and providers within a systems framework (Faculty Handbook, p. 2).
This particular southeastern university’s school of nursing offers two clinical nursing leadership courses in the final semester. In addition to a five hour preceptorship course, NURS 4911: Professional Nursing Leadership in Complex Systems includes experiences in simulation and in the inpatient clinical settings; Advanced Mock Hospital, SMART Training, and Leadership Clinical.
Advanced Mock Hospital and SMART (Safety Management and Response Team) Training are simulated experiences where evidenced based practices are incorporated into scenarios. Students learn and demonstrate clinical reasoning, delegation, organization, and team response to critical situations. Guided reflection is utilized by faculty facilitators during debriefing which strengthen critical components of the experiences and encourage perceptive learning (Meakim et al, 2013; Aebersold, Tschannen, & Bathishl, 2011).
Leadership Clinical is direct inpatient clinical experience where emphasis is placed on developing organization, delegation, prioritization, and other leadership skills. This experience consists of four 12 hour clinical shifts where students rotate serving in a charge nurse and staff nurse position. They learn to provide care for and mange up to four patients by the end of the fourth shift. Students administer medications, complete assessments and treatments, document in the medical record, and are supervised by faculty.
Student perceptions of these three clinical experiences are positive and encouraging to the future of nursing and nursing education. Statements such as “I feel these three clinicals brought all of my learning together”, “I feel like a real nurse now”, and “These clinicals have definitely prepared me for preceptorship” are common themes. The purpose of this presentation will be to describe in detail each simulation and clinical activity and to ground the experiences based on evidenced based practice.