The gap between a student’s preparation for practice and the practice requirements for a new registered nurse troubles educators and experienced nurses alike. The problem stems partly from the fact that students’ clinical experiences depend on random events. No educator can guarantee students will care for patients with specific diagnoses or symptoms. Thus, students graduate with different hands-on experiences and usually need more clinical practice experiences to develop competency and confidence in the practice setting.
To help bridge the gap between education and practice, the North Texas Consortium of Schools of Nursing and collaborating hospitals developed 10 learning modules on caring for patients with the most common diagnoses in area hospitals. Our goals were to enhance patient safety and care by teaching early assessment and intervention and to increase clinical competency and confidence in new graduates of initial licensure programs.
Developing the modules
To determine the top 10 high-risk, high-volume, problem- prone patient conditions, we reviewed the literature and the data from our North Texas hospitals. After determining the 10 conditions, we started work on the modules. Each module was developed by one of the North Texas schools and their practice partners. (See Most common high-risk conditions in pdf format by clicking on the download now button.)
Dr. Bonnie Higgins and her colleagues at Tarrant County College, with input from the nursing staff at Harris Methodist and John Peter Smith Hospitals, completed the first module, Scenarios of Psychosis.
It includes five comprehensive patient scenarios.
The schools and hospitals funded the module project, and faculty and hospital staff dedicated their time to write and pilot-test the modules. Faculty and staff members were also able to attend a 2-day summer conference for free. (We’ve held free summer institutes every year since 2005.)
Evaluating the program
During the pilot phase, students and faculty reported the value of using non-lecture teaching materials. We expect the modules, which are available on CD-ROM, to help students who are active learners gain more confidence and competency. (For information on obtaining the modules, contact the author at firstname.lastname@example.org.)
Faculty members welcomed the summer conference, which allowed them to meet colleagues from neighboring schools and exchange course-related information. They also valued the opportunity to talk with practice colleagues about the needs of new graduates and ways to assist their transition into practice.
We believe the collaborative development of educational materials is a model for ensuring that students develop their clinical thinking skills to promote excellence in practice. The program has also advanced our understanding of the concept of competency and provided insight into how we can evaluate the competency of new graduates.
Keys to success
The Texas Nurses Association honored our project by bestowing its 2006 Leadership in Education award. What were the keys to success? Having champions among the leaders of the schools and hospitals ensured that the project would be supported and completed. The project also required faculty and nurse partners to engage in work that was independent of the administration’s commitment. And our project depended on participants’ willingness to meet regularly and work together as equal partners.
For details on the project, see “Competency development in new registered nurse graduates: Closing the gap between education and practice” in the February 2008 issue of The Journal of Continuing Education in Nursing.
Elizabeth Poster is Dean of the School of Nursing at the University of Texas at Arlington.