Nursing Education and Adjunct Faculty, Dedicated Education Unit and Residency as Teaching Model In Clinical Teaching Environment

Adjunct Faculty As Teaching Model In Nursing Education, Dedicated Education Units As Teaching Model In Nursing Education, Residency Models As Teaching Model In Nursing Education.

Adjunct Faculty As Teaching Model In Nursing Education

    Adjunct faculty are health care
professionals who are employed in the service setting and have a part-time
academic appointment. Adjunct faculty may assume various roles, including those
of preceptor, CTA, mentor, guest lecturer, and supervisor.

    These individuals
may also collaborate on research projects. Faculty who are appointed in an
adjunct capacity are registered professional nurses or professionals who are
experts in areas such as clinical practice, research, leadership, management,
legislation, and law.

Dedicated Education Units As Teaching Model In Nursing Education

   Over the past decade, the dedicated education
unit (DEU) model has been implemented at various universities across the
country. Moscato, Miller, Logsdon, Weinberg, and Chorpenning (2007) indicate
that the “DEU offers a concrete strategy to more closely connect nursing units
and education programs” (p. 32). 

    DEUs involve new partnerships among nurse
executives, staff nurses, and faculty for transforming patient care units into
environments designed to support learning experiences for students and staff
nurses while continuing the critical work of providing quality care to acutely
ill patients. 

    Mulready Shick, Flannagan, Banister, Mylott, and Curtin (2013)
found that the DEU model facilitates stronger relationship building between
nurses in academia and practice, and students report significantly more
positive learning experience when compared with traditional clinical placement
experiences. 

   Universities are implementing this strategy in a variety of ways.
One Midwest university uses the term practice education partnership (PEP)
units. The PEP unit is a hospital-based unit designed to provide the student
with a strong partnership between the practice and education settings. 

    The PEP
model differs from the Australian DEU model in that it works to incorporate the
culture of the unit and its clinical specialty into the availability of
preceptors, level of patient acuity, and other influences on the education of
the student. 

    One of the unique aspects of the PEP model is that there is
continuity and consistency among preceptors, faculty, and students as they
partner to learn and grow together. Preceptors are coached on preceptor
competencies by attending a full-day workshop. It is at this time that the
partnership between the nurse and the faculty begins. 

    This partnership is
developed over time and ultimately the student learns the role of the nurse and
together the student and preceptor provide exceptional patient care. The use of
DEUs has increased significantly in the last decade (Moscato, Nishioka, &
Coe, 2013).

    Research indicates the educational quality and competency
development are significant for students receiving clinical instruction in DEUs
(Dapremont & Lee, 2013; Mulready-Shick et al., 2013).

Residency Models As Teaching Model In Nursing Education

    Recognizing that prelicensure programs may
not be sufficient for preparing nurses for practice in complex health care
settings, several studies and commissions (Benner et al., 2010; Institute of
Medicine, 2010; Tanner, 2010) report on the need for postgraduate residencies
and call for their increased use to improve transition to practice and
development of leadership and population management skills. 

    Accreditation and
regulatory standards have been developed for this approach to residency. The
American Association of Colleges of Nursing (AACN) developed a 12-month program
designed to facilitate further development of competency and ease the
transition into practice. 

    The AACN piloted six programs in 2004 and there are
now residency programs in more than 30 states (Barnett, Minnick, & Norman,
2014). The NCSBN developed a model that provides a framework for standardized
transition to practice and regulatory guidelines are under consideration
(Goode, Lynn, McElroy, Bednash, & Murray, 2013). 

    Several studies have been
conducted to examine the outcomes of nurse residency programs (Goode et al.,
2013). The findings suggest nurse residency programs increase overall
confidence and competence particularly in the ability to organize, prioritize,
communicate effectively, and provide leadership (Goode et al., 2013). 

    Residency
programs have a statistically positive influence on nurse retention rates
(Goode et al., 2013). Further research is needed to determine the influence of
postgraduate nurse residency programs on patient outcomes (Barnett et al.,
2014)

    In
short, several models for clinical education of student nurses exist.
Alternative models, collaborative in nature, have evolved because of the
increasing complexity of the health care environment. Among these models are
preceptorships, the teaching associate model, the paired model, clinical
teaching partnerships, and adjunct faculty. 

    The nature of each model dictates
the level of student that would benefit most. The paired and clinical associate
models have been used for beginning students, whereas the preceptorship model
is widely used for students in the upper level of their program and for
graduate students. 

    Empirical research on the effectiveness of these models has
been sparse; there is a need for further evaluation of and research on these
models in terms of their effectiveness on student learning and preparation for
the workforce. Clinical teaching involves student–teacher interaction in
experiential clinical situations that take place in diverse and often
inter professional practice environments. 

    These environments may include
laboratory, acute care, transitional, and community sites, including homeless
shelters, clinics, schools, camps, and social service agencies. Faculty must
have in-depth knowledge of teaching behaviors that facilitate students’
learning and development, and have complete knowledge of the culture of the
practice area as well as the health care provider. 

    Effective clinical teachers
are able to plan, facilitate, and evaluate experiences using instructive,
interpersonal, and evaluative strategies. These strategies facilitate faculty’s
acquisition of the knowledge and skills required to become nurses. A variety of
teaching methods can be used to enable students to achieve desired outcomes. 

    Patient assignments, clinical conferences, nursing grand rounds, concept-based
clinical activities, and written assignments are among these. The skill level
of students, patient’s acuity level, number of students, and patient care
resource availability will affect the method used. 

    Among the models suggested
for educating nursing students are the traditional approach and alternatives to
this model, including preceptorships, CTAs, teaching partnerships, and adjunct
faculty. Practicum experiences prepare students for working in a health care
system that is evidence based and patient centered. 

    Teaching in the practicum
setting blends faculty’s clinical expertise with teaching skills to prepare
nurses for current and future roles in an ever changing health care system.