Category Archives: Health Care Education and Training
Heather J. Kelley, MA, is deputy director of the Robert Wood Johnson Foundation (RWJF) Future of Nursing Scholars program.
“Being selected as a Robert Wood Johnson Foundation Future of Nursing Scholar was such an honor! I was already excited about starting my PhD program, but this took that excitement to another level. I wasn't sure what to expect from the boot camp, but it was truly transformative.” - Laren Riesche, a Future of Nursing Scholar attending the University of Illinois at Chicago.
Riesche was one of the 16 new scholars I was privileged to meet on August 5 and 6 at our program’s first-ever scholars’ event. In addition to providing financial support to nurses to complete their PhDs in three years, the Future of Nursing Scholars program will also provide a series of leadership development activities. One of these activities is a boot camp which will be held for each cohort prior to the start of their doctoral programs.
The first-ever boot camp was a two-day event at which the scholars were able to meet and connect with one another, and begin the work of developing skills that will serve them well as they pursue their PhDs. Sessions addressed crucial issues, including developing strategies for peer coaching, and identifying and understanding one’s own approach to change and exerting influence. The new scholars met with current doctoral students to discuss a variety of issues and were given time to network with program leaders, guest speakers, and each other. A workshop served as an introduction to scholarly writing and the event closed with a panel on selecting and working with mentors.
New guidelines from the American Association of Medical Colleges (AAMC) are intended to close the gap between expectations and the reality of what medical students are prepared to do at the start of their residencies.
Known as the Core Entrustable Professional Activities for Entering Residency, the guidelines include 13 activities—such as performing physical exams, forming clinical questions, and handing off patients to other physicians when residents go off duty—that all medical students should be able to perform, regardless of specialty, in order to be better prepared for their roles as clinicians. In August, AAMC launched a five-year implementation pilot with 10 institutions.
Ensuring that the nation’s medical school graduates “have the confidence to perform these activities is critical for clinical quality and safety,” AAMC President and CEO Darrell G. Kirch, MD, said in a news release earlier this year. “These guidelines take medical education from the theoretical to the practical as students think about some of the real-life professional activities they will be performing as physicians.”
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research and trends relating to academic progression, leadership and other essential nursing issues. Following are some of the stories in the October issue.
Campaign Helps Advance Institute of Medicine's Call for More Nurse Leaders
On the fourth anniversary of the release of the Institute of Medicine’s (IOM) landmark report on the future of the nursing profession, more nurse leaders are stepping into positions of power and influence—and efforts to prepare even more nurses for leadership are gaining ground. Today, the Future of Nursing: Campaign for Action is putting new emphasis on the report’s leadership recommendation, and nurses and their employers in government and other sectors are responding. The Campaign is a joint initiative of RWJF and AARP.
Nursing Improvements Could Boost Outcomes for 7 Out of 10 Critically Ill Black Babies
A new study funded by RWJF’s Interdisciplinary Nursing Quality Research Initiative and the National Institute of Nursing Research provides insight into the issue of very low birth weight (VLBW) infants, who are disproportionately black. Researchers found that nurse understaffing and practice environments were worse at hospitals with higher concentrations of black patients, contributing to adverse outcomes for VLBW infants born in those facilities.
California has “Well-Educated” Nurse Force, Study Finds
While California has a “well-educated” nurse force, a survey published by the state’s Board of Registered Nursing shows that there is a long way to go toward meeting the goal set forth by the Institute of Medicine’s landmark report on the future of nursing that 80 percent of nurses hold bachelor’s degrees or higher by 2020. About 60 percent of the state’s registered nurses have earned a bachelor’s or graduate degree in nursing or another field, the survey found. Nearly 40 percent of respondents—and nearly 80 percent of those under 35—said they are considering or seriously considering additional education.
For 23 years, Project L/EARN has created stronger candidates for admission to graduate programs. The intensive, 10-week summer internship provides training, experience, and mentoring to undergraduate college students from socioeconomic, ethnic, and cultural groups that traditionally have been underrepresented in graduate education. Project L/EARN is a project of the Robert Wood Johnson Foundation (RWJF), the Institute for Health, Health Care Policy and Aging Research, and Rutgers University. In this post, interns and mentors share their insights on the value of mentoring in general, and on Project L/EARN in particular. For more, check out an accompanying Infographic: Project L/EARN: Milestones.
“Project L/EARN mentoring has been incredibly instrumental in my career path and has contributed greatly to my professional success. The program was my first major introduction to research, and helped me to apply and reinforce research methods and statistical analysis skills throughout my undergraduate and graduate years.” — Anuli Uzoaru Njoku, MPH, DrPH, post-doctoral fellow, Fox Chase Cancer Center, 1999 Intern
“Mentoring means allowing me to experience how someone else sees me—someone who believes in me and sees my potential, someone who can set my sights higher and in the right direction.” — Tamarie Macon, MS, PhD in progress, University of Michigan, 2006 Intern
“Project L/EARN mentoring, then and now, has been the difference between the summer program being a one-time experience, and the beginning of an educational and professional career that will undoubtedly contribute to the story of my life. The mentoring was the avenue by which my truest potential, of which I had no real awareness, was discovered and cultivated. That cultivation has resulted, and is still resulting, in opportunities and accomplishments that are beyond my imagination.” — David Fakunle, PhD in progress, Johns Hopkins University, 2008 Intern
Sunny G. Hallowell, PhD, APRN, is a postdoctoral fellow, and Danielle Altares Sarik, MSN, APRN, a predoctoral fellow, at the Robert Wood Johnson Foundation-funded Center for Health Outcomes and Policy Research at the School of Nursing at the University of Pennsylvania. Hallowell is also a Leonard Davis Institute Fellow. Both are pediatric nurse practitioners serving on the executive board of the National Association of Pediatric Nurse Practitioners, Pennsylvania Delaware Valley Chapter. Monday, October 6, is National Child Health Day.
Many Americans may not know that children born in the United States are less likely to survive to their fifth birthday than children born in other high-income peer countries. The United States falls at the bottom of the Commonwealth Fund’s recently released “Mirror, Mirror” report, ranking last out of 11 countries for infant mortality.
As children hold the greatest potential to achieve good health, high infant and child mortality may be particularly surprising. Early lifestyle and health care decisions can set children on a trajectory that determines their health for a lifetime.
As a country, we can do more to ensure the health of our youngest and most vulnerable population. Using nurses and nurse practitioners (NP) to the highest level of their education and training is one strategy. Robust use of nurses and NPs can offer solutions to improve infant and child survival rates through prenatal, postnatal and early childhood health surveillance.
Please join the Robert Wood Johnson Foundation (RWJF) this Friday, October 3 from 12 p.m. – 1 p.m. ET for a First Friday Google+ Hangout. Panelists will discuss a new approach to medical education in which much basic content is delivered online, thus freeing up classroom time for more interactive sessions and learning what really “sticks” with students.
Susan Dentzer, senior policy adviser to the Foundation, will lead the discussion, sharing visions for the present and future of medical education that better serve emerging physicians and patients. This event is the ninth in the #RWJF1stFri series—a platform to inform RWJF audiences about lessons our partners are learning as we all work to create a Culture of Health.
Speakers will be:
- Michael Painter, MD, JD, Robert Wood Johnson Foundation
- Charles Prober, MD, Stanford School of Medicine
- Rishi Desai, MD, MPH, Khan Academy
- Jennifer DeCoste-Lopez, Stanford School of Medicine
- Shiv Gaglani, Osmosis and Medgadget
Prior to the Hangout, you can join the conversation and ask questions on Twitter at #RWJF1stFri. RSVP and learn more.
In the last 15 years, the availability of high-fidelity simulation has slowly begun to transform the clinical education of the nation’s nursing students. Schools that once relied on the combination of classroom education and hands-on experience in a clinical environment began to mix in time in a simulation lab, where nursing students could work with highly sophisticated mannequins able to display a range of symptoms and react in real-time to treatment.
Such simulation labs offer many advantages to nurse educators, including the ability to replicate a range of patient situations, thus allowing students to practice specific nursing skills without having to practice their budding skills on actual patients.
But how effective are simulators at training the next generation of nurses? That’s a question that the National Council of State Boards of Nursing (NCSBN) has a particular interest in answering, because the state boards it represents are asked with increasing frequency to permit nursing schools to replace on-the-ground clinical time with simulation.
In pursuit of an answer, NCSBN conducted a full-scale study, tracking 666 nursing students for two academic years, beginning in Fall 2011, and then for six months longer as they began their work in the nursing profession. During their nursing school experience, one-quarter of the students had traditional clinical experiences with no simulation, another quarter had 25 percent of their clinical hours replaced by simulation, and the remaining half had 50 percent of their clinical hours replaced by simulation. At various points during their training and subsequent work as nurses, all study participants were assessed for clinical competency and nursing knowledge.
The new Future of Nursing Scholars program has announced its first cohort of 16 nurse scholars who are receiving scholarships and other support as they pursue PhDs in nursing. The students were selected by schools of nursing that have received grants to provide those scholarships.
Each Future of Nursing Scholar will receive financial support, mentoring and leadership development over the three years of her or his PhD program. They are in the initial stages of selecting the topics for their doctoral research, which range from infection control in the elderly population to the impact of stigma on people with mental illness to the quality of life of children with implanted defibrillators.
In addition to the Robert Wood Johnson Foundation, United Health Foundation, Independence Blue Cross Foundation, Cedars-Sinai Medical Center and the Rhode Island Foundation are supporting the Future of Nursing Scholars grants to schools of nursing this year. The program is located at the University of Pennsylvania School of Nursing.
Deborah E. Trautman, PhD, RN, is the new chief executive officer of the American Association of Colleges of Nursing (AACN) and executive director of the Center for Health Policy and Healthcare Transformation at Johns Hopkins Hospital. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Health Policy Fellows program (2007-2008).
Human Capital Blog: Congratulations on your new position as CEO of AACN! What are your priorities as CEO?
Deborah Trautman: AACN is highly regarded in health care and higher education circles for advancing excellence in nursing education, research, and practice. I am honored to have this unique opportunity to support the organization’s mission and move AACN in strategic new directions. As CEO, I will place a high priority on continuing to increase nursing’s visibility, participation, and leadership in national efforts to improve health and health care. I look forward to working closely with the AACN board, staff, and stakeholders to advocate for programs that support advanced education and leadership development for all nurses, particularly those from underrepresented groups.
HCB: What are the biggest challenges facing nurse education today, and how will AACN address those challenges?
Trautman: Nurse educators today must meet the challenge of preparing a highly competent nursing workforce that is able to navigate a rapidly changing health care environment. As the implementation of the Affordable Care Act continues, health care is moving to adopt new care delivery models that emphasize team-based care, including the medical (health care) home and accountable care organizations.
These care models require closer collaboration among the full spectrum of providers and will impact how health care professionals are prepared for contemporary practice. Nursing needs to re-envision traditional approaches to nursing education and explore how best to leverage the latest research and technology to prepare future registered nurses (RNs) and advanced practice registered nurses (APRNs). Greater emphasis should be placed on advancing interprofessional education, uncovering the benefits of competency-based learning, identifying alternatives to traditional clinical-based education, and instilling a commitment to lifelong learning in all new nursing professionals.
As health reform increases access to care for people with chronic conditions at a time when the supply of primary care physicians is decreasing, one viable alternative is nurse-managed protocols for outpatient treatment of adults with diabetes, high blood pressure and high cholesterol, according to a study published in the Annals of Internal Medicine.
The research team reviewed 18 studies on the effectiveness of registered nurses (RNs) in leading the management of those three chronic conditions. In all 18 studies, nurses could adjust medication dosage; and in 11 studies, they could independently start patients on new medications. The review showed that patients with nurse-managed care had improved A1C levels, lower blood pressure and steeper reductions in LDL cholesterol.
“The implementation of a patient-centered medical home model will play a critical role in reconfiguring team-based care and will expand the responsibilities of team members,” the researchers wrote. “As the largest health care workforce group, nurses are in an ideal position to collaborate with other team members in the delivery of more accessible and effective chronic disease care.”