Collaboration, Cooperation Improve Care Model

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“Feeling part of a team” a mixed method evaluation of a dedicated education unit pilot programme

Background: Clinical education is the most critical component of surgical technology and anesthesiology student’s education. Therefore, this study was designed to determine the amendable challenges and barriers of clinical education from the viewpoints of operating room and anesthesia students and clinical instructors. Methods: In this descriptive cross-sectional study, 132 students (surgical technology and anesthesiology) and 17 clinical instructors of Sari Allied School were selected by consensus method. Data collection was performed using the Demographic and researcher-made questionnaire about the amendable challenges and barriers of clinical education. Data were analyzed by SPSS software version 20. Results: From the viewpoints of students, the most challenge and barrier was “lack of suitable space for clinical education”. Also, the most amendable barriers were “lack of clinical educators”. From the clinical educators’ perspective, the most challenges and barriers to clinical education were respectively; a large number of students in the ward and low motivation of students for teaching. Conclusion: The challenges and obstacles that can be corrected in clinical education from the perspective of surgical technology and anesthesiology students were the lack of instructors in the clinic. And from the point of view of clinical educators, there were a large number of students in the clinic; however, there was less motivation for students to learn. It is necessary to improve the quality of clinical education in these two fields and improve education.

Dedicated education units (DEUs) have emerged as an important clinical education innovation within academic practice partnerships. However, rigorous evaluation has not been conducted previously. This article presents findings from a randomized, controlled, multiyear, multisite study comparing the clinical education quality for students educated in either the DEU innovation or traditional clinical education model within the same nursing course. The evaluation occurred within a larger study focusing on teaching capacity, faculty work life, and educational quality at one large, urban university collaborating with three agency partners. To examine learning outcomes, the question posed was, "In what ways, if any, does the DEU intervention, when compared to traditional clinical education, enhance educational quality?" Results indicate that educational quality and learning gains are significantly more positive for students clinically instructed in DEUs. Findings will be of interest to education and practice leaders seeking to enhance the quality of clinical teaching, learning, and nursing practice.

Controversy exists between academic leaders and nurse executives in the health care system regarding whether or not new graduates especially second-career nurses are fully prepared to provide safe and effective patient care. Nurse educators are exploring innovative methods explored to improve clinical learning outcome and to foster successful career development of these students. The purpose of the paper is to examine the experience and self-regulated learning capacities of second-career nursing students who have received clinical teaching in a Veterans Affair Hospital’s dedicated education unit in the United States. The study setting is a 20-bed cardiac telemetry unit where staff nurses are purposely assigned to clinical teaching. Kuiper’s self-regulated learning model (Kuiper, 2005), a middle-range theory derived from constructivist theory, is used as the theoretical framework of the study. 13 students were recruited from the hospital’s partnership with a second-career program. The participants were asked to answer 10 open-ended questions during two focus group sessions of 6 and 7 people respectively. The conversations were audio-taped and transcribed. The scripts were input into a qualitative research software NVivo10 for data analysis. The study provides a glimpse into the lived experience of the second-career students. It compares the findings with those of prior published studies. It concludes that the dedicated education unit has a positive impact on second-career students’ self-regulated learning experience.

Phenomenon Clinical teachers perform overlapping tasks in education and patient care. They are therefore expected to juggle many professional identities such as educator and clinician. Yet little is known about how clinical teachers negotiate their professional identities. The present research examined the lived experiences of clinical teachers as they manage and make sense of their professional identities in the context of a faculty development program. Approach This study adopted interpretative phenomenological analysis, which is an idiographic and inductive methodological approach that enables an in-depth examination of how people conceptualize their personal and social worlds. In-depth semi-structured individual interviews were conducted with six purposively sampled Brazilian clinical teachers who were attending a faculty development program. Each participant’s lived experience was analyzed independently. Then, these individual analyses were compared against each other to identify convergence and divergence. Findings Participants recognized one identity, which was labeled as embedding identity, containing other identities and roles. Participants integrated their professional identities in agreement with their personal identities, values, and beliefs, striving thus for identity consonance. Participants understood their craft as a relational process by which they wove themselves into their context and entangled their experience with that of others. They, however, diverged when recognizing who their peers were; whereas some named a single professional group (i.e., family physicians), others had a more comprehensive view and considered as peers healthcare professionals, students, and even patients. Finally, participants identified time constraints and lower prestige of family medicine as a medical discipline vis-à-vis other specialties as challenges posed by their contexts. Insights Clinical teachers have multifaceted identities, to which they give a sense, manage, and integrate into their daily practice. Participants recognized an embedding identity and looked for common points between the identities it contained, which allowed them to meaningfully reconcile the different demands from their overlapping professional identities. Thus, this research introduces the notion of embedding identity as a strategy to make sense of many professional identities. Variability in the embedding identities depicted in this investigation suggests the fluid and contextualized character of professional identity development. How participants saw themselves also influenced how they behaved and interacted with others accordingly. Understanding clinical teacher identity development enriches current perspectives of what it is like to be one of these medical professionals. Faculty development programs ought to consider these perspectives to better support clinical teachers in meeting the overlapping demands in education and patient care.

The dedicated education unit (DEU) model was developed to address inadequacies in clinical nursing education. In contrast to the traditional clinical model, the DEU conceptualizes the cognitive apprenticeship theory by integrating bedside nurses into clinical educator roles, allowing students to be immersed in clinical settings that better prepare them for entry to practice. The Student Evaluation of Clinical Education Environment instrument was used to assess baccalaureate nursing students' perceptions of their DEU clinical experience. Students viewed their faculty, preceptors, and DEU sites positively; one-third of participants applied for employment at their DEU site.

Conduct of cancer clinical trials requires coordination and cooperation among research and clinic teams. Diffusion of and confusion about responsibility may occur if team members' perceptions of roles and objectives do not align. These factors are critical to the success of cancer centers but are poorly studied. We developed a survey adapting components of the Adapted Team Climate Inventory, Measure of Team Identification, and Measure of In-Group Bias. Surveys were administered to research and clinic staff at a National Cancer Institute-designated comprehensive cancer center. Data were analyzed using descriptive statistics, t tests, and analyses of variance. Responses were received from 105 staff (clinic, n = 55; research, n = 50; 61% response rate). Compared with clinic staff, research staff identified more strongly with their own group ( P < .01) but less strongly with the overall cancer center ( P = .02). Both clinic staff and research staff viewed their own group's goals as clearer than those of the other group ( P < .01) and felt that members of their groups interacted and shared information within ( P < .01) and across ( P < .01) groups more than the other group did. Research staff perceived daily outcomes as more important than did clinic staff ( P = .05), specifically research-related outcomes ( P = .07). Although there are many similarities between clinic and research teams, we also identified key differences, including perceptions of goal clarity and sharing, understanding and alignment with cancer center goals, and importance of outcomes. Future studies should examine how variation in perceptions and group dynamics between clinic and research teams may impact function and processes of cancer care.

Clinician and student evaluation of a collaborative clinical teaching model

Social risk screening rates in many US primary care settings remain low. This realist-informed evaluation explored the mechanisms through which a tailored coaching and technical training intervention impacted social risk screening uptake in 26 community clinics across the United States. Evaluation data sources included the documented content of interactions between the clinics and implementation support team and electronic health record (EHR) data. Following the realist approach, analysis was composed of iterative cycles of developing, testing and refining program theories about how the intervention did-or didn't-work, for whom, under what circumstances. Normalization Process Theory was applied to the realist program theories to enhance the explanatory power and transferability of the results. Analysis identified three overarching realist program theories. First, clinic staff perceptions about the role of standardized social risk screening in person-centered care-considered "good" care and highly valued-strongly impacted receptivity to the intervention. Second, the physicality of the intervention materials facilitated collaboration and impacted clinic leaders' perception of the legitimacy of the social risk screening implementation work. Third, positive relationships between the implementation support team members, between the support team and clinic champions, and between clinic champions and staff motivated and inspired clinic staff to engage with the intervention and to tailor workflows to their settings' needs. Study clinics did not always exhibit the social risk screening patterns anticipated by the program theories due to discrepant definitions of success between clinic staff (improved ability to provide contextualized, person-centered care) and the trial (increased rates of EHR-documented social risk screening). Aligning the realist program theories with Normalization Process Theory constructs clarified that the intervention as implemented emphasized preparation over operationalization and appraisal, providing insight into why the intervention did not successfully embed sustained systematic social risk screening in participating clinics. The realist program theories highlighted the effectiveness and importance of intervention components and implementation strategies that support trusting relationships as mechanisms of change. This may be particularly important in social determinants of health work, which requires commitment and humility from health care providers and vulnerability on the part of patients.

Background and Objective: Majority of new graduate nurses are not adequately prepared to assume the dynamic and complex role of today’s professional nurse. The Dedicated Education Unit (DEU) is a clinical teaching model developed in response to the limitations of traditional clinical model (TCM). The aim of the study is to examine the readiness for practice and level of confidence in clinical decision making among graduating nursing students in the DEU and compare it with the students in the TCM.Methods: A pre-test/post-test design was used. The Casey-Fink Readiness for Practice was utilized in the pre and post-test surveys and the Nursing Anxiety and Self-Confidence in Clinical Decision-Making was used in the post test. Data were analyzed in aggregate and pre-test scores were compared to post-test scores at the cohort level using t-test.Results: The pre-test results showed no significant difference between the DEU and TCM groups. However, the post-test results showed higher levels of readiness for practice and higher self-confidence and lower anxiety in clinical decision making among the DEU students.Conclusions: The study provides evidence on the impact of the DEU in providing graduating nursing students with high quality clinical education to better prepare them for practice.

This chapter situates the origins of the Dedicated Education Unit historically and geographically. The author details the conceptualisation of the Dedicated Education Unit at Flinders University, Adelaide, Australia, in the mid-1990s as a strategy to develop collaborative partnerships between the university and clinical venues and as a clinical learning environment that can meet students’ and clinical and academic staff’s learning, teaching and professional development needs while utilising existing resources. The author explains the catalysts for the Dedicated Education Unit and her thought processes, which include a critique of models of clinical learning and identifying the factors that impact on the clinical learning environment. She traces the Dedicated Education Unit’s conceptualisation from lessons learned from the critique to the development of principles, new academic and clinical staff roles and responsibilities (and the attendant increased collaboration between the university and clinical venues) and considerations related to student learning outcomes, curriculum, timetabling, cost and resources.

BackgroundWhile educational techniques to improve clinical reasoning (CR) skills among medical students have been developed, the lack of faculty expertise in teaching CR remains a significant barrier.1 Teaching the teachers...

Impact of the dedicated education unit teaching model on the perceived competencies and professional attributes of nursing students.

Effective training of clinical educators and preceptors is needed to support new nurses and to advance national recommendations that nurses be prepared to address health equity. A lack of instructors and preceptors has been identified as a contributing factor to the nursing shortage. Nurse educators and preceptors may not have had preparation in teaching concepts of health equity. The Oregon Nursing Education Academy (ONEA) prepares clinical nurse faculty and preceptors through pathways of achieving a master's in nursing degree or selected graduate coursework in clinical teaching and health equity, respectively. In 2 years, ONEA educated 32 clinical faculty and 46 preceptor scholars. Participant feedback indicates the program is reinvigorating enthusiasm for their career in nursing and substantiates their learning of health equity concepts. ONEA supports nurse educators and preceptors to advance their skill in educational principles and teaching health equity, to improve and transform health care. [J Nurs Educ. 2025;64(3):163-169.].