Reaching outside the Box

Article excerpt

An Academic-Community Model to Prepare Nurses for the Future

"One does not discover new lands without consenting lose sight of the shore for a very long time." ANDRE GIDE

FACULTY AND PRACTITIONERS, responding to changes in the health care system, must be willing to explore new opportunities and experiment with different teaching and practice modalities. In other words, they must be willing "to reach outside the box." * As cornerstones of the future health care system, interdisciplinary primary care education and community-campus partnerships provide avenues for the successful integration of teaching, practice, and research, essential components of contemporary health professions education (1-5). Creativity in health care delivery is also needed. The time is ripe for population-focused service delivery entailing grassroots community empowerment and what can be described as "curbside" delivery of health services (5). * Student Nurses in Action (SNIA) is a transdisciplinary, academic-service-research partnership model that responds to community needs by bringing care to residents of urban, suburban, and rural communities. SNIA links clinical settings with diverse research projects and funding sources. Ideas for partnerships and campus-community programs are replicated across economically and culturally diverse populations. * Evaluation of SNIA is based on data from fiscal estimates, questionnaires, and interviews from a purposive sample of students, clients, and preceptors. Evaluations conducted to date support the continuation and expansion of the program.

Background and Goals Responding to an increased demand for grassroots community health and social services, the author worked with civic leaders to develop Student Nurses in Action in 1994. This effort was a natural response by an academic institution to calls in the early 1990s for community-based education (4,6). Partnership goals, roles, and resources were clearly delineated in the early days of the program and revisited throughout the process.

Core public health measures serve as the framework for education outcomes and skills of SNIA nurses. These measures are community assessment, partnership development, grant writing, epidemiology and research, negotiation skills, health promotion and education, quality assurance, data collection and surveillance, and public policy development.

SNIA has six primary goals:

* To improve the public's access to health services, information, screenings, and education.

* To provide undergraduate and graduate nursing students with population-based clinical management and health policy experiences.

* To facilitate program and agency service missions, research activities, needs assessments, marketing projects, and staff development.

* To empower at-risk communities to attain United States Healthy People 2010 objectives.

* To promote faculty, student, and preceptor research-practice ventures.

* To facilitate community networking and partnerships between a college of nursing and health science and nonprofit agencies of a county government-based community action program.

A pilot project for one academic year involved one community nursing faculty member and 30 RN-to-baccalaureate degree students. The partners during the pilot were delegate agencies of a county community action department. Based on the success of the pilot, SNIA has been established for second degree and traditional senior nursing students and has been replicated at a suburban university nursing program. Graduate health and nursing students at both the master's and doctoral levels are also involved, as participants in appropriate research, policy, and clinical projects.

For the original partners, designated staff members have served as SNIA liaisons, collaborating with community health nursing faculty to maintain and evaluate the model. The more recent suburban partnership functions differently. …