Academic journal article Nursing Education Perspectives

CLINICAL IMMERSION: A Residency Model for Nursing Education

Academic journal article Nursing Education Perspectives

CLINICAL IMMERSION: A Residency Model for Nursing Education

Article excerpt


The education of future generations of nurses is in need of philosophic and programmatic transformation in keeping with the rapidly changing health care delivery system. The Nurse Residency Model is one baccalaureate nursing program's response to calls for reform. Rooted in a spirit of collegiality and lifelong learning, the three facets of its philosophy include enhanced socialization, improved transition to practice, and increased student accountability. Students gain increased competency and demonstrate increased accountability with each progressive semester in the program, which culminates in clinical immersion in the senior year. Unique programmatic features of this model include field experiences, the simulation lab, and a work requirement. Additional benefits include resource efficiency and patient safety. Implementation remains an ongoing process. Outcome indicators are expected to yield valuable data on which to develop an evidence base in support of the model.

KeyWords Baccalaureate Nursing Education - Curriculum Models - Clinical Education - Student Accountability -Transition to Practice

Nursing is at a crossroad. The current nursing shortage, characterized by numerous supply and demand variables, has provided an opportunity to radically redefine all areas of nursing, including the educational system that produces our newest professionals. * This article presents one baccalaureate nursing program's journey to redefine itself in the face of mounting odds. Just as practice often informs policy, and change in practice often precedes legislation, our department embraced a curriculum model that is, to the best of our knowledge, unique among nursing programs in the United States.

Calls to the Profession and Its Educators Recent calls by the National League for Nursing for innovation in nursing education have not been adequately answered. Most responses to the NLN position statement, "Innovation in Nursing Education: A Call to Reform," have taken the form of changes to curricular content rather than substantive redesign of underlying curricular delivery mechanisms and philosophy (1).

As a profession, nursing has been prescriptive in terms of curricular standards. Perhaps it is in our very nature as nurses to be thorough, organized, detail-oriented, and consistent. These values carry over into the prescriptive nature of our governing and credentialing bodies, as anyone who has gone through this process can attest. However, an untoward consequence of wide-ranging standardization of curricular content is stagnation. The energy of educators is spent complying with demands, guidelines, and rules, as opposed to being encouraged to dream, to hope, and to innovate.

Recently, the Robert Wood Johnson Foundation (RWJF) conducted a comprehensive analysis of the nursing shortage - why it has evolved, why it is persistent, and what strategies may help alleviate it. In addition to recommending systemic changes in both the supply and demand portions of the nursing shortage equation, RWJF recommended that the supply of nurses be increased "through expanded educational capacity and opportunity" (2, p. 26). Specifically, RWJF recommended increasing school and faculty capacity, forging community partnerships, and ensuring that educators and professionals are accountable for preparing students for today's health care environment and enhancing the quality of the work environment.

Encouraging nursing education organizations to "enhance collaboration between education and practice" (2, p. 33), the RWJF report calls for the development of a national forum to advance nursing in several key areas. In the area of nursing education, the report states that "to attract and retain a new generation of nurses, and to ensure that the new nursing workforce represents the ethnic and racial diversity of the United States, the Forum would focus efforts on reinventing nursing education and work environments to address the needs and values of these new workers. …

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