Academic journal article Nursing Education Perspectives

Increasing Faculty Capacity: Findings from an Evaluation of Simulation Clinical Teaching

Academic journal article Nursing Education Perspectives

Increasing Faculty Capacity: Findings from an Evaluation of Simulation Clinical Teaching

Article excerpt

In 2005, the New York University College of Nursing (NYUCN), which hoped to enroll more qualified students, faced the challenge of finding sufficient clinical sites and recruit- ing additional qualified faculty. Faculty recruitment and finding clinical sites can be expensive and time-consuming and com- promise the quality of education. NYUCN therefore sought an alternative clinical teach- ing model that would more efficiently utilize existing faculty and clinical site resources. The alternative that was chosen was a clinical teaching model using simulation as a substi- tute for half of the traditional hospital-based clinical hours in the four core undergraduate medical-surgical courses.

In 2010, the Robert Wood Johnson Foundation (RWJF), through its national program Evaluating Innovations in Nursing Education, funded an evaluation of NYUCN's clinical teaching model using the Johns Hopkins School of Nursing (JHUSN) as a comparison school. (At JHUSN, simula- tion was used as a complement to traditional clinical education.) This article describes the evaluation methods and results, focusing on changes in faculty capacity (defined as the ratio of students to faculty clinical days) gained by using simulation as a substitute for clinical teaching hours.

bACkGROUND

For more than a decade, attention has been focused on a pending nursing shortage in the United States. The Bureau of Labor Statistics (2014) projects that there will be a need for 500,000 nurses between 2012-2022 to replace retiring nurses and respond to the need for increased health care access for an aging pop- ulation and implementation of the Affordable Care Act. Buerhaus and colleagues predict that by 2025, the nursing shortage will be the largest the United States has experienced since the mid-1960s (Buerhaus, Auerbach, & Staiger, 2009).

A nurse faculty shortage has been iden- tified as a fundamental barrier to producing enough new entrants into the nursing work- force to serve national needs. Without a suf- ficient supply of qualified faculty, nursing programs are unable to admit enough qual- ified applicants to increase the supply of new graduates. Potential students are turned away due to limited numbers of faculty, clinical sites, classroom spaces, and clinical precep- tors, as well as budget constraints (American Association of Colleges of Nursing, 2014).

Nursing programs have invested time and money in initiatives attempting to address the nurse faculty shortage. Many programs have focused on short-term solutions, such as grant funding that pays for increased faculty staffing for a limited period of time (Allan & Aldebron, 2008). However, most initiatives have not addressed the underlying educa- tion model and the associated faculty staff- ing patterns that could sustain higher stu- dent enrollment levels over a period of years (Allan & Aldebron).

One option for changing the traditional model is to integrate new technologies, such as simulation and distance learning, which hold the promise of using faculty time more efficiently without compromising student outcomes. For this reason, the National League for Nursing (2014) has identified "developing effective emerging technologies to transform pedagogical approaches" as one of its goals to address the nurse faculty shortage.

Simulation that replicates key aspects of a clinical situation to facilitate student learn- ing is widely used in nursing and other health professional education programs to promote critical thinking and self-efficacy. It is also used to assess clinical competencies, includ- ing skills validation for licensing and creden- tialing purposes, and to expose students to a range of complex situations in a controlled environment to teach the principles of clin- ical quality and safety (Holmboe, Rizzolo, Sachdeva, Rosenberg, & Ziv, 2011; Jeffries, 2012; Shearer, 2013). Because of the realism of high-fidelity patient simulators, simulation can be viewed as an equally valuable clini- cal learning experience to those gained in traditional, hospital-based clinical teaching environments (Cook et al. …

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