Clinical Innovation: A key component to integrating concepts in the curriculum By Katherine A. Fletcher, R.N., Ph.D.
Objectives Describe the key aspects built into the innovative clinical tool of The Playbook developed by the Kansas University School of Nursing faculty. Examine how The Playbook assists clinical faculty to integrate concepts during the clinical practicum throughout the curriculum. Explore at the student level how one lesson integrates a concept into clinical practicum.
Clinical Experiences First 8 weeks Second 8 weeks Fall Junior Spring Junior Fall Senior Spring Junior Skills & Techniques Bootcamp Foundation clinical practica with experience in adult acute care. Lifespan clinical practica in adult or pediatric acute care unit. Diverse clinical practica in mental health, critical care, intraprofessional clinic or OB. [have choice of two over semester] Diverse clinical practica in mental health, critical care, intraprofessional clinic or OB. Population clinical practica in community clinical sites. Capstone clinical practica
Affiliate Clinical Model Clinical coordinator coordinates all clinical affiliate faculty. A few KU SON faculty do clinical practicum with students but most clinical supervision is completed by Clinical Affiliate Faculty. The clinical practicum is not hooked with a particular course it is connected with all courses in that semester.
Clinical Affiliate Faculty The sports analogy seemed appropriate for our structure. Clinical coordinator is much like an athletic director arranging for sites & necessary resources for clinical. Faculty are like the coaches responsible for mentoring their team of nursing students. Nursing students are the players.
The Playbook The Playbook is a group of lessons (plays) designed to capture learning moments faculty felt were essential for generalist nurse education. The Playbook choreographs the lessons so concepts can be consistently implemented by all clinical faculty in a variety of clinical settings.
Types of plays Direct Patient Care (DPC) Students within the clinical group on a hospital unit or community setting assigned to learning activities completed while providing patient care responsibilities to achieve a clinical competency. Focused Learning Activity (FLA) Students within clinical group are assigned to learning activities on the unit/community or laboratory setting that are associated with achievement of a clinical competency. Most of the time these students are not assigned to direct patient care.
Competency Development Competency a complex combination of knowledge, skills, and attitudes displayed in the context of task performance. Competence - thoughtful capabilities which involve a developmental process. There are levels of competence: Novice, advanced beginner, competent, proficient and expert.
The Playbook Conceptual Structure
Playbook Lessons - Safety Nurs 333 Foundations Nurs 338 Lifespan Nurs 475 Diverse Nurs 480 Populations Nurs 477 Capstone Identify seven environmental factors in patients room that promote patient safety as well as factors that put patients at risk. (FLA: Safety simulation-sam Jayhawk & James Robinson) Implement a root cause analysis in a simulated setting analyzing a medication error or near miss. (FLA: Safety simulation-maria Ruiz) Recognize when changes in the patient assessment data indicate the need for more skilled interventions and specifically delineates how to mobilize appropriate resources.(fla: Safety in specialty clinical arenas Simulation) (FLA: Environmental assessment using windshield survey) Administer patient medications according to standards (FLA: medication Administration Observation) Demonstrate how to care for patients with chest tube(s). (FLA: Chest Tube lab) (FLA: Community Disaster Preparedness simulation)
Playbook Lessons - Safety Nurs 333 Foundations Nurs 338 Lifespan Nurs 475 Diverse Nurs 480 Populations Nurs 477 Capstone Demonstrate knowledge of patient care technologies (PCA, Insulin pumps to provide safe patient care. (FLA: Pump Lab) Demonstrate blood/blood products transfusion procedure. Compare and contrast four types of transfusions reactions. (FLA: Blood transfusion lab) Describe what contributes to a Culture of Safety in a reflective journal. Demonstrate knowledge of nurse s role in a disaster. (FLA: Nurse s role in a disaster.)
Schedule for integration
Focused Learning Assignment
FLAs Significantly Changed Clinical Experiences Introduced to concepts early in career through the use of the FLAs i.e. evidence-based practice, safety, QI. Participated in unit based projects (QI project). Experienced assignment of staff and delegation of tasks much earlier in their career (2 nd semester). Worked in interdisciplinary teams (through simulation and in clinical). Cared for multiple patients earlier in their career (2 nd semester). Knowledgeable about microsystem and macrosystem environment the nurse works in. (3 rd and 4 th semester).
In Summary The Playbook was vehicle to consistently apply concepts at the different levels of our curriculum. The Playbook lessons were defined by competencies that they could be applied in diverse clinical arenas. These competencies were based on the eight major conceptual categories.