INNOVATIVE COMMUNITY PLACEMENTS: ENHANCING STUDENTS EXPERIENCES WITH DIVERSE POPULATIONS

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STTI 25 TH INTERNATIONAL RESEARCH CONGRESS INNOVATIVE COMMUNITY PLACEMENTS: ENHANCING STUDENTS EXPERIENCES WITH DIVERSE POPULATIONS R U T H T R U D G E O N, M S N, R N, P H N S T E P H A N I E C O R N E T T, R N I V Y T U A S O N, M S N, R N, F N P - BC

ACKNOWLEDGEMENTS Dr. Mary Lopez, Associate Dean of the College of Graduate Nursing, Western University of Health Sciences Pamela Lynn, founder of Angels Who Care Dr. Jan Boller, Fletcher Jones Foundation Endowed Chair for Nursing Quality and Safety

OBJECTIVES Differentiate traditional community health sites and ICP Describe roles of student nurses in ICP To evaluate students' perceptions of cultural competencies gained through ICP experience

College of Graduate Nursing Doctor of Nursing Practice (DNP) Master of Science in Nursing/Family Nurse Practitioner (MSN/FNP) Master of Science in Nursing (MSN) Master of Science Nursing Entry (MSN-E) Post-Master s Family Nurse Practitioner (FNP) Certificate

PURPOSE To explore the role of ICP in providing nursing students with comprehensive experiences with diverse populations

BENEFITS OF ICP Practice broader health promotion strategies including strengthening community action and development of health public policies Address community concepts such as social determinants of health, social justice and equity, community development, culture and diversity Enhance students engagement, initiative, critical thinking Application of interprofessional collaboration From an individual-level-as-client to community-level-asclient

CHALLENGES OF ICP Increased time to establish and coordinate Lack of nursing role models Few research studies evaluating student outcomes Lack of support from the facility

ICP SITES Impoverished Inner City Senior Centers Homeless Shelters Corrections Native American Aboriginal Communities

COMMUNITY HEALTH NURSING CGN 6902: Community Health Clinical Practicum Apply theory, trends, and related sciences Communication and collaboration skills Patient Centered Care Client is the source of control and full partner Culturally-competent care Client advocate Coordinated care Social justice Case management and care coordination Self-direction, accountability, & leadership Cultural Competency

ICP: LAUREL APARTMENTS Community partnership with community leaders Angels Who Care Not-for profit Outreach for the homeless and needy families Food banks Homeless shelter Community resources and referrals including Volunteers of America, Tri-City Mental Health Services, church networks, and local universities Tutoring

LAUREL APARTMENTS Low income, multi-apartment housing complex Predominantly Hispanic Approximately 35 families

METHODS

LAUREL APARTMENTS LEARNING ACTIVITIES Community health assessment Vision and dental Nutrition and exercise Chronic disease management: diabetes care Women s health and well baby Wellness promotion and disease prevention Nutrition Exercise Community garden Mentoring and tutoring Disaster preparedness Interprofessional collaboration Dental Optometry Community leaders Public health safety

TRADITIONAL SITES LEARNING ACTIVITIES Windshield survey Supervised by RN Screenings Chronic disease management Education Home visits Individual patient assessment within a community setting with diverse patient populations

RESULTS: COURSE EVALUATIONS 5 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Q1: Supportive environment Q2: Strengthened clinical reasoning ability Q3: Overall, provided valuable learning environment

ADDITIONAL SURVEY A 10-item Likert scale survey, guided by the Quality and Safety Education for Nurses (QSEN) competencies, was designed to explore learning experiences in various community sites First three questions pertained to opportunities in dealing with diverse populations and collaboration with other disciplines The rest of the questions asked students perceptions regarding patient- centered care and respect for culture and differences, collaboration skills, and safety

SURVEY QUESTIONS 1. I was given the opportunity to interact with the community members in my community health clinical. 2. I received a comprehensive experience interacting with diverse populations in my community health clinical. 3. I had the opportunity to collaborate with interdisciplinary teams in my community health clinical. 4. I feel that I was able to collaborate with other health care professionals (nurses, physicians, dentists, optometrists). 5. I feel that my community health clinical allowed me to respect patient's cultural values. 6. I feel that my community health clinical allowed me to better understand and value different cultures. 7. I feel that my community health clinical experience increased my ability to understand patient centered care. 8. I feel I had the opportunity to teach safety to the population I worked with. 9. I feel that my community health clinical experience increased my ability to better understand the diversity of the community in which I worked. 10. Please state your clinical site.

SURVEY RESULTS 4 3.5 3 2.5 2 1.5 1 Laurel Apts Tradition Sites 0.5 0

SURVEY RESULTS Total of 48 students responded, 42 from traditional sites and 6 from the ICP site. Overall, the ICP group scored higher than the traditional clinical groups. ICP group scored slightly lower on the last three questions pertaining to perceptions of patient centered care.

LIMITATIONS Small sample size of ICP group Reliability and validity of the survey tool First implementation of ICP

IMPLICATIONS ICP provide similar experiences as traditional sites to fulfill Community Health Nursing requirements. ICP may provide varied learning experiences with diverse population.

CONCLUSION This is the first implementation of ICP experience, on-going evaluations and additional sites are needed to provide more students with these types of diverse learning experiences Future research will focus on qualitative data to explore students lived experience with ICP Community outcomes should be measured to evaluate the effectiveness of students interventions such as increased attendance in tutoring and wellness classes

REFERENCES Dietrich, L., Meagher-Stewart, D. Cohen, B.E., Seaman, P. M., Buhler, S., Granger, M., Pattullo, H. (2011). Developing guidelines for quality community health nursing clinical placements for baccalaureate nursing students. International Journal of Nursing Education and Scholarship, 25, 23. Didion, J., Kozy, M.A., Oneail, K (2013). Academic/clinical partnership and collaboration in Quality and Safety Education for Nurses education. Journal of Professional Nursing, 29(2), 88-94. Harwood, H., Reimer-Kirkham, S., Sawatzky, R, Terbalnche, L., & Van Hofwegen, L. (2009). Innovation in community clinical placements: A Canadian survey. International Journal of Nursing Scholarship, 6, 28. Levett-Jones, T., Fahy, K., Parsons, K., Mitchell, A. (2006). Enhancing nursing students clinical placement experiences: a quality improvement project. Contemporary Nurse, 23(1), 58-71. Levi, J., Segal, M., St. Laurent, R., (2014). Investing in America s Health: A state by state look at public health funding and key health facts. Retrieved from: http://www.rwjf.org/en/researchpublications/find-rwjf-research/2014/05/investing-in-america-s-health.html. QSEN. (2014). QSEN Competencies. Retrieved from: http://qsen.org/competencies/. Wright, A. (2014). CA budget review: Will we seize further ACA opportunities? Retrieved from: healthaccess.org.