Equity and inclusivity in the faculty ranks: Our experience with a clinical track.

BACKGROUND: The evolution of nursing education requires a combination of strong academic faculty and expert clinicians. Different professional growth and development pathways are necessary to build a robust faculty with clinical and research expertise. Some schools have implemented a formal clinical track (CT) to complement the traditional tenure track for the professional advancement of CT. METHODS: The article presents a case example of how one institution maintains and advances a strong CT using the Kotter Change Model and discusses future directions. RESULTS: The school's infrastructure for promotion, which follows a similar structure and guidelines as Tenure Track (TT) Promotion and Tenure Guidelines, has led to an increase in the school's scholarly productivity among CT faculty across ranks. Increasing poster and podium presentations as well as publications to a national and international audience results in greater reach and improved reputation for the school, both nationally and internationally. CONCLUSIONS: While there is still work to be done to advance equity and inclusion for nursing CTs, developing and maintaining a CT with system-level structures holds significant value and provides a clear path to promotion, invests in clinical scholarship, and includes clinical faculty as full citizens in academia.

Re-envisioning Youth Sexual Health Care: Supporting Sex Positivity in a Digital World.

INTRODUCTION: Youth in a digital world face challenges to the healthy development of their sexuality from exposure to sexting, pornography, and other sexually explicit media. School-based sexual health education does not cover digital sexual content and its impact on sexuality and sexual relationships. Youth often avoid discussing sexual health with parents or other trusted adults, thus often relying on peers, making them ill-prepared to navigate the complexities (e.g., socially, emotionally, and romantically) of sexually explicit content. METHOD: A review of emerging evidence for application into clinical practice. RESULTS: This paper provides nurse practitioners with resources and information to incorporate this re-envisioned approach to sexual health care into practice to provide current, timely, and holistic youth sexual health care. DISCUSSION: Youth sexual health care must be re-envisioned. Nurse practitioners can improve youth sexual health by incorporating pornography and sexual media literacy, safe sexting, and concepts of consent into care using a sex-positive lens.

Evaluating an intervention of telehealth education and simulation for advanced practice registered nurse students: A single group comparison study.

As healthcare delivery continues to evolve and expand, nurse educators must prepare advanced practice registered nursing (APRN) students to use telehealth technology safely, effectively, and confidently. The aims of this study were to describe APRN students' beliefs and confidence regarding the delivery of care via telehealth in their future practice. To evaluate these aims, a single group comparison study was conducted. APRN students received an intervention comprised of multimodal telehealth instruction, which involved the simulated application of telehealth with standardized patients. Students' beliefs regarding telehealth did not significantly change between the pre- and post-intervention, in which all areas were rated high pre-intervention. Students reported an increase in their perception and confidence post-intervention. Integration of telehealth into the APRN curriculum is essential to instil knowledge and confidence as healthcare technology advances.

Examining the Influence of Academic Degree Level on Health Care Providers' Perceptions of Interprofessional Collaboration: A pilot study.

Purpose: Health care provider perceptions of interprofessional collaboration (IPC) have been well documented, however barriers to provider participation persist. The purpose of this pilot study was to examine differences in health care providers' perceptions of IPC based on the academic degree level.Methods: Licensed health care providers with faculty appointments at a four-year university-based setting were invited to participate in an electronic survey. Attitudinal questions in the survey instrument were based on the Theory of Planned Behavior and the Social Cognitive Theory and assessed perceptions, attitudes, norms, and self-efficacy toward IPC. Descriptive statistics were used to analyze the data.Results: Respondents (n=179) included faculty in medicine (29%), dentistry (23%), nursing (13%), dental hygiene (11%), physical therapy (8%), and pharmacy (7%). Ninety percent of respondents agreed or strongly agreed that IPC is important for improving patient health outcomes. Respondents across all degree levels were significantly more comfortable taking recommendations on patient treatment from another health care provider with a doctoral degree as compared to a health care provider with an associate degree, with mean scores declining from 5.58 to 4.58 (p=0.000).Conclusion: While all respondents valued IPC in improving patient outcomes, their perceptions of other health care providers' level of academic degree may play a role in their willingness to truly collaborate with them. Despite an institution's positive culture of IPC, bias and stereotypes regarding the level of academic degree need to be addressed. Results indicate that while health care providers with lower academic degrees may be valuable contributors to the IPC team, their academic degree could be a barrier to their meaningful inclusion.

Faculty, Preceptor, and Students' Perceptions of the Need for Trauma-Informed Education: Recommendations for Implementation.

BACKGROUND: The widespread physical, mental, and emotional health impacts of trauma are well established. Trauma-informed care (TIC) is an approach that uses knowledge about trauma and its effects to create safe care environments. PURPOSE: Using a concurrent mixed-methods design, this study assessed faculty, preceptor, and students' perceptions about the need for TIC content in nursing education. METHODS: Semistructured interviews were conducted with 15 faculty, and cross-sectional survey data were collected from a nonprobability sample of 99 nursing students at a large Midwestern university to evaluate the need for education on TIC. RESULTS: Faculty and preceptors stressed the importance of education on TIC and discussed barriers and facilitators to implementation. Nursing students reported that it is important to learn about TIC, yet do not feel prepared to provide TIC. CONCLUSIONS: The results illustrate the need for nursing content on TIC and provide recommendations for trauma-informed educational practices.

Implementing Patient-Centered Trauma-Informed Care for the Perinatal Nurse.

Adverse childhood experiences and trauma significantly impact physical and mental health. Increased maternal perinatal depression/anxiety, preterm labor, and low birth weight, as well as infant morbidity and mortality, are some examples of the impact of trauma on perinatal health. Trauma-informed care begins with knowledge about trauma, the ability to recognize signs of a trauma response, responding to patients effectively, and resisting retraumatization. As holistic providers, perinatal nurses can create safe care environments, establish collaborative patient relationships based on trust, demonstrate compassion, offer patients options when possible to support patient autonomy, and provide resources for trauma survivors. This can prevent or reduce the negative impact of trauma and improve the health and well-being of infants, mothers, and future generations. This clinical article outlines key strategies for implementation of patient-centered trauma-informed perinatal nursing care.

Trauma-informed education: Creating and pilot testing a nursing curriculum on trauma-informed care.

BACKGROUND: Trauma is a significant contributor to morbidity and mortality. Trauma-informed care (TIC) provides a safe and supportive healthcare environment for patients who have experienced trauma. Educating healthcare providers improves knowledge, attitudes, and skills related to TIC. However, nursing programs do not systematically integrate TIC education. PURPOSE: To create, implement, and evaluate nursing content on TIC at the graduate and undergraduate levels at one university. METHOD: A pretest-posttest survey was utilized to assess changes in TIC knowledge, attitudes, and skills related to the delivery of content on trauma and TIC to students in three courses at one large Midwestern university in January 2019. Safety, acceptability, and transferability were also measured. FINDINGS: The content improved nursing students' knowledge and skills related to providing TIC. Further, content on TIC is acceptable to both undergraduate and graduate students and is transferrable to non-nursing students. DISCUSSION: The current study provides a trauma-informed nursing education model that is safe, appropriate, acceptable, and efficacious.

Improving lesbian, gay, bisexual, transgender, and queer/questioning health: Using a standardized patient experience to educate advanced practice nursing students.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) persons account for 3.5% of the population. Nursing programs in the United States provide a median of 2.13 hours of formal content regarding LGBTQ health, which contributes to iatrogenic barriers to care. Patient experiences related to inadequate provider preparation include misguided treatment strategies, impedance of communication, and abuse. A pilot educational project was developed to provide advanced practice nursing (APRN) students meaningful clinical interactions with LGBTQ-identifying standardized patients (SPs) to better prepare them to care for LGBTQ patients with cultural humility. This project was determined to be Exempt by the Institutional Review Board at the University of Michigan. Implemented in an advanced health assessment course with 99 APRN students, components of the project included course readings, lecture content, laboratory activities, an SP experience, and both large and small debriefing sessions. The SP experience itself was a 15-minute clinical encounter with a patient presenting with "abdominal pain," with an emphasis on history-taking, communication, and cultural humility. Qualitative data analysis was performed using the constant comparison method to interpret the results from student evaluations and other written feedback. This pilot project has promise to inform future educational offerings and set the standard for LGBTQ health content and application for APRN students. Further research is needed to evaluate the quality of LGBTQ content in APRN curricula to improve the ability of APRN students to provide care to LGBTQ patients.

Current State of Trauma-Informed Education in the Health Sciences: Lessons for Nursing.

BACKGROUND: Trauma has significant effects on individuals' health. Nurses are well-positioned to deliver trauma-informed care; however, there is a lack of trauma nursing education. The development of trauma education in nursing is just beginning; therefore, it is unclear what details should be integrated into nursing courses. METHOD: CINAHL, PsycINFO, MEDLINE, PubMed, and Google Scholar databases were searched to identify theoretical and empirical literature regarding trauma-information educational practices in health sciences. RESULTS: Given that different disciplines have their specific training goals and requirements, trauma-related course goals, content, format, and structure are distinct and unique across disciplines. Educators in health sciences developed guidelines for trauma curricula and strategies for maintaining classroom safety. CONCLUSION: Trauma curricula in other health science disciplines provide a framework for creating trauma curricula in nursing programs. More groundwork is needed to integrate trauma into nursing education. [J Nurs Educ. 2019;58(2):93-101.].

Lesbian, Gay, Bisexual, and Transgender health: Creating safe spaces and caring for patients with cultural humility.

BACKGROUND AND PURPOSE: This article provides foundational information about 1) the significant health disparities LGBT individuals face, which are associated with persistent discrimination, oppression, and stigmatization in both societal and healthcare settings; and 2) how cultural humility can help nurses to create safe spaces and provide optimal care for all patients. METHODS: CINAHL, Medline, PsychInfo, and GoogleScholar databases were searched to identify theoretical and empirical literature regarding LGBT health, health disparities, barriers to accessing care, unconscious bias, cultural humility, and creating safe spaces to better meet the healthcare needs of the LGBT population. CONCLUSIONS: LGBT patients' health needs are not being adequately met in many healthcare settings due to inadequate education and preparation of healthcare providers, including nurses. Lack of access to safe, appropriate, and affirming healthcare services increases the risk of poor health and persistent health disparities. IMPLICATIONS FOR PRACTICE: As the largest professional healthcare workforce, nurses can have a significant role in reducing the health disparities LGBT patients face. When armed with the tools to care for LGBT patients with cultural humility, nurses can lead clinical change within their institutions to create safe, accepting, affirming, inclusive, and welcoming environments for all patients.

Preparing Advanced Practice Registered Nursing Students to Deliver Adolescent SBIRT for Substance Use.

BACKGROUND: Adolescent substance use is a significant public health problem in the United States screening, brief intervention, and referral to treatment (SBIRT) and is an evidence-based approach to assist individuals to reduce substance use before serious problems develop. Universal SBIRT is recommended for routine health care. METHOD: Advanced practice registered nursing (APRN) students completed a sophisticated adolescent SBIRT computer simulation, didactic content on substance use, and face-to-face simulation during laboratory. SBIRT skills were scored automatically by the computer program. Self-perceived competency and confidence were measured via pre- and postsurvey items, focused on adolescent SBIRT skills, using ordinal scales. RESULTS: Adolescent SBIRT was successfully integrated into an advanced health assessment nursing course. Improvements in self-reported competence and confidence scores were noted across all domains at p < .001. CONCLUSION: APRN students demonstrated learning and reported marked increases in competency and confidence in the delivery of adolescent SBIRT. This reveals promising results for SBIRT to be implemented into APRN student coursework. [J Nurs Educ. 2018;57(12):736-741.].

Adolescent vulnerability, sexual health, and the NP's role in health advocacy.

PURPOSE: To describe adolescents as a vulnerable population with unique healthcare needs, especially in relation to their sexual risk-taking behaviors; and to explicate the necessity of nurse practitioners (NPs) advocating for youth-friendly services and policies to meet adolescents' sexual and reproductive healthcare needs. DATA SOURCES: CINAHL, Medline, PsychInfo, and PsychArticle databases were searched to identify theoretical and empirical literature regarding adolescence, vulnerability, sexual health outcomes, barriers to accessing reproductive health services, what it means to be youth friendly, and health advocacy to meet the health needs of adolescents. CONCLUSIONS: Adolescents' health needs may not be fully met in traditional healthcare settings. Lack of access to youth-friendly sexual and reproductive health services increases adolescents' risks for poor health outcomes including sexually transmitted disease and unplanned pregnancy. Clinic, state, and national policies can create barriers for adolescents in obtaining sexual health services. IMPLICATIONS FOR PRACTICE: NPs are philosophically and educationally prepared to be leaders in improving adolescent health outcomes. NPs can directly provide youth-friendly care as well as advocate for youth-friendly practices within their health system. In addition, NPs are well positioned to be leaders in advocating for state and national policies that improve adolescents' access to appropriate sexual and reproductive health care.