Care coordination: Identifying and connecting the most appropriate care to the patients.

Although nurses are increasingly expected to fulfill the role of care coordinator, the knowledge and skills required to be an effective care coordinator are not well understood. The purpose of this study was to describe the knowledge and skills required in care coordination practice using an interpretive phenomenological approach. Fifteen care coordinators from 10 programs were interviewed over a 6-month period. Semi-structured face-to-face interviews were audio recorded, transcribed, and analyzed using interpretive phenomenology. The central theme of care coordination practice was bridging the patient and the healthcare systems. To bridge, care coordinators needed to have knowledge of the patient and healthcare system as well as the skills to identify and negotiate treatments appropriate for the patient. The most salient finding and new to this literature was that care coordinators who used their medical knowledge about available treatment options to discern and negotiate for the most appropriate care to the patient made differences in patient outcomes. Nurses with medical and healthcare system knowledge, combined with the skills to navigate and negotiate with others in an increasingly complex healthcare system, are well situated to be care coordinators and generate optimal outcomes. Further investigations of critical care coordinator competencies are needed to support nurses currently enacting the role of care coordinator and to prepare future nurses to fulfill the role.

Pursuing Improvement in Clinical Reasoning: Development of the Clinical Coaching Interactions Inventory.

BACKGROUND: Clinical coaching has been identified as a signature pedagogy in nursing education. Recent findings indicate that clinical coaching interactions in the clinical learning environment fail to engage students in the higher order thinking skills believed to promote clinical reasoning. METHOD: The Clinical Coaching Interactions Inventory (CCII) was based on evidence of supervisor questioning techniques, the Tanner clinical judgment model, Bloom's Taxonomy, and simulation evaluation tools. Content validity was established with expert assessment, student testing for clarity, and calculation of scale-content validity index/average (S-CVI/Ave). Reliability was established with Kuder-Richardson Formula 20 (KR-20). RESULTS: CVI (S-CVI/Ave) was .91, and KR-20 was .70. The CCII identified differences in clinical coaching behaviors in university faculty supervisors and staff nurse preceptor supervisors. CONCLUSION: The CCII advances the measurement of clinical coaching interactions from qualitative to quantitative. Ultimately, results from use of this inventory may facilitate the design of prelicensure clinical coaching strategies that promote the improvement of students' clinical reasoning skill. [J Nurs Educ. 2016;55(9):495-504.].

Association of faculty perceptions of work-life with emotional exhaustion and intent to leave academic nursing: report on a national survey of nurse faculty.

The current and projected nurse faculty shortage threatens the capacity to educate sufficient numbers of nurses for meeting demand. As part of an initiative to foster strategies for expanding educational capacity, a survey of a nationally representative sample of 3,120 full-time nurse faculty members in 269 schools and programs that offered at least one prelicensure degree program was conducted. Nearly 4 of 10 participants reported high levels of emotional exhaustion, and one third expressed an intent to leave academic nursing within 5 years. Major contributors to burnout were dissatisfaction with workload and perceived inflexibility to balance work and family life. Intent to leave was explained not only by age but by several potentially modifiable aspects of work, including dissatisfaction with workload, salary, and availability of teaching support. Preparing sufficient numbers of nurses to meet future health needs will require addressing those aspects of work-life that undermine faculty teaching capacity.

A measure to evaluate classroom teaching practices in nursing.

AIM: The Oregon Consortium for Nursing Education (OCNE) Classroom Teaching Fidelity Scale was created to measure the implementation of the OCNE curriculum and its related pedagogy. BACKGROUND: OCNE is a partnership of eight community colleges and the five-campus state-supported university. OCNE developed a shared competency-based curriculum and pedagogical practices. An essential part of the OCNE evaluation was to measure the extent the curriculum and pedagogical model were implemented on each partner campus. METHOD: The scale was developed using a multistep methodology, including review of the literature and OCNE guidelines and materials, frequent consultation with local and national advisory boards, and multiple observations of OCNE classrooms over a two-year period. RESULTS: Fidelity scores are reported for 10 OCNE colleges observed in 2009. CONCLUSlON: The creation and use of this fidelity scale and similar measures may contribute to the emerging science of nursing education by more clearly documenting educational reform efforts..

Factors affecting the academic progression of associate degree graduates.

The Oregon Consortium for Nursing Education (OCNE) is a coalition of community colleges and the campuses of the Oregon Health & Sciences University (OHSU), created to share a competency-based curriculum by which associate degree graduates from an OCNE campus are eligible to complete requirements for the bachelor's degree after 1 year of additional full-time study. Since 2006, three graduating classes from consortium community college programs have graduated 760 students eligible for direct transfer to OHSU; however, only 228 (30%) have actually transferred. This study aimed to explore the factors that influenced the 208 graduates in the class of 2010 not to transfer. The primary reasons for discontinuing their nursing education, in ranked order, were financial concerns, conflict with time and energy for work, and conflict with time and energy for family. This study has implications for achieving the academic progression goals recommended in the Institute of Medicine's The Future of Nursing report.

Transforming prelicensure nursing education: preparing the new nurse to meet emerging health care needs.

The Carnegie Foundation for the Advancement of Teaching joins a chorus of calls for transformation of prelicensure nursing education (Benner, Sutphen, Leonard, & Day, 2009). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as the increasing complexity of community-based practices, Benner and colleagues concluded that nurses entering the field are not equipped with the essential knowledge and skills for today's practice nor prepared to continue learning for tomorrow's nursing (p. 31). They found: a) weak curricula in natural sciences, technology, social sciences, and humanities, and in developing cultural competency; b) weak classroom instruction and limited integration between classroom and clinical experiences; c) limited strategies in helping students develop habits of inquiry, raising clinical questions, seeking evidence for practices; d) faculty and student perception that students are ill prepared for their first job and dissatisfaction with the teaching preparation of current nursing faculty; and e) multiple pathways to eligibility for the licensure examination, with tremendous variability in prerequisites, curricular requirements, and the quality of offerings.

The Oregon Consortium for Nursing Education: a response to the nursing shortage.

The Oregon Consortium for Nursing Education (OCNE) is a statewide coalition designed as a long-term solution to the nursing shortage and in response to the need for a new kind of nurse to care for Oregon's aging and increasingly diverse population. It is an effort to increase capacity in schools of nursing by making the best use of scarce faculty, classrooms, and clinical training resources in the delivery of a standard curriculum on 13 campuses, including 8 community colleges and the 5 campuses of the OHSU School of Nursing. This article describes the development of OCNE, including infrastructure development, creation of the shared curriculum, redesign of clinical education, faculty development, and plans for evaluation. If OCNE is successful in achieving its goals, it holds substantial policy implications for the development of nursing education systems, design of curricula, use of simulation as a component of clinical education, and delivery of clinical education.