U-M School of Nursing Revolutionizes Nursing Education with the Clinical Initiative for Excellence

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Educational model will expand faculty, increase accountability, and greatly strengthen ties between the School and UMHS.

The University of Michigan School of Nursing is expanding in momentous and innovative fashion with the implementation of the Clinical Initiative for Excellence in Education, Practice, and Scholarship. This initiative will revolutionize the way that nursing clinical education is taught and create an exciting new partnership between the School of Nursing and the University of Michigan Health System.

“What we wanted to do was to create more of a connection between the Health System and the School of Nursing,” said Associate Dean of Undergraduate Programs Dr. Bonnie Hagerty. “If we work together jointly, it will benefit all of us and ultimately the patients.”

The development of the Initiative was driven by input from faculty, students, and nursing staff from the Health System. Using the Whole Scale Change model, these groups initially met for three days to plan how to proceed with a partnership that promoted excellence for nursing education, nursing practice, and scholarship.

“A designated group assembled all of these written notes that we took from that change event, conducted a qualitative analysis. Dr. Hagerty said. “Then an advisory group began to examine how we would then roll this into something for action.”

She added, “The cluster system is a structure that emerged from all of this groundwork, then we looked at how it could become something concrete.”

The cluster system divides the hospital into three large groups called clusters, each of which includes multiple units. Each of these clusters has a focus — for instance, cancer care or cardiology — but also includes a wide variety of experiences for students. School of Nursing faculty will be embedded in each cluster taking on new clinical roles unique to the Clinical Initiative.

Nurses from the Health System will serve as Clinical Mentors for nursing students.. These mentors will work closely with a student,, monitor a student’s performance, and provide feedback about the student’s functioning throughout his or her clinical experience.

“A student will be assigned within that cluster on a unit to a clinical mentor. Historically we’ve assigned students to patients, now we’re assigning nursing students to nurses,” Dr. Hagerty said.

She added, “The faculty embedded in each cluster, many of them now doctorally prepared, work with the mentors to help them in their role being a mentor and helping the areas within the cluster develop their scholarship.”

Through these innovations, the faculty of the School of Nursing expect that the clusters will become true learning communities for staff at the Health System as well as nursing students and faculty at the School of Nursing.

“We don’t want to be seen as guests, we want to be fully embedded in a partnership on the units,” Dr. Hagerty said.

This increased involvement will also lead to increased academic rigor for students. They will be held more accountable and have a greater responsibility to handle a nurse’s actual workload.

“They will have to learn how to prioritize, how to organize themselves, how to communicate better with mentors and other nurses in the unit,” Dr. Hagerty said. “They will get to participate in unit activities and be embedded in the life of the unit.”

She added, “The students are going to have to be more accountable for their learning. When they go on a unit, they’re going to have to have goals for the day. What do they need to work on? Is there the opportunity to perform a certain procedure that day?”

Overall, students seem excited for the new responsibility.

“Students want innovative experiences. Most of our students say this is great,” Dr. Hagerty said. “They want to graduate and be confident and good at what they do.”

To help them do just that, the School of Nursing will be expanding with new clinical appointments. Each cluster will have a cluster lead, two clinical educators, and a lecturer. While some of these positions will be filled by current faculty members, others will be brought in externally as part of an exciting new faculty initiative.

The implementation of the new model of clinical education coincides with the expansion of the Health System, as marked by the new, soon to open Mott Children’s Hospital and Von Voigtlander Women’s Hospital. The clusters will move through all the University Hospital System’s facilities, providing an unparalleled breadth of experience.

Finally, the Health System staff are excited for this new relationship to begin.

“The UMHS people are very excited about it as well because it’s going to contribute to their practice, and we’re all going to be elevated in our learning and how we educate and in our practice,” Dr. Hagerty said. “The partnership between the School of Nursing and the Health System has been outstanding. We’ve worked together every step of the way.”