Maine Partners in Nursing Education and Practice May 23, 2012
Oregon Consortium for Nursing Education OCNE Do not replicate
without permission Paula Gubrud EdD RN FAAN Co-director of the
Oregon Consortium of Nursing Education Senior Associate Dean for
Education Oregon Health & Sciences University School of
Nursing
Slide 2
Introductions Oregon Consortium for Nursing Education OCNE Do
not replicate without permission
Slide 3
Workshop Outcomes Describe the essential components of
competency-based nursing education curriculum needed in response to
emerging health care needs and the changes in health care delivery.
Affirm commitment to use the Maine New Nurse Competencies as a
beginning framework for transforming curriculum in Maines nursing
education programs. Identify new assumptions needed to design
competency-based curriculum. Oregon Consortium for Nursing
Education OCNE Do not replicate without permission
Slide 4
Workshop Outcomes Identify agreements needed to facilitate
transfer of courses from ADN to BSN Agree to a timeline and
processes for developing agreements needed to facilitate the full
integration of competencies in Maines nursing education programs.
Oregon Consortium for Nursing Education OCNE Do not replicate
without permission
Slide 5
National Trends Driving Forces: Workforce Shortages Nursing
shortage with projected vacancy rate of 50% by 2020 Nursing faculty
shortage -Challenges with clinical sites -Education/Practice Gap
Magnet Status Need for BSN prepared nurses and beyond in rural
areas and in selected areas of practice (e.g. long term care)
Oregon Consortium for Nursing Education OCNE Do not replicate
without permission
Slide 6
Carnegie Study Findings Shift from decontextualized knowledge
to teaching for salience Situated cognition and action in
particular situations Integration of clinical and theory Strategies
for teaching salience Spiral learning Guide thinking through
questioning Rehearse verbally Ensure reflection Develop a clinical
imagination learning to stay open to unfolding cases Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission
Slide 7
Future of Nursing 4 Key Messages 1) Nurses should practice to
the full extent of their education and training. 2) Nurses should
achieve higher levels of education and training through an improved
education system that promotes seamless academic progression.
Oregon Consortium for Nursing Education OCNE Do not replicate
without permission
Slide 8
Future of Nursing 4 Key Messages 3) Nurses should be full
partners, with physicians and other health care professionals, in
redesigning health care in the United States. 4) Effective
workforce planning and policy making require better data collection
and an improved information infrastructure. Oregon Consortium for
Nursing Education OCNE Do not replicate without permission
Slide 9
Driving Forces: Emerging Health Care Needs Changing Health Care
Needs of Americans Aging population Increasing diversity Increasing
prevalence of chronic conditions 1 in 4 families involved in care
giving Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
Slide 10
Changing nursing practice >50% practicing in
community-based, non- acute care settings Advances in technology
and information Increased acuity & complexity in all settings
Need for the nurse as knowledge worker in rapid change environments
Uncertainty of the Affordable Care Act implications of supreme
court decision Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
Slide 11
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What does the nurse need to know & be able to do?
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Supported by grants from: Northwest Health Foundation DHHS,
Health Resource & Services Administration, Division of Nursing
William Randolph Hearst Foundations Kaiser Permanente Northwest
Meyer Memorial Trust James and Marion Miller Foundation Ford Family
Foundation Robert Wood Johnson Foundation US Dept of Education,
Fund for Improvement of Post-Secondary Education Oregon Consortium
for Nursing Education OCNE Do not replicate without permission
Slide 14
Key Questions in framing Curriculum What is the focus of the
practice we are preparing our graduates for. Is it generalist
practice? Is it specialty practice? What is foundational
(fundamental) to this practice? Oregon Consortium for Nursing
Education (OCNE). Do not replicate without permission.14
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OCNE Snapshot ~ What has been created: Partnerships and
Relationships Curriculum Transformation Pedagogical Reform Clinical
Education Redesign always a work in progress Oregon Consortium for
Nursing Education OCNE Do not replicate without permission
Slide 16
Partnerships and Relationships ADN (AAS) faculty and BSN (BS)
faculty Practice partners in health care agencies College
administrators with each other Student support personnel Oregon
Dept of Ed, State Board of Nursing. NLNAC, AACN Oregon University
System, Northwest Commission of Accreditation of Colleges and
Universities Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
Slide 17
OCNE snapshot: Curriculum Transformation Oregon Consortium for
Nursing Education OCNE Do not replicate without permission
Slide 18
OCNE Curriculum Transformation What has been created: Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission ONE common competency-based, integrated, baccalaureate
curriculum taught on 13 campuses, with CC students having an option
to complete AAS & sit for NCLEX-RN and/or transition directly
for 4th year courses
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OCNE Curriculum Transformation What has been created: Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission Common academic standards admission, progression,
transfer standards. Students admitted to community college are
co-admitted to University. A COMMON, SHARED CURRICULUM, MORE THAN
AN ARTICULATION AGREEMENT
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OCNE snapshot: Pedagogy Reform Oregon Consortium for Nursing
Education OCNE Do not replicate without permission
Slide 21
Pedagogy Reform What has being created: Oregon Consortium for
Nursing Education OCNE Do not replicate without permission Faculty
development started early and ongoing We learned together
teambuilding Educational evidence base & best practices Case
based instruction Sharing of instructional resources linked to
curriculum
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Shared Agreements Admission and Progression Faculty Sharing
Library Standards Financial Aid Disability and Accommodations
Oregon Consortium for Nursing Education OCNE Do not replicate
without permission
Slide 23
Creating a shared Curriculum between AAS and BS programs Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission
Slide 24
OCNE : building a Consortium between AAS and BS programs
Creating a shared vision (2001-03) Creating consensus Processes
& Infrastructure (2002-06) Designing Curriculum (2003-05)
Curriculum Approval & Implementation (2004-06) Faculty
Development (2003) Conducting a Comprehensive evaluation (2006)
Creating organizational sustainability (2010...) Oregon Consortium
for Nursing Education OCNE Do not replicate without permission
Slide 25
Creating Consensus Processes Early agreements through frank
discussion: changing nursing practice definition of Generalist
definition of Nursing Fundamentals what is foundational education
to promote deep learning and Enduring understanding of disciplines
most central concepts Oregon Consortium for Nursing Education OCNE
Do not replicate without permission
Slide 26
Creating Consensus Processes How OCNE built consensus: Time and
Money Regularly scheduled face to face meetings of directors and
faculty committees Hot buttons to help identify conflict Regularly
scheduled fun and celebrations Oregon Consortium for Nursing
Education OCNE Do not replicate without permission
Slide 27
Creating Consensus Infrastructure (2002-2006) Development of
Interagency agreements necessary to support shared curriculum,
admission and co-admission Oregon Consortium for Nursing Education
OCNE Do not replicate without permission
Slide 28
Designing a shared Curriculum Consultants in educational
evidenced based, best practices and cognitive science of learning
Look at both curriculum and pedagogy transformation Built from the
ground up. No one partners curriculum was used Oregon Consortium
for Nursing Education OCNE Do not replicate without permission
Slide 29
Designing a shared Curriculum Organization Framework OCNE not
based on a particular theory or formal model Outcomes-based all
courses, all learning directed to same end in view competencies of
graduate. Integrated & spiraled rather than Blocked &
leveled Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
Slide 30
Competency & dimension Health & illness context Focus
of carePopulation Concepts/content related to focus of care Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission
Slide 31
OCNE Framework for Content Organization & Selection
Competency & Dimensions Focus Of Care Concepts & Content
Population Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
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Designing a shared Curriculum Control of content expansion Use
of data such as IOM, Healthy People Clinical partner input Use of
exemplars Course selection teams Large amounts of faculty
development Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
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Table Talk WHERE do you see Maine in each area? #1.
Partnerships Strengths Challenges #2. Curriculum transformation
What is compelling about Oregons curriculum transformation What is
the ideal approach to integrating Maines competencies into nursing
programs Appoint a scribe Appoint a spokesperson to share Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission
Slide 34
Refresh
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Lunch & Networking Oregon Consortium for Nursing Education
OCNE Do not replicate without permission
Slide 36
Nuts & Bolts of the OCNE Curriculum Oregon Consortium for
Nursing Education OCNE Do not replicate without permission
Slide 37
OCNE Competencies 1. Ethical reasoning and practice 2. Insight
through reflection; self-care; 3. Intentional learning; 4.
Leadership in nursing and health care; 5. Collaboration as part of
health care team; 6. Practice within the health care system; 7.
Relationship-centered care; 8. Effective communication; 9. Sound
clinical judgments; 10. Practice decisions using best available
evidence..
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Curriculum Year 1 Pre-requisites Full Time- 45 quarter credits
Full Year of Anatomy and Physiology Nutrition Human Growth and
Development Social Sciences Writing Math Electives Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission
Slide 39
Year 2 Fall Quarter Health Promotion 9 credits Redefined
fundamentals introduced Health promotion across the life span
Skills Microbiology 4 credits Genetics- 2 credits Oregon Consortium
for Nursing Education OCNE Do not replicate without permission
Slide 40
Year 2 Winter Quarter Chronic Care I -6 Credits Pharmacology I
3 Credits Pathophysiology 1- 3 Credits Oregon Consortium for
Nursing Education OCNE Do not replicate without permission
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Year 2 Quarter 3 Acute Care I -6 Credits Pharmacology I 3
Credits Pathophysiology 1- 3 Credits General Electives 3-4 credits
Year 1 Benchmarks Oregon Consortium for Nursing Education OCNE Do
not replicate without permission
Slide 42
Year 3 Quarter 1 Acute Care II -9 Credits End-of-Life Care
General Electives 3-4 credits Oregon Consortium for Nursing
Education OCNE Do not replicate without permission
Slide 43
Year 3 Quarter 2 Chronic Care II -9 Credits End-of-Life Care
General Electives 3-4 credits Year 2 Benchmarks Oregon Consortium
for Nursing Education OCNE Do not replicate without permission
Slide 44
Year 3 Quarter 3 Community College Students Integrated
Practicum 1 9 Credits Electives 3 Credits University Students
Population Based Nursing 9 credits Epidemiology 3 Credits
Statistics 3 Credits Oregon Consortium for Nursing Education OCNE
Do not replicate without permission
Slide 45
Year 4 Quarter 1 University Students Leadership and Outcomes
Management 10 Credits General Electives 3 Community College
Transfer students join University Students or take Pop & Epi
Oregon Consortium for Nursing Education OCNE Do not replicate
without permission
Slide 46
Year 4 Quarter 2 University Students 9 credits Integrated
Practicum 1 Specialty focus 1 General Electives 3-6 credits
Transfer Students Pop & Epi OR Leadership & Care Management
Oregon Consortium for Nursing Education OCNE Do not replicate
without permission
Slide 47
Year 4 Quarter 3 All Students Integrated Practicum II 9 Credits
Specialty Practice 1 Credits Electives 3-6 credits Year 3
Benchmarks Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
Slide 48
OCNE : Competency Rubrics Faculty teams built rubrics to
identify expected level of student competency throughout courses.
Example-Modified with permission from the Lasater Clinical Judgment
Rubric. Lasater, K. (2007) Clinical judgment development: Using
simulation to create a rubric. Journal of Nursing Education, 46,
496-503. January 2007. Oregon Consortium for Nursing Education OCNE
Do not replicate without permission
Slide 49
Questions/Clarifications:
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Table Talk What is the preferred model for Maine Shared
curriculum Robust Articulation What is the needed Resources
Barriers Oregon Consortium for Nursing Education OCNE Do not
replicate without permission
Slide 51
Transforming Nursing Education in Maine 7 Highly Effective
Habits (lessons learned from your Oregon colleagues)
www.ocne.org
Slide 52
Hot House Effect (Kunstler, 2004) Oregon Consortium for Nursing
Education OCNE Do not replicate without permission
Slide 53
Habit 1 Keep the vision of the new nurse front and center
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Habit 2 Nourish relationship- centered leadership Create and
communicate group norms Revisit and renew them frequently Provide
visible symbols of your commitments to work together
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Habit 3 Embrace Ambiguity! Flexible and goal oriented Take
risks Extrapolate from your successes Refine your mission and
vision as emerging roles become evident (due to the ACA IOM,
Carnegie)
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Habit 4 -KNOW your Competencies Patient Centered Care
ProfessionalismLeadership System-Based Practice Informatics and
Technology Communication Teamwork and Collaboration Safety Quality
Improvement Evidence-based- practice
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Habit 5 Learn from successes, false starts, mistakes, and
failures Give me a fruitful error any time, full of seeds, bursting
with its own corrections. You can keep your sterile truth for
yourself. Vilfredo Pareto
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Habit 6 Recognize and respond to the Black Swans that come your
way
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Habit 7 Acknowledge and celebrate your accomplishments at
regular intervals
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Table Top Discussion List 4-6 next steps Prioritize your list
Create an abbreviated timeline of your prioritized list. Oregon
Consortium for Nursing Education OCNE Do not replicate without
permission