Approach Transforms Clinical Education
Approach Transforms Clinical Education

Patients placed in the care of nurses recently graduated from the College of Nursing can be confident they’ll be well cared for.

The doors for nursing at Creighton’s Phoenix campus, for example, open not just to classrooms but also to hospital units, where students gain comprehensive hands-on training under the supervision of experienced nurses and faculty.

It’s an approach that transforms the traditional clinical experience by making students part of a care team under the direct guidance of trained nurses. Unlike the traditional clinical model, where college faculty arrive on a ward with eight to 10 students and begin engaging in direct patient care, the Dedicated Education Unit (DEU) as the innovative concept is known, binds students much closer to the patient experience.

It’s a strategy, says Anne Schoening, PhD, RN, CNE, project director for Dedicated Education Units at the College of Nursing, that frees faculty to teach and allows nurses to pass on their expertise. And it’s a strategy that is being implemented throughout the Creighton universe — from Omaha, where it began, to Hastings, Nebraska, and to Phoenix.

“Instead of concentrating on tasks, the faculty has time for one-to-one conferences with the students as we pull them off the unit at least twice a day to go through what they have learned about medications, goals and outcomes,” Schoening says.

“Between the time they spend with that nurse — who really is the expert, who’s there every day, who knows the workflow — and then with faculty asking intentional questions, we are providing almost a one-to-one experience.”

The division of labor between clinical nurses and college faculty benefits everyone, says Catherine Todero, PhD, BSN’72, RN, FAAN, dean of the College of Nursing and vice provost of Health Sciences Campuses.

“One of the things that’s exciting about trying to create these academic-service partnerships are the new models of education that we’re rolling out,” Todero says.

“With the clinician actually helping to teach the technical side of things, it allows the faculty member more time to develop students’ clinical decision-making skills.”

Schoening and her staff have honed the DEU model since the fall of 2013 when it was introduced at the Creighton University Medical Center in Omaha. Six years later, with the model expanded to hospitals in Nebraska and Iowa, as well as to the College of Nursing’s Central Nebraska campus, the Phoenix campus is the beneficiary of a mature program that offers direct, nurse-supervised experience to students in the areas of medical/surgical, intensive care, emergency and obstetrics.

The value of the DEU experience is reflected in the ratings given to Creighton students once they advance to preceptorships, apprentice-type experiences that involve students practicing for 220 hours off campus, away from faculty and under the personal supervision of nurses.

“Our DEU students are rated significantly higher by their preceptors in overall competence, time management, prioritization and knowledge of pharmacology and pathophysiology than previous non-DEU cohorts,” Schoening says.

“That’s why the immersive DEU experience, right before that preceptorship experience, is so valuable.”

An expression of Creighton’s confidence in the program is the recent appointment of three new DEU coordinators charged with advancing the program across the Creighton network.

The Omaha DEU program will be led by Lori Lazure Rusch, PhD, BSN’97, RN, who is an associate professor. Directing the Central Nebraska program will be Joely Goodman, PhD, RN, coordinator of the accelerated nursing program on the Central Nebraska campus. The Phoenix program will come under the guidance of Keshia Kotula, MS, RN, assistant professor.

The DEU experience in Phoenix is provided through Creighton’s partnerships with St. Joseph’s Hospital and Medical Center, St. Joseph’s Westgate Medical Center and Chandler Regional Medical Center, all within the Dignity Health system, and Valleywise Health Medical Center.

The nurses to whom students are assigned are carefully chosen. Designated as Clinical Teaching Partners, they are chosen for their interest in nurturing a new generation of nurses and their willingness to work with small numbers of students during commitments that last from three to eight weeks, depending on the specialty. They undergo a four-hour orientation in which they learn about the curricula, what is expected of the students and their instructors, and become, essentially, an extension of the college’s faculty.

“It’s been a very positive experience overall both for the students and myself,” said Ashley Jenson, RN, BSN, a clinical teaching partner at Dignity Health Chandler Regional Medical Center.

“The students come in very prepared and very eager to learn about everyday situations in a hospital setting.

“They are very fortunate, with the DEU model, to be able to stay in the same setting for eight to 10 weeks. You build a trusting relationship with each other, as a student and as a professional working in the field. You build that trust level and learn each other’s strengths and weaknesses.

“That’s something that in the traditional nursing school model you don’t get. You’re usually in a different location every day, which is great for exposure but at the same time you don’t get to build that foundation of trust.

“I could just see the confidence grow in the students from day one to day 10 or 12. Watching them progress as individuals as well as nurses was really exciting to see.”