1. Partnerships for Professional Advancement
Mary Etta C. Mills, RN, ScD, NEA-BC, FAAN
Linda J. Hickman, RN, PhD, FACHE
Funding Support: NSP II Grant, Maryland Higher Education Commission
Health Services Cost Review Commission

2. Projected shortages of nurses vary across the nation
Workforce Demand*
Projected shortages of nurses vary across the nation
MidAtlantic: 42% of RNs are over 50 yrs of age
12% growth
9% growth projected
1%- 2% growth in FTE RN per capita
*Auerbach, D.I., Burerhaus, P.I. & Staiger, D.O. (2017). How fast will the registered nurse workforce grow through 2030? Nursing Outlook, 65 (1),

3. Advancing Academic Preparation of Nurses in the Workforce
Academic-service partnerships with 24 hospitals over 10 years (2006- present).
Purpose:
Initial- MS preparation of RNs to expand
clinical access in support of increased
nursing student enrollments
Expanded – RN-BSN preparation to assist in
meeting the IOM objectives of 80%
For utilization as Clinical Instructors, Mentors and Preceptors; Programs online

4. Academic- Service Partnership Model
University of Maryland, Baltimore
School of Nursing
NSP II Project Director, Academic Program Specialists
Develop nursing cohort & mentorship model
Recruit, admit & enroll nurses to earn BSN/MS degree
Service excellence onsite for NSP II students
Cohort: keeping student groups together throughout the program; individualized mentorship
Onsite academic advisement, counseling, progression assistance (LOA, etc)

5. Partner Medical Center
SERVICE
Partner Medical Center
Appoint NSP II Coordinator/Liaison
Promote NSP II in hospital communications
Provide tuition benefits and possible incentives
Administrative support for NSP II students
Administrative support through nurse educator coordinator working with the NSP II program directors

6. Partnership Process Relationship building: CNO  Project Directors
MS Nurse Educator Academic Prgm Specialists
Nurse Staff/Student
Working as a team to coordinate the program, mentor, advise and guide students through the educational experience and career progression, while sharing resources

7. Hospital Partner Enhancements
Tuition Reimbursement Support
Consideration of additional post graduate role as clinical instructor, mentor, preceptor, staff educator
Evaluation recognition
Expanded clinical access for Schools of Nursing

8. Academic Enhancements
One on one on-site advisement throughout academic program
Special assistance with academic matters
Guaranteed course availability
Flexible course schedule
Dual Role preparation in Leadership and Education

9. Evaluation Outcomes
150 MS Graduates with Leadership and Education focus over 10 years
Additional 165 BSN/MS projected
45 MS currently enrolled
Availability of hospital based clinical instructors has led to increased clinical rotations
Schools seeking clinical rotations at partner hospitals have enrolled 13.2% more students
Graduates are hospital based clinical instructors, faculty, preceptors, mentors
Clinical rotations of undergraduate students and with an individual preceptor: One hospital clinical usage increased from125 requests from a combination of 10 schools of nursing to 146 requests for a total of 580 students.

10. Graduate Survey
Conducted in 2015
42 randomly selected MS graduates invited to participate
Response: 22/42 = 52.4%

11. Demographic Characteristics
Initial Nursing Degree:
BSN: 77.3% (n=17) ADN: 13.6% (n=3) Diploma: 9.1% (n=2)
Yrs of Experience:
6-10 yrs 27.3% (n=6) yrs 22.7% (n=5)
> 15 yrs 50.0% (n=11)
Yrs with Current Employer: Range <2 to > 15 yrs
Full-time position:
Educator 31.8% (n=7) Clinical Staff 22.7% (n=5)
Manager 27.2% (n=6) Other 18.2% (n=4)
The majority, 17 (77.3%) had a BSN degree. 50% (11) of respondents had more than 15 years of nursing experience and most of them have worked with the current employer at least 6 years. (Years with current employer: most 7 (31.8%) had yrs; next 5 (22.7%) had less than 2 yrs.)

12. Program Impact on Organizational and Teaching Activities
Organizational Participation:
Research/EBP (from 10.7% to 17.9%)
Leadership and Management (from 9.3% to 17.9%)
Teaching Involvement: Increased frequency of participation:
CE Instructors (from 9.8% to 21.7%);
School of Nursing Clinical Instructor
(from 4.9% to 13.0%)
Simulation-Lab Instructor ( from 7.3% to 26.1%)
“Program impact” refers to the frequency of formal involvement. Although difficult to measure, respondents self reported the change in frequency of their organizational and teaching activities upon program graduation. Research activity such as development of research and EBP projects increased from 8 (10.7%) engagement to 14 (17.9%); Leadership and Management such as increased involvement in leading key nursing and hospital committees changed from 7 (9.3%) to 14 (17.9%).
Teaching involvement: Although there were small numbers of respondents, increased engagement was notable. 10 graduates taught more than 30 semesters at 6 Schools of Nursing. (20 semesters were at schools other than UMD

13. Professional Maturation
Notable Shifts in roles following program graduation:
From To
- Informal staff education Formal CE instructor
25.3% % %- 21.7%
In-unit preceptor SON Clinical Instructor
39.0% % % %
Simulation-lab instr.
7.3%- 26.1%
Staff education or staff development took on a more formal staff continuing education role. In-unit preceptor included precepting nursing students on an informal basis and changed to the more formalized Clinical instructor or simulation- lab instructor role. Overall there was a shift gain of 11.9% from informal staff education to formal CE Instructor and 26.9% gain from in-unit preceptor to the formal roles of SON clinical instructor and simulation-lab instructor.

14. Challenges Realities of Organizations:
- Meeting health environment demands
- Changes in project personnel, hospital
education coordinators, CNOs
- Increasing competition from new and
existing programs
- Adequate tuition support combined with work
obligations
1. Environment of pressures to contain costs, maintain revenue stream, meet IOM recommendations. Budgetary drawdowns can result in tight staffing on patient care units and produce constraints making it difficult to ensure staff nurses can be released to serve as clinical instructors. 2. Seven hospital program specialists among 6 hospitals left for other positions and almost one-third of CNOs changed. 3. Many new programs 4. Some staff, after program admission, delay progression due to work and family commitments.
Project personnel: realities of hiring (timing and availability); health issues

15. Opportunities - Academic- service partnerships through
relationship building to promote professional
advancement
Creation of innovative positions built on combined practice and faculty roles
Increased enrollment in schools of nursing to meet future health care needs
Positions include new performance standards and expanded clinical ladders (such as Hospital based clinical instructors, extended practice to care coordination across levels and settings)
As more staff complete program requirements there may be more flexibility and availability to provide preceptors for student clinical groups.