1. Practice & Education Partnerships Supporting the Development of Nurturing Clinical Learning Environments for Students & New Graduates Marilyn Kelly RN MEd Lisa-Anne Hagerman RN Ed.D Heather Cross RN MN Paris Jalali RN MA

2. Sherry FrizzellConestoga College Paris JalaliCambridge Memorial Hospital Maureen LeyserSt. Mary’s General Hospital Marilyn KellyConestoga College Maria PenaGuelph General Hospital Lisa-Anne HagermanConestoga College Kim PittawayCambridge Memorial Hospital Judy ShearerGrand River Hospital Heather CrossConestoga College Funded by Ontario Nursing Secretariat, MOHLTC

3. Agenda Theoretical Background Leadership Development Program Research Methods Results Conclusions

4. Theoretical Approaches

5. Leadership “…is a process ordinary people use when they are bringing forth the best from themselves and others. When the leader in everyone is liberated extraordinary things happen.” (Kouzes & Posner, 2007)

6. Five Practices of Exemplary Leadership Model the Way Inspire a Shared Vision Challenge the Process Enable other to Act Encourage the Heart Kouzes & Posner, 2007

7. Nurses at the bedside contribute to inviting clinical environments in which students and new graduates feel welcomed & accepted, and challenged in ways that help them grow Thomka, 2007

8. Invitational Theory Based on four basic assumptions about people: 1. Trust 2. Respect 3. Optimism 4. Intentionality (Purkey & Aspy, 2003)

9. Program Design 24 Emerging Nurse Leaders 24 Mentors 8 health care organizations within the LHIN

10. Emerging Nurse Leaders Engaged in 3 six hour leadership workshops at Conestoga College A short term leadership project A time limited mentorship relationship

11. Mentors Workshops Supported project Provided mentorship through meetings with new leaders

12. Aim of Study investigate whether an emerging nurse leader development program created a change in leadership practices uncover the experiences of program participation

13. Research Methods Purposive sampling strategy was used to recruit 48 nurses Measures Demographic information Learning Practices Inventory (Kouzes & Posner, 2003) Nursing Retention Index (Cowen, 2002) Focus groups

14. Demographics 98% female 94% RNs 6% RPNs 57% diploma 30% undergrad degree 13% graduate degree 65% full-time 35% part-time or casual

15. Leadership Practices Inventory Emerging Nurse Leaders Model the Way p<.001 Inspire a Shared Vision p<.001 Challenge the Process p=.003 Enable Other to Act Encourage the Heart P=.001

16. Leadership Practices Inventory Mentors Model the Way Inspire a Shared Vision Challenge the Process Enable Other to Act Encourage the Heart p=.002

17. Sample Group Pre Leadership Workshop Mean Post Leadership Workshop Mean T Score DFP Total Sample (N=46) ‘ Model the Way ’ ‘ Inspire a Shared Vision ’ ‘ Challenge the Process ’ ‘ Enable Others to Act ’ ‘ Encourage the Heart ’ 44.913 40.783 43.804 49.370 43.544 48.239 45.174 46.435 51.326 48.500 4.171 3.616 2.924 2.448 5.232 45.000.001.005.018.000 Emerging Nurse Leaders (N=23) ‘ Model the Way ’ ‘ Inspire a Shared Vision ’ ‘ Challenge the Process ’ ‘ Enable Others to Act ’ ‘ Encourage the Heart ’ 42.652 37.609 41.304 47.826 42.261 47.522 44.217 45.174 50.174 48.087 4.764 4.576 3.284 1.935 3.893 22.000.003.066.001 Nurse Mentors (N=23) ‘ Model the Way ’ ‘ Inspire a Shared Vision ’ ‘ Challenge the Process ’ ‘ Enable Others to Act ’ ‘ Encourage the Heart ’ 47.174 43.957 46.304 50.913 44.826 48.957 46.130 47.696 52.478 48.913 1.540 1.162 1.042 1.475 3.500 22.138.258.309.154.002

18. Emerging Nurse Leader Themes 1.Acquired Leadership Knowledge 2.Empowered to Make a Difference (Self Awareness) 3.Learning from Their Mentor

19. Acquired Leadership Knowledge “I found I learned a lot about myself, a lot about my own leadership. I think that was the part that was missing”

20. Empowered to Make a Difference “ I think..what I got …(is that).. you have to start the changes yourself” “..given me the courage to be involved in improving the work environment”

21. Learning From Their Mentor “My mentor was wonderful because she would provide me with a lot of background...[and] what we could do about it.”

22. Mentor Development of Self as Leader “This program has just made me realize that...I do have a lot of ways to show my leadership skills...and it’s helped me advance in a way”

23. “I just enjoy it…..I enjoy sharing my knowledge and experience and my leadership skills with my colleagues.”

24. Successes Completed projects, including ones that enhanced unit processes Individual empowerment and greater sense of control over the work environment Enhanced leadership behaviours Succession planning

25. Completed Projects Medication reconciliation in the ER Communication tool for transfer of care between units Generation gap between nurses Implementing responsibilities of night shift Orientation guide to pacemaker clinic

26. Limitations Small sample size for quantitative measures Participants self-selected Self-assessed leadership behaviours, immediately after program participation

27. Recommendations & Future Steps Concurrent investment in leadership & mentorship development Financial investment is essential Does leadership development in point of care nurses impact the clinical learning environment for students?

28. Conclusion A leadership development program that combines project experience, workshops & mentorship may impact leadership behaviours in mid-career point of care nurses Engage nurses at their moment of “readiness to learn”.

29. References Cowin, L. (2002). The effects of nurses’ job satisfaction on retention: an Australian perspective. Journal of Nursing Administration, 32 (5), 283-291. Cowin, L.S., & Hengstberger-Sims, C. (2006). New graduate self-concept and retention: a longitudinal survey. International Journal of Nursing Studies, 43 (1), 59-70. Kouzes, J., & Posner, B. (2003). Leadership Practices Inventory: psychometric properties. San Francisco,CA: Pfeiffer Kouzes, J., & Posnter, B. (2007). The leadership challenge (4 th ed.). San Francisco: John Wiley & Sons. Purkey, W., & Aspy, D. (2003). Overcoming tough challenges: An invitational theory of practice for human psychology. Journal of Humanistic Psychology, 43 (3) 146-155. Thomka, L. A. (2007). Mentoring and its impact on intellectual capital: Through the eyes of the mentee. Nurse Administration Quarterly, 31 (1) 22-26.

30. Nursing Retention Index 1.It is my intention to continue with my nursing career in the near future 2.I would like to stay in nursing as long as possible 3.As soon as it is convenient for me I plan to leave the nursing profession 4.I expect I will keep working as a nurse 5.My plan is to remain with my nursing career as long as I am able 6.I would like to find other employment by leaving nursing (Cowin, 2002)