1. South Central (New Haven)Connecticut Report

2. South Central Partners Gateway Community College (GCC) o Suzanne Conlon, MSN, RN, Chairperson and Associate Professor, Division of Allied Health and Nursing o Sheila B. Solernou, MSN, RN, Division Director of Allied Health and Nursing Southern Connecticut State University (SCSU) o Barbara Aronson, Ph.D., RN, CNE, Professor and Coordinator, Ed.D. in Nursing Education, Department of Nursing o Lisa M. Rebeschi, Ph.D., RN, CNE, Chairperson and Associate Professor, Department of Nursing Yale-New Haven Hospital (YNHH) o Judith Hahn, MSN, RN, Director, Center for Professional Practice Excellence o Russell Hullstrung, MPA, RN, Director, eLearning, Institute for Excellence o Patricia Span, MSN, RN, Strategy and Learning Specialist, Center for Professional Practice Excellence Doctoral Student o Pamela Forte, DNP, RN, Senior Clinical Placement Coordinator, Quinnipiac University

3. Process Review of curriculum at the Associate degree (GCC) and Baccalaureate degree (SCSU) for the presence of the Nurse of the Future Nursing Core Competencies©. (Massachusetts Department of Higher Education) Schedule of competencies to be reviewed determined by partners in summer 2012. GCC and SCSU reviewed their curriculum independently for the “number of opportunities/occurrences currently available for students to learn the knowledge, attitudes/behaviors and skills” for the assigned competencies. Each competency area was assigned a score between 1 (no opportunities) to 4 (7 or more opportunities). YNNH also reviewed each competency area to determine how many learning opportunities they believe should be available for students by graduation. GCC, SCSU and YNHH then met four times to review the results and then further discuss the competency areas for consistency regarding interpretation and scoring.

4. Gap Analysis Process Combined spreadsheet developed for each competency listing for the knowledge, attitudes/behaviors and skills areas. The three institutions identified their score (1-4 rating) on the spreadsheet. After discussion between all partners at these meetings, rating scores were finalized and gaps were identified for each competency. These discussions were a vital piece in consistent interpretation of the competency areas and also served to clarify “language gaps”.

5. Gap Analysis Results Safety o Major gap area between academia and practice. o Students are taught safety concepts related to patient care but not related to the larger macro- system. o There is a “language gap” between academia and practice. Terminology such as “culture of safety, high reliability organizations, root cause analysis” not introduced to students in the classroom. o Students are not exposed to the “processes” surrounding reporting or communicating adverse events.

6. Gap Analysis Results Quality Improvement o Major gap area between academia and practice. o There is a “language gap” between academia and practice. Terminology such as “value based purchasing” and other terms not introduced to students in the classroom. o Students do not see the link of patient satisfaction to QI as they are not exposed to unit based data- NDNQI, core measures, and HCAPS.

7. Gap Analysis Results Communication o No major gaps identified. o Gap areas identified centered on conflict resolution. o Students have difficulty in this area related to confidence level. Patient-Centered Care o No gaps identified. Evidence-Based Practice o Gaps identified in academia from the ADN to the BSN. Students at ADN level get exposure but research is focused for the BSN level. o Gap is expected due to outcomes of program.

8. Gap Analysis Results Systems-Based Practice o Gaps identified in academia to practice related to terminology used, i.e. micro system and macro system. o Students don’t see the connection that nursing has to influence macro system to effect delivery of care at the micro system (unit) level. o Students do not understand the larger system: staff nurse councils, shared governance. o Academia responsible for providing the knowledge and practice setting focuses on the attitudes and skills areas of the competency.

9. Gap Analysis Results Teamwork and Collaboration o Gaps noted in K7a, K7b and K7c- Impact of systems on team functioning. o Some minor gaps with the role of the Interprofessional team. Professionalism o No major gaps identified.

10. Gap Analysis Results Leadership o No major gaps noted. o Both academia and practice agreed that it is difficult to teach leadership: role modeling and mentoring are needed. Informatics and Technology o No major gaps as students receive more training on EHR Systems in both academia and practice prior to graduation. o Using data to improve nursing practice.

11. Recommendations to Close Gaps Safety o Academia needs to incorporate “current terms and language into curriculum”. o Expose students to safety at systems level through clinical experiences. o Some areas need to be done once the student enters the practice area, i.e. S4a: Participates in collecting and aggregating safety data. o Incorporate language and system processes into simulations. o Students attend “safety huddles” at YNHH. o Students participate in hospital teams focused on safety initiatives. o Students participate in committees and/or taskforces on safety. o Students shadow patient safety nurses on unit. o Safety alerts from YNHH being distributed to schools of nursing.

12. Recommendations to Close Gaps Quality Improvement o Students participate in committees and/or taskforces on Quality Improvement. o Expose students to the QI team on assigned clinical unit. o Students attend YNHH Annual QI Conference. o Students shadow QI Coordinators as part of clinical rotation. o Expose students to NDNQI data and explain how that data links to the concepts they learn related to patient care, i.e. why is it important to turn and reposition.

13. Recommendations to Close Gaps Evidence-Based Practice o Symposium for students with the Nurse Researcher at YNHH. Systems-Based Practice o Academia can use case studies to introduce the concepts and language. o In the Capstone assignment, educate practice site preceptors to provide systems-based practice opportunities to their assigned student.

14. Recommendations to Close Gaps Teamwork and Collaboration o Simulated learning experiences that are designed around interprofessional situations. o Classroom education with other professions outside of nursing. o Shadow experiences at the clinical affiliate site with other disciplines. o Expose students to transition teams on clinical units. o Involve students in mock JCAHO to instill continuous readiness.

15. Lessons Learned Practice Partners and Education use different language. Practice Partners uses a micro and macro systems approach. Education Partners use a patient/nurse approach. Practice Partners focus on a team based practice. Lack of communication exists between what is taught in the classroom and what actually happens at practice sites.

16. Lessons Learned Conversations between academic institutions and practice partners are essential to provide seamless progression to practice. There are opportunities to connect the essential competencies through dotted and connected education and practice experiences which enhance students critical appraisal and analysis of evidence to support practice.

17. Where Do We Go From Here? Academic institutions conduct assessments for curricular re-design to address GAPs. Continue practice-academic discussions to ensure new curriculum address GAPs. Ensure seamless progression to practice partner orientations/ residency programs. Continue discussions with practice partners to develop new opportunities for student learning in clinical practicums,, i.e. include students in more of the initiatives occurring on the unit, include critical thinking activities into the clinical experience that incorporates the competencies. Develop a plan for the implementation of the team recommendations.