Nursing Education

Prepare and Inspire Nursing Students to Make a Positive Impact in Healthcare

A webinar featuring Dr. Tiffany Kelley, a leading expert and thought leader on nursing innovation

Nursing innovation expert Dr. Tiffany Kelley shares how to equip students with the skills they need to innovate and drive change in healthcare. The slides from the workshop are also available.

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Jessica Hurdley:

Hello, and welcome to our webinar today. We are thrilled that you have joined us and hope that you enjoy the presentation and walk away prepared to inspire your students to make positive impact in their careers. My name is Jessica Hurdley. I’m with GoReact and your host for today’s event. For those of you who aren’t familiar with GoReact, we are a competency or skills-based assessment and feedback tool used by higher education institutions and nursing programs all across the United States and the UK, primarily to help streamline processes and save time in skills check-offs and practice leading up to those processes as well. It really helps them, the student connect theory to practice in the didactic type of courses, and for allowing for really deeper, richer conversations and debriefs in the lab spaces. If you’re interested in learning more about us, please feel free to click on the link that’ll be in the chat as well.

And that brings me to first say thank you to our presenter today, Dr. Tiffany Kelley, the Frederick A. DeLuca Foundation, a visiting professor for Innovations and New Knowledge and the director of the Healthcare Innovation Online Graduate Certificate Program at the University of Connecticut School of Nursing. Dr. Kelley is a leading expert on the topic of healthcare innovation and informatics in the contemporary times of delivering safe, efficient, timely, patient-centered, effective, and equitable care to patients and their families. Thank you so much for leading today’s discussion.

Before I hand it over to Dr. Kelley, just want to cover a few housekeeping items. We are recording this webinar, so if you would like to share it with a colleague or review an item afterwards, we’ll be emailing the recording shortly at the conclusion of the event. Please look for it in your email. Today’s webinar will be about 45 minutes and that includes about 30 minutes of presentation followed by a live Q&A. We really want to make this presentation as conversational and interactive as possible. So, throughout the presentation feel free to think about questions that you have for Dr. Kelley.

You will see the option to submit those questions, and if you see a question posted by another attendee that you want to see answered, be sure to up-vote that question. We will definitely cover those most popular questions first. You will also see an option to chat and we have Abby from our GoReact team monitoring the chat. So, if you have any technical issues, please use the chat. Great space to connect with your colleagues as well. The Q&A, just to clarify too, is for questions for Dr. Kelley. So, without further ado, we’ll have Dr. Kelley start with her presentation.

Tiffany Kelley:

Thank you, Jessica for that introduction and thank you for having me today. I look forward to talking to all of you and sharing some perspective on the title of this presentation today is, To Prepare and Inspire Nursing Students to Make a Positive Impact in Healthcare. And it was a couple months ago that the GoReact team reached out. We got to talking and I really thought, “What is it that’s going on in nursing today that is likely on the minds of nursing students, as well as faculty? And what is an approach we can start to offer for our faculty to help inspire students to look at what’s ahead, in ways that they can help make a difference?” So, that is a little bit of perspective for this today.

I’ll be covering three different objectives. The first is preparing and inspiring nursing students for how to make change in healthcare. And that is essential for the profession. The second being strategies to support students in identifying possible opportunities to address gaps. And the third is identifying alignment with AACN 2021 new Essentials. I’ll talk more about this towards the end, but if there was ever a time in which we have an opportunity to really look at how do we give a little bit more or something a little bit extra that aligns with looking into the future, this is the time with the new Essentials that have come out, to really look at, where could we make some changes, additions, or modifications?

So, with that, I pulled this together for today, “In the middle of difficulty lies opportunity.” And we’ve all seen a very challenging two, two and a half, nearly three years for the nursing profession through the COVID-19 pandemic. And we’ve seen issues that have rose to the forefront, and I would say be amplified. I don’t think these are new issues, in terms of workforce and expectations and what it is like to be a nurse once you’re graduated from school, whether that’s as an undergraduate student or a graduate student. And so, I’d like to look at these challenges that arise and really force us to look at, how do we make changes as opportunities?

And I teach my students about that too. So, with that, that’s another perspective for this. And I’ll start with a poll question just to get a sense from each of you. This is a question I ask my students. Obviously I ask it in a slightly different way. It’s not a multiple choice. But for the purpose of this exercise today, who is or are the person or persons that are responsible for creating innovative change and solutions in nursing and healthcare? Is it the executives, the professors? I put professors because many of you here are likely educators. Nurses, whether in nurse leadership or at the bedside. Government agencies, such as centers for Medicare, Medicaid services or the Joint Commission, or all of the above. And I’d like to see your thoughts on what you believe.

So, it’ll take a minute just to have people respond and then we’ll talk about it. Okay, so all of the above, 92%. Wonderful. I was likely leading you in that direction with that. But what this presents is that it’s not a one person or one group of people situation that we’re in with many of the challenges that we’re seeing at a profession level. And this is something that I’ll talk a little bit later about, how I reviewed this with the students, but also shared with them that there is an opportunity for them to get involved, and we’ll go over some ways to do that today.

So, with that, let’s go into, this is an excerpt of an article that I had wrote last year. What Does it Mean to Be a Nurse Innovator? And I’ll read this quote and then reflect on why I pulled this out of the paper. “Instead of attributing the role of the nurse innovator to a select few that emerge throughout time, we have an opportunity today to consider educating our current and future nurses on the science of innovation to make an even greater impact on the health of our patients, families, communities, populations, and society at large. We, as a society often expect that innovations are going to just emerge, to fix the many problems we face each day. And in that case, we do have an obligation to prepare nurses with an innovative mindset to become nurse innovators.”

So, I’ll break this down a little bit in terms of where I see that fitting into the conversation for today. And just breaking it apart with the sense that that first line of identifying the role as a nurse innovator, as one of a select few, or that there’s only the chosen few are the ones that are able to do this. And while there may be a natural inclination for many to lead in this direction, really I think it comes down to, are we teaching people how to address change in ways that are different from how to operate the day-to-day operations?

Creating change is very different from managing day-to-day what the standard operating procedures are. And if we begin to teach students the theories and the methodologies and the behaviors that they can strengthen, then by that very nature we will in turn produce individuals who have a mindset that is prepared for looking at things in a different way. And an example I’ll often share with my students is really just to break the ice at the beginning and get people talking, is how many have had a perfect day so far? So, we’re a little after noon, maybe everybody’s morning has gone pretty smoothly. But generally speaking, there’s usually a hiccup over the course of the day, or maybe it’s a little bit bigger than a hiccup. And we tend to complain. We tend to think about, just dwelling on what didn’t go right or what isn’t working or why this should be fixed.

But getting beyond that to thinking, “Okay, I recognize the opportunity here. What can I do to make it better?” And bridging that problem identification into something that is a solution-creating opportunity is something that can be taught. We’re seeing it happen through our students at the University of Connecticut in the School of Nursing. I will tell you a little bit more about that in a bit, but I do believe there’s a mindset shift that we need to start to embrace, in looking at how each one of us has a role and an ability to influence positive change in healthcare. Whether it is a small thing that can be done today or something that needs national influence, there is a place for everyone to help us address these challenges, especially when we have, there’s four million of us, which is four times the amount of physicians that are out in the healthcare workforce.

So, there’s far more many of us. So, preparing and inspiring nursing students for how to make change in healthcare is essential for the profession. So, what am I thinking about here when I’m talking about that? And often I will talk to my students, and they’ll come to me with ideas or share thoughts of things that probably need to be addressed. And I’ll often challenge them for the sake of saying, “But why?” Right? So, we need to be able to describe at a level of impact, what is it that we’re trying to solve for? And just going back to 2010, I pulled this out of an article that I… No, I didn’t pull this one out of an article. It was… that I wrote, this was from the Institute of Medicine on the future of nursing in 2010. “Nurses have a crucial role in building a healthcare system that will meet the demand for safe, quality, patient-centered, accessible, and affordable care.”

So, we’re going back almost 13 years now and recognizing that there, from the Institute of Medicine, now the National Academy of Medicine, the impact nurses can have. And in just 13 years we’ve really made some significant progress at a systematic and operational level for a strategic focus in nursing, across many organizations, about creating change through innovative solutions and approaches. And so, these are just five that I have mentioned. I led with academic institutions just for the purpose of this conversation and the sense that there are universities and schools and maybe many of you are already doing things of this nature in your universities.

There’s an article, which I’ll highlight a little bit later, that talks about seven different institutions that offer models that could be explored. The American Nurses Association has had a strategic focus on nurse-led innovation since 2017 and their strategic plan from that, there have been conferences on innovation, there are grant opportunities for nurses, and the same with Johnson & Johnson, who has offered opportunities and funding pathways for nurses that have ideas and want to bring them forward. We’ve had students be finalists in these competitions.

And then, most recently, the future of nursing in 2020 and through 2030, right? So, now we have the next version of that. Within that, there’s one of the recommendations, is that nurses are working effectively with physicians to help lead and transform healthcare. And then, most recently, the AACN Essentials, which does introduce innovation, intellectual curiosity, and many other things that can help us really strengthen even further ways for nurses to be able to think about how to make change for healthcare.

To innovate is to create positive change. This is something I share with nurses, faculty, whomever it is I’m speaking with. And I stress that for us, to really be talking about this concept of innovation or innovate, is the ability to define it in a measurable way. So, I will, whether it’s an undergraduate student or a graduate student, we start with this understanding of, well what does it mean when we’re talking about creating positive change? What does it mean to innovate? And an innovation is an outcome, and it’s a new product, a process or service that emerges as a result of an unmet need, something that’s not being served, for a population of users that drives positive change for quality care.

And stressing that whatever it is, that if we want to look at it from, let’s say an intervention perspective, the desired outcome has to reach at least one of these aspects of quality care that’s defined in crossing the quality chasm, safe, effective, efficient, equitable, patient-centered and/or timely. We need to be doing things that can be measured in a way that addresses at least one of these factors, if not more. And the unmet need is really that gap. What isn’t being met? What are the challenges that are not really being fulfilled, that are leading to work arounds?

And the population of users, in this case, it could be nurses, it could be our patients, it could be nursing students. That depends on what it is that the unmet need is. And it doesn’t have to be a tangible item in terms of a product, but it can. It could be a new process or a new service. If we look at telemedicine, that has been around since the ’60s, but it wasn’t until we really needed to be able to care for people in a safe way in which they were distanced from one another, and telehealth all of a sudden became something that could be reimbursed through CMS.

So, there are multiple factors involved in healthcare, which often makes it a little bit more complex, but it does start with people. So, that is a definition that I often use. And so, here’s another poll question for each of you to think about. When might you optimally start this process for your nursing students? When might you start to introduce them to the idea of their ability to make change and how to do that? And so, there’s four options here. One in a graduate program, the second after passing their NCLEX, their first year, first semester, typically freshman year, or their last semester last year, typically referred to as their senior year. And I’d like to hear your thoughts as to what you think about this, as there’s varying opinions. And I will share with you my perspective after I get a sense of the audience. Just give everybody a minute.

Okay. So, we have 95% first semester, first year, and 5% in a graduate program. So, I’m excited about where things landed because my next slide is going to say, “As early as possible.” And I think what we do at UConn is first semester, first year, but that’s not something that’s always possible. And so, as early as possible in an educational program is ideal. And I’d like to explain a little bit why that is. You’re looking at not just giving people tools for how to do something, but influencing their mindset and looking beyond the problem itself and saying, “Okay, we know this is here. What can I do? What is something that I could do to help influence that?” I’ll give you some strategies in the next objective, but let’s say that you had already completed your undergraduate program and you’re coming back for a graduate degree or even a certificate of some sort.

That’s still a great opportunity, especially if we’re looking at leaders, because we have a need for people to not just be able to create solutions but also support these ideas and this approach and culture from a leadership level. So, as early as possible, and that’s going to mean something different to other people. I feel as though I got a lot of my formalization and understanding the innovation process through my PhD, and if we can support students to learn that earlier, than waiting until that time period or maybe not even having that opportunity, then we’re going to create mindsets that are going to be far more advanced by the time they reach those points, or throughout their career. So, these are just three examples of students that have been able to really take their ideas or their thoughts of, “I feel like this could be done better, or why is it that this isn’t happening?”

So, I’m going to explain these three stories. The first one on the left is one of our undergraduate students early in her undergraduate career, was in a course where they asked her to identify a challenge or something that needed to be improved. And she was in a group that was not just nursing students, and noticed in one of her labs that every time you go to take a glove out of a glove box that half a dozen of them or maybe more, sort of trickle out, and started to see this happening a lot and thought, “This seems like this is kind of an issue. Why is this happening?” And so, she ended up working to create a technology she calls ReduSeal, to be able to reduce glove waste, so that you’re at a greater likelihood of just pulling one glove instead of a half a dozen that fall on the floor.

And then, some of them, people stick them back in the box, which I hope isn’t really something that’s happening very often, or they throw them in the trash so there’s waste there. Throughout her journey, and this idea that sparked, we had the ability to support her efforts. She was able to go on to form a team and received several awards, non-dilutive grant funding. She actually filed a patent while in undergrad, and graduated with a patent from the USPTO before becoming a nurse. So, that’s just one idea that, from something she happened to see in a classroom and thought, “This doesn’t really make a lot of sense. I’d like to see if this is something I can pursue.”

The second example in the middle is from a student who really has an interest in public policy. And for those of you that get American Nurse Today, there was an article that was in the most recent version that mentioned there has never been a nurse in the Senate in history. And so, this student ended up applying for a internship in DC. She really wanted that experience, and was selected and had a wonderful time over in Washington, DC over the summer. And that’s an experiential learning opportunity to understand the process of, “How do I get involved in policy? How might I be able to influence that?” So, that’s another type of way in which we as a profession can really help direct what the future of healthcare looks like.

And then, the third example here was during the height of COVID, we had launched our Healthcare Innovation Certificate Program in January, 2020. And then, about six weeks later is when we were all really starting to see COVID come at us quite quickly, and the students were in the midst of trying to identify a problem that they felt as though they wanted to work to solve. One of our students is a nurse at a hospital in Boston, and noticed that nurses were pulling out their phones to help connect patients with family members or friends because the visitor restrictions were such that people couldn’t come visit.

And this was happening so frequently that she thought, “There should be a technology that can support this, regardless of COVID or regardless of having my phone, but allowing people to be able to communicate with one another, without needing me to be here or someone else’s device to be here.” And so, she actually, through the program, has created a product, she’s launched a company and is working to bring that to market. So, these are three different examples, two from undergrad, one from a graduate level, but just of how an idea stemming from a problem that someone’s seeing and feeling can lead to us to create opportunities and pathways for students to pursue that align with their interests and what they’re seeing in healthcare today.

So, that takes me to strategies. So, how do we support students in identifying these opportunities to address these gaps? And from a faculty and an organizational perspective, I think having a commitment to such an initiative really can thrive with a culture that supports that, as well as support from leadership and faculty, and then discussing their opportunities. So, this being with students and abilities to improve healthcare through innovative solutions. I’ll get a little bit more specific in coming slides. And then, the third is much more tactically driven, but dedicating time in coursework that might be strategically placed, to focus on identifying gaps.

So, one of the things that we did at UConn was, one of the expectations was that we weren’t going to add new courses or credits to the established programs, which then led to, okay, so where might such knowledge, skill set development might… how might we do this? And what we ended up doing was looking across the core programs and identifying where we could introduce this in a way that would not disrupt the core of the course, but would allow for this opportunity to really reflect on opportunities or problems, however you want to say it. Problems in healthcare tend to have a little bit more painful reaction than opportunity, so it’s a matter of how you want to frame it.

But so, dedicating time, strategically placed to focus on these gaps for students. And that can be done through a variety of ways. These are just two that’ll offer. One is in the classroom, one is outside of the classroom, but on the left you see, I have a picture of the National Patient Safety Goals. And so, in our first semester of our first year for students, I meet with all of them, and this course is called Healthcare Delivery Systems. I go through, what is innovation, different theories, and then towards the latter part of the class, I go through these different National Patient Safety Goals and say, “These are currently opportunities for improvement or areas where we can use some strengthening of our approaches.” And typically they’re often surprised to see at least the first one there, identifying patients correctly. Remember, these are newly graduated high school students who probably haven’t had a lot of exposure to a hospital.

And so, each student’s asked to think about… they break into small groups and pick a topic and formulate, what is a solution that could be presented? And they’re given 20 minutes to do this. The only guidelines that I provide for them is that it should be ethical and it should be something that is feasible to the extent that may be not available today but perhaps in the next five to 10 years. And so, then they come up and present their work, what their idea is to the class. At the end of these classes, students typically come up and I’ve had several that have said, “I didn’t know I could have an influence in healthcare.” Or I’ve even asked students, “Who can be an innovator?” I’ve started with that question, and I’ll hear all sorts of different roles and then I’ll say, “But who else?” And then, eventually nursing comes up, and my goal would be that that’s at the top of their list in coming years, but just as a place to plant it into their mindset, to think about how they could help make change.

On the right, we have an event that took place last spring as an example, where many of our undergraduate students partnered with engineering students to create air purifying boxes. These are called Corsi-Rosenthal Boxes, and they went across the community, created these boxes for school systems in other areas and they were able to make them in 30 minutes with $60 worth of supplies, to help address a need within the community. And so, this is a learning activity that can also talk about creating change. In this case it’s around public health measures and influencing that area, as well as working with another discipline.

Let’s see, formalizing the opportunities. So, I’m just keeping track of my time if you see me look down, to make sure I’m not too far off. So, formalizing the opportunity can start as a pilot in a course. You don’t necessarily need to start with a huge workforce plan, but maybe you just want to pilot something to see the response and identify leadership and faculty support on this effort, and get feedback from how do the students respond? Do they want more? Do they want it in a different way? Is it reaching where you wanted them to go with this? And then, you can adjust and improve. There’s also opportunities to seek grants that can create new courses and programs. VentureWell is one organization that has specifically a grant to this nature, that you might want to explore. There’s others as well, but that’s one that just jumps into my mind. And then, as you’re advancing this forward, integrating that into the coursework, which is something we’ve done at the university across all degree programs now.

So, within their program level objectives, their course descriptions and course objectives so that there is that framework already established. Modeling the way, this is actually one of the leadership characteristics from Kouzes and Posner’s book, The Leadership Challenge. I use this with my graduate students in their course on developing a culture of innovative leadership. And I use that title there for two reasons. One, we have a responsibility to model the way for our students, in terms of how to look at the world in a way of being able to influence change, and being a profession that’s advancing and working to make healthcare better, for not just our patients and families, but also for our nurses that are delivering that care and others. And the second factor is with regards to this paper. So, this might be something you want to take a look at. A team from Ohio State put this paper together, it’s a blueprint for nursing innovation centers and they talked to seven centers across the United States.

I wrote them down so I wouldn’t forget all seven, UPenn, Duke, Cleveland Clinic, Ohio State, Johns Hopkins, NYU, and UConn are highlighted in this paper, and talks about different factors that can contribute towards how they’ve reached that goal. So, this might be something of help, of interest as a reference point for you. And then, exploring opportunities on campus that can be shared with students. So, sometimes we tend to think, “Oh my goodness, how in the world am I going to add something else to my list of what I’m doing, and how might I fit this in?” And not everything needs to be added in new. There are often resources available that can tie in to students’ needs that can be helpful in building that infrastructure and culture you’re striving for. Explore university innovation events. Are there things specific towards healthcare innovation or hackathons that the students might enjoy? Promote those through your student bodies.

Are there student innovation grant opportunities that can be shared with students to explore? Suggesting students contribute ideas when there’s called for feedback, whether it’s this, an example might be in student health or areas across the university where they’re looking for student feedback, having students contribute. Promoting internships, fellowships, whether that’s within the university or something external, if you see it. And I’d love to hear if there’s things that you see or you promote. If there’s others that you can think of, please share them with me. I’m happy to add to my list. This is a strategy in the classroom I’d like to share. So, I get to know the students’ concerns about becoming new nurses. In the spring I talk to the seniors and it’s their capstone course. And this past spring I tried a different strategy.

I like to engage with students, I like to get them talking, but not everybody wants to talk or raise their hand. And when you’ve got over 100 students, how that works can be a little tricky sometimes. So, I ended up bringing a couple packs of note cards and index cards and I gave one to each student, and I asked them to write down answers to three questions. What is an issue that is in need of a solution in nursing today? Who are the responsible parties that should be solving it? And then, what can they as students do to help solve it or influence change? And so, I handed out these note cards and I had no idea what I was going to get back and I started to collect them all and I actually printed out my notes, I’m not going to go through all of them today.

But the top three, just to give you a sense of what the feedback was, and these are in order of how repetitive they were on the index cards. Staffing or staffing workload was the top, nurse burnout was number two, and nurse shortage number three, those are the top three. And I thought, “Okay, wow, we have students that are just about to graduate and these are their top concerns. So, how do we support them in this and how do we start to give them tools so that they can be able to enter into the workforce knowing about these things, without feeling discouraged or overly concerned?”

And what ended up coming back from who can help solve it, so there’s huge lists that I got from the aggregated data, but we did talk about how some issues are more complicated than others in the terms of there are things that require a lot of leadership involvement at multiple levels to address, and then there are ways in which that each of these students could get involved. So, some tactics, I listened to these students and thought in just preparing for this, reflecting back on that again, our students aren’t necessarily going to be able to solve these larger problems, but they can become prepared with questions that can be helpful to them.

So, we can offer them as faculty, tactics, questions to ask when interviewing, things that they might want to know before they make a commitment at a job. I don’t think that in my experience I felt comfortable asking questions, I just wanted to make a good impression and get my first job. But we’re at a place now where I think asking these questions is appropriate. What does a typical day look like? What’s the average length of stay of nurses here? Is this a nurse residency program or not? How they can get involved as a new graduate. Getting on committees, finding one committee that is going to give them exposure and a voice in areas that is of interest to them. There’s always someone looking for more help than volunteers. And so, this is a great way to not just help and influence change, but grow your career and get more exposure to people.

How to find professional networking opportunities. I don’t think I attended a networking opportunity until my graduate degree. I didn’t even know about nursing networking opportunities. So, the earlier we can share these things with students, the greater likelihood they’ll have more exposure. When to recognize you’re ready for a next step. So, what does growth feel and look like for a new nurse? And encouraging mentorship. I think some of the best experiences I’ve had in growth have been through really, having a mentor. So, us as faculty, giving these tactics to students and things to look for and ways to help shape their outlook.

And then, just on the flip side of that, these are expressions that aren’t my favorite. I think they can tend to minimize hope, things of the nature of, “That’s just the way it is, or we’ve just always done it this way.” I know we all might have a tendency to have that come out in some way or in response to something at some point, but what people hear is likely different than the intent. And so, being able to reframe that in a way that might say, “You know, it’s probably time that we look at this a different way. What are your thinking? What are your thoughts?”

The other is, “You won’t or can’t be or do X, until you do this.” That can be really minimizing too, sort of setting these expectations for students new in their career, that they can’t go do X until they’ve reached this. And I didn’t get really specific here because I think it can be variable, and there are times when there are things you need to accomplish. You do need to pass your NCLEX. But in terms of what specialty to work in, or when to go to grad school or not go to grad school, those I think, the less we place restrictions in that way, I think the better outlook our students will have in terms of building their future. And if there’s others that you can think of, or techniques to use to reframe this, please do share.

I know we’re getting short on time, so this is probably the most important area, so I’ll spend five minutes here and then time for question. Identifying alignment. So, we’ve gone through the big picture of why this is important for the profession, how students have the ability to make this be part of their day-to-day life. A few years ago I remember hearing, I can’t remember exactly where, but just some discussion that nurses really needed. They need to be nurses first before they could possibly think of ideas that needed to be improved upon. And I think exactly the opposite, and our examples demonstrate that as well, because you’ve got a fresh pair of eyes who are looking at what you’ve been doing or how things are happening and thinking, “Why is that happening that way?”

Now, there’s techniques and tactics to not upset someone or feel as though they’re being disrespectful, but those questions should be seen as areas to think, “Huh, maybe we have been doing this a little outdated. or maybe this doesn’t fit the model anymore. What do you think the idea should be?” It doesn’t always have to be put on the person that’s being asked the question. Reflect back on the students. Say, “What are some of the thoughts that you have?”

So, the emergence of the AACN Essentials is great timing, and especially in the context of this conversation, but in the purpose of, how might you be able to do this without needing to completely reframe or change, because you’re already likely going through these new Essentials. So, where could something like this fit? Now, these are just a few examples. I didn’t pull them all out, but I wanted to reflect on a few. So, this is at the entry level. So, professional nursing education, from Domain 1, which is Knowledge for Nursing Practice 1.2, “Demonstrate intellectual curiosity.” So, that example with the National Patient Safety Goals, intellectual curiosity, they’re thinking of beyond what’s visible today, and how do we help identify patients better? So, that falls off of the list and we no longer need to have that at the top of the National Patient Safety Goals.

1.3 B, Integrating Nursing Knowledge from Other Disciplines and Inquiry to Inform Clinical Judgment. Clay Christensen is an author in a book I use, Innovator’s DNA, and association is one of the five behaviors that innovators use to be able to perform these new ideas and solutions. And by taking insights, applications, findings, or approaches from other industries, that can often influence a new way of looking at something. So, that could fit here in a theoretical perspective, in a methodology perspective.

Demonstrating competencies of empathy. This is something I think we as nurses do very well. That is the first stage of the design thinking methodology that is used to help formulate new prototypes. So, that ability to sort of walk that… it’s not the greatest expression, but being able to walk in someone else’s shoes or feel like you’re walking in someone else’s shoes, that empathetic understanding of what is it that you need, and what is not being met for that person-centered care?

Managing population help, defining the target population and what are their needs? What is it that’s not being addressed? I mean, this is something that we’re always working towards, scholarship for the nursing discipline. So, scholarly inquiry can be publishing, it can be research, but it can also be innovation development. We have an honors innovation track, where students can create their own individual innovation project as part of their honors thesis. Quality and safety. I included this because every time we’re making change it should lead to some impact in quality and safety. So, there should be at least one of those factors.

Professionalism, our professional identity, contributions to the healthcare team. That’s multifaceted. But again, the more we develop, the greater contributions we have, the further we advance our profession. All of these fall into this, as well as leadership development as well. So, that’s entry level, that’s just a few that I picked out. There’s likely more, but offering you examples of how that can be used to integrate new activities, new content to help influence the mindset of students. And from an advanced level, nursing education, knowledge for nursing practice, integrate an understanding of nursing history in advancing the influence in healthcare.

And I believe there’s a strong connotation between what’s happened in the past and how we look at what will happen in the future. There’s a strong history of nurses as innovators in creating solutions that we’ve needed throughout history. Some of them have sort of started to reach the common sort of knowledge, I would say, like the crash cart, pediatric pain scale, but there’s many others. And those can be seen as examples of what’s possible. Incorporate innovations into practice when evidence is not available. Nurses are doing this every day through workarounds, but what if we were able to actually make those workarounds into things that are solving the problem for everyone? And I think I have just one more slide.

Manage population health and integrating best evidence into nursing practice. So, again, addressing opportunities for innovation and changes in practice. Sometimes I think that we’re waiting for permission to be able to offer ideas, or think, “Is this going to be good enough?” And it really is about building that culture, to be able to share ideas and explore them and think, “Maybe this is something that could work or, well, maybe not that, but maybe this.” But just opening the door for people to know that it’s something that they could contribute to, can make a big difference.

So, with that, I believe this is all of my… yes. This is my disclaimer. This is just a few examples. This was not meant to be a comprehensive analysis of AACN Essentials, but just some examples to explore and give you ideas on how to leverage for the benefit of your students, whether at the undergraduate or graduate level. And I think we have time for questions. So, there’s my email address if you need or want to reach out to me, please do and I will stop sharing so that we can address the questions.

Jessica Hurdley:

Thank you so much, Dr. Kelley. That was a lot of great information and I know we can all learn from at least something that you’ve shared. So, we do have one question that came in. “How do we as faculty nourish utilizing knowledge from other disciplines, when most programs are looking to reduce the number of credits, and streamlining educational requirements so that students can finish quicker?”

Tiffany Kelley:

Okay, can you say that one more time?

Jessica Hurdley:

“How do we as faculty nourish utilizing knowledge from other disciplines, when most programs are looking to reduce the number of credits, and streamlining educational requirements so that students can finish quicker?”

Tiffany Kelley:

Well, I think there’s two questions in there. One is, I think, if I’m hearing it right, how do we, I think make space and bring in new knowledge into an already full program? And that’s something that we faced as well. But what it comes down to is looking at, okay, what are the topics we want to be able to cover? Where might they fit best in the course? Working with the faculty that are either leading the course or directing the program, having those conversations and saying, “This is important. We have to address this for the AACN Essentials. How do we adjust what we’re teaching or offer a time slot?” So, in many of these courses, I am given one of their lecture times in the course of a semester to… so that could be anywhere from an hour to an hour and a half. And I don’t see it as taking away from anything, but rather building on top of, where I’m not changing the topic of what we’re talking about.

So, talking about an example of healthcare delivery systems. It’s just, I’m offering another perspective on, how do we think about these systems? How do we begin to give you tools so you can see them as something that you could help influence and not just something that’s, that’s going to be the way it is. The second question I think, was about how to streamline programs and have people graduate quicker, which is, I think a different question, if I understand the question correctly. I don’t know the specifics of the context in which this came, but that becomes really looking at a program level of what do we… from an accreditation perspective and what are the opportunities? Is it something that students run through the summer and add on a semester there to be able… maybe two years and then they’re cutting out an academic year?

I don’t know if that’s what the question’s about, but I think the first is about content in the course, and I think the second is about program and speeding things up a little bit, if I understand that correctly. But whomever asked, you can tell me if I got it wrong, please. I can try to help.

Jessica Hurdley:

We do have another question, if there is any additional context on that first one that wants to be provided in the chat. The second question is, “How do we as faculty overcome the fixed mindset within nursing programs? The, ‘We have always done it this way. We have a great NCLEX pass rate.’ Those type of thoughts.”

Tiffany Kelley:

You know, I don’t love that question, “We’ve always done it that way.” I just had it in my slides, right? So, I think I understand that there’s the desire to not necessarily break what’s working, or disrupt what seems to be working well, but there’s no… How do I want to say this? When we start to say things like, “We’ve always done it this way,” and I think it’s a matter of having a discussion about that and saying, “Well, just because we’ve done it this way for this long period of time, does that mean we’re meeting the best needs of our students?” We’re seeing what’s happening, and would we be doing a disservice to the students if we didn’t offer them strategy, at a minimum? How do you ask, “What’s the question I should be asking in an interview to know if I’m going to like where I’m going to work?” Right?

Even if that’s the minimum entry, is that something that is going to impact an NCLEX pass rate? Probably not. So, I think it shouldn’t be seen as a loss, if you will, by adding in the ability to critically think about making change. It should really be seen as an addition, and an extra skill set and competency that can only benefit our students, even before they become nurses. So, it’s a tough one, I understand that, but I think that it’s also a mindset and a culture perspective that might take a little bit of time to influence.

If we look at Rogers’ diffusion of innovation theory, not everyone’s going to be on board with adopting the new idea at the beginning, but it does take those conversations and perspectives and examples. That’s why I gave you many examples today. You can go to these papers and read them and decide what sounds appropriate to you. So, I’ll stop there because I could just keep going, and see if there’s more that I can answer for anyone.

Jessica Hurdley:

All right. Well, that looks like we’ve covered everything today. Dr. Kelley, thank you so much for sharing your experience and expertise with your colleagues all across the world. We’re so grateful that you volunteered your time to all of us, and for all of the information that you’ve provided in this workshop. We know that this workshop and information will be particularly valuable for our participants, so we’ll make sure to make the recording available as soon as possible and send it to all the registered attendees through email. Please feel free to share with any of your colleagues as well. That’s it for today. Thank you again to Dr. Kelley, those behind the scenes, and of course to all those who attended today. We’ll see you next time.

Tiffany Kelley:

Thank you.