The face of healthcare is constantly changing, and nursing care is becoming increasingly complex. Nurses are caring for higher acuity patients and being asked to do more with less while still providing high-quality, safe patient care (Masters, 2015). The Institute of Medicine (2011) report, The Future of Nursing: Leading Change, Advancing Health, speaks to the need for major transformation in nursing education. Preparing nursing students to transition to safe, competent, and confident professionals is key, and having the educational resources to do that is essential to the future of nursing. The Health Resources and Services Administration estimates that over one million nurses will be lost to retirement in the next decade; and, it is estimated that almost 204,000 new nurses will be needed every year through 2026 (American Association of Colleges of Nursing, 2019, pp. 1-2). However, thousands of nursing school applicants are turned away due to faculty shortage, lack of clinical sites, insufficient classroom space, lack of clinical preceptors, and financial constraints (American Association of Colleges of Nursing, 2019, pp. 1-2). A dedicated education unit (DEU) model may help to resolve some of those resource issues and provide a positive learning environment for students.
The DEU model was first developed in Australia in the late 1990s and first used in the United States at the University of Portland School of Nursing in 2003 (University of Portland School of Nursing, 2020). Although varying forms of the model exist, they all involve close collaboration between the academic institution and the clinical organization (Hunt et al., 2015). Typically, faculty is on site, but the students work directly with staff nurses who have been designated as clinical instructors (CIs) for the rotation. This allows CIs to share their clinical expertise with students, allows students more opportunities for learning, and allows faculty more time to integrate theory into clinical (Hunt et al., 2015). Rusch et al. (2018) stated, “As opposed to the traditional model, DEU faculty are able to spend more quality time to focus on promoting and evaluating clinical reasoning, critical thinking, prioritization, and time management skills, which research shows many new graduates lack” (p. 15). The purpose of this project is to explore the potential benefits of a DEU for the student, the faculty, DEU nursing staff, the academic institution (Saint Francis Medical Center College of Nursing), and the clinical institution (OSF HealthCare Saint Francis Medical Center) as a whole.
Formulating a research question is often a challenging task for researchers when starting a project (Aslam & Emmanuel, 2010). To help frame the criteria needed to create this research question, the mnemonic PICO (or PICOT) is commonly used. PICOT stands for the population of interest, intervention of interest, comparison group, desired outcome, and time required to achieve the outcome (Melnyk & Fineout-Overholt, 2019). It is important that the topic chosen is relevant, researchable, and significant; and breaking up the question into separate parts allows for ease of research and for relevant information to come through (Aslam & Emmanuel, 2010).
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The nursing shortage and nursing faculty shortage are both relevant issues in nursing education. The potential benefits of implementing a DEU led us to our PICOT question for this project: In an undergraduate nursing program (P), how does clinical rotation on a dedicated education unit (I) compared to a traditional clinical setting (C) impact student satisfaction within the nursing program and improve student confidence with transitioning into a clinical nursing role (O) within the first year of registered nurse practice (T)? In other words, will a DEU provide a better educational experience and/or improve learning outcomes for the students? Will the partnership developed between Saint Francis Medical Center College of Nursing (SFMC CON) and OSF Healthcare Saint Franics Medical Center (OSFHC SFMC) in a DEU setting improve collaboration, interprofessional education, professional development, and staff satisfaction? Could a DEU have a positive impact on recruitment and retention of current students? Is there a cost benefit to the DEU? And finally, does care provided in the DEU setting impact patient satisfaction?
