Title : Creating an academic corporate partnership to support international nurses transitioning to the us healthcare system
Abstract:
Rationale/Background The purpose of this project was to determine the effectiveness of a proof-of-concept design for an academic-corporate partnership aimed at enhancing clinical skills, clinical judgement, and communication skills of internationally educated nurses (IENs) transitioning into professional nursing roles in the United States. During the transition period, IENs face many challenges, including negative perceptions of educational preparation, communication, and differences in nursing practice. The concept design included the use of simulation and opportunities for students and faculty to engage with nurses representing nine different countries. Methods: A proof-of-concept paper was created by School of Nursing leadership, in collaboration with the fourth largest international recruiting agency for U.S. healthcare organizations. The paper was presented to and approved by university and corporate leadership after outlining the scope, goals, timeline, and execution and evaluation plan. Kolb’s experiential learning theory was used a framework, simulation scenarios were designed using Healthcare Simulation Standards of Best Practice TM Simulation Design and were led by a Certified Healthcare Simulation Expert (CHSE). Using a corporate partner’s knowledge of nursing practice areas that are typically challenging for IENs beginning a nursing assignment in the US, activities were designed to provide opportunities to enhance assessment, communication, and interprofessional collaboration skills while promoting self-efficacy through frequent, focused feedback, encouragement, and opportunities to master skills by repeating tasks, if needed. Both mid and high-fidelity simulators were used to depict stroke, heart failure, cholecystectomy with postop complications, diabetes mellitus, asthma exacerbation, and cardiac arrest. Scenarios provided the opportunity to assess participants’ ability to communicate using SBAR, accurately assess patients, determine the ongoing disease process, and implement appropriate care. Debriefing, using the Plus-Delta method, followed each simulation requiring participants to selfreflect on individual and team performance. Evaluation: All participants (n=11) successfully completed each simulation by effectively communicating using SBAR, accurately assessing each patient, determining the ongoing disease process, and implementing appropriate care. Accurate response to the cardiac arrest was evaluated based on the quality of CPR performed and choice of ACLS pharmacologic treatments, monitored using software in the high-fidelity simulator. A post simulation experience survey was administered to assess simulation design. Ninety percent of participants agreed or strongly agreed that the fidelity of each simulation was appropriate. All participants agreed or strongly agreed that the simulations were appropriate for their skill level, feedback was constructive, and they felt supported. Qualitative responses were solicited to determine what participants found most useful, and to identify areas for improvement. Overwhelmingly, SBAR, code blue, and assessment activities were identified as most useful. Adding more hours, ICU scenarios, and common cultural norms were suggested as areas for improvement. Conclusions/Recommendations: Following the success of the project, both stakeholders agreed to continue the partnership on a larger scale. Flexibility, early and ongoing communication, alignment of missions and visions, and setting realistic measurable goals, were key to project success. Findings demonstrate that academic-corporate partnerships can and should be mutually beneficial, and that simulation can be successfully used to help IENs enhance clinical skills, clinical judgement, and communication while also promoting self-efficacy.
