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Interprofessional education ushers in age of successful collaboration
It took a while, but IPE finally hit its stride
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EDITOR'S NOTE: Robert G. Hess Jr., PhD, RN, FAAN, is OnCourse Learning's executive vice president and chief clinical executive, and founder and CEO of the Forum for Shared Governance. As an editor for Nurse.com, Hess has penned several editorials on career topics. As a presenter at professional conferences, Hess often addresses participants on how to find the right job and steps for building a successful career.
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By Robert G. Hess Jr.
PhD, RN, FAAN Executive vice president and chief clinical executive
  • Interprofessional education Bakewell-Sachs could talk forever about IPE at her school. I had heard about IPE happening with medical students enrolled at OHSU several years ago. It was gratifying for me to hear about progressive IPE in which, from the very first year, students learn with students from different disciplines, just as we at OnCourse Learning produce 25% of our new-course output every year as IPCE as required for our joint accreditation as providers for nursing, pharmacy and medicine. We surmised that new practitioners from institutions that used IPE were being schooled to be our new customers because they would already be acclimated to learning interprofessionally within a multidisciplinary team. IPE made Foley’s short list of trends as well. She is involved in IPE, incorporating concepts and content as well as service learning and clinical experiences into all the undergraduate nursing courses.
  • Competency-based education — What was unexpected to me was Bakewell-Sachs’ emphasis on competency-based education as a second trend in nursing academia. Again, this paralleled what we are trying to accomplish at OnCourse Learning. Our involvement with using competencies for CE started several years ago at the American Nurses Credentialing Center when I was vice-chair of the Commission on Accreditation.
Commissioners toyed with the idea of one day granting CE credit without using time as a metric. In other words: no contact hours, just formal acknowledgement for demonstrating competencies in clinical areas. Almost two years ago ANCC convened a think-tank day with five organizations, including OnCourse Learning, to see if it would be possible to make this a reality. Now in 2018 these five groups are awarding limited credits without time as a metric, and some credentialing agencies, particularly for those renewing board certifications, are accepting this. I found it rewarding that competency-based education was trending in nursing academia.
  • Nursing shortage — Nickitas reminded me of a nursing-school basic — educating enough nurses to meet the demands of the marketplace. Although the devastating shortage predicted by many is not likely to occur, regional problems plague nursing service administrators all over the U.S. To meet the demand, schools have had to continually invent new ways to attract and educate candidates. For instance, by educating the public about not just what nurses do, but what nurses know about making a real difference in advancing the health of individuals and populations, we can recruit more talented folks from a nontraditional workforce as well as the usual high school students. Once recruited, accelerated programs such as the one at Rutgers School of Nursing — Camden, allow students with a previous degree to complete the BSN in as few as 12 months.
Nickitas further commented on an equally important national shortage of nurses with advanced degrees necessary to teach new nurses and to supplement a shortage of primary care providers. I can personally attest to longstanding innovation in this area at Seton Hall where more than 30 years ago, I was able to enter a master’s degree in nursing program even though I didn’t have a BSN. The program allowed me to use my nursing diploma and undergraduate degree in comparative religion to satisfy sentry requirement without repeating a second undergraduate degree in nursing.
Schools are responding to niche shortages as well as the need arises. For example, Rutgers School of Nursing – Camden offers a certificate program in school nursing through its graduate division. In New Jersey, school nurses must be certified. Nickitas cites school nurses as the front line of care as the degree of toxic stress or adverse childhood events escalates in our K-12 programs in a world of more gun violence, growing threats of deportation and immigration issues confronting children and their families, as well as increased incidents of domestic violence.
  • Population health — The days of viewing recipients of our nursing care as individual patients is still relevant but only in the context of an expansive version of what used to be community or public health nursing. Schools of nursing tend to teach students to assess and treat patients within the context of where they live and traits they share with others in their communities. And along with this trend, according to Bakewell-Sachs, are related issues of social determinants of health, access to health services, and health literacy, all feeding into the trend encompassing students’ learning about population health.
  • The opioid epidemic — Foley reminded me of schools’ obligation to teach potential nurses, especially new nurse practitioners, how to recognize the symptoms of opioid addiction and how to make appropriate referrals to treat the problem both behaviorally and medically.
Years ago, we spent a great deal of time and resources to develop interprofessional continuing nursing education only to find out that many of our customers didn’t understand what is was, let alone its worth.
These clients were not alone. Some of the credentialing agencies that accredited our courses didn’t understand the worth of IPCE either. For example, several state physical therapy boards didn’t find it “relevant to the practice of PT,” and they wouldn’t accredit courses that included other disciplines.

As providers of IPCE, we occasionally still have to educate consumers about why interprofessional courses are good for professional practice and patient outcomes. But unorthodox trends can become standards of practice. This is why many progressive nursing schools have committed to interprofessional education by having nursing students study side by side with students of medicine, physical therapy, social work and other healthcare disciplines.

Visionary deans are usually behind avant-garde practice within their institutions, which is why when I wanted to explore trends in nursing education, I made a beeline to some of them. I spoke with Susan Bakewell-Sachs, PhD, RN, FAAN, vice president for nursing affairs, professor and dean at Oregon Health & Science University School of Nursing; Donna Nickitas, PhD, RN, NEA-BC, CNE, FAAN, dean of the Rutgers School of Nursing — Camden; and Marie Foley, PhD, RN, CNL, dean at Seton Hall University’s College of Nursing.

And of course, this group was busy nurturing IPE at their respective institutions. Together these three deans identified the following top trends in nursing education:
An exhaustive list of trends in nursing education is impossible because health and social issues zip in and out of visibility with increasing speed. And when nursing schools effectively counter problems with successful innovation, these issues tend to disappear. For example, why won’t the devastating shortage that was predicted for years occur? Because of the innovative programs devised by American nursing schools, like the ones represented by these three deans.
Top trends in nursing education
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