EDUCATING THE NON- NURSE MIDWIFE: STRATEGIES FOR SUCCESS Lynette Ament, PhD, CNM, RN Yale School of Nursing
ACCELERATED NURSING PROGRAMS Generic Master s Need for career mobility Innovative programming to maximize the availability of providers Why would a bachelor s prepared applicant want to get a second bachelor s degree when they can get a professional master s in health care?
TYPICAL CHARACTERISTICS RN program is 12 months in length Generic master s is 3 years 36 generic programs (AACN, 2004) 18 new generic master s programs being planned (AACN, 2004)
Should an RN be a prerequisite to PRO Position: graduate programs? Needs day-to to-day clinical experience for practical knowledge base Develops a nursing identity Builds a secure and competent clinician Hones counseling skills, caring and compassion Builds intuition
Should an RN be a prerequisite to CON Position: graduate programs? Nursing needs innovative approaches Acculturates students without preconceived beliefs Students are motivated, older, and have higher expectations Graduates are more mature and are quick studies Postponing education is not conducive to best learning or best practice
Myths of Graduate Entry Needs experience as an RN after graduation Are slower than RN students in the clinical setting
HISTORICAL DEVELOPMENT YSN began first graduate entry program in U.S. in 1974 Goal: Create Nurse Leaders
History of Yale School of Nursing 1923: for students with some college education, BN degree 1296: MS degree for public health nsg, education, and nsg administration 1937: requirement for admission was bachelor s degree, awarded the MN 1956: midwifery program began (MSN + Certificate until 1972) 1958: MN program closed; opened 1 yr MSN program for RNs 1969: Yale became co-ed
Needs Assessment 1969 More medically sophisticated public More scientifically astute medical professionals Gap between quality of care desired and quality of care delivered
Refocusing Nursing Education New roles for the nurse Pressing need for clinical specialization Meet current health demands Plan future programs of prevention and care New ways of educating for these roles Technical nurse (AD, diploma) Professional nurse (BSN) Professional nurse (specialized master s) Doctoral degree
Graduate Clinical Education Essential in preparing leaders Allows pursuit of clinical area in depth Provides for intellectual and personal growth through self-directed study Demonstrates the ability to do scholarly work and form creative, logical conclusions
Objectives of YSN s 1st Program Beginning competence Able to design and conduct simple studies and evaluate research Assume responsibility for communicating research results Formulate, evaluate, develop, test, and use theory in practice and research Implement research findings in practice
Aims of First YSN Program Ability to use a high degree of critical thinking Ability to work as a member of an interdisciplinary health care team Ability to anticipate demands for future health services Ability to give expert care
Beliefs of Foremothers creeping curriculum is uneconomical with respect to time, resources, and personnel and results do not justify the expenditures Intensive, well-integrated experiences can be provided in a shorter time and be more effective Will produce a beginning specialist who knows how and where to continue her education after graduation
Who Was It Planned to Attract? Students nationwide Students interested in both the science and the art Students who want their educational foundation for expert practice in the shortest possible time
First RN Curriculum at YSN Medical ecology Interviewing Anatomy Biochemistry Growth & development Physiology Biochemistry Pharmacology Nursing Nutrition Medical aspects of care Diet therapy Microbiology Social science elective
Hopes of 1 st Curriculum Students who came with science courses will choose electives in other departments in the University or pursue more advanced work in the basic sciences Some of the courses might be offered interdepartmentally to collaborate within the medical complex
Curriculum 2003-04 04 40 credit hours in 3 semesters Maternal newborn nursing Medical surgical nursing Pediatric nursing Psychiatric/mental health nursing Community nursing Physiology Pathophysiology Human anatomy Nutrition Pharmacology Issues in Nursing
YSN Admission Requirements Bachelor s degree; graduation from an accredited program Grade of C or higher in statistics Courses in anatomy, physiology, and biological and social sciences are recommended, but not required
RN to Midwifery Meets CT State Board of Nursing requirements after 4 semesters Receives Certificate in Nursing and MSN after completing midwifery curriculum Must complete NCLEX by July 15 prior to last year of midwifery RN meant to be an endpoint, ie can t receive a degree if student does not continue in specialty
Who Applies to the Program? GEPNs GEPNs Minority RNs RNs Minority 88 8 19 1.5
Who Is Admitted? Mean Age = 20-29 29 GEPNs SAT Verbal 560 SAT Quantitative 588 SAT analytical 623 GPA 3.4 RNs 539 536 552 3.4
Institutional Factors for Success Administrative: Philosophy Educational environment Support systems
Recruitment of Students How Do You Screen Candidates? Exposure to midwifery Idealism Rigors of the program An accelerated program is not for everyone
Guiding Questions for Interview Conflict management Stress management Expectations of program Expectations of faculty Learning style Why this program versus CM versus CPM?
Student Retention Cultural issues Learning styles Test-taking taking skills Writing skills Special needs
Progression Needs Why do you want to be a midwife? Need to excel Competency-based learning
Educational Factors for Success Didactic curriculum Adult learning principles Modular learning Critical thinking skills Student buy-in
Principles of Adult Education Adults learners are: Goal-oriented oriented Persistent Highly motivated Committed to many things
Adult Learning Cycle Experiencing Processing Generalizing Applying Integrating
Thus.. Use work and life experiences to integrate learning Provide specific goals for learning Provide adequate time for learning Allow active participation in learning
Modular Learning Detailed description Comprehensive Clear information Coherent objectives Flexible Open and dynamic Non-dogmatic User friendly
Modular Learning KNOWLEDGE SKILLS APPLICATION
Critical Thinking Skills Case-based learning encourages: Creativity and independence Assumption of leadership roles Willingness to take risks Assumption of personal responsibility (Diers)
Case-based Learning Narrative writing Reflects progression of learning
Clinical Curriculum Progressive Acquisition of Skills For each Modules: Entry skills Exit skills
Preparing for Clinical Learning Profile: How do I learn best? What can preceptors do to facilitate my learning? What inhibits my learning? My areas of strength are: My areas of need are: My fears and anxieties are: My long-term goals are: Pre and Post-Conference Clinical Evaluation Tools
Ambulatory Clinical Pearls Students don t have to see all the patients Students don t have to do the entire visit How much supervision? Time management
Intrapartum Clinical Pearls Is an L&D pre-experience experience necessary? Team call Skills checklists: practice, practice, practice Expect hesitancy, doubts, poor performance Circle of safety, and patient pushing
WHY DO YOU WANT TO DO THIS?
Preceptor Issues Precepting the graduate entry student is not for everyone! Address pearls and issues at preceptor workshops, site visits
Challenges Don t be intimidated, know your stuff, know what you don t know, and don t be afraid to learn with your student!
Integration
Numbers
QUESTIONS