Linda Norman

Collaborating for improvement in health professions education.

Continual improvement efforts have been slower in health professions education than in health care delivery. This article identifies the lessons learned by teams working in an Interdisciplinary Professional Education Collaborative in overcoming barriers to carrying out continual improvement efforts in these educational organizations.

Continuous self-improvement: systems thinking in a personal context.

BACKGROUND Continuous quality improvement (CQI) thinking and tools have broad applicability to improving peoples lives--in continuous self-improvement (CSI). Examples include weight loss, weight gain, increasing exercise time, and improving relationship with spouse. In addition, change agents, who support and facilitate organizational efforts, can use CSI to help employees understand steps in CQI. A STEP-BY-STEP APPROACH: Team members should be involved in both the definition of the problem and the search for the solution. How do everyday processes and routines affect the habit that needs to change? What are the precursors of the event? Clients list possible solutions, prioritize them, and pilot test the items selected. One needs to change the daily routines until the desired behavior is accomplished habitually and with little external decision. DISCUSSION CSI is successful because of its emphasis on habits embedded in personal processes. CSI organizes support from process owners, buddies, and coaches, and encourages regular measurement, multiple small improvement cycles, and public reporting.

Making organizational change to achieve improvement and interprofessional learning: perspectives from health professions educators

Health professionals must learn to work in the context of an interdisciplinary team in order to meet the needs of the evolving health care delivery system. These teams must work successfully with community systems to achieve common goals, while understanding and respecting diverse perspectives, experiences and skills. Strategies for changing health professions education to prepare new health professionals for such work have been tested by the Interdisciplinary Professional Education Collaborative. Illustrations of making educational change, and creating situations to sustain the change, are offered from the Collaboratives experience. Teams participating in the Collaborative engaged in interprofessional education, working on community-based health improvement issues. The illustrations are offered in the context of higher education, and the many barriers to making change that must be overcome. The work of the Collaborative provides valuable illustrations of successful activities to promote and create change, and ultimately to achieve improvement and interprofessional learning, better preparing new health professionals for the health systems in which they will work.

Leadership in doctoral nursing research programs.

The expansion of U.S. doctoral nursing research programs and transitions based on demographic distribution of the nursing academic workforce raises questions about the preparation for leadership transition planning. The purpose of this study was to describe the program leaders, job conditions, and status of transition efforts. A survey of U.S. nursing research doctoral programs (N = 105) was conducted in 2008. The response rate was 84.8%. A Web search of nonresponding schools provided some data from all programs. Most research doctoral program leaders hold additional responsibilities (mean = 4.2). The mean budgeted leadership time was 32.9% (SD = 21.4). Among programs in which the directors age was at least 60 years, 59% had no succession plan. Continuing improvement of the quality of doctoral nursing research programs could be compromised by leadership transition issues. To produce research-competitive graduates, continued support and attention to leadership of these programs is essential.

Formulating the mess: lessons from "Building Knowledge of Health Care as a System".

This article describes the experiences of a group of health adminstration educators, a group of medical educators, and a group of nursing educators in applying the lessons of the exercise “Building Knowledge of Health Care as a System” to the organization of health professions education.

Promoting Faculty Scholarship: A Clinical Faculty Scholars Program

BACKGROUND The importance of supporting and promoting faculty scholarship in nursing is acknowledged, but the reality of scholarship for faculty engaged in clinical teaching can be challenging. METHOD The article describes the development and initial results of the scholarly practice program. Mentorship, time, and limited funding are essentials for the program. RESULTS After submitting detailed proposals, 15 faculty were chosen to be project leaders in the first 2 years of the program, resulting in 15 presentations, three posters, 19 publications, and a webinar, to date. External continuing funding has been secured by three projects. Additional dissemination efforts are awaiting peer review. CONCLUSION The program has successfully increased the level of scholarship among clinical teaching faculty and contributed to the facultys professional satisfaction. Faculty have increased experience and ability to conduct clinical quality improvement. Experience supports targeted, substantial support for projects, rather than a general average faculty allocation strategy to promote scholarship. [J Nurs Educ. 2018;57(2):121-125.].

Health care reform and managed care: challenges for nursing education.

The future of nursing education is inextricably linked to structural changes in the health care delivery system, changes brought about by health care reform, integrated health care delivery systems, and the use of “managed care.” Multiple entry points to nursing education cause overlap in skills of graduates and result in rework. This article discusses this problem, the impact of the changing job market and case management on nursing education, and two new emerging advanced practice roles: the primary care nurse practitioner and the acute care nurse practitioner.