Mary Wyckoff and Rebecca L. Rogers
United States of America, Samuel Merritt University, United States of AmericaTitle : Evolution of a DNP program during a National Crisis
Abstract
Purpose
The purpose of the project is to evaluate:
Will the implementation of the Diffusion of Innovation (DOI),
facilitate the development of practice and projects in the Doctor of Nursing
Practice (DNP) to enhance practice change through online and individual
interactions, which reduces uncertainty and improves self-efficacy in the DNP
program?
The Goals are the graduation of leaders, with Higher Order of
Thinking (HOT) ready to practice as DNP Leaders and DNP/FNP with completed
projects effecting practice change. These goals incorporate change through practice and the
dissemination of outcomes and through
poster presentation and publication. This will continue to be demonstrated
through presentation, national, local and through publication.
Background
The
DNP program previously had few graduates with classes frequently less than 10.
Now through implementing DOI, innovation
and development of the program has enrolled over 150 students with graduations
increasing yearly, with outcomes changing practice daily. Based on the success
and evolution of the program with the implementation of the philosophy of
education for the Doctor of Nursing Practice is focused on innovation,
diversity and the living environment, which encompasses each student to
experience a quality education.
The
evolution to DOI was through a diverse experience and evaluation of the needs
of the student to assure the students were individually precepted, chairs /
faculty were supported and learning was a 360 degree adventure.
In
our current situation of healthcare, the experience of the student should
prepare the individual to manage patients in difficult, existing environments,
including in the midst of the pandemic, bringing care to the population and
prepare the individual to be innovative in managing the healthcare needs across
the continuum from newborn to the chronicity of geriatric population. The innovation of the learning culture has been
individualized, motivational, and focused on providing information,
situations and technology, such as simulation, innovative project
development to facilitate exceptional experiences for each student
individually.
The
philosophy of teaching and learning at Samuel Merritt University and in providing
a system of beliefs and values while developing an integral partnership with
students, meeting the student in their environment, in a collaborative union
and in collaboration with peers, in the teaching and learning process. The goal
is clear and directed toward the preparation of advanced health care
practitioners whose practice is detailed, organized, and coordinated to
facilitate the care of each individual within their current environment and
with respect to their specific situations.
The
framework for learning is focused on the Diffusion of Innovation (DOI),
developed by Everett M. Rogers (1962). The focus is on diffusion, which
integrates through innovation and remains focused over time and infiltrated
with practice change. The framework is based on information, communication and
the uncertainty of life. Through online and individual interactions, the
current environment, culture and fast pace of technology breeds communication,
knowledge and information, which reduce uncertainty. Through these attributes of innovation, with establishment of
universally relevant ideas, demonstration of relative advantage, compatibility,
complexity, trialability and observability, through higher learning
environments, will change culture with evidence and science, ultimately
decreasing global burden of disease.
The novel ideas of individualized
diversity for students to expound upon their passion through gap analysis,
development of innovation to advance nursing practice to higher levels of
evolution and to fulfill the mandate of the Institute of Medicine for nurses to
function at their highest level of education and diversity. This will be and is
being achieved through the innovation of the integration of the Diffusion of
Innovation as a framework and practice theory for advanced nursing practice. Further
evolution of the process has occurred by measuring HOT through the
implementation of onsite intensives to facilitate clinical readiness,
actualizing the Simulation Thinking Rubric (STR) a valid and reliable tool developed
by Doolen, 2015() measuring clinical readiness through developmental language
and knowing.
What we know
Learning
is a social process and takes place within the context of the learner’s
lifestyle, culture, and readiness to learn. DOI is an image of the philosophy
of Samuel Merritt, which requires that our graduates use sound reasoning, which
incorporates the current best evidence, integrating their clinical expertise,
and the individual preferences to individualize the uniqueness of the people
served. In actuality we meet the student where they are and through the
evolution of DOI facilitate and enhance the process of innovation to develop
projects that change practice in facilities, clinics, and in homeless,
underserved populations. The diversity of learning offers multiple student
learning experiences, including onsite intensives and offers community partners
the opportunity to work with developing Doctor of Nursing students on actual
practice changes instead of theory based learning experiences.
Project contribution
As
faculty we are representative of the culture of Samuel Merritt. The actual
process, outcomes, and competencies are integral to the educational development
of the students. As a member of the faculty of Samuel Merritt, the
responsibility to establish an environment conducive to learning, exhibit
expertise within the discipline of nursing, and facilitate learning through use
of current, best practices of effective teaching and learning. Correlating
extensive educational and nursing experience, we have the ability to facilitate
an educational advantage for our students by providing research experience,
clinical expertise, individualized instruction with integral strategy, to
facilitate learning within different individualized preferences. By applying
individual and a variety of approaches to the learning process and the
integration of technology, with the incorporation multidisciplinary learning
strategies into the daily learning through which each student processes
conceptualized learning, the students’ actualize the learning process with the
experiential learning theory. The integration of Doctoral pedagogy in a
learning laboratory such as a clinical site provides actualization of theory in
to practice.
The Novelty
The
partnership in learning is focused on the student, the healthcare of our
population, reducing global burden, peer faculty and the philosophy of Samuel
Merritt. The learning plan, is a partnership that honors the individual and
respects the varied life experiences students bring to the learning
environment. In today's culture, remaining compassionate, diverse and
aware of each individual student’s emotional, social, psychological, and
cognitive development.is critical to transform the experience of care in
diverse communities.
Design and
Methods
The
goal is to provide a defined, concise experience with clear rationale,
incorporating innovation in evidence-based information supported with
scientific fact, while facilitating thought and process in individual
situations. This theory facilitates analysis and reflection with the
implementation of care experienced in the learning process, while enhancing the
student's ability to evaluate individualized patient care needs. Case
situations, simulations, online and face to face learning environments
including clinical experience facilitate the formation of innovative care
concepts and enhanced learning in clinical situations with focus on change.
This experiential learning then allows students to clinically evaluate patients
and facilitate care in healthcare environments bringing evidence-based care to
our patients. The clinical concepts and practical applications, including inter
professional education, provide a critical foundation for learning in the
health professions. Our graduates demonstrate use of sound reasoning,
evidence-based care, and clinical expertise to respond to the needs of the people
they serve. The actual process, outcomes, and competencies are integral to the
educational development of the students. By applying individual and a variety
of approaches to the learning process and the integration of technology, with
the incorporation multidisciplinary learning strategies into the daily learning
through which each student processes conceptualized learning, the student’s
actualize the learning process with the experiential learning theory.
The
outcomes measured will be practice change through project implementation in our
community facilities, measured by statistical data of the practice change,
evaluated by sustainability of the practice change, poster presentation,
publication, and graduation, culminating with over time a cultural focus on
wellness.
Findings /
Results
Have been measured through
the pre and post self-efficacy and evaluation of student outcomes over time.
This is in early stages with enrollment expounding from 10 students to
currently over 150 students, publications. Anticipated graduation to increase
10 fold.
Discussion /
Conclusion
Data collection in beginning states and will be measured overtime
by documentation of practice change, outcome analysis, improvements in quality
and safety, publication and graduation.
Limitations /
Reflective Critique
Evolution of the process of the development of the program. Bias
may be focused on a cultural drive for doctoral prepared nurses, though the
choice of programs remains available. Though now through change in philosophy
and practice the enrollment has significantly increased.
Biography
Mary Wyckoff has been a faculty member at Samuel Merritt University since 2015. Prior to taking this position, she was faculty in the Master and DNP program at the University of Miami and Barry University. She was the Director of Research at the William Lehman Trauma Research Center, University of Miami and Jackson Health System. She was the Nurse Pracitioner Supervisor in Acute Care Trauma/Surgery/Transplant/Cardiothoracic at Jackson Health System in Miami for 22 years. Her career encompassed neonatal nurse manager, neonatal nurse practitioner and trauma nurse specialist. She remains board certified as a nurse practitioner in family practice, neonatology and acute care adult. She has also been faculty at Northeastern University and Chamberlain University. She was an elected member of the nursing congress from 2006-2010 and worked on the L.A.C.E. project through ANA. She is also a nominated Fellow in the American Acadamy of Nurse Practitioners. She is currently an Associate Professor in the FNP program in Sacramento. Her primary focus is on research, quality, vascular access, health policy, palliative care, intensive care with experience across the continuun of life from neonatal to geriatric.
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