Impact of a summer extern program on nursing student’s awareness of interprofessional collaboration and healthy, healing environments: A level II quasi-experimental design

Abstract

Background: Student nurse externships bridge the gap between education and practice. These programs expose students to the interprofessional healthcare team, the work environment and its impact on themselves as well as their patients. Methods: Research Objective/Questions: 1) What is the nurse externs' knowledge of a healthy healing environment (HHE) at the beginning of an 8 week summer externship program? 2) How does participation in the interprofessional externship inform the externs' knowledge and awareness of a HHE and 3) How does this knowledge affect the extern themselves and their patient outcomes? Design: A Level II Quasi-Experimental design was completed in 2013-2015 involving 3 cohorts each with 20 externs. Participants and Setting: A convenience sample of student nurses from baccalaureate and associate degree nursing programs who participated in a nursing externship. Methods: After informed consent, a survey of open-ended questions was administered at the beginning (week 1) and end (week 8) of the externship. Survey findings were compared using thematic content analysis. Results: At the outset, externs demonstrated basic knowledge as to what a HHE means. By the end, externs were able to describe in depth a HHE for themselves and their patients. They also described their role on an interprofessional health care team when establishing and maintaining a HHE. Findings were 1) increased cognizance of a HHE (88%); 2) enhanced mindfulness of working in a truly collaborative manner with the interprofessional healthcare team to improve decision-making (85%); 3) broadened recognition how skilled communication among all interprofessional team members leads to a HHE (85%); and 4) raised awareness of a HHE positively affecting their own health and improved outcomes in their patients (90%). Conclusions: The externs' perceptions of a HHE broadened over the course of the externship as did their understanding of their obligations in forming and maintaining a HHE. Externs also described the impact on patient outcomes.

Innovative nurse externship that fosters interprofessional collaboration, resilience, and self-advocacy

“…The results from the participant questionnaires validated previous literature regarding healthy work environments. 4 These externs noted that interprofessional collaboration is a key component in a healthy work environment. Furthermore, externs gained an appreciation of how quality interprofessional collaboration positively impacts teamwork which improves the work environment.…”

“…Externships, very similar to the transition-to-practice residency programs, align with clinical immersion experiences to reinforce safe patient care, clinical reasoning, and holistic decision-making 4,5. When students are immersed in the clinical environment through externships, real-life opportunities are presented that benefit students' knowledge which is essential for the new, novice nurse's survival in today's complex healthcare arena 4,5…”

Nursing Students and Nurses’ Recommendations Aiming at Improving the Development of the Humanistic Caring Competency

“…To the knowledge of the authors, the impacts of prelicensure clinical extern programs on humanistic caring (or related concepts such as empathy and compassion) have rarely been reported. Indeed, the outcomes mostly revolve around students benefits such as confidence and clinical skills ( Rugs et al, 2020 ), interprofessional collaboration ( Ruth-Sahd, 2016 ), professionalism, job satisfaction, and sense of belonging ( Cantrell et al., 2005 ), transition into the professional nurse role ( Cantrell & Browne, 2005 ) in addition to recruitment and retention ( Cantrell & Browne, 2006 ; Friday et al., 2015 ; Remle et al, 2014 ). However, two studies ( Massé, 2016 ; Oja, 2013 ) reported a development of communication skills in externs who completed their program.…”

Experiences and Perceptions Gained by Student Nurse Externs Working During a Pandemic

“…Two studies highlight improvement in professional values, knowledge base, teamwork skills, and overall self-confidence from experiences as SNEs (Shipman et al, 2016; White et al, 2019b). Ruth-Sahd (2016) also found that participation in externships fostered interprofessional collaboration and promoted a smoother transition to professional practice. Wilkerson and Faber (2015) noted outcomes of improving recruitment and easing the transition from education to the hospital work environment as well as boosting retention through externships.…”

“…Summer nurse externships provide prelicensure students with the opportunity to work in a registered nurse (RN)-supervised position and function like a nurse while under the direction of nursing faculty (Rugs et al, 2020; White et al, 2019b). Goals of externships are to increase acute care clinical exposure, build critical thinking skills, and foster networking and relationships between the student nurse extern (SNE) and RN role models (Ruth-Sahd, 2016). Externships provide opportunities for students typically entering the final 6–12 months of their academic program to practice skills, clinical decision-making, delegation, and prioritization (White et al, 2019a).…”