Different models of collaboration between nursing service and

DIFFERENT MODELS OF
COLLABORATION
BETWEEN NURSING
EDUCATION AND
SERVICE
Thanuja eleena Mathew

INTRODUCTION
• The Nursing profession is faced with
increasingly complex healthcare issues
driven by technological and medical
advancements, an ageing population,
increased numbers of people living with
chronic disease.

• Collaborative partnership between
educational institutions and service agency
have been viewed as on way to provide
research which ensures an evolving health
care system with comprehensive and
coordinated services that are evidence
based, cost effective and improve health
care outcomes.

MEANING
• ‘Co’ and ‘Laborie’ in Latin meaning ”work
together”
Interaction among two or more individuals,
which can encompass a variety of actions
such as communication, information
sharing, co-ordination, co-operation,
problem solving and negotiation.

• Collaboration is an intricate concept with
multiple attributes. Attribute identified by
several nurse authors include planning, making
decisions, solving problems, setting goals,
assuming responsibilities, working together
cooperatively, communicating and
coordinating openly.
• (Baggs and Smith 1988).

DEFINITION
• Collaboration is the most formal inter
organizational relationship involving
shared authority and responsibility for
planning, implementation and evaluation
of a joint effort.
---HORD,1986

DEFINITION
• Collaboration is a mutually beneficial and
well defined relationship entered into by
two or more organizations to achieve
common goals.
----MURRAY,MONSEY

TYPES OF COLLABORATION
• INTERDISCIPLINARY
• MULTI DISCIPLINARY
• TRANSDISCIPLINARY
• INTERPROFESSIONAL

INTERDISCIPLINARY
• The term used to indicate the
combining of two or more disciplines,
professions, departments usually in
regard to practice, research and/or
theory.

MULTI DISCIPLINARY
• Refers to independent work and decision
making such as when disciplines work
side by side on a problem.
• Collaborative communication rather than
shared communication. (Garner, 1995 &
Hoeman 1996)

TRANSDISCIPLINARY
• Involves multiple disciplines sharing together
their knowledge skills across traditional
disciplinary boundaries in accomplishing
tasks or goals. (Hoeman,1996)

• Transdisciplinary efforts reflect a process
by which individuals work together to
develop a shared conceptual framework
that integrates and extends discipline
specific theories, concepts and methods to
address a common problem

INTER PROFESSIONAL
• Involve interaction of two or more
disciplines involving professionals who
work together, with intention, mutual
respect and for commitment for the sake
of a more adequate response to a human
problem
-(Harbough,1994).

NEED FOR COLLABORATION
Increasing the gap between nursing service
and education
Graduate nurses often lack practical skills
despite their significant knowledge of
nursing process and theory
partnership between nursing education and
hospital nursing personnel is essential to
meet this challenge

MODELS OF COLLABORATION
1. Clinical School of Nursing Model (1995)
2. Dedicated Education Unit Clinical Teaching
Model(1999)
3. Research Joint Appointments [clinical chair]
(2000)
4. Practice research model [PRM] (2001)

5. Collaborative Clinical education Epworth
Deakin [CCEED] Model (2003)
6. The collaborative Learning Unit Model
[British Columbia] (2005)
7. The collaborative Approach to nursing
care [CAN Care] model(2006)
8. The bridge to practice model [2008]

Clinical school of nursing model
[1995]
• This was the concept of visionary nurses from
both La Trobe and The Alfred Clinical School
of Nursing University.
• The development of the Clinical School offers
benefits to both hospital and university.

 Encompasses the highest level of academic and clinical
nursing research and education.
 It brings academic staff to the Hospital, with opportunities for
exchange of ideas with clinical nurses with increased
opportunities for clinical nursing research.
 It is importance of continuing link between theory & practice.

Dedicated Education Unit
Clinical Teaching Model [1999]
In this model a partnership of nurse executives,
staff nurses and faculty transformed patient care
units into environments of support for nursing
students and staff nurses while continuing the
critical work of providing quality care to acutely
ill adults

• Results of implementation of this model
in which staff nurses assumed the role of
nursing instructors showed high student
and nurse satisfaction and marked
increase in the clinical capacity that
allowed for increased enrolment

Key Features of the Dedicated Education
Unit for UG nursing students are:
• Uses existing resources.
• Supports the professional development of
nurses
• Potential recruiting and retention tool
• Allows for the clinical education of
increased numbers of students

• Exclusive use of the clinical unit by School
of Nursing
• Use of staff nurses who want to teach as
clinical instructors
• Preparation of clinical instructors for their
teaching role through collaborative staff
and faculty development activities

• Faculty role to work directly with staff as
coach, collaborator, teaching/learning
resource to develop clinical reasoning skills,
to identify clinical expectations of students,
and evaluate student achievement
• Commitment by all to collaborate to build an
optimal learning environment

RESEARCH JOINT APPOINTMENTS
[CLINICAL CHAIR] , 2000
• A Joint Appointment has been defined by
Lantz et al. (1994), as “a formalised
agreement between two institutions where
an individual holds a position in each
institution and carries out specific and
defined responsibilities”.

Research Joint Appointments
(Clinical Chair) [2000]
• The goal of this approach is to use the
implementation of research findings as a
basis for improving critical thinking and
clinical decision-making of nurses.

In this arrangement, the researcher is a faculty
member at the educational institution with credibility
in conducting research and with an interest in
developing a research programme in the clinical
setting
Formal agreement exists between two organizations.

Outcomes for educational institution
 More in touch with the real world
 More readily able to identify research question,
that have the potential to make a difference to
quality of consumer care delivery
 Increase collaborative relationship with the service
provider

Practice-Research Model (PRM)
• It is an innovative collaborative partnership
agreement between Fremantle Hospital
and Health Service and Curtin University
of Technology in Perth, Western Australia.
• The partnership engages academics in the
clinical setting in two formalized
collaborative appointments.

• This partnership not only enhances
communication between educational and
health services, but fosters the development
of nursing research and knowledge.
• Enhances communication between
educational and health services, but fosters
the development of nursing research and
knowledge.

 Key Concepts:
Practice – driven research development
Collegial Partnership
Collaborative Partnership
Best Practice

Key elements
1. Collaborative Partnership
• It was formed by nursing health professionals, from the
community health service and the university who
recognized the need to bridge the theory-clinical
practice gap
• In practical terms, this involved a formal contractual
arrangement between the organizations that led to the
establishment of a Nurse Research Consultant (NRC)
position.

2. Nurse Research Consultant
In the PRM, the role of Nurse Research consultant
(NRC) was articulated as that of mentor and
consultant on issues related to research
methodology, publication and dissemination
Also encouraged involvement of multidisciplinary
team to work to achieve the aims of partnership
agreement.

COLLABORATIVE CLINICAL
EDUCATION EPWORTH DEAKIN
[CCEED] MODEL, 2003
• In an effort to improve the quality of new graduate
transition, Epworth Hospital and Deakin University
ran a collaborative project (2003) funded by the
National Safety and Quality Council to improve the
support base for new graduates while managing
the quality of patient care delivery

It developed to facilitate clinical learning,
promote clinical scholarship and build nurse
workforce capability
Tutorials, laboratories and clinical placements
are conducted by Epworth clinicians who are
prepared and supported by Deakin School of
Nursing faculty.

• The expectation was that increased
integration between Hospital and
University would enhance clinical
education resulting in improved student’s
application of knowledge and skill as well
as increased socialisation to the ‘clinician
role’

 The key findings of pilot CCEED program are:
Students learning objectives were met and
satisfaction was high
Undergraduate clinical education was valued
by preceptors and managers as a workforce
investment strategy

Preceptors were enriched in their clinician
role
Preceptors continually promoted a trusting
relationship that enabled them to
encourage student initiative
Preceptors managed multiple roles in
order to meet demands of patient care and
student learning

COLLABORATIVE CLINICAL EDUCATION
EPWORTH DEAKIN MODEL

THE COLLABORATION LEARNING
UNIT [BRITISH COLUMBIA]MODEL,2005
• This is based on “Dedicated Education Units” concept
implemented in Australia.
• In the CLU model, students practice and learn on a
nursing unit, each following an individual set rotation
and choosing their learning assignment according to
their learning plans.

• Unlike the traditional one-to-one preceptor
ship , an emphasis is placed on student
responsibility for self guiding and for
communicating their learning plan with
faculty and clinical nurses.

• All nursing staff members are involved in this model
and therefore the students gain a wide variety of
knowledge and also has the ability to provide practice
experiences for a large number of students
• As learners in CLU model are supported by
experienced clinical nurses, faculty and nurse
researchers. Students recognize a positive learning
environment and provide high quality nursing care

THE COLLABORATION LEARNING UNIT
[BRITISH COLUMBIA]MODEL,2005
STUDENT
NURSES
CLINICAL
NURSES
CLINICAL SITE
CO-
ORDINATORS
NURSE
RESEARCH
ERS
NURSE
EDUCATORS

COLLABORATIVE APPROACH TO
NURSING CARE [CAN- CARE] MODEL,
2006
 As academic and practice leaders acknowledged the need
to work together to promote the education, recruitment and
retention of nurses at all stages of their career.
 The goal was to design an educationally dense, practice
based experience to socialize students to the role of
professional nurse
 A secondary goal was to enhance and support the
professional and career development of unit based nurses

 The essence of CAN care model is the relationship
between the nurse learner (student) and nurse expert
(unit based nurse) within the context of each nursing
situation
 It focus of student’s activities moves from the
demonstration of discrete skills and prescribed
outcomes to an immersion into professional nursing
role, learning to hear and respond to the patient’s
needs and to provide nursing care to achieve quality
outcome

 Through this model the student comes to know the
organizational context of nursing practice , the
multifaceted role of professional nurses and
assumes responsibility for coming to know the
meaning of nursing in each unique situation
 This approach to education in the practice setting is
thought to be more consistent with the educational
needs of nurses who are preparing for the
challenges of professional practice in today’s acute
care settings

Different models of collaboration between nursing service and

Role of faculty:
• Nurture the nurse expert/nurse learner relationship
• Support the growth and development of both expert
and learner in their roles and responsibilities
• Act as an advisor, resource, role model and
educator for both of them
Role of health care organization:
• Provide a creative learning environment that
contribute to learning activities as opposed to just
being a setting in which college affiliated faculty
appear with students for a teaching encounter.

THE BRIDGE TO PRACTICE MODEL,
2008
 First, students complete all of their clinical experiences in one
participating hospital.
 Second, one full-time teaching faculty serves as a liaison for each
bridge hospital. This faculty member is given a space usually in
the nursing education department and is available to serve as a
resource for not only the clinical associates but also for hospital
nursing staff

 Third, students are actively involved in
selecting their clinical placements
 In this model therefore there can be
numerous clinical associates in one
hospital with one full time University
faculty overseeing the clinical experiences

 Challenges include
 recruitment of interested senior clinical nurses,
 retention of clinical liaison faculty and
 management of trade-off between institutional
stability offered by clinical site continuity and variety
of experiences offered by rotation across several
clinical settings

COLLABORATION OF NURSING
EDUCATION AND SERVICE IN INDIA
 The gap between nursing practice and education has
its historical roots in the separation of nursing schools
from the control of hospitals to which they are
attached.
 While this separation has been beneficial in
advancing nursing education, it has also had adverse
effects.

• Under the divided system, the nurse
educators are no longer the practicing nurses
in the wards or directly involved in the delivery
of nursing services used for student’s learning
• The practicing nurses have little opportunity to
share the practical knowledge with students
and no longer share their responsibility for
ensuring the relevance of the training that the
student receive.

As the gap between the education and
practice has widened, there are now significant
difference between what is taught in the
classroom and what is practiced in the service
setting. The need for the greater collaboration
between nursing education and service call for
urgent attention.

We have two institution which are practicing
dual role, education and practice:
NIMHANS Bangalore.
CMC Vellore.

DUAL ROLE MODEL IN NIMHANS
Following the amalgamation of 1974 resulting
in NIMHANS, the faculty of the nursing
department took up the dual role of providing
clinical services as well as conducting
teaching program. The head of the
department of nursing was given the
responsibility for both the service and
education components of the department.

DUAL ROLE MODEL IN NIMHANS
Integration of the education with the service
raised the quality of the patient care and
also improved the quality of learning
experience for nursing student, under the
close supervision of teachers who were
also practitioners.

INTEGRATIVE SERVICE
EDUCATION IN CMC VELLORE
College of nursing under Christian Medical
College Vellore where nurse educator
practicing in the ward are directly involving
in the delivery of the nursing services. This
enable the practicing nurse to share her
practical knowledge to the student nurse
who is practicing in the concerned ward.

CONCLUSION
• Collaborative care models are increasingly
popular in healthcare settings today.
Judicious use of nursing knowledge and
expertise along with strategic planning is
essential if nursing is to make
collaborative models a successful reality.

BIBLIOGRAPHY
↣ Basheer. p. shebeer. Text book of nursing education. 1st edition.
2015. EMMESS publications. New Delhi. Pp.462-482
↣ Pamela. J grace. Nursing ethics and professional responsibility. 2nd
edition. Jones and Bartlett publications. P.P 132-147
↣ Molly Catherine. Donahue. t. Francis. Collaboration projects
between nursing education and service. Nurse education today. P.P
368-377
↣ Palmer. P. sherry et.al. nursing education and service collaboration.
2003. Springer publishing company. P.P 123-128.

↣ Hood. J. Lucy. conceptual bases of professional nursing. 7th
edition. 2015. Lippincott publications. P.p. 87-90.
↣ Diane. L. Huber. Leadership and nursing care management. 3rd
edition. Saunders publications. P.P 831-834.
↣ Roussel Linda. Sandburg. Russell. Management and leadership
for nurse administrator. 5th edition. Jones and Bartlett
publications. P.P 141-150
↣ Chitty kittler kay. Professional nursing. Concepts and challenges.
4th edition. Saunders publishers. P.P 186.

• NET REFERENCES
↣ www.kkhsource.in
↣ www.eduhk.hk
↣ http://content.wisetep.com
↣ http://www.slideshare.net
• www.ccsent.org
• JOURNAL REFERENCE
↣ www. Njem.org
↣ www.Bcg.perspectives
↣ www.sgoSagePub.com
↣ www.bmj.com
↣ www.curtaionis.org
↣ global journal of health
science.org

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