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Teaching Outside the Box

Feb 7, 2008 12:00 PM

The predicament continues to stymie nursing colleges across the country. For years, the University of Utah College of Nursing has been able to accept only one out of every three or four qualified applicants. In addition, four to six budgeted faculty positions go unfilled each year.

That prompted Carole Gassert, Ph.D., R.N., U associate professor of nursing and associate dean of information and technology, to come up with an innovative program designed to simultaneously address the nursing shortage and the nursing faculty shortage. The Clinical Faculty Associate (CFA) Model Program offers nurses an opportunity to take master’s-level classes while spending half of their time teaching undergraduate students at their workplace and the other half continuing to work at the bedside.

Gassert knew that one of the most difficult hurdles to recruiting faculty members is financial: teaching salaries are on average 25 percent lower than clinical salaries. “The CFA is a really exciting dual position that gives nurses an opportunity to explore teaching in-depth and learn a new skill set, while maintaining their clinical expertise and keeping their higher salary,” said Gassert. Among other program benefits, CFAs can begin teaching immmediately, before finishing their master’s degrees; most of their education is paid for by their hospitals’ tuition reimbursement programs; and they receive a $2,000 stipend each semester to cover additional expenses, such as books and computers.

The U.S. Department of Labor selected the CFA program as one of five health-care projects to receive federal funding. Out of 200 grant applicants, the U College of Nursing was awarded a two-year, $871,000 grant to launch the pilot program in fall 2005. Even Gassert didn’t anticipate the multi-tiered success of the program, which has become a national example of collaboration among a nursing school, government agency, and three clinical partners: University Health Care, Intermountain Healthcare, and the George E. Wahlen Department of Veterans Affairs (VA) Medical Center in Salt Lake City.

When the CFA model is presented at nursing conferences around the country, the question that’s always raised is: How do you get partnering institutions to loan out their nursing staff to teach 20 hours a week, but continue to pay them full-time salaries?

“It’s an effective way to retain some of the best staff nurses,” said Sylvia McKee, M.N., R.N., clinical staff development and education coordinator at  the VA. “By giving them an opportunity to learn a new set of skills, you increase job satisfaction. And any time a staff person continues his or her education, it’s helping improve patient care.”

Additionally, CFAs regularly go beyond the preceptor role and become recruiters for their hospitals. That’s not an easy task in a tight nursing market, noted George W. Lindsay Jr., M.S.N., R.N., manager of the VA Center for Learning. “Every year, 350 nursing students rotate through the VA. Because the CFAs have worked with the students one-on-one, they know who would be a good fit and are in a position to make that contact. So we’re recruiting not just the best students, but those who will make the best nurses to provide care to our veterans.”

The familiarity that CFAs have with their institution is one of the most distinguishing, and beneficial, characteristics of the program. Traditionally, a full-time faculty member with a master’s or Ph.D. in nursing education takes seven to 10 students onto a hospital floor to gain clinical experience. Faculty ask staff nurses to allow them to take over care of certain patients and request that students be allowed to shadow the nurses as they work. While faculty members are experienced teachers, they often aren’t familiar with the hospital’s culture, staff, and the ever-changing technology.

CFAs, on the other hand, know intimately the quirks and personalities, and the technology, because they regularly work on the unit. “The CFAs offer students the absolute best clinical experience,” said Gassert. “The program is turning out graduates who are fantastically prepared.”

Maureen R. Keefe, R.N., Ph.D., dean of the U College of Nursing, agrees: “We’ve reconnected nursing students with the clinical experts.”

Since the program began, 20 CFAs have taught 327 students, enabling the college to admit an additional eight students per semester. That raises the total number of students admitted each semester from 56 to 64. It may feel like a drop in the proverbial bucket, but the program creates a promising model that can be expanded and replicated. “It’s really been a model project and an innovative strategy to address the nursing faculty shortage,” said Keefe. “We’ve been very successful in increasing the interest of nurse-clinicians becoming faculty members or even part-time faculty.”

Although the two-year grant period has ended, the College of Nursing was granted a no-cost extension to continue the program for another year. After that, the college is committed to supporting the CFA program administratively and will ask the other hospitals to continue subsidizing CFAs’ staffing salaries. “Our partnering agencies have really supported the program,” said Keefe. “Now we are talking to them about how we can sustain and expand the model to take it to the next level.”

That discussion may be just in time. According to the U.S. Bureau of Labor Statistics, 79 million baby boomers are nearing retirement age. Because of technological advances, another million or so nurses will be needed to care for them. Ironically, many faculty members—boomers themselves—are preparing for retirement.

Read the complete article in Health Sciences Report.

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