- Email: [email protected]
Partnering to educate: Dedicated education units
Nurse Education in Practice 13 (2013) 335e337
Contents lists available at SciVerse ScienceDirect
Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Issues for debate
Partnering to educate: Dedicated education units Jill Dapremont*, Shirleatha Lee The University of Memphis, Loewenberg School of Nursing, 610 Goodman, Memphis, TN 38152, USA
a r t i c l e i n f o
a b s t r a c t
Article history: Accepted 25 February 2013
A current focus of the healthcare industry is centered on addressing the nursing shortage. In the midst of a nursing faculty shortage the Institute of Medicine (2010) recently released a report that calls for increasing the number of baccalaureate prepared nurses to 80% of the workforce by 2020. Therefore, nursing schools are faced with graduating more nurses to meet the demand. Yet, admission to schools of nursing are often limited because of clinical placement sites. The Dedicated Education Unit (DEU) model has been recently introduced to address the challenge of increasing the enrollment of nursing students in spite of a nationwide shortage of nursing faculty. Dedicated Education Units are clinical sites in hospitals where staff nurses serve as preceptors for students in all levels of their nursing education. This model is designed to improve practice education to better prepare students for actual practice while decreasing the number of faculty required at clinical sites. The purpose of this article is to discuss the implications of this model for nursing education, our experience with the DEU model, and issues of deliberation. Ó 2013 Elsevier Ltd. All rights reserved.
Keywords: Dedicated education unit Student outcomes Collaboration Effectiveness
Introduction The Dedicated Education Unit (DEU) model was first introduced at Flinders University of South Australia in 1997 (Gonda et al., 1999; Edgecombe et al., 1999) as an innovative teaching strategy to address the nursing faculty shortage and increase the number of nurses available to provide patient care (Ryan et al., 2011). Canada experiencing a similar challenge of educating more nurses in the midst of a nursing shortage soon followed (Budgen and Gamroth, 2008). Currently, in the United States the Institute of Medicine has called for an increase in the number of baccalaureate prepared nurses to 80% of the workforce by 2020 (Institute of Medicine [IOM], 2010) to meet health care needs. Therefore, nursing colleges and universities are consequently facing similar challenges as other countries and struggle to expand enrollment to meet healthcare demands (AACN, 2012; Moscato et al., 2007). The growing nursing faculty shortage in the United States (Murray et al., 2010), likewise requires academic institutions to explore innovative approaches to clinical teaching such as the DEU. The DEU model optimizes undergraduate student learning by enhancing the clinical learning environment and forging partnerships between clinicians, academics, and students (Moscato et al., 2007; Mulready-Shick et al., 2009). The model addresses both
* Corresponding author. University of Memphis, 207 Newport Hall, Memphis, TN 38152, USA. Tel.: þ1 901 678 3502; fax: þ1 901 678 4906. E-mail address: [email protected] (J. Dapremont). 1471-5953/$ e see front matter Ó 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.nepr.2013.02.015
nurse and nursing faculty shortages as it allows more students to be educated using fewer Master’s educated academic faculty while students gain hands on experience from practicing nurses (Collins, 2011). In the DEU model, staff nurses provide education, coaching, and mentoring to students (Rhodes et al., 2012) and academic faculty support the staff nurses in their role (Moscato et al., 2007; Mulready-Shick et al., 2009). These staff nurses are responsible for the clinical teaching of students and academic faculty are responsible for guiding the staff nurses in education practices (Murray et al., 2011). In the traditional clinical education model academic nursing faculty are typically seen as guests on health care units who possess clinical skills and knowledge of the curricula while nursing clinicians are seen as immersed in the day-to-day care of patients and assisting student accomplishment of skills through demonstration (Wotton and Gonda, 2004). Therefore, the introduction of the DEU model: a partnership that brings together clinicians, academics, and students has received much interest. Unlike the preceptor model that has; no dedicated on-site person, no more than one to two students on site, a clinical instructor and preceptor that are responsible for student orientation, and individual preceptors are responsible for facilitating student learning; the dedicated education unit has a clinical liaison nurse that is a part of the facility staff and an academic liaison nurse from the educational setting that are both familiar with each setting, and the entire DEU staff is responsible for facilitating student learning with an increased number of students (minimum of six) (DEU Project Team, 2008). These units are thought to help improve student learning by placing students with nurses who are currently in the practice area
336
J. Dapremont, S. Lee / Nurse Education in Practice 13 (2013) 335e337
(Murray et al., 2011). The collaboration between health units and universities prepares students for the reality of graduate practice and changes the perception of the educational role of academics and clinicians (Edmond, 2001; Wotton and Gonda, 2004). Moreover, this targets the concern that nursing graduates are not prepared to adequately assume their role in registered nurse practice and the collaborative partnership can ensure a smoother transition for students to the registered nurse role (Wotton and Gonda, 2004) within the partnering facility. The primary goal of the DEU model is to ensure students have enough academic preparation along with practice experience (Budgen and Gamroth, 2008). The evaluation of the DEU model by both Australia and Canada yielded similar results; a high respectability for connecting education and practice (Edgecombe et al., 1999; Murray et al., 2011). Also, studies indicated that students voiced an enhancement between transfer of theory and practice integration, development of collegial relationships, and increased learning support from clinicians on the units (Budgen and Gamroth, 2008; Gonda et al., 1999; Edgecombe et al., 1999). While there are positive outcomes to report with DEU implementation there are also limitations. Areas to work on for the DEU model include; clinician recruitment and preceptor burnout, increased workload for students having both faculty and nurse expectations, a challenge of getting feedback from preceptors, and preceptors not being experts in teaching and evaluating students (Budgen and Gamroth, 2008). Despite these challenges, the implementation of the DEU model in the United States is well-timed considering the current need for more nurses to graduate and assume the nursing role in practice areas (Edmond, 2001). As the Dedicated Education Unit model is evolving in the United States more schools of nursing are considering this method of education. Questions frequently arise among faculty concerning the overall value and impact on student outcomes. Therefore, we will describe the first semester implementation of the DEU model in our school of nursing and discuss matters of deliberation that arose from the experience. Implementation of the DEU Our baccalaureate nursing program located in the southern United States has over 500 undergraduate students and 55 fulltime faculty. We were interested in creating more clinical opportunities for students because we faced similar challenges as both Australia and Canada, the need to graduate more nurses to meet health care demands, limited hospital placements, and connection of theory with practice (Budgen and Gamroth, 2008; Gonda et al., 1999; Edgecombe et al., 1999). Thus, local hospitals where a placement agreement existed with the university were contacted. Once the hospitals stated they were interested in establishing a DEU partnership, multiple meetings were scheduled. Hospitals administrators met with the nursing school administration. The hospitals provided a unit within the facility and the names of nurses who would serve as the clinical liaison and DEU nursing staff. A relational governance type contract or agreement was initiated. This type of agreement is based on the trust and goodwill between the institutions (Murray et al., 2011). During the establishment of this new venture several meetings were conducted during the development process. Meetings times were arranged so school of nursing administration, faculty, hospital nursing administrators, charge nurses, and nurse preceptors could all meet together. Prior to the start of the semester, orientation was provided for the nursing preceptors by faculty to orient them to their role and expectations. A full-time faculty was assigned to each facility to serve as an academic liaison for the DEU staff. Nursing students were randomly assigned to either a DEU unit or a traditional faculty instructed clinical experience. Students on the DEU
were required to meet the same course objectives as their peers in traditional clinical courses in order to successfully pass the course. Nursing students were assigned their DEU staff nurse; and clinical experiences began for the semester. The faculty academic liaison communicated weekly with DEU staff nurses and provided guidance when needed. One challenge that arose early was related to the grading of clinical assignments. Depending on the course, some students were required to submit weekly written assignments such as nursing care plans. The grading of these assignments were challenging for DEU staff nurses, as they would have to take these papers home to grade after their shifts. This requirement goes beyond their scheduled work-day. This workload concern was also noted in the original evaluation of the DEU project (Edgecombe et al., 1999). The DEU staff nurses voiced their need for more time to grade papers and/or requested that the full-time faculty (academic liaison) grade student assignments. This resulted in student concerns regarding not receiving feedback as timely as students in traditional clinical groups. Hence, the faculty academic liaison had to make some changes. First, the faculty academic liaison had to grade the DEU student’s course assignments and give feedback. Secondly, because DEU nursing staff still had the responsibility of providing care to hospital assigned patients when students left for the day, the faculty academic liaison provided pre and post conference experiences with the students assigned to the DEU. It was noted that nursing preceptors kept an open line of communication with the students and were available for the students to self-reflect on the clinical day regarding time management strategies and linking theoretical content to the clinical experience using additional resources that included email, text, and phone; not disclosing protected health information. Students stated they were enjoying the experience of having DEU nursing staff. The students expressed they felt more comfortable approaching DEU staff nurses than traditional clinical instructors and that they were learning a lot from their DEU staff nurses. As the semester progressed; faculty, students, and DEU nursing staff all described the partnership as a positive experience. The development of partnerships can be demanding and in order to be successful all parties must have an equal role in achieving student outcomes. The DEU model required a true collaboration among all parties involved; administrators, faculty, nursing staff, and students. Overall DEU staff nurse feedback indicated it was an enjoyable experience. This perception was also reported from other studies (Edgecombe et al., 1999; Gonda et al., 1999; Wotton and Gonda, 2004). While some DEU nursing staff found the workload overwhelming, many indicated it was tolerable; particularly when the academic faculty liaison graded written assignments. A followup meeting was held with DEU nursing staff and administrators at the conclusion of the semester. Many DEU staff nurses expressed they wanted to continue in their teaching role in the future. They requested continued orientation each semester for new and ongoing DEU nursing staff; due to staff turnover and promotions for current DEU staff nurses to new position within the facility. Therefore, continued DEU nursing staff orientation was essential to maintain this partnership. Future inquiry This experience stimulated many questions; (1) Does the DEU afford nursing students the clinical experiences they need to become competent nurses? (2) How does the education of students on the DEU compare to traditional clinical teaching units? (3) Are students assigned to DEU’s able to link theoretical and clinical knowledge as effectively as or better than students assigned to traditional clinical groups? It was clearly verbalized from students
J. Dapremont, S. Lee / Nurse Education in Practice 13 (2013) 335e337
that they enjoyed their learning experience; and there were no “noticeable” differences among the students. However, this model is a new approach to educating students in the clinical setting for many institutions. So, understandably it is questioned if the DEU model for nursing education is heading in the right direction to increase student enrollment while maintaining or improving student outcomes. Future research and the reporting of successful and challenging experiences will help provide more details as we deliberate this topic. References American Associate of Colleges of Nursing, 2012. Advancing Higher Education in Nursing: Nursing Shortage. Retrieved from: http://www.aacn.nche.edu/mediarelations/fact-sheets/nursing-shortage. Budgen, C., Gamroth, L., 2008. An overview of practice education models. Nurse Education Today 28 (3), 273e283. Collins, R., 2011. A Policy Brief on Innovation in Nursing Education. The Council for Adult and Experiential Learning. Accessed from: www.cael.org/pdfs/132_ innovationinnursingeducation2011-1- November 12, 2012. Dedicated Education Unit Project Team, 2008. Dedicated education unit e a new way of supporting clinical learning. Kai Tiaki New Zealand 14 (11), 24e27. Edgecombe, K., Wotton, K., Gonda, J., Mason, P., 1999. Dedicated education units: 1 a new concept for clinical teaching and learning. Contemporary Nurse 8 (4), 166e171.
337
Edmond, C.B., 2001. A new paradigm for practice education. Nurse Education Today 21, 251e259. Gonda, J., Wotton, K., Edgecombe, K., Mason, P., 1999. Dedicated education units: 2 an evaluation. Contemporary Nurse 8 (4), 172e176. Institute of Medicine Report, 2010. The Future of Nursing Leading Change Advancing Health. The National Academic Press, Washington, DC. http://www. iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-AdvancingHealth.aspx (accessed 12.11.12.). Moscato, S.R., Miller, J., Logsdon, K., Weinberg, S., Chorpenning, L., 2007. Dedicated education unit: an innovative clinical partner education model. Nursing Outlook 55 (1), 31e37. Mulready-Shick, J., Kafel, K., Banister, G., Mylott, L., 2009. Enhancing quality and safety competency development at the unit level; an initial evaluation of student learning and clinical teaching on dedicated education units. Journal of Nursing Education 48 (12), 716e719. Murray, T.A., Crain, C., Meyer, G.A., McDonough, M.E., Schweiss, D.M., 2010. Building bridges: an innovative academic-service partnership. Nursing Outlook 58 (5), 252e260. Murray, T.A., MacIntyre, R.C., Teel, C.S., 2011. An analysis of partnership performance: the St. Johns Mercy Medical CentereSaint Louis University School of Nursing dedicated education unit project. Journal of Professional Nursing 27 (6), e58ee63. Rhodes, M., Meyer, C., Underhill, M., 2012. Evaluation outcomes of a dedicated education unit in a baccalaureate nursing program. Journal of Professional Nursing 28, 223e230. Ryan, C., Shabo, B., Tatum, K., 2011. Using experienced clinicians to facilitate clinical education. Nurse Educator 36 (4), 171e174. Wotton, K., Gonda, J., 2004. Clinician and student evaluation of a collaborative clinical teaching model. Nurse Education in Practice 4 (2), 120e127.
Contents lists available at SciVerse ScienceDirect
Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Issues for debate
Partnering to educate: Dedicated education units Jill Dapremont*, Shirleatha Lee The University of Memphis, Loewenberg School of Nursing, 610 Goodman, Memphis, TN 38152, USA
a r t i c l e i n f o
a b s t r a c t
Article history: Accepted 25 February 2013
A current focus of the healthcare industry is centered on addressing the nursing shortage. In the midst of a nursing faculty shortage the Institute of Medicine (2010) recently released a report that calls for increasing the number of baccalaureate prepared nurses to 80% of the workforce by 2020. Therefore, nursing schools are faced with graduating more nurses to meet the demand. Yet, admission to schools of nursing are often limited because of clinical placement sites. The Dedicated Education Unit (DEU) model has been recently introduced to address the challenge of increasing the enrollment of nursing students in spite of a nationwide shortage of nursing faculty. Dedicated Education Units are clinical sites in hospitals where staff nurses serve as preceptors for students in all levels of their nursing education. This model is designed to improve practice education to better prepare students for actual practice while decreasing the number of faculty required at clinical sites. The purpose of this article is to discuss the implications of this model for nursing education, our experience with the DEU model, and issues of deliberation. Ó 2013 Elsevier Ltd. All rights reserved.
Keywords: Dedicated education unit Student outcomes Collaboration Effectiveness
Introduction The Dedicated Education Unit (DEU) model was first introduced at Flinders University of South Australia in 1997 (Gonda et al., 1999; Edgecombe et al., 1999) as an innovative teaching strategy to address the nursing faculty shortage and increase the number of nurses available to provide patient care (Ryan et al., 2011). Canada experiencing a similar challenge of educating more nurses in the midst of a nursing shortage soon followed (Budgen and Gamroth, 2008). Currently, in the United States the Institute of Medicine has called for an increase in the number of baccalaureate prepared nurses to 80% of the workforce by 2020 (Institute of Medicine [IOM], 2010) to meet health care needs. Therefore, nursing colleges and universities are consequently facing similar challenges as other countries and struggle to expand enrollment to meet healthcare demands (AACN, 2012; Moscato et al., 2007). The growing nursing faculty shortage in the United States (Murray et al., 2010), likewise requires academic institutions to explore innovative approaches to clinical teaching such as the DEU. The DEU model optimizes undergraduate student learning by enhancing the clinical learning environment and forging partnerships between clinicians, academics, and students (Moscato et al., 2007; Mulready-Shick et al., 2009). The model addresses both
* Corresponding author. University of Memphis, 207 Newport Hall, Memphis, TN 38152, USA. Tel.: þ1 901 678 3502; fax: þ1 901 678 4906. E-mail address: [email protected] (J. Dapremont). 1471-5953/$ e see front matter Ó 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.nepr.2013.02.015
nurse and nursing faculty shortages as it allows more students to be educated using fewer Master’s educated academic faculty while students gain hands on experience from practicing nurses (Collins, 2011). In the DEU model, staff nurses provide education, coaching, and mentoring to students (Rhodes et al., 2012) and academic faculty support the staff nurses in their role (Moscato et al., 2007; Mulready-Shick et al., 2009). These staff nurses are responsible for the clinical teaching of students and academic faculty are responsible for guiding the staff nurses in education practices (Murray et al., 2011). In the traditional clinical education model academic nursing faculty are typically seen as guests on health care units who possess clinical skills and knowledge of the curricula while nursing clinicians are seen as immersed in the day-to-day care of patients and assisting student accomplishment of skills through demonstration (Wotton and Gonda, 2004). Therefore, the introduction of the DEU model: a partnership that brings together clinicians, academics, and students has received much interest. Unlike the preceptor model that has; no dedicated on-site person, no more than one to two students on site, a clinical instructor and preceptor that are responsible for student orientation, and individual preceptors are responsible for facilitating student learning; the dedicated education unit has a clinical liaison nurse that is a part of the facility staff and an academic liaison nurse from the educational setting that are both familiar with each setting, and the entire DEU staff is responsible for facilitating student learning with an increased number of students (minimum of six) (DEU Project Team, 2008). These units are thought to help improve student learning by placing students with nurses who are currently in the practice area
336
J. Dapremont, S. Lee / Nurse Education in Practice 13 (2013) 335e337
(Murray et al., 2011). The collaboration between health units and universities prepares students for the reality of graduate practice and changes the perception of the educational role of academics and clinicians (Edmond, 2001; Wotton and Gonda, 2004). Moreover, this targets the concern that nursing graduates are not prepared to adequately assume their role in registered nurse practice and the collaborative partnership can ensure a smoother transition for students to the registered nurse role (Wotton and Gonda, 2004) within the partnering facility. The primary goal of the DEU model is to ensure students have enough academic preparation along with practice experience (Budgen and Gamroth, 2008). The evaluation of the DEU model by both Australia and Canada yielded similar results; a high respectability for connecting education and practice (Edgecombe et al., 1999; Murray et al., 2011). Also, studies indicated that students voiced an enhancement between transfer of theory and practice integration, development of collegial relationships, and increased learning support from clinicians on the units (Budgen and Gamroth, 2008; Gonda et al., 1999; Edgecombe et al., 1999). While there are positive outcomes to report with DEU implementation there are also limitations. Areas to work on for the DEU model include; clinician recruitment and preceptor burnout, increased workload for students having both faculty and nurse expectations, a challenge of getting feedback from preceptors, and preceptors not being experts in teaching and evaluating students (Budgen and Gamroth, 2008). Despite these challenges, the implementation of the DEU model in the United States is well-timed considering the current need for more nurses to graduate and assume the nursing role in practice areas (Edmond, 2001). As the Dedicated Education Unit model is evolving in the United States more schools of nursing are considering this method of education. Questions frequently arise among faculty concerning the overall value and impact on student outcomes. Therefore, we will describe the first semester implementation of the DEU model in our school of nursing and discuss matters of deliberation that arose from the experience. Implementation of the DEU Our baccalaureate nursing program located in the southern United States has over 500 undergraduate students and 55 fulltime faculty. We were interested in creating more clinical opportunities for students because we faced similar challenges as both Australia and Canada, the need to graduate more nurses to meet health care demands, limited hospital placements, and connection of theory with practice (Budgen and Gamroth, 2008; Gonda et al., 1999; Edgecombe et al., 1999). Thus, local hospitals where a placement agreement existed with the university were contacted. Once the hospitals stated they were interested in establishing a DEU partnership, multiple meetings were scheduled. Hospitals administrators met with the nursing school administration. The hospitals provided a unit within the facility and the names of nurses who would serve as the clinical liaison and DEU nursing staff. A relational governance type contract or agreement was initiated. This type of agreement is based on the trust and goodwill between the institutions (Murray et al., 2011). During the establishment of this new venture several meetings were conducted during the development process. Meetings times were arranged so school of nursing administration, faculty, hospital nursing administrators, charge nurses, and nurse preceptors could all meet together. Prior to the start of the semester, orientation was provided for the nursing preceptors by faculty to orient them to their role and expectations. A full-time faculty was assigned to each facility to serve as an academic liaison for the DEU staff. Nursing students were randomly assigned to either a DEU unit or a traditional faculty instructed clinical experience. Students on the DEU
were required to meet the same course objectives as their peers in traditional clinical courses in order to successfully pass the course. Nursing students were assigned their DEU staff nurse; and clinical experiences began for the semester. The faculty academic liaison communicated weekly with DEU staff nurses and provided guidance when needed. One challenge that arose early was related to the grading of clinical assignments. Depending on the course, some students were required to submit weekly written assignments such as nursing care plans. The grading of these assignments were challenging for DEU staff nurses, as they would have to take these papers home to grade after their shifts. This requirement goes beyond their scheduled work-day. This workload concern was also noted in the original evaluation of the DEU project (Edgecombe et al., 1999). The DEU staff nurses voiced their need for more time to grade papers and/or requested that the full-time faculty (academic liaison) grade student assignments. This resulted in student concerns regarding not receiving feedback as timely as students in traditional clinical groups. Hence, the faculty academic liaison had to make some changes. First, the faculty academic liaison had to grade the DEU student’s course assignments and give feedback. Secondly, because DEU nursing staff still had the responsibility of providing care to hospital assigned patients when students left for the day, the faculty academic liaison provided pre and post conference experiences with the students assigned to the DEU. It was noted that nursing preceptors kept an open line of communication with the students and were available for the students to self-reflect on the clinical day regarding time management strategies and linking theoretical content to the clinical experience using additional resources that included email, text, and phone; not disclosing protected health information. Students stated they were enjoying the experience of having DEU nursing staff. The students expressed they felt more comfortable approaching DEU staff nurses than traditional clinical instructors and that they were learning a lot from their DEU staff nurses. As the semester progressed; faculty, students, and DEU nursing staff all described the partnership as a positive experience. The development of partnerships can be demanding and in order to be successful all parties must have an equal role in achieving student outcomes. The DEU model required a true collaboration among all parties involved; administrators, faculty, nursing staff, and students. Overall DEU staff nurse feedback indicated it was an enjoyable experience. This perception was also reported from other studies (Edgecombe et al., 1999; Gonda et al., 1999; Wotton and Gonda, 2004). While some DEU nursing staff found the workload overwhelming, many indicated it was tolerable; particularly when the academic faculty liaison graded written assignments. A followup meeting was held with DEU nursing staff and administrators at the conclusion of the semester. Many DEU staff nurses expressed they wanted to continue in their teaching role in the future. They requested continued orientation each semester for new and ongoing DEU nursing staff; due to staff turnover and promotions for current DEU staff nurses to new position within the facility. Therefore, continued DEU nursing staff orientation was essential to maintain this partnership. Future inquiry This experience stimulated many questions; (1) Does the DEU afford nursing students the clinical experiences they need to become competent nurses? (2) How does the education of students on the DEU compare to traditional clinical teaching units? (3) Are students assigned to DEU’s able to link theoretical and clinical knowledge as effectively as or better than students assigned to traditional clinical groups? It was clearly verbalized from students
J. Dapremont, S. Lee / Nurse Education in Practice 13 (2013) 335e337
that they enjoyed their learning experience; and there were no “noticeable” differences among the students. However, this model is a new approach to educating students in the clinical setting for many institutions. So, understandably it is questioned if the DEU model for nursing education is heading in the right direction to increase student enrollment while maintaining or improving student outcomes. Future research and the reporting of successful and challenging experiences will help provide more details as we deliberate this topic. References American Associate of Colleges of Nursing, 2012. Advancing Higher Education in Nursing: Nursing Shortage. Retrieved from: http://www.aacn.nche.edu/mediarelations/fact-sheets/nursing-shortage. Budgen, C., Gamroth, L., 2008. An overview of practice education models. Nurse Education Today 28 (3), 273e283. Collins, R., 2011. A Policy Brief on Innovation in Nursing Education. The Council for Adult and Experiential Learning. Accessed from: www.cael.org/pdfs/132_ innovationinnursingeducation2011-1- November 12, 2012. Dedicated Education Unit Project Team, 2008. Dedicated education unit e a new way of supporting clinical learning. Kai Tiaki New Zealand 14 (11), 24e27. Edgecombe, K., Wotton, K., Gonda, J., Mason, P., 1999. Dedicated education units: 1 a new concept for clinical teaching and learning. Contemporary Nurse 8 (4), 166e171.
337
Edmond, C.B., 2001. A new paradigm for practice education. Nurse Education Today 21, 251e259. Gonda, J., Wotton, K., Edgecombe, K., Mason, P., 1999. Dedicated education units: 2 an evaluation. Contemporary Nurse 8 (4), 172e176. Institute of Medicine Report, 2010. The Future of Nursing Leading Change Advancing Health. The National Academic Press, Washington, DC. http://www. iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-AdvancingHealth.aspx (accessed 12.11.12.). Moscato, S.R., Miller, J., Logsdon, K., Weinberg, S., Chorpenning, L., 2007. Dedicated education unit: an innovative clinical partner education model. Nursing Outlook 55 (1), 31e37. Mulready-Shick, J., Kafel, K., Banister, G., Mylott, L., 2009. Enhancing quality and safety competency development at the unit level; an initial evaluation of student learning and clinical teaching on dedicated education units. Journal of Nursing Education 48 (12), 716e719. Murray, T.A., Crain, C., Meyer, G.A., McDonough, M.E., Schweiss, D.M., 2010. Building bridges: an innovative academic-service partnership. Nursing Outlook 58 (5), 252e260. Murray, T.A., MacIntyre, R.C., Teel, C.S., 2011. An analysis of partnership performance: the St. Johns Mercy Medical CentereSaint Louis University School of Nursing dedicated education unit project. Journal of Professional Nursing 27 (6), e58ee63. Rhodes, M., Meyer, C., Underhill, M., 2012. Evaluation outcomes of a dedicated education unit in a baccalaureate nursing program. Journal of Professional Nursing 28, 223e230. Ryan, C., Shabo, B., Tatum, K., 2011. Using experienced clinicians to facilitate clinical education. Nurse Educator 36 (4), 171e174. Wotton, K., Gonda, J., 2004. Clinician and student evaluation of a collaborative clinical teaching model. Nurse Education in Practice 4 (2), 120e127.