Vanderbilt University School of Nursing created a new leadership development program for nurses new in health care leadership and academic positions who are from groups historically underrepresented in nursing and/or those who support them. The Academy for Diverse Emerging Nurse Leaders will be held in Nashville from November 14-18. Applications for the inaugural class of fellows are now being accepted.
“The need for nursing faculty and nurse leaders from groups historically underrepresented in nursing is well established, but research shows a need for career development resources that address the specific needs and challenges of diverse nurse leaders,” says Pamela Jeffries, PhD., FAAN, ANEF, FSSH, dean of Vanderbilt School of Nursing. “We believe that the knowledge, mentorship, strategy, and skills that new leaders will attain via the Academy for Diverse Emerging Nurse Leaders will empower them to continue to advance and lead.”
VUSN Associate Dean for Diversity, Equity and Inclusion Rolanda Johnson and Vanderbilt University Medical Center Senior Director for Nurse Diversity and Inclusion Mamie Williams will co-direct the academy, designed for nurses who have been in academic or health care leadership roles for less than three years.
“What makes this fellows program different from other professional development opportunities is that it incorporates and builds on the lived experiences of diverse faculty and health care leaders who have navigated a similar leadership path,” says Johnson. “It explores the challenges of being a leader from an underrepresented group as well as the challenges of supporting and expanding diversity in nursing leadership.”
Academy for Diverse Emerging Nurse Leaders
Academy for Diverse Emerging Nurse Leaders
The academy is taught by experienced faculty and health care leaders from diverse backgrounds and is specifically designed to serve the needs of new and emerging nurse leaders and faculty. In addition to the initial five-day, in-person meeting, fellows will also participate in virtual sessions, receive mentorship from an executive coach and institutional mentor and develop a leadership project.
Williams said that the idea for the academy resonated with her as she thought about her own nurse leadership journey of more than 25 years. “This leadership academy, based on specialized education, discussions, and interactions with peers and diverse nurse leaders, affords the emerging leader an opportunity to thoughtfully design their leadership journey,” she says.
She and Johnson said the academy was developed to help new nursing faculty and new nurse leaders build skills, gain knowledge, and build a network of colleagues and mentors to help them advance their careers and mentor other emerging nurse leaders.
Virtual Reality (VR), once a province of science fiction, is becoming an everyday fact of life – and health care practitioners have been quick to recognize its potential.
Although physically in a classroom at the Vanderbilt University School of Nursing (VUSN), a group of students was far, far away, virtually experiencing campfires, galaxies, snowfall, and other relaxing settings.
The Psychiatric-Mental Health Nurse Practitioner students were exploring how virtual reality can be used in health care and education, taking part in an innovative VUSN pilot program called SparkleVille, which uses technology to enhance kinesthetic learning. The program also offers learning opportunities for nursing informatics students as part of their practicum.
“Students read research papers about virtual reality and are entrenched in didactic learning, but we wanted to provide an opportunity to experience the technology firsthand,” explained Assistant Professor and Skills and Simulation Lab Director Jo Ellen Holt, DNP. “The trial run gave students the opportunity to use VR and even consider prescribing it to clients in the future.”
The idea and VR class stemmed from a startup called Very Real Help, Inc. founded by Vanderbilt Psychological Sciences PhD candidate Noah Robinson, who studies clinical psychology and cognitive behavioral therapy in the College of Arts and Science. Kelly Aldrich, DNP, FHIMSS, VUSN Associate Professor and Director of Informatics Innovation, was introduced to Robinson through her projects at the Wond’ry, Vanderbilt’s Center for Innovation and Design. Very Real Help was spun out of the Wond’ry and has raised over $2MM to build its virtual reality clinical research platform. Robinson’s startup created a free VR app, Help Club (app.helpclubvr.com), to allow people to join peer-led mental health groups and experience calming situations. Aldrich thought it would provide a great opportunity to enhance nursing education.
Leaders of VUSN’s highly ranked Psychiatric-Mental Health Nurse Practitioner program agreed, always seeking ways to bring new experiences to their students.
After donning VR headsets, the students experienced the app’s areas of relaxation for themselves. When asked about the experience, most found it relaxing. They could see it being used for therapy, chronic pain management, working through fears and to offer unique experiences to people in nursing homes or hospice care.
“Initially the students were excited to try something new other than lecture,” Holt explained. “Some were skeptical or just had never considered VR environments. They had the courage to try and found it to be beneficial.”
Students shared their thoughts on Post-it notes mounted on a wall under different categories, including future applications/benefits, lingering questions, etc.
“Immersive virtual reality is the most interpersonal and anonymous technology—it simultaneously allows people to feel as if they are with others while also becoming an anonymous avatar with a username,” Robinson said.
Aldrich and Holt plan to set up research projects to see how VR can play a role in nurse support, stress reduction and retention, starting with a dedicated space for School of Nursing students, faculty and staff to try out VR technology for stress reduction later this spring. Some nurses leave the profession after a few years, citing stressful situations, Aldrich said. An app like Robinson’s could offer peace to those working this important, yet emotionally taxing job.
Under the SparkleVille program umbrella, Holt and Aldrich also work to advance innovation in nursing and health sciences through use of 3D printers, a maker’s space and smaller pilot programs.
“The program is a unique opportunity—a spark or magical area—where the two worlds of technology and informatics combine,” Holt said, adding that Sparkle stands for Simulation Projects Advancing Research and Kinesthetic Learning Experiences. “We want to see how we can advance these ideas and disseminate them.”
Aldrich believes VR nurse training will be a fruitful research avenue going forward. Vanderbilt may one day use VR to help students experience everything from empathy training to the positions of internal organs and disease processes.
“We’ve been exploring and pushing innovation in our curriculum,” Aldrich said. “As virtual reality gets better and better, we hope to find ways to advance the simulation environment through immersion experiences.”
Simulation pairs nicely with a virtual environment, offering numerous opportunities for educational experiences and learning critical techniques in a safe space.
“It’s fun to see how faculty are continuously trying to improve the experience for their students through our simulation lab,” Holt said. She said that the school’s simulation team is continually working with informatics faculty to help apply technology in smart ways.
“We were really excited to collaborate with Jo Ellen Holt and Kelly Aldrich to create a rich simulation experience for the PMHNP students in the Neuroscience for Mental Health Practitioners course,” said Assistant Professor Megan Simmons, DNP, PMHNP-BC. “The VR experience was a wonderful way for the students to explore an innovative form of self-care, which is especially important for mental health providers. After the simulation, many students commented that this was their first time using VR and they were surprised how much their mood was improved by the experience.”
“This interesting approach to education can scale beyond the traditional simulation environment,” Aldrich explained. “It will help as we watch pandemic protocols and want to continue helping students with this advanced learning experience.”
SparkleVille’s VR project, which is poised to support nurse well-being and retention, is being developed through a collaboration between VUSN’s nursing informatics program faculty and its simulation team.
Nursing educators challenged with incorporating nursing informatics into their curriculum in accordance with the new AACN Core Competencies for Professional Nursing Education can get a jump start at a three-day conference offered by Vanderbilt University School of Nursing this summer.
The Vanderbilt Informatics Summer Teaching Academy (VISTA) will be July 20-22, 2022, at Vanderbilt’s park-like campus in Nashville, TN. This informatics immersion for educators will be led by nursing informatics experts who will use the new AACN informatics essentials (No. 8) as a framework to provide attendees with concrete ways to embed informatics into their curricula.
“The AACN Core Competencies call for the incorporation of essential informatics and communications technologies into nursing curricula within a few years,” said Patricia Sengstack, DNP, RN-BC, FAAN, FACMI, Senior Associate Dean for Nursing Informatics at Vanderbilt School of Nursing. “The nursing faculty across the nation responsible for making this happen need knowledge on how to do that. Informatics can be confusing. This conference will give nursing faculty and curriculum developers the knowledge they need to bridge that gap for their students and their schools.”
Conference attendees will identify teaching strategies, develop content and create assessment measures to help their schools of nursing transition programs to meet the new AACN informatics-focused competencies. The academy format will include case examples, use of hands-on technology and breakout sessions focused on ideas, innovation and transformation. Attendees will return to their home institutions equipped with new knowledge, applicable strategies and realistic plans to add informatics concepts to their schools’ courses and programs.
“With the pervasiveness of technology in health care today, and the need for robust analytics, informatics concepts are no longer optional in nursing education,” Sengstack said. “They are now essential components to understand in the delivery of transformational care.”
VISTA instructors include Sengstack, a former president of the American Nursing Informatics Association who has also served as chief of clinical informatics at the National Institutes of Health, Clinical Center, and as chief nursing informatics officer for the Bon Secours Health System.
Other presenters are Kelly Aldrich, DNP, MS, RN-BC, FHIMSS, director of innovation, and Brenda Kulhanek, PhD, RN-BC, NPD-BC, NE-BC, director of Vanderbilt’s Nursing Informatics specialty. Aldrich was the first chief nursing informatics officer for HCA Healthcare and is the former chief clinical transformation officer for the Center for Medical Interoperability, a nonprofit led by health systems to simplify and advance data sharing among medical technologies and systems.
Kulhanek has served as division vice president of clinical education for TriStar Health, corporate associate vice president of clinical education for HCA Healthcare, and corporate director of informatics at Adventist Health; she is a past president of the American Nursing Informatics Association. As educators, the three have approximately a century of combined education experience.
“We’re using a train the trainer model to equip faculty to serve as informatics subject matter experts in their own schools. It’s our hope that nursing school deans and department heads encourage their faculty to attend and then return to share with their colleagues,” Sengstack said.
“Nurses of the future need to be educated on informatics concepts and foundations as part of their nursing education. Clinical practice cannot be separated from the technology used in health care,” she said. “It’s a vital and ever-evolving part of patient care.”
Assistant Professors Christian Ketel, DNP’14, RN, and Carrie Plummer, PhD, MSN’05, ANP-BC, received Vanderbilt’s 2022 Martin Luther King, Jr. Award on Monday, Jan. 17, for developing and leading the VUSN/VUMC Mobile Vaccine program. The award recognizes Vanderbilt University School of Medicine, School of Nursing or Medical Center staff or faculty who emulate the principles of Dr. Martin Luther King Jr. in their work.
Ketel and Plummer were honored for their leadership of Vanderbilt’s mobile vaccine program, which launched in March 2021. The program, a joint venture between Vanderbilt University School of Nursing and Vanderbilt University Medical Center, provides COVID-19 vaccines to the uninsured and others who might not otherwise have access to the vaccine.
14,000 doses and counting
It has focused primarily on residents in Hispanic, Somalian, Kurdish, African American, homeless and low-income communities. Since the program began, Vanderbilt volunteers have vaccinated more than 6,500 people and given approximately 14,000 doses (first, second and booster).
The mobile program provides vaccinations both through door-to-door outreach and clinics organized with community and neighborhood groups. Ketel and Plummer cite partnerships as key to success.
“Since the program began, I’ve learned about the power of partnership in helping break down barriers to health care access,” Plummer says. “The Mobile Clinic would not have been nearly as successful in its vaccination outreach efforts without the support of our diverse group of community partners and the passion of our volunteers.”
Among those community partners are the Hispanic Family Foundation, Elmahaba Center, Fannie Battle Day Care, Valor Academy Charter School, Amed Clinic, East Nashville Tomato Festival, YMCA of Middle Tennessee, and churches such as Our Lady of Guadeloupe Catholic Church, Casa de Gloria and Seventh Day Adventist Church South Nashville. The Metropolitan Development and Housing Agency and Urban Housing Solutions are key partners in reaching residential communities.
Staffing for the mobile clinics, door-to-door campaigns and outreach to homebound individuals has included faculty, staff and students from the School of Nursing, Vanderbilt School of Medicine, VUMC, Monroe Carell Children’s Hospital at Vanderbilt, Lipscomb College of Pharmacy, Vanderbilt Global Health Institute and volunteers from the Nashville and Murfreesboro communities. Undergraduate interns from Vanderbilt’s College of Arts and Science, Middle Tennessee State University and Tennessee State University have also been part of the project.
“These last few years of the pandemic have been challenging for all of us—on so many different levels. One of the things that kept me feeling hopeful was being able to engage in this on-the-ground work with my amazing co-director Dr. Christian Ketel, our pharmacy colleagues Dr. Sarah Uroza and Dr. Justin Kirby from Lipscomb University, and the rest of our volunteer crew.”
What started as two nurse practitioners’ instinctive desire to help vulnerable people during a health crisis of unprecedented magnitude has provided insight into strategies for fighting health inequity.
“Serving my community through the VUSN/VUMC Mobile Vaccine Program has shown me that equal access for all to medical care is possible. When you strip away the systematic barriers to health care and place people and communities first, you can achieve great things,” Ketel says.
Both faculty were surprised and humbled that they were nominated for the award and that others saw them as emulating King.
“Dr. King spoke of and fought against systemic inequities in the U.S.—including those embedded in our health care system. To receive the MLK Award, alongside my colleague Dr. Christian Ketel, is an honor and truly humbling,” Plummer said.
“Martin Luther King, Jr. paid the ultimate price for standing up for his values and beliefs. I am humbled to think that I have reflected even a miniscule amount of the love that he radiated with his life,” Ketel said. “I am so grateful for my co-director, Dr. Carrie Plummer. I have found a life-long friend and ally in the fight against health disparities.”
What do you do with 154 nursing students who are suddenly unable to participate in the hands-on nursing (clinical) care that makes up 60% of their education each week?
That was the challenge facing Mary Ann Jessee, PhD, director of PreSpecialty education at Vanderbilt University School of Nursing, and the 30-plus faculty who instruct those first-year (prelicensure) nursing students in patient care.
With the spread of COVID-19, the students’ clinical education in hospitals, clinics and other facilities was suspended in mid-March. VUSN was unwilling to postpone clinical learning and possibly delay the students’ path to becoming advanced practice registered nurses. So faculty got creative.
“For a couple of weeks, we had been determining what we would do if students weren’t able to be in the clinical setting,” Jessee said. “The course coordinators, Erin Rodgers, DNP, and Heather Robbins, DNP, and I brainstormed what would it look like to do a virtual experience for students that would enable them to experience the same clinical learning. Could we use the Simulation Lab and have the students participate by telling someone in the lab what to do?” The faculty consulted VUSN Simulation Lab Director Jo Ellen Holt, DNP, who responded enthusiastically with suggestions.
The result was a virtual live-streamed learning experience with students using their instructors and Simulation Lab staff as avatars to interact with the school’s high-fidelity nursing mannequins and provide patient care.
“One instructor acted as the student’s eyes, ears and hands while another observed and coached, just as they would do with actual patients in the clinical setting,” Rodgers said. “Students instructed their avatar on what to do, step-by-step. The avatar reported the results, and then the students as a group evaluated whether that skill was implemented correctly and discussed the outcome.”
The students joined the simulations via video conferencing, working in the same six-student cohorts as for their in-person clinical learning. Each student experienced directing the avatar and discussed the scenario with their group.
“What we’re trying to mirror is the typical direct patient care experience and clinical conference, but in a virtual format,” Jessee said. “We had to determine how to recreate those patient interactions, and in those, ensure that students had the ability to conduct assessments, prioritize patient needs, make decisions about care, implement that care and evaluate the results.”
Throughout the simulation, the instructor is observing and coaching, as they would with actual patients. “In the virtual clinical experience, the faculty member can’t see the student doing the assessment or preparing for safe medication administration. The student needs to explain it before the avatar acts so the faculty can see that the student knows how to do it. This allows faculty to assess the same competencies in the virtual simulation as in the clinical setting.”
The School of Nursing’s PreSpecialty program is for students with bachelor degrees in a field other than nursing. They spend 12 months in intense generalist nursing learning, then spend 12-18 months gaining specialty education. In addition to directing the PreSpecialty level, Jessee serves as assistant dean for academics, generalist nursing practice.
The virtual clinical simulation is only one strategy that the PreSpecialty faculty are using for clinical skills. The school also uses the Virtual Healthcare Experience portal, developed by Canadian schools of nursing to engage students in highly complex scenarios using actors, as well as materials from the Institute for Healthcare Improvement, ReelDX videos and faculty-created case studies.
VUSN PreSpecialty clinical faculty created multiple virtual clinical simulations to support pediatric, adult, obstetric and psychiatric-mental health care. Students whose clinical experiences did not require the simulation lab participated in similar virtual situations within a simulated home or office setting.
Before starting the virtual curriculum, the School of Nursing consulted the Tennessee Board of Nursing and the Commission on Collegiate Nursing Education (CCNE) to determine how the simulations would relate to the students’ future licensing. “They sent us confirmation that simulation can be used one-to-one in place of direct patient care,” Jessee said. “Every hour that students are logging in these virtual activities counts toward their preparation for the national council licensure examination, NCLEX.”
Student reaction has been positive. “Students are amazed that we created these things. They’ve had great experiences—it’s been intense and challenging—and they’ve had good team work,” Jessee said. “One student told her instructor that she felt the virtual clinicals were valuable and that they’d helped her with exams in other courses.”
One student gave feedback not on the clinical experiences but on her reaction to how VUSN has handled the COVID-19 crisis. “I have felt supported and seen by you, and all of my instructors in the past weeks…Earlier this week, our clinical group was discussing how, despite all the craziness going on in the world, we feel least concerned about our education and trajectory because of the incredibly talented faculty and resources at VUSN. Thank you!”
The faculty also judged the simulations successful. “We were able to develop meaningful, realistic virtual experiences that would provide students with opportunities to learn and demonstrate competency in essential clinical thinking skills,” Jessee said.
Although she doesn’t know of other schools that have created similar virtual clinical simulations, Jessee said that nursing schools across the country are developing various creative learning experiences. “We’re all working to enable on-time graduation of nurses to fill vacancies in the nursing workforce,” she said. “Our students won’t miss a beat.”
“It’s been stressful for students and added an extra workload on faculty but it has been so worth it to see the learning realized by the students,” she said. “It’s really rewarding.”