Integrating Experiential Learning into a Double Degree Masters Program in Nursing and Health Informatics Elizabeth M. Borycki, RN, PhD1, Noreen Frisch, RN, PhD1, Andre W. Kushniruk, PhD1 Marjorie McIntyre, RN, PhD1, David Hutchinson, MSc1 1 University of Victoria, British Columbia, Canada Abstract In Canada there are few nurses who have advanced practice competencies in nursing informatics. This is a significant issue for regional health authorities, governments and electronic health record vendors in Canada who are implementing electronic health records. Few Schools of Nursing provide formalized opportunities for nurses to develop informatics competencies. Many of these opportunities take the form of post-baccalaureate certificate programs or individual undergraduate or graduate level courses in nursing. The purpose of this paper will be to: (1) describe the health and human resource issues in this area in Canada, (2) provide a brief overview of the design and development of a new, innovative double degree program at the intersection of nursing and health informatics that interleaves cooperative learning, (3) describe the integration of cooperative learning into this new program, and (4) outline the lessons learned in integrating cooperative education into such a graduate program. Introduction Canadian health care organizations are experiencing considerable health and human resource issues when attempting to recruit and retain nurses who have advanced practice competencies in nursing informatics. This is a significant issue for regional health authorities, governments and electronic health record vendors in Canada as the recruitment and retention of such individuals is difficult. Many regional health authorities across Canada have embarked upon implementing components of the electronic health record (EHR). As a consequence, the demand for trained and qualified individuals with such backgrounds has risen significantly1,5 . Presently, there are few opportunities to develop such competencies at Canadian university schools of nursing. According to the Canadian Nursing Informatics Association website, the majority of learning opportunities in nursing informatics can be classified into one of two categories: post-baccalaureate certificate programs and individual courses (at the undergraduate and graduate levels)6. There are few Schools of Nursing that provide formalized opportunities for nurses to develop informatics competencies that would prepare graduating students to work as Nursing Informatics Specialists, Clinical Informatics Specialists or Chief Nursing Information Officers. In an effort to address this nursing health and human resource issue, the Schools of Nursing and Health Information Science at the University of Victoria, Victoria, British Columbia, Canada collaborated on the development of a double degree program where nurses would have the opportunity to develop advanced practice competencies in nursing and health informatics upon graduation. An important and essential component of this graduate program is the integration of cooperative education or experiential learning opportunities for enrolled students. Over the course of the three year graduate program, nurses are expected to complete two cooperative education placements: (1) one with an emphasis on developing advanced practice competencies in nursing informatics and (2) another where there is a focus upon more technical graduate level competencies. The double degree program and the cooperative education component of the program to the best of our knowledge is the first of its kind in Canada (based on lists of published academic program information on the Canadian Nursing Informatics Association and Canada’s Health Informatics Association websites). The purpose of this paper is to: (1) describe the health and human resource issues in this area in Canada, (2) provide a brief overview of the design and development of a new, innovative double degree program at the intersection of nursing and health informatics that interleaves cooperative learning, (3) describe the integration of cooperative learning into this new program, and (4) outline the lessons learned in integrating cooperative education into such a graduate program. In the next section of this paper we discuss the background to the program. Background: Health and Human Resource Issues in Nursing and Health Informatics in Canada According to a recent report published by Canada’s Health Informatics Association (COACH) and Canada Health Infoway, 32,000 professionals work in the field of health informatics (including nursing informatics). Many of these professionals are nurses who work at the intersection of nursing and health informatics (e.g. Clinical Informatics Specialists, Application Specialists, Directors of Clinical Informatics). Given the current rate of growth in electronic health record implementations across Canada, it is expected that there will be a need for 8,500 new health informatics professionals (including nursing informatics professionals) in the next 5 years.
NI2012: 11th International Congress on Nursing Informatics 36
As outlined earlier in this paper, there are few educational programs in Canada that offer formalized nursing informatics education at the intersection of nursing and health informatics6. With the rise in the demand for professionals with health informatics competencies at the undergraduate and graduate levels, there has also be a significant rise in the need for individuals with advanced practice nursing and nursing informatics competencies. In response to this demand the Schools of Nursing and Health Information Science collaborated to develop a new, graduate level program at the intersection of nursing and health informatics. Faculty used the best educational knowledge and evidence in both nursing and health informatics when designing the curriculum. Overview of the Double Degree Program The program has several core courses (see Table 1), from the nursing and health informatics program. Nursing courses include those that are focused upon developing advance practice graduate level nursing competencies in nursing theory, philosophy and methodology. Health informatics courses focus upon developing graduate level health informatics professional competencies in the information sciences (i.e. information technology and information management), management sciences (i.e. project management, organizational behavior, analysis and evaluation) and health sciences (i.e. clinical and health services, Canadian health care system) as outlined by COACH1. In addition, a total of two nursing and two health informatics electives are required and are selected by the students. Students select electives in consultation with their supervisors (one from nursing and one from health informatics). Students also complete a Master’s thesis as part of their program of study. The thesis is co-supervised by two faculty (one from nursing and one from health information science). The Master’s thesis is focused on aspects of nursing informatics. For example, student thesis work may involve evaluating the usability of an electronic nursing documentation for a cardiac care unit – drawing on health informatics faculty expertise in the field of usability engineering and nursing expertise in the clinical area of cardiovascular nursing to evaluate a nursing information system developed for a cardiac care unit. In another example, a nurse may develop and test a new design for a computerized care planning system for home and community care, drawing on health informatics faculty expertise in the area of database design to design, develop and implement the system and nursing faculty expertise in the area of evidence-based nursing care plan development. Approach: Integrating Cooperative Education or Experiential Learning Cooperative education can be defined as a structured approach to combining classroom-based education with realworld work experiences. It is an approach that provides academic credit for structured job experiences. Cooperative education is especially effective when helping students transition between the classroom and the workplace or between two differing types of work2. Cooperative education is a well accepted method that has been used to provide students (mostly from technical degree programs – engineering, computer science) with paid work opportunities to apply classroom based learning to real-world projects3. The Cooperative Education Program at the University of Victoria is well supported by the University administration and is available for almost every academic program on campus, from Fine Arts to Law. Cooperative Education at the School of Health Information Science Over the past 30 years the School of Health Information Science cooperative education program has led the way in Canada, providing students with experiential learning experiences at the undergraduate and graduate level in the field of health informatics4. The underlying educational philosophy of cooperative education at the School of Health Information Science and the University of Victoria is to view learning as extending beyond the classroom. Students generally alternate between classroom and work terms in their field of study, bringing knowledge obtained in the classroom setting to the employers and returning to their classes having gained valuable practical experience working on real-world projects. This is an iterative cycle where theory, knowledge and skills are acquired in a classroom context followed by their application in the work setting. The alternation between work and academics is a key part of cooperative learning pedagogy and differentiates it from more traditional types of learning-work experiences such as internships. Most cooperative education work experiences take place in one of three settings: government (i.e. federal or provincial), private sector industry (e.g. a vendor organization or consulting company) and regional health authority (e.g. hospital, home care long term care). Students, employers and the cooperative education office in the School of Health Information Science collaborate to identify and match students and employers in terms of student learning needs and employer skills needed for projects.
NI2012: 11th International Congress on Nursing Informatics 37
Table 1: Overview of Course and Cooperative Education Components Year 1 September-December NURS 506 Philosophical Knowledge & Advanced Practice Nursing HINF 572 Health Informatics: An Overview
Year 2 September-December HINF 503 Research Methods in Health Informatics HINF Elective HINF Elective
January-April NURS 507 Theoretical Knowledge & Advanced Practice Nursing HINF 550 Health Information Systems Design HINF 501 Database Design
May-August NURS 508 Methodological Knowledge & Advanced Practice Nursing Coop or Experiential Nursing Experience
January-April Coop or Experiential Nursing Experience
May-August NURS 565-566-567 Trends and Issues in Advanced Practice Nursing NURS Elective NURS 593 or HINF 580 Thesis/Project Seminar
Year 3 September-December January-April NURS Elective NUHI 599 Thesis [until completion] NUHI 599 Thesis NURS = nursing course; HINF = health informatics course; NUHI = nursing and health informatics Cooperative Education and the Double Degree Program in Nursing and Health Informatics Based on years of experience with health informatics students, we anticipated that there would be a need to provide double degree students with similar opportunities to alternate between classroom learning and real-world work experiences to develop advanced nursing practice and health informatics competencies (i.e. nursing informatics competencies) at the graduate level. The intent of this work was to provide double degree students with opportunities to apply their learning within real-world government, regional health authority, health information system vendor and information technology settings that undergraduate and graduate health informatics students receive. Drawing upon these prior experiences at the School of Health Information Science, we identified that a key and fundamental aspect of the double degree program is to interleave classroom-acquired theory, knowledge, skills and judgment with real-world work experiences where students could draw on their advanced practice nursing knowledge, skills and judgment (i.e. double degree students could apply theory and knowledge gained in the classroom to health information system project work). In addition to this is was felt that each cooperative education experience should lead to the development of nursing informatics competencies – one cooperative education work term would have more of a focus upon clinical and nursing informatics competencies associated with the delivery and care of patients and the other would have a focus upon the more technical, information and communication technology competencies as applied to the support of nursing and clinical practice to afford students with the ability to understand the roles and responsibilities of advanced practice nurses and health informatics professionals. To ensure students were provided with such robust learning opportunities, the curriculum design team (i.e. faculty from the Schools of Nursing and Health Information Science) worked with cooperative education experts from our university’s coop placement office. The team identified that there would be a need for students to complete two cooperative education experiences (each four months in length for a total of eight month of cooperative learning experience - each cooperative education experience would in turn be normally 600 hours, and a minimum of 420 hours in length). The cooperative learning experience would be integrated in years 1 and 2 of the double degree program, and each would lead to three academic credits being assigned (see Table 1). The double degree students, like the other health informatics students would be paid during their cooperative education placement. The double degree student cooperative learning experiences (like those of the health informatics student at the undergraduate and graduate levels) would take place in locations across Canada and with the same types of organizations as those that would typically employ health informatics students.
NI2012: 11th International Congress on Nursing Informatics 38
The double degree students are expected to develop core cooperative education and discipline specific competencies in health informatics and advanced nursing practice (see Table 2). To do this, at the outset of each work term double degree students are asked to outline their learning goals and objectives. The cooperative education coordinator conducts in-person or phone visits with the double degree students and their employers to monitor as well as facilitate student acquisition of their learning goals and objectives. Students are also expected to complete a work term report that summarizes the types of projects that students have undertaken as well as outline how this work led to their achieving their goals and objectives. This is followed by conference call where the students present information about the types of projects with which they were involved and their contributions to these project goals. In addition, the students document their progress toward achieving graduate level competencies in informatics and nursing. Unique to this double degree program is the involvement of a faculty member along with a cooperative learning specialist to support the students in both their work and in their understanding of the discipline-specific roles taken on during their work terms. Table 2: Core Cooperative Education and Discipline Specific Competencies Competencies Cooperative Education Health Informatics Nursing Personal Management Information Science Nursing Theory and Inquiry Communication Health Science Nursing Science Managing Information Management Science1 Advanced Practice Nursing Roles Implications for Societal Health7
Research and Analysis Project, Task and Organizational Skills Teamwork Commitment to Quality Professional Behaviour Social Responsibility Continuous Learning2 Lessons Learned and Experiences to Date
The double program was developed over a two year period (i.e. 2008-2009) and received its final approval from the Ministry of Education in British Columbia, Canada in 2010. The double degree program had its first intake in the Fall of 2010. There has been a significant interest in the program from baccalaureate prepared nurses who wish to develop competencies at the intersection of nursing and health informatics or nursing informatics competencies. Faculty and employers have identified that the program of study leading to two degrees: a Masters of Nursing and a Masters of Science in Health Informatics, provides students with significant career opportunities upon graduation in the fields of nursing, health informatics and nursing informatics. To date we have received nearly 100 queries about the program and we have enrolled approximately 15 students. One of the key features of the program that makes it attractive is that it provides students with the ability to engage in cooperative learning. Baccalaureate prepared nurses have inquired about the program and have expressed excitement about using the knowledge, skills and judgment garnered in the classroom and the ability to work on real-world projects while at the same time learning about differing types of nursing informatics work (i.e. work that is more clinically focused and work that is more technically focused). Administratively, the cooperative education experiences have represented an extension of the existing structure of the cooperative education program at the School of Health Information Science and the University of Victoria. In the past (in placing our undergraduate and graduate students) this has typically involved several phases: (1) helping students to find jobs by matching their requests with lists of employer job openings (2) extensive coaching of students prior to (as well as during) the cooperative education experience (3) helping students develop learning objectives (4) site vists by the co-op coordinator (5) generation of work term reports by students at the end of the work term, and (6) debriefing of students upon end of the work term. Placement of double degree students with employers was initially more challenging. Typically, students were more likely to be mid-career, had more geographic restrictions (regarding what cities or locations where they could work in), and had more restrictions in terms of the type of cooperative education placement that was needed (i.e. clinical and nursing versus more technical work placements). There was a need to identify and create linkages between the cooperative education office and employers to address these new challenges. The cooperative education coordinator worked with nurse faculty in the School of Health Information Science and the School of Nursing to identify
NI2012: 11th International Congress on Nursing Informatics 39
potential employers in a given location and opportunities that would support nursing informatics knowledge, skill and judgment development (e.g. professional practice leaders were contacted at health care organizations). This required more time and effort to identify potential health care organizations, key employer leaders and time spent on educating potential employers about the new double degree program and the types of knowledge, skills and judgment such students would develop over the course of the three year program. Once the cooperative education coordinator identified, contacted and educated potential health care organizations that might be interested in hiring double degree students, potential employers (i.e. those that have hired undergraduate and graduate health informatics students) and employers who had not hired informatics students in the past expressed considerable enthusiasm with the new degree and interest in hiring students with competencies at the intersection of nursing and health informatics. Employers identified a considerable need in their organizations for such individuals. In other cases employers sought out the cooperative education coordinator, having learned about the program. Here, several leading employer organizations identified positions in their own organizations where there was a need for such individuals and expressed a desire to hire double degree students when they were seeking employment for future work terms. Regarding the typical types of positions double degree students have taken up and the cooperative education coordinator and the faculty have been approached by employers about double degree students. It has been noted that double degree students (given their competencies) are being recruited for positions where they can enact leadership and organizational decision making roles and responsibilities. Employers reported that the combination of clinical knowledge and health informatics skills is highly valued and needed. Employer identified roles and responsibilities for work terms are typical of the job descriptions of clinical analysts, clinical informatics specialist, nursing informatics specialists, research analysts, trainers and clinical coordinator (see COACH’s professional career matrix). Responsibilities in these roles have varied but have included work on requirements gathering, coordinating information and communication technology projects, involvement in evaluations of health information systems and acting as a liaison between clinical and health informatics staff. Students have reported that they have faced a general lack of understanding of the dual nurse-informaticist role as a challenge in performing their work. Students report that neither the IM/IT nor the nursing staff seem prepared to understand that one person can have both skill sets. However, once others recognize the students’ skills, the students have served in liaison roles between clinical and infomatics departments, and between developers, implementers and end-users. In summary a partnership between the Schools of Nursing and Health Information Science at the University of Victoria, Victoria, British Columbia has led to the design and development of an innovative, double degree program leading to a Masters in Nursing and a Masters in Health Informatics. The three year distance education program relies on interleaving classroom learning and cooperative education experiences involve work on real-world health information systems projects to solidify learning. There has been a significant and enthusiastic response to the launch of this program that links classroom to experiential learning by Baccalaureate prepared nurses who are interested in careers in nursing informatics and employers who are seeking out individuals with expertise in advanced practice nursing and health informatics. Based on our experiences to date, new opportunities for bridging nursing and health informatics have emerged and continue to evolve. References 1. 2. 3. 4. 5. 6. 7.
Canada’s Health Informatics Association (COACH). Health informatics professional core competencies Version 2.0. Toronto: Canada, 2009. University of Victoria. Put your learning in motion. Cooperative Education Program and Career Services, 2010. Smollins JP. The making of history: Ninety years of Northeaster coop. North Easter Mag. 1999; 24(5). Kushniruk A, Lau F, Borycki E, Prott D. The School of Health Information Science at the University of Victoria: Towards and integrative model for health informatics education and research. 2006. COACH. Health informatics and health information management: Human resources report, 2009. Canadian Nursing Informatics Association. www.cnia.ca [Accessed on September 10, 2011]. School of Nursing, University of Victoria. http://nursing.uvic.ca [Accessed on September 10, 2011]
.
NI2012: 11th International Congress on Nursing Informatics 40
NI2012: 11th International Congress on Nursing Informatics 36
As outlined earlier in this paper, there are few educational programs in Canada that offer formalized nursing informatics education at the intersection of nursing and health informatics6. With the rise in the demand for professionals with health informatics competencies at the undergraduate and graduate levels, there has also be a significant rise in the need for individuals with advanced practice nursing and nursing informatics competencies. In response to this demand the Schools of Nursing and Health Information Science collaborated to develop a new, graduate level program at the intersection of nursing and health informatics. Faculty used the best educational knowledge and evidence in both nursing and health informatics when designing the curriculum. Overview of the Double Degree Program The program has several core courses (see Table 1), from the nursing and health informatics program. Nursing courses include those that are focused upon developing advance practice graduate level nursing competencies in nursing theory, philosophy and methodology. Health informatics courses focus upon developing graduate level health informatics professional competencies in the information sciences (i.e. information technology and information management), management sciences (i.e. project management, organizational behavior, analysis and evaluation) and health sciences (i.e. clinical and health services, Canadian health care system) as outlined by COACH1. In addition, a total of two nursing and two health informatics electives are required and are selected by the students. Students select electives in consultation with their supervisors (one from nursing and one from health informatics). Students also complete a Master’s thesis as part of their program of study. The thesis is co-supervised by two faculty (one from nursing and one from health information science). The Master’s thesis is focused on aspects of nursing informatics. For example, student thesis work may involve evaluating the usability of an electronic nursing documentation for a cardiac care unit – drawing on health informatics faculty expertise in the field of usability engineering and nursing expertise in the clinical area of cardiovascular nursing to evaluate a nursing information system developed for a cardiac care unit. In another example, a nurse may develop and test a new design for a computerized care planning system for home and community care, drawing on health informatics faculty expertise in the area of database design to design, develop and implement the system and nursing faculty expertise in the area of evidence-based nursing care plan development. Approach: Integrating Cooperative Education or Experiential Learning Cooperative education can be defined as a structured approach to combining classroom-based education with realworld work experiences. It is an approach that provides academic credit for structured job experiences. Cooperative education is especially effective when helping students transition between the classroom and the workplace or between two differing types of work2. Cooperative education is a well accepted method that has been used to provide students (mostly from technical degree programs – engineering, computer science) with paid work opportunities to apply classroom based learning to real-world projects3. The Cooperative Education Program at the University of Victoria is well supported by the University administration and is available for almost every academic program on campus, from Fine Arts to Law. Cooperative Education at the School of Health Information Science Over the past 30 years the School of Health Information Science cooperative education program has led the way in Canada, providing students with experiential learning experiences at the undergraduate and graduate level in the field of health informatics4. The underlying educational philosophy of cooperative education at the School of Health Information Science and the University of Victoria is to view learning as extending beyond the classroom. Students generally alternate between classroom and work terms in their field of study, bringing knowledge obtained in the classroom setting to the employers and returning to their classes having gained valuable practical experience working on real-world projects. This is an iterative cycle where theory, knowledge and skills are acquired in a classroom context followed by their application in the work setting. The alternation between work and academics is a key part of cooperative learning pedagogy and differentiates it from more traditional types of learning-work experiences such as internships. Most cooperative education work experiences take place in one of three settings: government (i.e. federal or provincial), private sector industry (e.g. a vendor organization or consulting company) and regional health authority (e.g. hospital, home care long term care). Students, employers and the cooperative education office in the School of Health Information Science collaborate to identify and match students and employers in terms of student learning needs and employer skills needed for projects.
NI2012: 11th International Congress on Nursing Informatics 37
Table 1: Overview of Course and Cooperative Education Components Year 1 September-December NURS 506 Philosophical Knowledge & Advanced Practice Nursing HINF 572 Health Informatics: An Overview
Year 2 September-December HINF 503 Research Methods in Health Informatics HINF Elective HINF Elective
January-April NURS 507 Theoretical Knowledge & Advanced Practice Nursing HINF 550 Health Information Systems Design HINF 501 Database Design
May-August NURS 508 Methodological Knowledge & Advanced Practice Nursing Coop or Experiential Nursing Experience
January-April Coop or Experiential Nursing Experience
May-August NURS 565-566-567 Trends and Issues in Advanced Practice Nursing NURS Elective NURS 593 or HINF 580 Thesis/Project Seminar
Year 3 September-December January-April NURS Elective NUHI 599 Thesis [until completion] NUHI 599 Thesis NURS = nursing course; HINF = health informatics course; NUHI = nursing and health informatics Cooperative Education and the Double Degree Program in Nursing and Health Informatics Based on years of experience with health informatics students, we anticipated that there would be a need to provide double degree students with similar opportunities to alternate between classroom learning and real-world work experiences to develop advanced nursing practice and health informatics competencies (i.e. nursing informatics competencies) at the graduate level. The intent of this work was to provide double degree students with opportunities to apply their learning within real-world government, regional health authority, health information system vendor and information technology settings that undergraduate and graduate health informatics students receive. Drawing upon these prior experiences at the School of Health Information Science, we identified that a key and fundamental aspect of the double degree program is to interleave classroom-acquired theory, knowledge, skills and judgment with real-world work experiences where students could draw on their advanced practice nursing knowledge, skills and judgment (i.e. double degree students could apply theory and knowledge gained in the classroom to health information system project work). In addition to this is was felt that each cooperative education experience should lead to the development of nursing informatics competencies – one cooperative education work term would have more of a focus upon clinical and nursing informatics competencies associated with the delivery and care of patients and the other would have a focus upon the more technical, information and communication technology competencies as applied to the support of nursing and clinical practice to afford students with the ability to understand the roles and responsibilities of advanced practice nurses and health informatics professionals. To ensure students were provided with such robust learning opportunities, the curriculum design team (i.e. faculty from the Schools of Nursing and Health Information Science) worked with cooperative education experts from our university’s coop placement office. The team identified that there would be a need for students to complete two cooperative education experiences (each four months in length for a total of eight month of cooperative learning experience - each cooperative education experience would in turn be normally 600 hours, and a minimum of 420 hours in length). The cooperative learning experience would be integrated in years 1 and 2 of the double degree program, and each would lead to three academic credits being assigned (see Table 1). The double degree students, like the other health informatics students would be paid during their cooperative education placement. The double degree student cooperative learning experiences (like those of the health informatics student at the undergraduate and graduate levels) would take place in locations across Canada and with the same types of organizations as those that would typically employ health informatics students.
NI2012: 11th International Congress on Nursing Informatics 38
The double degree students are expected to develop core cooperative education and discipline specific competencies in health informatics and advanced nursing practice (see Table 2). To do this, at the outset of each work term double degree students are asked to outline their learning goals and objectives. The cooperative education coordinator conducts in-person or phone visits with the double degree students and their employers to monitor as well as facilitate student acquisition of their learning goals and objectives. Students are also expected to complete a work term report that summarizes the types of projects that students have undertaken as well as outline how this work led to their achieving their goals and objectives. This is followed by conference call where the students present information about the types of projects with which they were involved and their contributions to these project goals. In addition, the students document their progress toward achieving graduate level competencies in informatics and nursing. Unique to this double degree program is the involvement of a faculty member along with a cooperative learning specialist to support the students in both their work and in their understanding of the discipline-specific roles taken on during their work terms. Table 2: Core Cooperative Education and Discipline Specific Competencies Competencies Cooperative Education Health Informatics Nursing Personal Management Information Science Nursing Theory and Inquiry Communication Health Science Nursing Science Managing Information Management Science1 Advanced Practice Nursing Roles Implications for Societal Health7
Research and Analysis Project, Task and Organizational Skills Teamwork Commitment to Quality Professional Behaviour Social Responsibility Continuous Learning2 Lessons Learned and Experiences to Date
The double program was developed over a two year period (i.e. 2008-2009) and received its final approval from the Ministry of Education in British Columbia, Canada in 2010. The double degree program had its first intake in the Fall of 2010. There has been a significant interest in the program from baccalaureate prepared nurses who wish to develop competencies at the intersection of nursing and health informatics or nursing informatics competencies. Faculty and employers have identified that the program of study leading to two degrees: a Masters of Nursing and a Masters of Science in Health Informatics, provides students with significant career opportunities upon graduation in the fields of nursing, health informatics and nursing informatics. To date we have received nearly 100 queries about the program and we have enrolled approximately 15 students. One of the key features of the program that makes it attractive is that it provides students with the ability to engage in cooperative learning. Baccalaureate prepared nurses have inquired about the program and have expressed excitement about using the knowledge, skills and judgment garnered in the classroom and the ability to work on real-world projects while at the same time learning about differing types of nursing informatics work (i.e. work that is more clinically focused and work that is more technically focused). Administratively, the cooperative education experiences have represented an extension of the existing structure of the cooperative education program at the School of Health Information Science and the University of Victoria. In the past (in placing our undergraduate and graduate students) this has typically involved several phases: (1) helping students to find jobs by matching their requests with lists of employer job openings (2) extensive coaching of students prior to (as well as during) the cooperative education experience (3) helping students develop learning objectives (4) site vists by the co-op coordinator (5) generation of work term reports by students at the end of the work term, and (6) debriefing of students upon end of the work term. Placement of double degree students with employers was initially more challenging. Typically, students were more likely to be mid-career, had more geographic restrictions (regarding what cities or locations where they could work in), and had more restrictions in terms of the type of cooperative education placement that was needed (i.e. clinical and nursing versus more technical work placements). There was a need to identify and create linkages between the cooperative education office and employers to address these new challenges. The cooperative education coordinator worked with nurse faculty in the School of Health Information Science and the School of Nursing to identify
NI2012: 11th International Congress on Nursing Informatics 39
potential employers in a given location and opportunities that would support nursing informatics knowledge, skill and judgment development (e.g. professional practice leaders were contacted at health care organizations). This required more time and effort to identify potential health care organizations, key employer leaders and time spent on educating potential employers about the new double degree program and the types of knowledge, skills and judgment such students would develop over the course of the three year program. Once the cooperative education coordinator identified, contacted and educated potential health care organizations that might be interested in hiring double degree students, potential employers (i.e. those that have hired undergraduate and graduate health informatics students) and employers who had not hired informatics students in the past expressed considerable enthusiasm with the new degree and interest in hiring students with competencies at the intersection of nursing and health informatics. Employers identified a considerable need in their organizations for such individuals. In other cases employers sought out the cooperative education coordinator, having learned about the program. Here, several leading employer organizations identified positions in their own organizations where there was a need for such individuals and expressed a desire to hire double degree students when they were seeking employment for future work terms. Regarding the typical types of positions double degree students have taken up and the cooperative education coordinator and the faculty have been approached by employers about double degree students. It has been noted that double degree students (given their competencies) are being recruited for positions where they can enact leadership and organizational decision making roles and responsibilities. Employers reported that the combination of clinical knowledge and health informatics skills is highly valued and needed. Employer identified roles and responsibilities for work terms are typical of the job descriptions of clinical analysts, clinical informatics specialist, nursing informatics specialists, research analysts, trainers and clinical coordinator (see COACH’s professional career matrix). Responsibilities in these roles have varied but have included work on requirements gathering, coordinating information and communication technology projects, involvement in evaluations of health information systems and acting as a liaison between clinical and health informatics staff. Students have reported that they have faced a general lack of understanding of the dual nurse-informaticist role as a challenge in performing their work. Students report that neither the IM/IT nor the nursing staff seem prepared to understand that one person can have both skill sets. However, once others recognize the students’ skills, the students have served in liaison roles between clinical and infomatics departments, and between developers, implementers and end-users. In summary a partnership between the Schools of Nursing and Health Information Science at the University of Victoria, Victoria, British Columbia has led to the design and development of an innovative, double degree program leading to a Masters in Nursing and a Masters in Health Informatics. The three year distance education program relies on interleaving classroom learning and cooperative education experiences involve work on real-world health information systems projects to solidify learning. There has been a significant and enthusiastic response to the launch of this program that links classroom to experiential learning by Baccalaureate prepared nurses who are interested in careers in nursing informatics and employers who are seeking out individuals with expertise in advanced practice nursing and health informatics. Based on our experiences to date, new opportunities for bridging nursing and health informatics have emerged and continue to evolve. References 1. 2. 3. 4. 5. 6. 7.
Canada’s Health Informatics Association (COACH). Health informatics professional core competencies Version 2.0. Toronto: Canada, 2009. University of Victoria. Put your learning in motion. Cooperative Education Program and Career Services, 2010. Smollins JP. The making of history: Ninety years of Northeaster coop. North Easter Mag. 1999; 24(5). Kushniruk A, Lau F, Borycki E, Prott D. The School of Health Information Science at the University of Victoria: Towards and integrative model for health informatics education and research. 2006. COACH. Health informatics and health information management: Human resources report, 2009. Canadian Nursing Informatics Association. www.cnia.ca [Accessed on September 10, 2011]. School of Nursing, University of Victoria. http://nursing.uvic.ca [Accessed on September 10, 2011]
.
NI2012: 11th International Congress on Nursing Informatics 40
