Abstract
Background: As integrated care models emerge in Ontario’s health care system, nurses are assuming new and expanded roles and responsibilities including care coordination and care transitions. Nursing education programs must therefore ensure graduates are prepared to work in evolving health care systems that emphasize population health and place nurses in roles that address the increasingly complex needs of patients with multiple chronic conditions. Supporting these complex patients across the health care continuum requires nurses to coordinate, communicate and collaborate with members of interdisciplinary and intersectoral teams. Canadian nursing schools currently face ongoing challenges of securing placement sites for undergraduate and graduate students. Typically, student placements occur within a single health care organization, often with an emphasis on acute care. However, nurses need to understand how to work in all health sectors, not just acute care. New and innovative clinical placement opportunities for both undergraduate and graduate nursing students are needed where they can be embedded within hospital to home integrated care or primary care teams and learn alongside other professionals in caring for patients across health and social care sectors. Exploring the feasibility of such placements is critical for training nurses to develop the required knowledge, skills, and competencies for integrated care.
Approach: Our team comprised of faculty, a graduate student, practice partners from acute care, and home and community co-designed and used a qualitative descriptive approach. We aimed to explore the feasibility of implementing new clinical placement opportunities for senior undergraduate and graduate nursing students in the context of integrated care teams. We interviewed 15 key stakeholders including educators, clinical placement staff, nursing leaders within hospital and home integrated care programs, integrated care leads, undergraduate and graduate nursing students. Demographic data were collected including participant roles, place of employment and years of experience. Interviews were conducted and audio-recorded and transcribed using the Zoom platform. Data analysis included descriptive statistics for quantitative data analysis and thematic analysis for the qualitative data. Ethics approval was received prior to commencing the study.
Results: Preliminary findings indicate integrated care student placements would be valuable learning experiences for students to learn about integrated care delivery model, working in interprofessional teams, as few such placements currently exist. Broader knowledge of integrated care among health professionals working in practice and new academic-practice policy agreements should be explored to facilitate these placements.
Implications: Creating student placements in integrated care is critical for nurses to develop competencies for interprofessional teamwork and integrated care. As Ontario universities increase the number of nursing seats, faculty face ongoing challenges to find placements; new opportunities where nurses can support patients across the care sectors may offer important solutions. Findings from this work can inform what partnerships among academic and practice organizations, health professions and communities are needed to develop, implement and sustain clinical placements within integrated care programs. Next steps: We plan to engage patients and caregivers co-designing new placement opportunities in collaboration with integrated care practice sites and identifying opportunities within curricula to implement integrated care placements.