Table 4 Critical elements: implementation activities and outputs for increasing recruitment and retention
Critical element | Indicators of success | Indicators of challenge |
|---|---|---|
Activities | ||
Identify VA units to be used for VANA placements | ● Units struggling to accommodate nursing students receive increased mentorship and support by VANA faculty | ● No VA units slated for VANA clinical placements viewed as being able to provide unique clinical learning opportunities |
Involve nursing staff in planning | ● VA-based faculty (i.e., staff nurses hired into faculty positions) highly integrated into workflow on units where students were placed | ● Unit nursing staff as a whole not enthusiastic about having VANA students placed there |
● VA-based faculty highly engaged in all aspects of clinical teaching (e.g., preceptor training, DEU implementation) | ● Presence of VANA students seen by unit staff as an increased workload burden and interruption to workflow | |
● VANA faculty activated to develop their careers (e.g., furthering own education, gaining broad teaching experience) | ● Unit staff not willing to participate in VANA-related activities, such as EBP projects | |
● No formal clinical preceptor program was in place at VA facility | ||
● Benefits offered at some VAs encouraged RN nursing staff to further their education (e.g., tuition reimbursement, release time incentives, giving credit for precepting nursing students) | ● VANA faculty minimally involved with clinical teaching, especially with large clinical groups | |
● Over-reliance on nursing staff for clinical teaching, often beyond their training; often disrupting responsibilities of staff nurse | ||
● Too much time spent acclimating students to the unit environment at the expense of patient interactions | ||
Outputs | ||
Increased stakeholder satisfaction with participation | ● Clinical innovations resulting from VANA (e.g., DEU, embedded faculty) perceived to directly result in improved care quality | ● Presence of VANA students is perceived as an increased burden and disruption |
● Unit nursing staff value input from VANA faculty | ||
● Unit workflow viewed as improved with presence of VANA faculty and students | ||
Benefits of VANA participation realized | ● VANA program provides clinically expert VA nurses teaching opportunities | ● Unit nursing staff remain uninterested and unengaged in the placement of nursing students on their units |
● Nursing positions at VA provided for newly graduated VANA students | ||
● Positive perceptions of VA clinical training improve VA’s reputation among subsequent groups of nursing students | ● No positions exist at VA for newly graduating VANA students | |
● Over-reliance on unit nursing staff for clinical teaching | ||