UR School of Nursing Internal Fellowship Supports Meaningful Clinical Work

Since 2012, Jessica Lapinski, MNE, RN, CNEcl, instructor of clinical nursing at the University of Rochester School of Nursing, has introduced students to real-life, hands-on experience in a local Dedicated Education Unit (DEU). 

Established in the Neurosurgery Medical/Surgical Unit at Highland Hospital, the DEU provides a more realistic view of a typical nursing assignment than traditional clinical instruction. The model uses staff nurses—Student Nurse Instructors—to educate nursing students, while academic faculty serve as a resource for both students and nursing staff. Students are paired with the same nurse every week, allowing for more consistent evaluation of student progress and improved communication among faculty and nurses. Traditionally, students work with multiple nurses during a clinical rotation and often miss opportunities to learn about the nurses’ other patients.

As one of the nurses trained in the DEU and then later as a clinical instructor, Lapinski experienced the model’s benefits and wanted to replicate it across different URMC-affiliated institutions. She had seen the increased job satisfaction among nurses, improved learning outcomes for students, and enhanced relationships between practice and academic institutions overall.

Despite the benefits, there were a few considerations that, if addressed, would make the DEU more sustainable. Student Nurse Instructors expressed difficulty providing a rich learning experience and required more time and attention when working with students at varying skill levels. Another hurdle was a 4-week clinical rotation, which did not allow for enough time for novice students to become immersed in the unit culture.

Lapinski was already collecting data to improve the DEU when she saw the call for the UR School of Nursing clinical faculty to apply for the Clinical Scholar Fellowship Program.

Formed in 2019 and directed by Susan Ciurzynski, PhD, RN, NPD-BC, PNP, VCE, FNAP, assistant director of the Doctor of Nursing Practice program and professor of clinical nursing, the Clinical Scholar Fellowship Program is an internally-funded initiative that provides release time to clinical faculty to conduct and publish scholarly projects in a peer-reviewed journal. 

UR School of Nursing clinical faculty members can apply to receive one of the two annual scholarships—Writing for Publication Fellowship, which internally funds one semester for clinical faculty to publish findings from a previously-completed scholarly project; and the Clinical Scholar Fellowship, which internally-funds one year to allow for data collection and analysis, followed by manuscript development. Both fellowship options pair fellows with a mentor to provide support throughout the publication process.

“The idea is that we give visibility to the school through getting the word out regarding the great work our faculty are doing. We give clinical faculty members the time they’re asking for to collect outcomes to evaluate their programs, and it brings positive attention back to the school,” said Ciurzynski.

“It also helps with professional development because publications are a requirement to advance from assistant professor to associate professor of clinical nursing. Publication in peer-reviewed journals is universally accepted as an indicator of scholarship among faculty.”

Mitchell Wharton, PhD, RN, FNP-BC, CNS, associate dean for equity and inclusion and associate professor of clinical nursing, and Susan Blaakman, PhD, RN, PMHNP-BC, FNAP, director of the Family Psychiatric Mental Health Nurse Practitioner program and professor of clinical nursing, were the inaugural recipients of the Writing for Publication Fellowship.

Wharton’s project,“Self-preservation strategies of young Black men who have sex with men to remain HIV negative,” was overseen by Ciurzynski and James McMahon, PhD, associate professor at UR School of Nursing. Blaakman was mentored by Jill Halterman, MD, MPH, professor of pediatrics at University of Rochester School of Medicine and Dentistry, and Maria Fagnano, MPH, associate director of clinical research at the University of Rochester Medical Center, for her project, “Understanding treatment motivation in urban teens with asthma.”

Lapinski—like most clinical faculty—never received significant preparation in writing for a peer-reviewed journal. She felt the Clinical Scholar Fellowship Program could be an opportunity to measure the effectiveness of proposed changes in the DEU on its sustainability. She reached out to Ciurzynski and together, they worked on the abstract to apply to the Clinical Scholar Fellowship Program.

Lapinski was approved as the first recipient of the clinical scholar fellowship program. She and Ciurzynski held monthly meetings to discuss areas for improvement in the DEU based on data and what outcomes to measure for value-added academic-practice collaboration. 

Lapinski addressed the disparity between novice and advanced level students by selecting DEU students based on their prior academic achievement. Students will now participate in the DEU in their final semester for an extended clinical rotation to get better acquainted with the unit and their Student Nurse Instructors. Additionally, the nurse instructor-to-student ratio changed from 1:1 to 1:2 to accommodate all eight students on the DEU for the full 10 weeks.

Throughout a subsequent 12-month formative program evaluation, Lapinski collected data from three clinical cohorts using written evaluations and focus groups conducted with nursing students and Student Nurse Instructors.

The redesigned DEU elements received overwhelmingly positive feedback from nurses, students, and faculty. Participants reported increased collaboration between the academic and practice partners, improved communication between faculty and nurses, increased student satisfaction, and improved role preparation for the DEU nurses.

In September 2020, “Enhancing the sustainability of a Dedicated Education Unit: Overcoming obstacles and strengthening partnerships,” was published in the Journal of Professional Nursing.

“Jessica had the knowledge in her head and it was my job to help her figure out how we package it for dissemination. There’s probably a level of journalism that we normally don’t get educated in. It’s very rewarding to see somebody go from an idea in their head to then seeing their name in print,” said Ciurzynski.

“We got to work together on a project and I may have never gotten to know her otherwise. She knows that if she needs anything I will always be her mentor. It’s not limited to this timeline. Now she has a mentor for life.”

As for the future, Lapinski plans to educate faculty and practice administrators so they can be more aware of the benefits of the DEU, and so she can focus on improving and expanding the model to other departments.

“It’s because of the Clinical Scholar Fellowship Program that I had the confidence to continue with the future. I think having clinical faculty work on publications keeps us invested in what we’re doing and current within the research,” said Lapinski.

“I felt like I was an expert on the DEU, but I was also becoming more of a leader because I was able to have something of my own to show the world how we’re really making an impact at the University of Rochester School of Nursing. I think it gives us more pride in what we’re doing and we can put it out there for other people to see.”

Since its inception in 2019, there have been four Clinical Scholar Fellowship Program recipients and five Writing for Publication Fellowship recipients:

2019

Clinical Scholar Fellowship:

• Jessica Lipinski, instructor of clinical nursing, “Enhancing the sustainability of a Dedicated Education Unit: Overcoming obstacles and strengthening partnerships.”

Writing for Publication Fellowship:

• Mitchell Wharton, PhD, RN, FNP-BC, CNS, associate professor of clinical nursing and associate dean for equity and inclusion,“Self-preservation strategies of young Black men who have sex with men to remain HIV negative.”
• Susan Blaakman, PhD, RN, PMHNP-BC, FNAP, professor of clinical nursing, “Understanding treatment motivation in urban teens with asthma.”

2020

Clinical Scholar Fellowship:

• Kaitlyn Burke, MS RN CCRN CNEcl, instructor of clinical nursing, “Nursing flips out! Innovative methods to redesign a psychomotor nursing course.”
• Carolanne Bianchi, DNP MBA RN ANP-BC CRRN, assistant professor of clinical nursing, “Development and validation of a tool to measure barriers to walking hospitalized older adults.”

Writing for Publication Fellowship:

• Kristin Hocker, EdD, assistant professor of clinical nursing and co-specialty director of leadership in health care systems program, “Narratives of emergent leadership.”

2021

Clinical Scholar Fellowship:

• Joseph Gomulak-Cavicchio, EdD, MSEd, assistant professor of clinical nursing and education innovation coordinator, “Graduate nursing students’ perceptions of online learning and interaction.”

Writing for Publication Fellowship

• Andrew Wolf, EdD, RN, AGACNP-BC, director of educational effectiveness and assistant professor of clinical nursing, “Diversity and equity from application to graduation: A holistic approach.”
• Jamie Oliva, PhD, MS, RN, ANP-BC, assistant professor of clinical nursing,“Rare helper T-cell populations are quantifiable at an early time point in allogeneic stem cell transplant recipients.”