Journal of Professional Nursing 37 (2021) 366–372

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Journal of Professional Nursing

journal homepage: www.elsevier.com/locate/jpnu

Enhancing the undergraduate nursing education experience with clinical

elective courses
Rhonda Maneval a, *, Millie Hepburn b, Christopher Brooks c, Marissa Tamburi d,
Susan Di Nonno Chin e, MariLou Prado-Inzerillo e, Karen Toby Haghenbeck-Nunnink b,
Susan J. Flaum b
a
College of Health Professions and the Lienhard School of Nursing, Pace University, 163 Williams Street, New York, NY 10038, United States
b
College of Health Professions, Pace University, 861 Bedford Road, Pleasantville, NY 10570, United States
c
Nursing Professional Development, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, NY 10065, United States
d
Maria Fareri Children’s Hospital Member of the Westchester Medical Center Health Network, 100 Woods Road, Valhalla, NY 10595, United States
e
New York-Presbyterian, 466 Lexington Ave, New York, NY 10017, United States

A R T I C L E I N F O A B S T R A C T

Keywords: The nursing faculty, in concert with the University’s vision of personalized learning for undergraduate students,
Clinical elective sought creative opportunities for nursing students to explore distinctive career specialty paths. The development,
Nursing students implementation, and evaluation of three undergraduate clinical electives developed by a School of Nursing
Academic-practice partners
(SON) is described here, in collaboration with three clinical practice partners. These nursing elective courses
Undergraduate nursing education
Preceptors
were designed to meet student requests for additional content in specialty nursing practice areas, enhance new
Curriculum nurse career readiness, and meet practice partner staffing needs for nurses with additional knowledge and skills
in specific identified specialties. These nursing specialties included perioperative nursing, neonatal intensive care
nursing, and oncology nursing. The SON faculty and each practice partner co-developed unique specialty-nursing
elective courses that provide foundational specialty knowledge and skills in each practice arena. Project out­
comes include enhanced relationships between the SON and practice partners, high levels of satisfaction of
students and employers, and subsequent recruitment and employment of these students as new graduate nurses
by our practice partners.

Introduction concerned about the high cost of education and strive to maximize their
educational experience in order to gain the required skills to ensure
The new generation of college students, Generation Z (Gen Z), successful transition to their desired careers (Northeastern University’s
include students who were born after 1994 and arrived in college Innovation Survey, 2014).
beginning in 2013 (Seemiller & Grace, 2017). This cohort of students The American Organization of Nurse Executives (AONE) (2012),
differ from the Millennial generation, as they are said to value hands-on now known as the American Organization of Nurse Leaders, in collab­
learning opportunities and prefer an interpersonal learning approach oration with the American Association of Colleges of Nursing (AACN),
(Seemiller & Grace, 2017). According to Northeastern University created the Task Force on Academic-Practice Partnership to enhance
(2014), Gen Z students are confident that higher education is important academic and practice partnerships as a means to improve public health.
in achieving their career goals, but students wish to be very involved in Subsequent to this collaboration, the AACN Vision for Nursing Educa­
shaping that education. Over 75% of students report that colleges should tion Position Statement White Paper (AACN, January, 2019a) provides
allow students to design their own course of study or major, and 79% recommendations for transition to practice and academic-practice
state that practical experiences, like employer internships, are essential interface. Specifically, the recommendations for Gen Z students
in a college education. The report also indicated that Generation Z is include a collaboration between Schools of Nursing and their practice

* Corresponding author.
E-mail addresses: rmaneval@pace.edu (R. Maneval), mhepburnsmith@pace.edu (M. Hepburn), brooks6@mskcc.org (C. Brooks), Marissa.Tamburi@wmchealth.
org (M. Tamburi), suc9004@nyp.org (S. Di Nonno Chin), mrp9002@nyp.org (M. Prado-Inzerillo), khaghenbeck@pace.edu (K.T. Haghenbeck-Nunnink), sflaum@
pace.edu (S.J. Flaum).

https://doi.org/10.1016/j.profnurs.2020.04.014
Received 2 February 2020; Received in revised form 17 April 2020; Accepted 21 April 2020
Available online 26 April 2020
8755-7223/© 2020 Elsevier Inc. All rights reserved.
R. Maneval et al. Journal of Professional Nursing 37 (2021) 366–372

partners in the development of joint education ventures that include development of the Academic-Practice Partnership model, refer to
short courses or learning modules separately as undergraduate students, Maneval et al., 2019).
as well as graduate programs that are tailored to employer requirements
and needs (AACN, 2019a, p. 12). These recommended courses and Memorandum of agreement (MOA)
programs should be geared to impact the student’s ability to develop
competencies that are essential in the delivery of healthcare, promote The co-development of the clinical elective courses was one aspect of
career advancement, and are approved for academic credit (AACN, larger agreements with each partner institution. Each institution shared
2019a, p. 13). The AACN (2019a) further expands this recommendation a desire to increase the strength of the academic-practice partnership by
to include an expansion of university and practice partnerships, in order negotiating a variety of specific needs of the organizations involved. The
to improve public health by matching the academic preparation of memorandum of agreement (MOA) with the cancer and research center
students to the current needs in the health care delivery system. (CCC) involved an agreement to provide expert staff to serve as faculty
These recommendations informed the work of our group, particu­ for the didactic component of the course and baccalaureate prepared
larly in the development of the ideals of open communication, frequent nurses as onsite preceptors for the clinical component. In return, the
engagement, mutual investment/commitment, and transparency SON agreed to allow the CCC to have use of the schools’ simulation
(AACN, 2019b). Robust, interactive and engaging academic-practice center up to 8 h a month or 96 h a year for their own staff training. SON
partnerships are critical for students to thrive, build competence and simulation experts were made available to the CCC for ongoing devel­
ensure optimal transition into the practice environment after course­ opment of simulation experiences for their staff.
work completion (AACN, 2019b). The agreement with the regional medical center (RMC) included the
Therefore, our collaborative project addresses both the concerns of same provision of expert staff to serve as faculty, and preceptors for
Gen Z students by creating opportunities for a more customized and students’ clinical experience. In exchange, the SON agreed to provide a
individualized approach to nursing education, and the AACN-AONE task faculty member for 90 h of services to RMC each semester, including
force recommendations for academic-practice partnerships that shape assistance with the administration of the hospital’s nurse residency
the curriculum and meet nursing workforce needs. Herein, we describe program (NRP), collaboration on research efforts, and service as an
how our project serves as a model exemplar of how one school of nursing academic advisor for nurses wishing to pursue advanced degrees at Pace
(SON) changed its approach to curriculum design in order to accomplish University.
these transformative aims. In the year prior to the development of the perioperative elective, the
academic healthcare system (AHCS) and the SON met several times in
Background order to establish a close partnership. As part of an addendum to the
clinical affiliation agreement, the SON agreed to provide AHCS with a
At the undergraduate level, the School of Nursing (SON) offers both a list of faculty who would be willing to provide educational offerings at
traditional four-year baccalaureate pre-licensure nursing program the hospital based on their staff needs and the faculty member’s
(RN4) and an accelerated second-degree pre-licensure nursing program expertise. In addition, the SON agreed to work with AHCS’s Nursing
(ABS), enrolling approximately 500 students annually across all levels. Professional Development department to provide access to the SON’s
Senior nursing students are required to enroll in one three-credit nursing simulation center, which includes approximately 150 h annually and
elective. Students in their last semester of the program must complete support of the simulation staff.
either 135 h (ABS) or 150 h (RN4) of supervised precepted clinical
nursing experience with a bachelor’s prepared registered nurse. Course development
Pace University has developed, and embraces a unique program,
called the Pace Path. The Pace Path is required for all undergraduate Each course was assigned a full-time faculty champion to work with
students, as it provides a personalized educational plan that integrates the practice partner’s staff in developing the course. This faculty
internships and other real world experiences to assure that students member was also responsible for shepherding the course through the
achieve their individualized career goals. Fostering nursing student School of Nursing, College of Health Professions and University course
attainment of their unique Pace Path is part of our commitment to stu­ approval processes. All practice partner faculty received courtesy faculty
dent success. Though the SON actively seeks novel pedagogical ap­ appointments, and in some instances practice partner faculty were hired
proaches to assist students in customizing education to unique career as adjunct faculty. We assigned a full-time SON faculty member to each
goals, this is often challenging, given the prescriptive nature of the course, who assumed accountability for course management, including
curriculum and the clinical program of study, which by design, offer a posting of the syllabus, overseeing the course calendar, student atten­
limited variation of experiences. Students often comment that they dance, and grades.
wished to explore particular areas of nursing in more depth and some
had plans to pursue a specialty area upon graduation, but felt discour­ Literature review
aged about their opportunities given their lack of experience or expo­
sure. Thus, the SON began to explore the possibility of establishing This review describes three types of nursing elective courses found in
clinically based nursing elective courses to meet this need in a cohesive the literature; didactic, didactic with observation; and didactic with
manner with our closest practice partners. clinical. Didactic electives in nursing programs offer a wide variety of
Following extensive discussion and collaboration with our practice topics, including critical care, palliative and end of life care, cancer care,
partners, the SON co-established three distinct nursing specialty courses. neuroscience, gerontology, ethics, diabetes, and the opioid crisis (Hold,
Our first partner, an American Nurses Credentialing Center (ANCC) Blake, & Ward, 2015; Lavandero & Farley, 1990; Purnell, Walsh, &
Magnet® and the National Cancer Institute (NCI) designated Compre­ Milone, 2004; Petrozella, 1997; Slaninka, 1992; Strang, Bagnardi, & Utz,
hensive Cancer Center (CCC), expressed the need to hire nurses that 2010; Stanley & Burggraf, 1986; Whelpley & Feurer, 2019). The didactic
were better prepared to practice in the oncology specialty. Our second electives typically provide in-depth knowledge in caring for particular
partner, a large suburban regional medical center, was experiencing a populations of patients and address elements of care that are of concern
shortage of neonatal intensive care nurses, due to a rapid growth and to nurses, and some include clinical observation. For example, Holler­
expansion of its neonatal intensive care unit and nurse retirements. Our bach and Hilton (1989) described a self-structured elective in which the
third collaborator, a large urban academic health care delivery system, faculty assists the student in an in-depth exploration of nurse anesthesia.
expressed the need for filling a staffing gap for qualified perioperative This elective provided the opportunity for students to observe certified
nurses across their enterprise. (For more information on the registered nurse anesthetists in the clinical setting, and although it

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included only observational experiences, it was one of but a few elec­ new nurse orientation, placing new graduates in a position of practice
tives that directly linked the didactic course to the clinical environment readiness, and this reduces the expense of onboarding nurses to practice
(Hollerbach & Hilton, 1989). Nursing electives that provided both di­ roles.
dactic and clinical components were identified in six articles and all of
these focused on perioperative nursing (Beitz & Houck, 1997, Holmes, Course development, implementation, and evaluation
2004; Kurtz & Eichelberger, 1999; Long, George, & Gulledge, 1995;
Penprase, Monahan, Poly-Droulard, & Prechowski, 2016; Ruth-Sahd & Oncology elective
Wilson, 2013).
Happell (2000) has described the specialty of perioperative nursing As part of the undergraduate curriculum, junior level students are
as being in crisis 20 years ago, due to the unpopularity of the role, and introduced to a broad overview of oncology nursing in their junior level
identified a threat of non-nurses entering roles traditionally performed medical-surgical course. This content served as the foundation from
by nurses. Perioperative nursing electives were described more which the elective course was developed by four clinical nurse experts
frequently than any other elective nursing course. Perioperative elec­ from the CCC. Each of these experts are Nursing Professional Develop­
tives were developed in response to the following: 1) Previous removal ment Specialists, with advanced oncology training. These experts agreed
of perioperative concepts from the basic undergraduate nursing to consult with our faculty to promote course development and serve as
curricula, 2) employer demand for perioperative nurses, and 3) a onsite faculty for the course. The CCC educators developed and deliv­
shortage of perioperative nurses (Beitz, 2019; Holmes, 2004; Kurtz & ered the course content, in alignment with the Core Curriculum for
Eichelberger, 1999; Long et al., 1995; Penprase et al., 2016; Ruth-Sahd Oncology Nurses (Brant, 2019). This six-module course is based on na­
& Wilson, 2013). tional standards for nurse orientation to the oncology specialty. For their
The earliest article describing a clinically based perioperative elec­ part, the SON faculty formatted the course content in the syllabus and
tive was published in 1995 (Long et al., 1995) and was described as a 2- topical outline, entered grades, and participated in classroom activities.
credit course offered to junior and senior nursing students. The course Curricular approval occurred at the School and University levels. (Refer
consisted of classroom instruction, clinical workshops and labs, obser­ to Table 1: Oncology Elective).
vational experiences, as well as an opportunity for students to scrub in This 3-credit elective course was offered in the fall and summer se­
for up to two surgeries. Alternatively, Beitz and Houck (1997) developed mesters for accelerated program cohorts and in the spring semester for
a 2-credit entry level and a 2-credit advanced level elective offered the traditional program cohort. The clinical component of the course
during the summer months that included a lab component and up to 20 h included placement at the CCC in a preceptorship spanning between 135
of clinical experiences. By comparison, Kurtz and Eichelberger (1999) and 150 h and guided by a staff RN. Students were assigned to a variety
developed a course consisting of four-days of didactic instruction fol­ of settings at the CCC, including, inpatient, outpatient, and periopera­
lowed by an unspecified number of clinical hours. Holmes (2004) also tive areas. Class size was limited each semester to 16 students in order to
described a perioperative elective for senior nursing students that ensure all could be accommodated with preceptors.
required 18 h of didactic and 90 h of clinical experiences across seven In addition to the didactic component of the course, CCC faculty
rotations. By comparison, Ruth-Sahd and Wilson (2013) developed a 3- collaborated with SON simulation faculty in developing two simulation
credit (1 credit didactic; 2 credit clinical) elective that was offered be­ scenarios as part of the course: 1) Management of Chemotherapy
tween semesters and included 14 h of didactic content prior to 84 h of Induced Complications, 2) Management of Hypercalcemia for a Breast
clinical experience in the perioperative areas. One hospital introduces Cancer Patient Who Self-Identifies with LGBTQ Population. In the
nursing students to the perioperative environment in a summer chemotherapy simulation, students are expected to perform a focused
externship program that incorporates both didactic and clinical experi­ assessment, recognize signs and symptoms of hypovolemia and throm­
ences (Trice, Brandvold, & Bruno, 2007). bocytopenia, implement provider’s orders, evaluate patient’s response,
Lastly, Penprase et al. (2016) utilized two faculty members with communicate findings to the primary care provider, provide proper
perioperative expertise to create a one-credit course with supplemental management and care, and addresses patient’s and relatives concerns
online discussion paired with the students’ already existing 210-h im­ about the DNR/DNI status. In the malignancy related-hypercalcemia
mersion clinical rotation. One challenge identified was the lack of fac­ simulation, an important objective was to employ evidence-based
ulty expertise to teach the course, and as a result, new faculty were culturally competent nursing practices by prioritizing and implement­
required to spend many hours to expand their knowledge. ing appropriate nursing interventions for a patient from underrepre­
Credit hours in the described electives ranged from one to three sented patient population for the management of an oncological
credits and clinical time from 20 h to 204 h (Beitz & Houck, 1997; Long emergency. (Ozkara-San, Maneval, Gross, & Myers, 2019).
et al., 1995; Penprase et al., 2016; Ruth-Sahd & Wilson, 2013; Trice Course evaluations are sent to the students as well as preceptors at
et al., 2007). In most cases, class sizes were typically under 12 students, the end of the semester. Thus far, seventy-eight students, across five
due to the need for paired clinical placements in perioperative settings. cohorts, completed the course and 94% completed evaluations. Ninety-
In all cases, relationships were cultivated with a clinical partner to five percent of students reported that the course prepared them to care
facilitate the clinical component of the course and provide a pathway for for oncology patients and 90% believed it prepared them for their
employment for the students. Authors indicated that the elective courses capstone experience. Moreover, 97% of students reported feeling more
provided an opportunity for students to find out more about the peri­ comfortable caring for patients with cancer, 95% rated their readiness to
operative area in order to determine if it might be a good career choice
for them. Students evaluated these courses positively and in one-
instance students requested more time in clinical and an increase in Table 1
course credit due to the heavy workload required (Beitz & Houck, 1997). Oncology elective course objectives
In summary, the delivery of elective courses for nursing students is 1. Describe cancer cell biology and genetics throughout all stages of the cancer
not new, but the novel nature of a joint investment by both the school trajectory.
and the practice partner, codified in a memorandum of agreement be­ 2. Summarize the disease process for the major types of cancers.
3. Compare and contrast the various oncologic emergencies and associated
tween the entities, extends the relationship well beyond the course of­ manifestations of symptoms.
ferings. In addition, our model is not dependent on the schools’ faculty 4. Explore the psychosocial impact of cancer on patients and families.
for course delivery, which allows schools to offer specialty courses even 5. Identify key strategies for patient teaching along the cancer care continuum.
if they lack faculty expertise. Additionally, clinical elective courses that 6. Implement evidence-based nursing interventions in the care of patients throughout
the cancer care trajectory.
combine precepted clinical experience provides an experience similar to

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practice oncology nursing as average or above, 97% reported that they Neonatal resuscitation of an infant is simulated with a high-fidelity
were likely to choose oncology nursing after graduation; and 100% newborn manikin capable of a demonstrating muscle tone, vocal
would recommend the course to others. sounds such as grunting, and cyanosis, as well as heart and breath
The evaluations of the students by preceptors was also important to sounds. Students are expected to perform a proper assessment of a
note, as they reported that students were engaged (88%), prepared newborn including Appearance, Pulse, Grimace, Activity, Respirations
(78%) and fairly ready to practice oncology nursing. Based on their (APGAR) scoring, and should warm, dry, stimulate, clear upper airway
clinical experiences, these students were encouraged to apply for posi­ secretions and identify the need to call for help. Students also participate
tions at the cancer center after graduation. Thus far, twenty-one grad­ in a newborn resuscitation with positive pressure ventilations, com­
uates, representing five cohorts, have been hired at the cancer center pressions and administration of epinephrine.
and others are in the process of applying and interviewing. A second station provides an opportunity for students to perform
nursing care, utilizing a high fidelity premature (28-week gestation)
Neonatal intensive care unit (NICU) nursing elective infant simulator. Neonatal nursing care activities include measurement
and assessment of vital signs, length, abdominal girth and urine output.
The NICU at the RMC is a forty-nine bed level IV Regional NICU that Patient care objectives include environmental regulation with the use of
manages and cares for the highest acuity level of patients. Several an infant warmer, insertion of oral gastric tube for feeding that is
meetings between the SON Associate Dean, faculty, and RMC leadership maintained with a syringe pump, and administration of oral medica­
determined the feasibility of an introductory didactic and preceptor led tions. A procedural simulation station promotes the skills acquisition of
neonatal elective experience for senior nursing students. NICU nurse endotracheal tube suctioning, care and use of an umbilical artery
educators and nurse manager met with SON faculty to discuss their including obtaining blood specimen.
current orientation processes and what content and level of patient The simulation fidelity is promoted with use of authentic medical
would be appropriate for the senior level nursing elective. equipment such as infant warmer, suction catheters, bedside vital sign
The RMC has a well-established orientation program that follows the monitors, syringe pumps and multiple high-technology manikins.
national association for neonatal nursing standards, and served as the Experienced neonatal nurses employ an evidence-based research
foundation for development of the course. SON faculty and RMC edu­ approach by using current guidelines from the American Academy of
cators collaborated to develop the course that focused on the nursing Pediatrics and the American Heart Association, in regard to neonatal
care of preterm and ill neonates. Topics included immediate and long- resuscitation, in a realistic setting to ensure that all elements of the
term physical and psychosocial support of the preterm and ill neonate scenario relate in a lifelike way, providing a realistic clinical situation.
and family, along with the common health issues experienced by pre­ Student debriefing is achieved using the Debriefing with Good Judgment
term and ill neonates, such as assessment, management, and evaluation method (Rudolph, Simon, Dufresne, & Raemer, 2006) at each station
of these conditions. The psychosocial themes of care of crisis, grief and immediately after the experience that encourages student reflective
loss, discharge planning and long-term follow up were also included. thinking and constructive feedback is provided by experienced neonatal
(Table 2: Neonatal Elective Course Objectives) Though successful, nurses.
changes were implemented to strengthen the delivery of the didactic In the clinical setting, students are paired with an experienced NICU
content and the simulation component, the course was revised for the nurse preceptor. The nurse manager and NICU clinical nurse specialist
second offering. Additional simulation was added, and included the choose preceptors, based on years of experience and prior experience
purchase of a second high fidelity newborn simulator and a 28-week with serving as preceptor for new graduate hires. Students work one to
neonate simulator by the SON. In addition, an advanced practice one with the preceptor at the bedside for the 11.5-h shift until
neonatal nurse was hired as an adjunct to visit students frequently on the completing their required total number of clinical hours (150 for
unit and assist as faculty in both the didactic and simulation components traditional cohorts and 135 for accelerated cohorts). The elective is
of the course. It was determined that faculty involvement in all aspects offered in the fall and spring semesters.
of the course was critical to ensuring a high quality course in this The student cohort was determined according to the availability of
particular specialty. experienced NICU nurse preceptors, the acuity of the unit and the need
Simulation is an important component to the course given the high to comply with hospital and other regulatory responsibilities. Eight
acuity and unique environment of the NICU. A 3-h learning experience students are the maximum number permitted to register for the elective.
provided simulated activities representing situations experienced in Given the limited number of seats, registration is competitive. Eligibility
neonatal nursing practice was developed. These structured activities includes a student’s expressed interest in pursuing the neonatal nursing
allow students to advance their knowledge and skills, responding to specialty and the following educational prerequisites: successful
realistic situations in a safe simulated environment. Experienced prac­ completion of their pediatric and obstetric courses and clinical, the
ticing neonatal nurses work alongside SON simulation facilitators during required minimum GPA, and the recommendation of Pediatric and
these activities providing expertise and guidance promoting student skill Obstetric faculty.
development, priority setting, and critical reasoning ability. Objectives To date, two cohorts (16 students) have completed the course. Stu­
for these experiences include: 1) performing an accurate and complete dents evaluated the course highly with 100% reporting they obtained a
assessment of a neonate, 2) participating in a neonatal resuscitation, 3) valuable learning experience and that the experience further reinforced
prioritizing nursing care activities, and 4) demonstrating skills including their interest in the specialty. Preceptors evaluated each student on
maintenance and use of an umbilical catheter and tracheal suctioning. communication, critical thinking skills, NICU specific tasks, such as
The simulation consists of three stations in which 3–4 students rotate as medication, intravenous fluid, and tube feeding calculations, and pro­
a small working group, facilitating teamwork and communication. fessionalism. Preceptors rated students as satisfactory, good or excellent
in all categories, with the exception of two students. One was rated less
Table 2
than satisfactory with medication calculations and problem solving, and
Neonatal elective course objectives the other in professionalism due to use of her phone on the unit and
changing her scheduled shifts without prior approval. Both students
1. Discuss key concepts to support the ill and preterm neonate and family through
hospitalization and discharge.
were in the first cohort. Hiring an advanced practice neonatal nurse as
2. Apply standards of care and evidence-based nursing management strategies in the an adjunct faculty member to provide closer supervision of students
care of preterm and ill neonates. seems to have resolved these issues with the second cohort. Four of the
3. Analyze psychosocial aspects of neonatal care. eight students in cohort one interviewed for position in the NICU after
4. Examine own values and beliefs in the role of neonatal nurse.
graduation. All four were offered a position, and two accepted. Both of

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the hired NICU RNs are currently on orientation and doing well. Seven their level of education. To address this issue, the course was changed to
cohort 2 students have expressed interest in applying for positions once require students be assigned to complete specific numbers of hours in
they have completed their licensure examination. each of three unique areas: pre-operative, interoperative, and the post-
anesthesia care unit. Additionally, an information sheet was developed
for staff that outlines the skills and competencies students possess
Perioperative elective
(assessment, documentation, medication administration, IV fluid man­
agement, etc.) and should be expected to use in the patient care areas.
The Program Director for School Affiliations for the Academic
These changes afforded opportunity for students to practice according to
Healthcare System (AHCS) was responsible for working with the school
their level of education and competency.
of nursing (SON) in the development of the Perioperative Elective
The didactic component of the course includes three simulation ex­
course. Due to national trend of an aging operating room (OR) nursing
periences that provide the student with foundational hands-on skills and
workforce, it is estimated that 64% of perioperative nurses surveyed
clinical reasoning techniques that are specific to the perioperative
plan to be retired by 2022 (Sherman, 2014). The Association of Oper­
setting. These skills include completion of a pre-operative assessment
ating Room Nurses (AORN) has proposed a comprehensive strategic
and checklist, handoff communication, surgical scrub, time out pro­
succession plan whereby OR nursing practice content is integrated
cedures, set up and management of a sterile field, as well as intra
within the baccalaureate education. In alignment with the AORN stra­
operative counting procedures and postoperative assessment and clin­
tegic plan to replace the retiring workforce with new nurses, the AHCS
ical management. The students develop these skills throughout the
and the SON agreed to partner in order to integrate education and
course, and are required to integrate these skills in a simulated follow
clinical experience with a specialized OR nurse residency program. A
through patient encounter as a component of their final grade.
SON faculty agreed to manage course (oversight, grading, curriculum
In addition to developing a program that will provide a high quality
development, and student evaluation), and the AHCS provided clinical
educational experience, the AHCS implemented strategies to best facil­
experts from the perioperative leadership team. Additional faculty were
itate hiring from this student group upon graduation. Interview dates
hired by the SON to provide a comprehensive expertise for the didactic
and ‘Lunch and Learn” University-based sessions have been planned to
content.
directly encourage students to apply for new graduate positions. Senior
The faculty member brought the group together with the AORN
nursing leadership from the AHCS attend selected classroom dates to
perioperative modules serving as the foundation for curriculum content
teach content and promote a career in perioperative nursing for the
development. This course expands on the existing undergraduate cur­
organization. The Program Director for School Affiliations coordinates
riculum content provided in the fundamentals and medical surgical
with the Talent Acquisition team to track number of students hired upon
courses that is related to perioperative nursing. This expanded content
graduation and meets periodically with the perioperative leadership
includes concepts of nursing accountability related to perioperative
team to continue to adjust and refine the clinical experience. The goal is
safety, instrumentation, sterility practices, anesthesia and continuum of
a strong clinical experience that will better prepare students for hire and
perioperative care, in addition to general and specialty operative pro­
transition to practice within the AHCS (Schmidt and Brown, 2019).
cedures. The course objectives illustrate the integration of content in
Students and faculty offered constructive critique of the course, and
Table 3: Perioperative Elective Course objectives.
although this critique was very positive, the recommendations for
This 3-credit elective course is offered in the fall and summer se­
further development have served to support continued positive dialogue
mesters for accelerated program cohorts and in the spring semester for
and collaboration between SON and AHCS faculty. Based on this
the traditional program cohorts. The maximum number of students in
critique, future course offerings will provide more hands-on learning in
the course is limited to 14, in order to ensure clinical placement at the
the classroom, and students will have the opportunity to dialogue one on
AHCS with an experienced preceptor. As with the other electives, stu­
one with experts in various roles in the perioperative setting while in the
dents complete either 135 or 150 h based on their cohort type. A faculty
classroom.
liaison from the school coordinates with preceptors a minimum of three
The current shortage of perioperative nurses in the US creates real
times throughout the semester to ensure that students meet clinical
time limitations in the availability of clinical sites and student pre­
objectives and to provide ongoing guidance for preceptors in providing
ceptors. Given these limitations, our SON faculty plans to maintain a
student learning oversight. Preceptors complete the AHCS Preceptor
class size between 10 and 14 students so as to offer the highest quality of
Workshop Course. A maximum of two students are assigned to each
individualized learning opportunities for our students possible.
hospital’s perioperative department within the AHCS system.
Students who have completed our pilot perioperative course have
Reviews of first offering of the course were positive, however, some
described increased confidence in their abilities in the perioperative
modification was recommended regarding types of experiences the
setting. Students have also reported an increased ability to secure pro­
students should have, and a need for staff education regarding the
fessional roles in reputable health care institutions, based on their
anticipated role of the students. During a discussion between the SON
additional experiences in the perioperative setting and preceptorship by
faculty and the AHCS faculty and leadership, it was determined that in
a broad array of experienced OR faculty and preceptors. As our school of
some areas, students, were being underutilized and not practicing to
nursing continues to pioneer novel partnerships with our regional AHCS
facilities, we anticipate that we will generate additional preceptors and
Table 3
experiences for our students, and ultimately develop a pipeline for
Perioperative elective course objectives
nursing recruitment for specialized areas that are hard to fill.
1. Discuss key theoretical and clinical principles applicable to perioperative nursing
care.
2. Describe the nursing accountabilities related to the scope and standards of AORN
Discussion
and ASPAN guidelines for perioperative practice.
3. Examine the legal and ethical considerations that are relevant to perioperative The development and implementation of specialty nursing electives
nursing has been positive for students, practice partners, and the SON. Students
4. Demonstrate collaboration with the perioperative interprofessional team in the
have expressed their appreciation for the opportunity to explore areas of
optimal delivery of healthcare.
5. Demonstrate effective time management in various perioperative clinical roles specialty nursing practice while enhancing their job readiness, and the
during simulation experiences. opportunity to apply for, and in many cases achieve, positions in these
6. Discuss and examine the importance of each perioperative nursing role as each areas. Practice partners also benefit from the opportunity to develop
relates to patient safety. potential new nurse hires in areas of high need for their organizations.
7. Discuss the theoretical, and research evidence of perioperative nursing.
The SON has strengthened its relationships with practice partners

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dedication to the established partnerships.

Declaration of competing interest

None to declare.

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