Nurse Managed Wellness Clinic

Toolkit for Developing Clinical Education for Nursing Students


 

Overview of this Toolkit:

Purpose:

This toolkit is intended to provide a resource for educators involved in developing and implementing clinical learning opportunities for nursing students within an on-campus nurse managed wellness clinic.

Objectives:

  • Identify the need for alternative clinical learning opportunities to prepare nursing students for a changing healthcare environment.
  • Describe on-campus learning activities offered in an NMWC and alignment with fundamental and specialty nursing course content.
  • Discuss the impact of the NMWC alternative clinical learning opportunities on the student and college community.

 

instructor, student, and young patient

 


What is The Nurse Managed Wellness Clinic?

The Nurse Managed Wellness Clinic (NMWC)  at Allegany College of Maryland (ACM) was adapted from the model of Nurse Led Health Centers (Hansen-Turton et al., 2015), to provide student learning opportunities while providing health and wellness services on the campus of Allegany College of Maryland, a rural community college in Western Maryland. While unique to community college undergraduate health programs, this model has been used by numerous 4-year colleges and university health programs to provide healthcare to specific community populations.

 


Why It Matters: Meeting Our Needs

Changes in the current healthcare environment have shifted patient care from in-patient to community-based, focusing on wellness, disease prevention, early detection, and early interventions. There has been a shift in hospital admissions- patient stays have become shorter, acuity is higher, and patient care is more complex than before, impacting student opportunities during hospital clinical rotations. Nursing faculty are called to create additional opportunities for students to develop technical and critical thinking skills foundational to quality bedside nursing practice (National Academies of Sciences, Engineering, and Medicine, 2021). Increasing collaboration between education and practice and interprofessional education are suggested actions to meet the educational needs of future nurses (American Association of Colleges of Nursing [AACN], 2019).

The NMWC provides a safe learning environment for students to apply classroom theory to real-world practice. These clinical activities enhance learning, develop technical skills, focus on wellness and health promotion, and prepare nursing graduates for a diverse workforce. The NMWC activities support academic programs and align with the college's mission and strategic goals.

 

NMWC Impact video



Benefits of the NMWC

The NMWC provides innovative multidisciplinary clinical experiences for nursing and allied health students to prepare them to enter a diverse healthcare environment. The wellness clinic utilizes a holistic approach to provide services that promote community wellness, disease prevention, and health promotion. Furthermore, the NMWC empowers individuals to be self-directed and well-informed consumers of healthcare services, promoting lifelong patterns of health-optimizing behaviors.

The NMWC impacts the health and well-being of students, college employees, and the local community.


The NMWC offers students convenient, affordable healthcare services, providing a means for overcoming barriers and preparing for nursing. Many students beginning a health career program at a community college need help accessing preventative health services or lack health education or financial resources. The NMWC addresses many social determinants of health through education and low or no-cost services.

The NMWC provides health services which are required for health career programs:

  • Physical examinations
  • Immunizations (Influenza, TDAP, MMR, Hepatitis B)
  • Tuberculin screening
  • Immunology (titers for MMR, Varicella and Hepatitis B)
  • Health Risk Assessments (lifestyle behaviors, anxiety, depression screening and education)
  • Referral to ACM student services and community resources (food pantry, transportation/ housing, mental health counseling, additional health services)

 


The NMWC provides opportunities for independent student projects and activities to raise awareness of health topics relevant to the college population including but not limited to, healthy lifestyle choices, domestic violence awareness, and infectious disease prevention. The NMWC maintains partnerships with local community health agencies and the college employee wellness committee.


Nursing faculty work scheduled hours in the clinic. This enables faculty to easily balance academic responsibilities while accruing practice hours needed to maintain advanced practice certification.

 


Clinical Learning Activities:

Student-led clinics are designed to align with course content areas and accommodate student learning styles. Students apply theory and practice skills in a supervised clinic environment.

Students experience the core values of the nursing profession within the context of wellness promotion, early detection, and intervention. The NMWC supports nursing students' academic success by providing opportunities to enhance nursing graduates' knowledge, skills, and attitudes.  

 


Nursing and allied health students provide health education and wellness services to a targeted audience. This real-world clinical experience combines Healthy People 2030 Objectives evidence-based practice, clinical reasoning, and collaborative interprofessional education in clinical settings.

RESOURCES


Fourth semester nursing students assume the role of a nurse to provide vaccinations and health education to targeted audiences in a supervised academic environment. This real-world clinical experience begins with identification of the nurse’s role in vaccination clinics, and includes evidenced-based practice guidelines, clinical reasoning, documentation, and patient education.

RESOURCES


Volunteers from targeted populations participate in learning activities to supplement classroom learning. These clinics include:

  • Prenatal Assessment
    • Healthy pregnant women (>20 weeks)
  • Well Child Assessment
    • Children between newborn-18years attend with a parent/caregiver
    • Head Start preschool children
Live Simulation

Students from multiple health programs learn with and about each other to provide patient care. IPE activities focus on two core competencies - Roles and Communication.

  • Preventative Screening Clinics - Teams work together to identify patient risk factors, provide laboratory testing and patient education. The clinics are open to the college and local community. These clinics include:
    • Diabetes (hgbA1C)
    • Cholesterol (lipid panel)
    • Anemia (hemoglobin testing)
IPE Students

  • FORMAL EVALUATION
    • The Course Rubric provides a summative evaluation of the learners’ performance and attainment of the course objectives. The rubric also defines the expectations for learner’s performance.
    • Course evaluation This anonymous survey provides additional assessment of course outcomes to improve learning activities.
  • INFORMAL EVALUATION
    • Socratic questioning is used to evaluate knowledge during the initial group discussion at the beginning of the class. The student responses will indicate whether additional content review is needed before advancing to application within clinical scenarios and role playing.
    • Peer Review- Students participate in a role-play of a clinic visit as either a patient or the nurse. After completing the scenario each pair of students will consider the following questions. Students provide verbal feedback to each other and then share themes in group discussions.
    • Self-Reflection offers students the opportunity to determine if they achieved their personal learning goal for the course and identify barriers and facilitators for their learning. This serves to reinforce expected outcomes and can contribute to a deeper understanding and responsibility for learning (Kirkpatrick, 2020).


Developing the NMWC:

Identifying stakeholders and advocates for the clinic

The nursing faculty and the program director championed the project's development, garnering the support of the other healthcare programs and the college senior leadership. The NMWC director works closely with finance and instructional affairs to maintain sustainability (including the college president, the vice president of instructional affairs, human services, and finance). Several accredited healthcare programs require interprofessional education.

Fiscal support

The Maryland Higher Education Commission’s (MHEC) Nurse Support Program (NSPII) provided grant funding for the project's development, implementation, and dissemination.  The clinic is currently supported financially through service revenue, student fees, and college funds.

Adapting to the needs of the college population

Initially, each ACM nursing student was assigned one clinical rotation in the NMWC during the 2-year program. Clinical learning activities and service hours were expanded during the pandemic to meet the need for additional clinical time and preventative health services because of limited access during the COVID pandemic.  

Post-pandemic, the college has focused on the impact of anxiety and stress on academic success. The NMWC offers a Health Risk Assessment visit to help individuals become aware of their mental and physical health and the impact of lifestyle behaviors on overall health. Resources for mental and physical health available through the college and local community are discussed during the 30min visit.

RESOURCES

 


References

American Association of Colleges of Nursing (2019).
Vision for Academic Nursing White Paper.
Washington, DC

Hansen-Turton, T., Sherman, S., & King, E. S. (2015).
Nurse-Led Health Clinics: Operations, Policy, and Opportunities
(1st ed.). Springer Publishing.

Kirkpatrick, J. (2020). Strategies for Evaluating Learning Outcomes.
In D. Billings Teaching in nursing: A guide for faculty (pp.450-473). St Louis: Elsevier.

National Academies of Sciences, Engineering, and Medicine 2021.
The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.
Washington, DC: The National Academies Press. https://doi.org/10.17226/25982.

(n.d.).Quality and Safety Education for Nurses.
QSEN Competencies. Retrieved June 26, 2023, from https://www.qsen.org/competencies

 


This toolkit contains free-source activities and materials to engage students in clinical learning experiences. All materials are available for download and use.

For more information call ACM Nurse Managed Wellness Clinic @ 301-784-5670 or email: nmwc@allegany.edu

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