INTRODUCTION:

Initiatives for academic Nursing Practice began in 1960’s. The integral relationship between practice and learning in a practice based discipline such as nursing meant that Deans and Faculty needed to find a way to ensure that faculty was competent to teach clinical Nursing. One of the high costs of moving nursing education out of hospital was the geographic, psychological and experiential distance created among teachers, students and nurses caring for patients. This is called the practice – education gap.

The American Association of Colleges of Nursing (AACN) and National Organization of Nurse Practitioner faculties (NONPF) have endorsed faculty practice as a means to cement the relationship between education and service. Although nursing faculty are charged with educating students in theoretical content and teaching clinical skills, the majority of faculty themselves do not practice. AACN in its vision for nursing education for this decade called for teaching based “in the reality of clinical practice” acknowledging that this will result in “practice becoming as integral to the faculty role as teaching, research and service”. Faculty practice is essential for nurse faculty to gain collegial respect, improve communication with students, and increase realism in the classroom.⁽²⁾

Clinical credibility includes familiarity with current issues, safe practice within the clinical area and being able to apply the theory to practice and vice versa and thus extends further than competence.⁽³⁾

Clinical currency: Provision of Direct patient care to expert knowledge of that area of practice.

Faculty practice: Faculty practice should include Clinical consultation, volunteering professional services, working part-time (moonlighting), clinical research ^.(4)

Current scenario in Nursing Education

Clinical education is an advance form of education that is not routinely given a rightful status in nursing academicia. Fresh graduates who do not have clinical practice after graduation (Basic/Masters) are ranked faculty members and are separated from clinical practice and explained away by teaching, research or administrative-related activities. Nurse faculty visit the clinical setting during the students clinical posting which is usually minimum one month to a maximum of three months clinical block according to the Master Rotation prepared. Professional faculty members who are separated from clinical practice are missing out on the opportunity to align education with the real world clinical practice, emphasize enduring concepts that are central to their discipline, participate in ongoing clinical research, and renew their own passion for their chosen profession.

Elements of Faculty practice⁽⁵⁾

· Formal contractual arrangement, with a defined focus and clear boundaries.

· Patient care is the center focus of the teaching /practice / service/ research activities.

· Clinician, educator, researcher, consultant and administrator roles are visible in the settings.

Basic Requirements for Faculty practice⁽⁵⁾

· Obtain approval from the senior levels of the hospital and the university.

· Obtain positional authority.

· Allow details of timing and workload to the individuals directly involved.

· Continually report and evaluate so as to demonstrate the continuing value of the role.

· Ensure non interference in the clinical setting by university.

Organizational models to link Education and Practice⁽⁵⁾

A. Models by Hutelymer and Donnelly (1996)

· The unification Model- Head of institution is the Director of Nursing for Hospital

· Collaboration Model – a variety of joint appointments between university and the clinical service - Nurse –Researcher Model, Nurse Clinician Model, Nurse –consultant Model

· Dyad model- shared services and joint involvement in research, education and clinical practice.

B. Models By Potash and Taylor (1993)

· Entrepreneurial Or linkage model- academic staff develop their own practice roles as part of their scholarly activity, and all academics have an explicit clinical role.

· Private practice model (Moonlighting) - In which academic staff develop their own private practice separately from their academic roles.

· Integration or Nursing center model – academic staff and graduate students share patient care responsibilities

Types of Hybrid and Joint Appointments for Faculty Practice⁽⁵⁾

Liason lecturer- They work on ad-hoc basis , as time allows , in clinical setting on behalf of the academy, advising clinicians about educational and staff development issues , monitoring the experience and progress of students assigned to that setting, and acting as a conduit for the exchange of information between the two organizations

Lecture Practitioner – Academic staff who teaches and practices in the clinical setting, and virtually synonymous with the clinical educator.

Clinical Facilitators – Represent a significant bridge between the academy and the clinical setting, and are employed primarily to “Teach nursing student nurse’s clinical skills in academic setting and to support and enhance such practices within the clinical setting.

Clinical chairs or Clinical Professors—Based primarily in the clinical setting or the university, or may divide time between each.

Adjunt lecturer- Is an expert clinician who provides clinical instruction and other educational activities in the university and in the clinical setting, in addition to their usual direct patient care

Casual clinical teachers- Brought into colleges on and “as needed” basis to teach, support and asses, in relation to clinical topics in which they are expert practitioners.

Sessional teachers – Are clinically current graduate nurses, who will bring a contemporary clinical perspective to the class room.

Benefits of faculty practice^(5):

· Justifies re registration of academic staff as registered nurses, which may be a requirement imposed by bodies..

· Teachers able to integrate lecture material into every day practice.

· Familiarity with clinical environment and enhances teaching performance.

· An opportunity to develop a range of management and leadership skills.

· Enhanced Faculty self confidence, nursing skills and professional credibility.

· Strengthens the clinical focus of nurse education.

· An opportunity to develop and test new approaches to care delivery.

· Increased practice based research studies

· Provision of a safe and controlled clinical placement option for nursing and other students, where high quality learning may take place.

· Students experience the advantage of instructors familiar with the operations of clinical units.

· Students have role model to look up to in the clinical setting.

· Enhanced cross institutional co operation and communication.

· Opportunities for inter professional collaboration / education

Barriers to participate in Faculty Practice ⁽⁶⁾

Maintaining currency in clinical practice itself is challenging, given the rate of knowledge development and technological, even without the competing demands of attaining and sustaining an academic position. Once in full time faculty position, it becomes less and less realistic to return to active clinical practice. Constant pressure to expand one’s teaching abilities and scope, learn the intricacies of educational administration and in some settings develop a research program, reduces the time and energy available. Even without adding clinical practice to the mix, the workload is heavy and often very stressful.

· Lack of dedicated workload

· Professional Exhaustion (‘trying to do all”)

· Faculty practice not valued by academic institution

· Difficulty juggling both clinical practice and non academic requirements/expectations.

· Difficulties obtaining appropriate and acceptable practice sites.

· Time needed for practice ,conflicts with time needed for teaching and scholarly pursuits

· Role strain and conflict

· Work over load

· Lack of career structure

· Lack of recognition of professional practice within the reward system of teaching, scholarship and service

RECOMMENDATIONS:

· Establish standards for nurse teaching faculty practice.

· Develop guidelines for incorporation of faculty practice into academic promotion

· Faculty practice should be integrated within the institutions present cultural values and academic triad.

· Clinical practice should be incorporated as a component of salaried workload.

· Faculty practice as a component of academic promotion should be viewed as a form of scholarship.

CONCLUSION:

Early aspirants on appointment to education role usually have a strong desire to retain clinical connection, but this can be sabotaged rapidly by an increasingly academic workload. Experience is a powerful component of clinical practice, but a challenge arises aiming to sustain its effectiveness with a change of role. Nurse Academicians are often viewed with skepticism by clinical nurses, thinking that they lost touch with reality of nursing practice. ⁽⁷⁾If nurse academicians are visible and accessible in the clinical environment, improved relationship between learning institutions and clinical care providers may be seen. Bridging this perceived gap not only benefits each group but also benefits the students through improved relationships with institutions that may visit during their clinical rotations. It is essential that teachers not only have knowledge, teaching and academic credibility but also clinical credibility in respect of their capacity to teach the art and science of Nursing⁽⁸⁾

Present and future nursing faculty must be clinically credible- aware of and knowledgeable about current clinical practice, adapt at a wide range of technology, practice improvement and research approaches, posses relational capacity, be able to role model caring relationships, provide academic progression models that engage students and practicing nurses, facilitate and seek grant proposals and funding streams, and convey passion for the practice of nursing⁽⁹⁾

REFERENCES:

1. Fisher Melanine (2005) Exploring how nurse lecturers maintain clinical credibility. Nurse education in Practice 5 (1) 21-29, Available from : URL :http://dx.doi.org/10.1016/j.nepr.2004.02.003

2. Norma .M. Lang .Academic Nursing Practice. Available from https://books.co.in/books?isbn=0826120458

3. Natalie, Heidi Vonkoss, 2^nd opinion : should clinical practice be required of Nurse Faculty? The American Journal of maternal/child nursing Dec 2008,33 (6)336-336.Available from :URL: http://www.nursingcenter.com/journalarticle?article_ID=825551#p13%20P14

4. Nurse Practitioner Faculty Practice 2015.Available from :URL:http://c.ymcdn.com/sites/nonpf.site-ym.com/resource/resmgr/docs/facultypractice Paper Final201.pdf

5. Colin .A. Holmes. Faculty Practice in Australian Nurse education: status and Prospects. Available from URL:www.cdnm.edu.au/wp-content/.../FacultyPracticeliteraturerereview.pdf

6. Angela Morgan, Call yourself a nurse! Defending the clinical credibility of educators and managers in intensive care. Oct 15 2012 Available from URL: http://onlinelibrary.wiley.com/doi/10.1111/j.1478-5153.2012.00535.x/abstract

7. Mable H. Smith. The legal, Professional and Ethical Dimensions of Higher Education. Available from URL: https://books.google.co.in/books?isbn=0781752043

8. Amy Roberts, Faculty practice among commission of Collegiate Nursing education Accredited Nursing schools. Available from :URL: digital.library.unt.edu/ark:/67531/metadc3317/m2/1/high_res_d/dissertation.pdf

9. Joanne R. Duffy, Quality caring in Nursing and Health systems: Implications for Clinicians. Available from URL:https://books.google.co.in/books?isbn=0826110142

Received on 10.02.2016 Modified on 03.05.2016

Int. J. Adv. Nur. Management. 2016; 4(3): 199-202.

DOI: 10.5958/2454-2652.2016.00046.9

Clinical credibility includes familiarity with current issues, safe practice within the clinical area and being able to apply the theory to practice and vice versa and thus extends further than competence.(3)

Clinical credibility includes familiarity with current issues, safe practice within the clinical area and being able to apply the theory to practice and vice versa and thus extends further than competence.⁽³⁾