NURSING EDUCATION

SEMINAR
ON

DIFFERENT MODELS OF COLLABORATION

BETWEEN EDUCATION AND SERVICE

SUBMITTED TO:

Mrs. Jaya Mathew

Vice principal

TMM College of nursing

SUBMITTED BY:

Ms. Thanuja eleena Mathew

1st year MSc nursing

Tmm college of nursing

SUBMITTED ON

19-04-2018

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 DIFFERENT MODELS OF COLLABORATION BETWEEN EDUCATION AND
SERVICE

Introduction
The nursing profession is faced with increasingly complex health care issue driven by technological and
medical advancements, an aging population, and increased number of people with chronic illnesses.
Collaborative partnership between educational institutions and service agency have been viewed as on way to
provide research which ensures an evolving health care system with comprehensive and coordinated services
that are evidence based, cost effective and improve health care outcomes.
Meaning
Collaboration is an intricate concept with multiple attributes. Attribute identified by several nurse authors
include planning, making decisions, solving problems, setting goals, assuming responsibilities, working
together cooperatively, communicating and coordinating openly (Baggs and Smith 1988).
The word collaboration, namely co-and Laborie combine in Latin to mean “work together”. That means the
interaction among two or more individuals, which can encompass a variety of actions such as communication,
cooperation, information, sharing, coordination, problem solving and negotiation.
A description of the concept of collaboration is derived by integrating Follett’s outcome-oriented perspective
(1940) and Gray’s process-oriented perspective (1989). Both authors strengthen the definition of collaboration
by considering the type of problem, level of interdependence and type of outcomes to seek. According to them,
collaboration is both a process and an outcome in which shared interest or conflict that cannot be addressed by
any single individual is addressed by key stakeholders. The collaborative process involves a synthesis of
different perspectives to better understand complex problems. A collaborative outcome is the development of
integrative solutions that go beyond an individual vision to productive resolution that could not be
accomplished by any single person or organization.

Definition
Hennemen et.al has suggested that collaboration “is a process by which members of various discipline (or
agencies) share their expertise. Accomplishing this require these individuals understand and appreciate what it
is that they contribute to the whole”.

Types of collaboration
1. Interdisciplinary is term used to indicate the combining of two or more disciplines, professions,
departments, or the like, usually in regard to practice, research, education and/or theory.
2. Multidisciplinary refers to the independent work and decision making, such as when disciplines work
side by side on a problem. The interdisciplinary, according to Garner (1995) and Hoeman (1996), expands the
multidisciplinary team process through collaborative communication.
3. Trans disciplinary efforts to involve multiple descriptive sharing together their knowledge and skills
across traditional disciplinary boundaries in accomplishing tasks or goals (Hoeman, 1996). Trans disciplinary
efforts reflect a process by which individuals work together to develop a shared conceptual framework that
integrate and extends discipline specific theories, concepts and methods to address a common problem.
4. Inter professional collaboration has been described as involving “integrating of two or more
disciplines involving professionals who work together, with intention, mutual respect, and commitment for the
sake of more adequate response to a human problem” (Harbaugh, 1994).

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Need for Collaboration between Education and Service
Considerable progress has been made in nursing and midwifery over the past several decades, especially in the
area of education. Countries either developed new, or strengthened and re-oriented the existing nursing
educational programmes in order to ensure that the graduates have the essential competence to make effective
contributions in improving people’s health and quality of life. As a result, nursing education has made rapid
qualitative advances. However, the expected comparable improvements in the quality of nursing service have
not taken place as rapidly.
The gap between nursing practice and education has its historical roots in the separation of nursing schools from
the control of hospitals to which they were attached. At the time when schools of nursing were operated by
hospitals, it was students who largely staffed the wars and learned the practice of nursing under the guidance of
the nursing staff. However, under the then prevailing circumstances, service needs often took precedence over
student’s learning needs. The creation of separate institutions for nursing education with independent
administrative structures, budget and staff was therefore considered necessary in order to provide an effective
educational environment towards enhancing students learning experiences and laying the foundation for further
educational development.
While separation was beneficial in advancing education it also had adverse effects. Under the divided system,
the nurse educators are no longer the practicing nurses in the wards. As a result, they are no longer directly in
the delivery of nursing services nor are they responsible for quality of care provided in the clinical setting used
for student’s learning. The practicing nurses have little opportunity to share their practical knowledge with
students and no longer share the responsibility for ensuring relevance of the training that the students receive.
As the gap between education and practice has widened, there are now significant differences between what is
taught in the classroom and what is practiced in the service settings.
Most nursing leaders also assert that something has been lost with the move from hospital bases schools of
nursing to the collegiate setting. The familiar observation that graduate nurses can “theorize but not catheterize”
reflects the concern that graduate nurses often lack practical skills despite their significant knowledge of nursing
process and theory. Nursing educators know that development technical expertise in the modern hospital is
possible only through on-the-job exposure to the latest equipment and medical interventions. Schools of nursing
have tried to bridge this gap using state-of-the-art simulation laboratories, supervised clinical experiences in the
hospital, and summer internships. However, the competing demands of the classroom and the job site frequently
result in a less than optimal allocation of time to learn technical skills and frustration on the part of the nursing
student who tries to be both technically and academically expert.
The hospital industry has also recognized the need to support a graduate nurse with additional training. As a
result, graduate nurses are required to attend an orientation to the hospital and have additional supervised
practice before they can function independently in the hospital. The cost of orienting a new nursing graduate is
significant, particularly with high levels of nursing turnover.
The challenges to nursing education is how to combine theoretical knowledge with sufficient technical training
to assure a competent performance by a professional nurse in the hospital setting. Clearly partnership between
nursing educators and hospital nursing personnel is essential to meet this challenge.

MODELS OF COLLBORATION BETWEEN EDUCATION AND SERVICE

The nursing literature presents several collaborative models that have emerged between educational institutions
and clinical agencies as a means to integrated education practices and research initiatives. (Boswell & cannon,

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2005;McKenna & Roberts, 1998;Acorn, 1990), as well as, providing a vehicle by which are theory clinical
practice gap is bridged and best practice outcomes are achieved. (Gerrish & Clayton, 2004; Gaskill et al, 2003).

1. Clinical School Of Nursing Model (1995)

The concept of a clinical school of nursing in one that encompasses the highest level of academic and clinical
nursing research and education. This was the concept of visionary nurses from both La Trobe and The Alfred
clinical school of nursing university. This occurred within a context of a long history of collaboration and
cooperation between these two institutions going back many years and culminating in the establishment of the
clinical School in February, 1995.

The development of clinical School offers benefits to both hospital and university. It brings academic staff to
the hospital, with opportunities for exchange of ideas with clinical nurses with increased opportunities for
clinical nursing research. Many educational openings for expert clinical nurses to become involved with the
university’s academic program were evolved, the move to the concept of the clinical school is founded on
recognition of the fundamental importance of the close and continuing link between the theory and practice of
nursing at all levels.

2. Dedicated Education Unit Clinical Teaching Model (1999)

The current model of clinical teaching and learning for undergraduate students centres on the preceptor ship
model of individualised one-on-one support, provided by experienced Registered Nurses (RNs) from within the
clinical environment. In this model, academic staff visit intermittently to provide curriculum integration and to
monitor the student’s progress with the student and their preceptor. However, given the current clinical
environment of busy wards, high acuity patients and the staff mix of full time, part time and casual works the
preceptor ship model has been difficult to maintain.

The impetus for establishing Dedicated Education Units (DEUs) for undergraduate nursing students was based
on both anecdotal evidence and emerging quality data from within the CPIT School of Nursing and the CDHB.
Data gathered using a Clinical Evaluation Tool (CET) supported anecdotal evidence that the existing preceptor
ship model was not meeting the needs of students, clinical or academic staff in many clinical placement areas.

Factors thought to be impacting on the successful implementation of one-on-one preceptor ship include:

 The inability of undergraduate nursing students to ‘mirror’ the rostered – rotating shifts undertaken by
RNs.
 Preceptor absence from the clinical environment due to sickness, study or annual leave.
 The fluctuating demands of the clinical environment.
 The impact of casual ‘hospital pool’ or outside agency staff on each area
 Limited knowledge and understanding of the BN programme by CDHB staff
 The perceived ‘invisibility’ of the CPIT clinical Lecturer (CL)
 The challenges faced by both CDHB preceptors and CPIT clinical
 Lecturers around student assessment.

3. Research Joint Appointments (Clinical Chair) (2000)

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A joint appointment has been defined by Lantz et al. (1994) as a “formalised agreement between two
institutions where an individual holds position in each institutions where and individual holds apposition in each
institution and carries out specific and defined responsibilities”

The goal of this approach is to use the implementation of research findings as a basis for improving critical
thinking and clinical decision making nurses. In this arrangement the researcher is a faculty member at the
educational institution with credibility in conducting research and with an interest in developing a research
programme in the clinical setting. The director of nursing research provides education regarding research and
assists with the conduct of research in the practice setting. She/he also lectures or supervises in the educational
institution. A formal agreement exists within the two organizations regarding specific responsibilities and the
percentage of time allocated between each. Salary and benefits are shared between the two organizations.

Outcomes identified by Donnelly, Warfel and Wolfe (1994) for the educational institution are that it become
more in touch with the real world and more readily able to identify research questions, that have the potential to
make a difference to quality of consumer care delivery. There is also an increasing collaborative relationship
with the service provider, which is important for long term workforce planning. The position has benefits to
nursing/midwifery students due to more explicit focus in directly linking the education setting to the clinical
context. For practice the outcomes are increased staff involvement in professional activities including writing
for publication, presenting at seminars and conferences and preparing submissions on professional issues. The
clinical chair also facilitates improved access and support to external research project funding.

4. Practice Research Model (PRM) (2001)

It is an innovative collaborative partnership agreement between Fremantle Hospital and Health Service and
Curtin University of Technology in Perth, Western Australia. The partnership engages academics in the clinical
setting in two formalised collaborative appointments. This partnerships not only enhances communication
between educational and health services, but fosters the development of nursing research and knowledge.

The process of collaborative partnership agreement involved then development of a Practice Research Model
(PRM) of collaboration. This model encouraged a close working relationship between registered nurses and
academics, and has also facilitated strong links at the heath service with the Nursing Research and Evaluation
Unit, medical staff and other allied health professionals. The key concept exemplified in the application of the
model includes practice driven research development, collegial partnership, collaborative ownership and best
practice. Many specific outcomes have been achieved through implementation of the model but overall the
partnership between the registered nurses and academics in the pursuit of research top support clinical practice
has been the highlight.

The key elements underlying the process of collaboration and development of the PRM are: Collaborative
partnership was formed by nursing health professionals from the community health service and the university
who recognized the need to bridge the theory – clinical practice gap and acknowledged the futility of continuing
to work in isolation from each other. In practical terms, this involved a formal contractual arrangement between
the organizations that led to the establishment of a Nurse Research Consultant (NRC)

Core values and aims of the collaborative partnership: Before the actual framework of the collaborative
partnership was decided, a literature review of the most common models of collaboration in nursing practice
was used to promote discussion between the organizations to clarify and formalize the assumptions underlying

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the core values. Roles and responsibilities of the partners as indicated by Spross(1989). During this phase, four
key concepts emerged: firstly, that practice drives research: secondly, the principal of collegial partnerships;
thirdly, collaborative ownerships, and finally, best practice (Downie et al., 2001).

As a consequence of this process of clarification and negotiation, the practice Research Model was developed to
operationalize the agreed aims of the partnership, which were:

 To encourage nursing staff to reflect on current nursing practice in order to develop meaningful research
proposals.
 To teach staff the research process via research experience.
 To enable nursing staff to have a key role in the professional development of other staff via the
dissemination of research and quality improvement findings.
 To plan and implement changes to practice based on research evidence.
Nurse Research Consultant (NRC)- In the PRM, the role of the Nurse Research Consultant (NRC) was
articulated as that of mentor and consultant on issues related to research, methodology publications and
dissemination. Although the PRM was specifically designed to enhance nursing research activity and the
implementation of evidence based community health nursing practice, the model also encouraged the
involvement of the multi disciplinary team work to achieve the aims of the partnership agreement.

Operational framework of the PRM

To fulfil the aims of the partnership several key elements formed the operational framework of the collaborative
agreement. One important element of the framework was to enhance nursing staff’s knowledge of the research
experience. To achieve this journal clubs were established in the community health service on a monthly basis.
The Nurse Research Consultant then worked with staff to identify, plan and implement changes to practice
based on research evidence.

A second important element of the PRM was to encourage nursing staff to reflect on current nursing practice
and identify clinical problems based in their knowledge and experience of nursing in order to develop
meaningful research proposals and best practice guidelines. The main reasons for the success of the
collaborative arrangement has been the provision of infrastructure to support the dissemination of research and
quality improvement findings through clinical meetings, workshops and conference presentations by the nursing
staff involved in the various projects.

5. Collaborative Clinical Education Epworth Deakin (CCEED) model (2003)

In an effort to improve the quality of new graduate transition, Epworth Hospital and Deakin University ran a
collaborative project (2003) funded by the National Safety and Quality Council to improve the support base for
new graduates while managing the quality of patient care delivery.

The Collaborative Clinical Education Epworth Deakin (CCEED) model developed to facilitate clinical learning,
promote clinical scholarship and build nurse workforce capability. This model provided a framework for the
first initiative, a CCEED undergraduate program that nested the clinical component of Deakin University’s
undergraduate nursing curriculum within Epworth Hospitals health service environment.

The CCEED undergraduate program sees undergraduate nursing students attending lectures at Deakin
University in the traditional manner but completing all tutorials, clinical learning laboratories and clinical

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placements at Epworth Hospital throughout their three year course. Tutorials, laboratories and clinical
placements are conducted by Epworth clinicians who are prepared and supported by Deaking School of Nursing
Faculty. These clinicians also support the student preceptor relationship in the clinical learning component of
the curriculum. The expectation was that increased integrating between hospital and university would enhance
clinical education resulting in improved student’s application of knowledge and skill as well as increased
socialization to the clinician role.

Key findings of the 2005 pilot CCEED program were

1. Students learning objectives were met and satisfaction was high

2. Undergraduate clinical education was valued by preceptors and managers as a workforce investment
strategy
3. Preceptors were enriched in their clinician role as a result of their participation in the program and
reflection on the process.
4. Preceptor’s continuity promoted a trusting relationship that enabled preceptors too confidently
encourage student initiative.
5. Preceptors managed multiple roles in order to meet demands of patient care and student learning.

6. The Collaborative Learning Unit (British Columbia) Model, 2005

The collaborative Learning Unit Model was based on the ‘Dedicated Education Units’ concept developed,
successfully implemented, and researched in Australia. The Collaborative Learning Unit (CLU) model of
practice education for nursing is a clinical education alternative to preceptor ship. In the CLU model, students
practice and learn on a nursing unit, each following an individual set rotation and choosing their learning
assignment (and therefore the Registered Nurse with whom they partner), according to their learning plans.
Unlike the traditional one to-one preceptor ship-, an emphasis is place on student responsibility for self guiding,
and for communication their learning plan with faculty and clinical nurses (e.g., the approaches to learning and
the responsibility they are seeking to assume). All nursing staff members on the Collaborative Learning Unit are
involved in this model and therefore not only do the student’s gain a wide variety of knowledge but the unit also
has the ability to provide practice experiences for a larger number of students.

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Specifically, a Collaborative Learning Unit is a nursing init where all members on the staff, together with
students and faculty, work together to create a positive learning environment and provide high quality nursing
care. Clinical nurses preparing to adopt the CLU model have described a positive learning environment as on
where questions are expected. In the CLU approach the students are not attached to the units as an extra set of
hands to augment the nursing workforce, but are present as learners with a primary interest in gaining entry
level knowledge and competency associated with baccalaureate prepared nursing practice. As learners in the
CLU model, students are supported by experienced clinical nurses, faculty and ideally, nurse researchers.
Students recognize a positive learning environment when they receive thoughtful responses at mutually selected
times for students and staff. For faculty (e.g., academic instructors), key questions focus on determining what
nursing knowledge is needed to provide high quality nursing care. Thus, in CLU, where critical questioning is
promoted, students can systematically learn to ‘think like a nurse’ and can demonstrate what they know and can
do, as undergraduate nurses who are members of health care team.

While staff and faculty work together to support and advance student learning and promote high quality nursing
care, the CLU model enables a level of student independence that help them move into the work world. As well
the CLU concept bridges a perceived gap between academic and clinical expectations. In this mode, nursing
faculty, clinical nurses and students work collaboratively to enhance learning opportunities as well as develop
the professional knowledge base of nursing.

7. The Collaborate Approach to Nursing Care (CAN Care) model (2006)

The CAN care model emerged as academic and practice leaders acknowledged the need to work together to
promote the education, recruitment and retention of nurses at all stages of their career. The idea of partnership
model emerged when the Christine E. Lynn College of Nursing, Florida Atlantic University, was awarded a
grant from Tenet Healthcare Foundation to initiate as Accelerated Second degree BSN program. The goal was
to design an educationally dense, practice based experience to socialise second-degree students to the role of
professional nurse. A secondary goal was to enhance and support the professional and career development of
unit-based nurses. A commitment to a Constructivist approach to learning, an immersion experience to
recognize the unique needs of accelerated second degree learners, and to emphasize the partnership among the
academic and practice setting, were guiding forces in the creating and enactment of the model. The model
emerged from a dialogue among leaders from the academic and practice setting focusing on the areas of
expertise and potential contributions of each partner.

The essence of the CAN- care model is the relationship between the nurse learner (student) care and nurse
expert (unit-based nurse), within the context of nursing situation. The semantics of the based nursing student as
learner and unit based nurse as expert in place of the more common traditional labels of based preceptors and
preceptee are critical to the intentionality of the collegial focus of the model. The label nurse learner was
designated to place emphasis on the learning role and the reflective and as continuous nature of knowledge
construction. The learner is responsible and accountable for engaging in the learning process and taking an
active role in establishing a dyadic learning partnership with the nurse expert. Unit based nurses are experts in
the work of nursing care. The title unit based nurse expert was chosen to recognize the gifts they bring to the
profession and share with the nurse learner.

The nurse learners and nurse experts engage in a dyadic partnership for the purpose of nurse meeting the needs
of the assigned patient population as well as to reflect on and to come to know the art and science of nursing

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practice. The onsite faculty member is the expert in educational processes and is essential in the support and
nurturing the expert/learner partnership. The faculty member promotes the growth of the nursing expert as a
professional and journey of the learner is coming to know a career in nursing. This is a major change in focus
from the more traditional role of faculty change being in control of the teaching of students. By the application
of CAN-care model the focus of the student’s activities moves from the demonstration of discrete skills and
prescribed outcome to an immersion into the professional nurse role, learning to hear and respond to patient
needs, and to provide nursing care to achieve quality outcomes.

Through this model the student comes to know the organizational context of nursing practice, the multifaceted
role of professional nurses, and assumes responsibility for coming to know the meaning of nursing in each
unique situation. The unit-based nurse acquires new skills based in mentoring, exposure to evidenced-based
practice, and to theoretical knowledge through association with the college. The approach to education in the
practice setting is thought to be more consistent with the educational needs of nurses who are preparing for the
challenges of professional practice in today’s acute care settings.

The most dramatic changes with this model is the re-conceptualization of the work of the faculty member. The
faculty is the education focused expert who supports and nurtures the nurse expert/nurse learner partnership.
The faculty member must relinquish control of the students. While the faculty still has accountability for overall
evaluation of the student’s achievements of the nursing practice course objectives, even the process of the
ongoing evaluation becomes a collaborative effort with the nurse expert. The primary role of the faculty
member in the model is to nurture the nurse expert/nurse learner relationship and t support the growth and
development both expert and learner in their respective roles and responsibilities. The on-site faculty member
becomes an advisor, resource, role-model and educator for both the nurse expert and the nurse learner. The
work of the faculty is re-conceptualized as the creator of the environment to support learning and professional
growth as opposed to the direct teaching of preselected content.

In this model, the healthcare organization becomes an active participant in creating learning environments and
contributing to the learning activities, as opposed to just being a setting in which college affiliated faculty
appear with students for a teaching encounter. In return, the college becomes an active and retention of nurses at
the practice facility.

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8. The Bridge to Practice Model (2008)

The Bridge to Practice Model is distinctly different from other clinical model. First students complete their
clinical experiences in one participating hospital. Second, one full-time teaching faculty serves as a liaison for
each bridge hospital. This faculty member is given a space, usually in the nursing education department, and is
then available to serve as a resource for not only associates but also for the hospital nursing staff. In this model,
therefore, there can be numerous clinical associates in one hospital with one full time University faculty
overseeing the clinical experiences. Third students are actively involved in selecting their clinical placements.

The Bridge to practice model proposed by catholic University of America, School of Nursing (2008), uses a
cohort approach in which student’s complete medical surgical clinical nursing education at the same facility.
Students must apply for clinical placement in the hospital of their choice via a clinical application form. Clinical
placements decisions are based on academic performance and maturational level. Participating students undergo
415 hours of clinical experiences (nine academic credits) focused on medical surgical nursing. These clinical
practices progresses from Adults in Health and Illness: Basic, an introductory nursing course, to Medical-
Surgical Nursing Leadership, a senior level course taken in the last semester of baccalaureate study.

Thus the bridge to Practice Model provides undergraduate nursing students with continuity in medical-surgical
education through placement in the same hospital for all medical-surgical clinical rotations. Hospitals that
participate in the bridge model provide senior clinical nurse preceptors whose time is paid for by the university.
The bridge to practice model emphasizes professional incentives for hospital nurses to participate in nursing
education. Planned incentives include the rewarding of hospital nurses with continuing education credits for
participation in the short-term training on educational methodology and approaches. A tuition discount is

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offered for graduate course work at the university for institutional students and faculty, more involvement with
clinical support services and care management, and more informed employment choices by senior students.
Challenges include recruitment of interested senor clinical nurses, retention of clinical liaison faculty, and
management of the trade off between institutional stability offered by clinical site continuity and the variety of
experiences offered by rotation across several clinical settings

COLLABORATION OF NURSING EDUCATION AND SERVICE IN INDIA

The gap between nursing practice and education has its historical roots in the separation f nursing schools form
the control of hospitals to which they were attached. At the time when schools of nursing were operated by
hospital, it was the students who largely staffed the wards and learned the practice of nursing under the
guidance of the nursing staff. However, service needs often took precedence over students learning needs. The
creation of separate institutions for nursing education with independent administrative structures, budget and
staff was therefore considered necessary to provide an effective educational environment towards enhancing
student’s learning experiences and laying the foundation for further educational development.
While this separation has been beneficial in advancing nursing education, it has also had adverse effects. Under
the divided system, the nurse educators are no longer the practicing nurses in the ward or directly involved in
the delivery of nursing services, not responsible for the quality of care provided in the clinical setting used for
students learning. The practicing nurses have little opportunity to share their practical knowledge with students
and no longer share the responsibility for ensuring the relevance of the training that the students receive. As the
gap between education practice has widened, there are now significant differences between what is taught in the
classroom and what is practiced in the service setting. The need for greater collaboration between nursing
education and services calls for urgent attention. We have two institutions which are practicing dual role,
education & practices: NIMHANS, Bangalore and CMC, Vellore. More institutions need to adopt this model.
This will help improve the quality of nursing Education with overall objective of improving the quality of
nursing care to the patients and community at large.

A. Dual Role Model in NIMHANS

Following the amalgamation of 1974 resulting in NIMHANS, the faculty of nursing department took the dual
responsibility of providing clinical services as well as conducting teaching programs. In 1975, all the grade II
nursing superintendents working in the hospital were designated tutors to maintain uniformity in the
department. Combined workshops were conducted under the guidance of WHO consultant MRS. Morril to
prepare the tutors who came from Grade II Nursing Superintendent cadre for teaching purpose and to make the
Lectures and tutors associated with educational programmes (DPN course & 9- months course in psychiatric
nursing) comfortable with clinical supervision. After both group felt comfortable to assume the dual
responsibility, the areas of supervision were designated. The Head of the Department of Nursing was given the
responsibility for both the service and the education component of the department. Integration of education with
service raised the quality of patient care and also improved the quality of learning experiences for nursing
students, under the close supervision of teachers who were also practitioners.

B. Integrative Service-Education Approach in CMC Vellore

College of Nursing under Christine Medical College Vellore, where nurse educators are practicing in the
wards or directly involving in the delivery of nursing services. This enables the practicing nurse to share her
practical knowledge to the student who is practicing in the concerned wards.

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Government of India conducted a pilot study in bridging the gap between education and service in select
institutions like one ward of AIIMS. The project was successful, patients and medical personnel appreciated the
move but it required financial resources to replicate this process.
Conclusion
Estimating the future need for Registered nurses with various educational backgrounds is complicated by
differing perceptions of educators and employers about the appropriate base of knowledge and skills new
graduates need. These differences began to be apparent when nursing education moved away from its historical
base in hospitals in response to abuses and inadequacies that were believed to characterize the apprentice type
of training they provided. They continue to plague the profession. Many nursing service administrators believe
that academic nurse educators, removed from the realities of the employment setting, are preparing students to
function in ideal environments that rarely exist in the real and extremely worlds of work. In turn, many nurse
educators believe that nursing service administrators fail to provide work environments conducive to the kinds
of nursing practice their graduates—particularly baccalaureate RNs-are equipped to conduct and that,
furthermore, new graduates of baccalaureate, and diploma programs should be differentiated in their functional
work assignments. the report of a task force of American Association of colleges of Nursing observes
that”...conflicting philosophies ,values, and priorities between nurse educators and nursing services
administrators have generally served to deter a mutual understanding and acceptance of responsibility for
quality patient care.” To succeed, nursing educators and care providers alike must strengthen their response to
these challenges with innovative solutions built into the program design and administration. Closer
collaboration between the nurse educator and nurses who provide patient services is essential to give students
an appropriate balance of preparation
All the models pursue collaboration as a means of developing trust, recognizing the equal value of stakeholders
and bringing mutual benefits to both partners in order to promote high quality research, continued professional
education and quality health care. The literature supports the utility of such collaborations. For example, the
most frequently cited positive outcomes are job satisfaction, improved educational experiences for pre-
registration nursing student, increased self confidence and improved knowledge base for nurses. The majority
of these models are based on a joint appointment model where the nurse is initially employed by a health
service or a university and divides his or her time between teaching and clinical practice. Application of these
model s can reduce he perceived gap between education and service in nursing thereby can help in the
development of competent and efficient nurses for the betterment of nursing profession.

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NET REFERENCES
↣ www.kkhsource.in
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↣ www.ccsent.org

JOURNAL REFERENCE
↣ www. Njem.org
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↣ www.curtaionis.org
↣ global journal of health science.org

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