The 130th Annual Meeting of APHA

Abstract #47242

Mary Kay Anderson, MSN, PhD, Family & Community Nursing, East Tennessee State University, PO Box 70 676, ETSU, Johnson City, TN 37614-0676 and Sonda Oppewal, RN, PhD, Office of Practice and Research, East Tennessee State University, P.O. Box 70,403, Johnson City, TN 37614, 423-439-7643, anderson@etsu.edu.

Preparing nursing students to care for clients considered "vulnerable" can be a daunting task for nurse educators for numerous reasons. Clinical time for students in community-based settings that serve poor, medically and socially complicated patients is often limited, and students often face communication challenges with persons they perceive as very different or difficult to deal with. Without guidance, students may simply reinforce negative stereotypes they've accepted about vulnerable and poor populations. This paper presents findings from open-ended interviews with instructors and students about "best practice" clinical teaching and learning strategies in nurse-managed health centers that serve predominantly vulnerable populations. Preliminary findings of interviews with instructors and students revealed these challenges: engaging the student with the vulnerable population and facilitating comfort level, helping the student with role boundaries, and teaching skills for successful patient outcomes and skills needed to "work" the system. Strategies to deal with the challenges will be explored that were culled from the interviews, pertinent literature, and teaching and learning theories. Examples include offering "eye opening" experiences to fuel student interest, helping students deal with their emotions, role modeling appropriate communication, and monitoring student level of comfort throughout the clinical course. Additional strategies included establishing mutual goals with clients and validating the learner's plan of treatment within boundaries of the client's health plan. In general, planning and repetition of key concepts related to poverty, vulnerability, health disparities, cultural competence, and managed care was identified as essential throughout the curriculum.

Learning Objectives:

• 1) Describe at least three challenges for educators who facilitate clinical teaching and learning of students in care settings with vulnerable populations
• 2) Identify three teaching and learning strategies perceived by students as effective when working with patients with complex health and social problems.
• 3) Identify three teaching and learning strategies perceived by nursing instructors as effective when facilitating clinical experiences for students in nurse-managed health centers which serve vulnerable populations.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.