Changing thinking to improve outcomes

The definition of insanity is doing the same thing over and over again and expecting a different result. That sentiment is widely credited to Albert Einstein in the mid-20th century.

But faculty at the Betty Irene Moore School of Nursing at UC Davis say it describes what’s wrong in health care today.

“When you look at the statistics for health care in the United States, of the developed nations, we spend the most amount of money on health care,” said Kathryn Sexson, family nurse practitioner (FNP) and inaugural program director for the new Doctor of Nursing Practice — Family Nurse Practitioner Degree Program (DNP-FNP). “But when you look at our patient outcomes, they are sadly not congruent with that.

Sexson says that in order to get different outcomes, clinicians need to try different approaches. That fundamental lies at the core of the new doctoral program.

The School of Nursing seeks to inspire graduates to integrate innovation in clinical practice across the spectrum of roles they take on throughout their career. Innovation involves courage, flexibility and creativity through the application of evidence-based decision-making, translation of research into clinical practice, and the involvement of the entire health care team.

“We can't actually effect change unless we change the way that we're thinking. And so that's part of what innovative clinical practice encompasses,” she explained.

Sexson admits that the innovative approach the faculty is using in the DNP curriculum challenges them in the same way we hope to challenge students. But she strongly believes that this School of Nursing is the best environment to tackle old beliefs and innovate for better patient outcomes.

“The Betty Irene Moore School of Nursing offers us a venue in which we can really start challenging our thinking,” she said. “So, we've been having these wonderful discussions about how do we enrich the learning? How do we innovate our educational practices?”

The DNP-FNP program was carefully designed to take students through a sequential series of courses and clinical experiences. The program first prepares students to think at the doctoral level about their role as a nurse practitioner and instills critical thinking in all future areas in which they could serve — administration, private practice, community based or hospital care.

The second year of the program focuses on taking this advanced knowledge and integrating it in clinical practicums. By shifting students’ thinking from bedside nursing to that of primary care provider, students will practice and discuss with peers and mentors how to best support patients through their lifespan in multiple clinical environments.

Finally, in year three, students will cumulate their knowledge and practice in a clinically based scholarly project.

“Part of the wonder of what we're creating here is that we're going to learn from each other, because obviously, if we had all figured it out, we'd be doing it,” Sexson said.

She points to research that concluded, in the past, 80% of students were auditory, learning by listening. Today it’s fewer that 20% who learn best by listening during a lecture-style presentation. She and the faculty developing the DNP program factor in how to present material so that today’s students actually engage and solidify content in their long-term memory.

“We want them to have a working knowledge to draw from that enables them to critically assess and analyze the multiple factors affecting someone’s health and well-being.

Sexson and clinical faculty hope to develop future DNPs who grew into their profession because of innovative thinking and who can draw from the knowledge that they experienced while a student. School of Nursing students will develop those skills firmly within in the context of the program’s other core values of health equity and bold leadership.

“Starting a new program in the midst of today’s environment allows us access to a lot of tools that I don't think we would have had at any other point in our history,” Sexson said. “The environment is ripe for doing what I hope everybody's here to do, which is to improve the health and well-being of the nation that we serve.”