Dr. Hermann is Associate Professor, Ms. Conner is Director of Special Projects, School of Nursing, University of Louisville, Louisville, Kentucky; Dr. Mundt is Dean and Professor, College of Nursing, Michigan State University, East Lansing, Michigan. At the time this article was written, Dr. Mundt was Dean and Professor, School of Nursing, University of Louisville, Louisville, Kentucky.
A related presentation was delivered at the American Association of Colleges of Nursing Baccalaureate Conference, Chicago, Illinois, December 2005. The Cancer Nursing Faculty Fellows Program is part of the Center for Cancer Nursing Education and Research, funded by the Division of Nursing, Bureau of Health Professions, Health Resources and Services Administration, Department of Health and Human Services (grant no. 1D1DHP04016-01-00).
Address correspondence to Carla P. Hermann, PhD, RN, Associate Professor, School of Nursing, University of Louisville, 555 South Floyd Street, Louisville, KY 40292; e-mail: firstname.lastname@example.org.
More than 1.4 million people in the United States will be diagnosed with cancer in 2008; however, the survival rate has increased significantly in recent years (American Cancer Society, 2008). Because of the large number of patients with cancer and survivors, nurses encounter these individuals in a variety of settings. The trend to provide cancer care in general medical and surgical areas rather than in specialized oncology units was noted by Satryan (2001). The Center for Cancer Nursing Education and Research at the University of Louisville School of Nursing conducted a survey of practicing nurses in a variety of settings in 2004. Eighty-one percent of nurses reported caring for patients with cancer, and 87% indicated they encounter patients with cancer for noncancer-related problems (Mundt, Hermann, & Conner, 2005). The results affirm the need for all nurses to have current cancer nursing knowledge.
It is imperative that nursing students receive current and complete information regarding the most salient causes of morbidity and mortality in the United States. Cancer, the second leading cause of death in the United States (Jemal et al., 2004), is a prime example. For nursing students to gain appropriate cancer knowledge, nursing faculty must be well prepared in the areas of cancer prevention, detection, and treatment. This article describes the Cancer Nursing Faculty Fellows Program implemented at the University of Louisville School of Nursing. The Faculty Fellows Program aimed to enhance the knowledge of faculty regarding the care of patients with cancer to provide nursing students with the best cancer nursing education possible.
Center for Cancer Nursing Education and Research
The Faculty Fellows Program was developed through the Center for Cancer Nursing Education and Research at the University of Louisville School of Nursing. The center began in 2003 and was funded by a federal grant from the Health Resources and Services Administration (Mundt, Hermann, Conner, & Von Ah, 2006). The aim of the center was to change nursing education and practice in the Louisville metropolitan area to improve and enhance nursing care for patients and families. The Center for Cancer Nursing Education and Research was recognized as a part of the University’s strategic initiative to improve cancer care. At the inception of the center, partnerships with six area schools of nursing, as well as five cancer practice institutions and five cancer community groups, were formed. The Dean of the University of Louisville School of Nursing, who served as the center’s Project Director, established relationships with the administrators of the partner institutions through in-person meetings. The partnership model, the aims of the center, and the community-wide intervention strategy were explained prior to the signing of a partnership agreement by each institution and their identification of individuals to serve as institutional representatives to the center. This individual, termed the center associate, attended meetings and participated in designing strategies for cancer nursing education, practice, and research.
The center associates from the schools of nursing comprised the group referred to as the education associates. These individuals were the faculty members who primarily taught the cancer content in their school. Regular meetings were held with the education associates to discuss ways to enhance cancer nursing education and served as the link between the center and the schools of nursing. The center accomplished several major goals during the first 2 years, including the establishment of close working relationships among the area schools of nursing, development of an oncology clinical nurse specialist track, completion of a curriculum survey at each participating school of nursing, and presentation of cancer nursing educational seminars. The curriculum assessment revealed a lack of cancer-related content and learning experiences in the schools of nursing. The Faculty Fellows Program evolved from the work with the schools of nursing and was one approach to enhance nursing education regarding cancer care.
The Cancer Nursing Faculty Fellows Program
The aim of the Faculty Fellows Program was to enhance the cancer expertise of nursing faculty in the six schools of nursing in metropolitan Louisville by equipping them with the most current cancer nursing information. The fellows then could share this information with faculty and students at their respective institutions, with the ultimate goal of an institutional influence at each school of nursing in the area of cancer education.
Through discussions with the deans of schools of nursing in the area, the Project Director obtained support for the concept of institutional improvement through enhanced faculty development. All of the schools of nursing had been active partners in the center and viewed this program as a continuing source of enrichment. After benefits to the school and expectations of the fellow were explained, deans from five of the six schools nominated a fellow. One school was experiencing substantial administrative and faculty changes and chose not to participate. Benefits included an honorarium for the fellow’s participation, paid expenses to the annual Oncology Nursing Society (ONS) Congress, and a full complement of cancer-related books and materials for each school.
The selection criteria included:
- Full-time faculty status.
- Support of their dean.
- Availability to attend the ONS Congress.
- Ability to attend and fully participate in the 4-week program.
- Agreement to develop a specific project to implement in their school of nursing within 6 months of the experience.
- Agreement to participate in the evaluation of the program and submit data for an outcomes assessment of the fellow’s project.
It was not a requirement for fellows to have oncology experience.
After each school had chosen a faculty fellow and a signed agreement was returned to the center, a luncheon was held to introduce the fellows to one another as well as to the center’s faculty and staff. In addition, the aim and expectations of the Faculty Fellows Program were reviewed and attendance at the ONS Congress was discussed. Fellows were introduced to the concept that this was both an individual and institutional enrichment program with an inherent responsibility for them to use the experience to influence the quantity and quality of cancer nursing content at their school of nursing. The nursing background of the five faculty fellows varied widely. The fellows’ clinical experience included pediatrics, maternal-child, community, and adult nursing and only one fellow indicated having had oncology experience.
The fellows attended the ONS Congress with a center faculty member, who served as a mentor. Attendance at the Congress served to stimulate fellows’ interest in the area of oncology nursing, increase their knowledge level of caring for patients with cancer, acquaint them with available resources, and allow networking among fellows and faculty.
The primary component of the Faculty Fellows Program was a 4-week program held during June. This course, which included classroom and clinical experiences, covered information spanning the scope of care from prevention to end of life. Basic knowledge to cutting-edge research was presented. Presenters were from a variety of disciplines, including nursing, medicine, public health, pharmacology, genetics, and biobehavioral oncology. Speakers consistently highlighted evidence-based practice and interdisciplinary care. To provide the fellows with expanded knowledge of evidence-based nursing practice, a nationally known nurse researcher presented research on the quality of life of hospice patients. Content for the 4-week program was based on the Statement on the Scope and Standards of Oncology Nursing Practice (Boyle, Bruce, Iwamoto, & Summers, 2004). Each fellow received a copy and the document was discussed during the initial days of the fellows program. The 14 high-incidence problem areas in the Scope and Standards served as a guide in identifying essential content.
The fellows program was held 5 days per week. Classroom content was presented by 3 center faculty members and 25 guest speakers. Local experts were invited to present as a way of exposing the fellows to the depth and breadth of cancer-related expertise available in the community. The goal was for fellows not only to learn basic cancer care knowledge, but also to become knowledgeable about state-of-the-art care and research in the metropolitan Louisville area. Not only would the fellows be able to share this knowledge with students and faculty at their institutions, but the guest speakers could serve as resources for the fellows in the future.
Although most classes occurred in the school of nursing, some were held off site. For example, when content on prevention and screening was presented, class was held at the local office of the American Cancer Society. After a presentation on pharmacogenetics, a tour of a pharmacologist’s research laboratory proved to be a firsthand learning experience. The fellows also attended various educational sessions offered at the university, including oncology nursing grand rounds, cancer prevention and control lectures, and medical oncology multimodality conferences.
An important component of the Faculty Fellows Program was the observational clinical experiences that occurred. An underlying assumption of the Faculty Fellows Program was that nursing faculty may not have current knowledge of practice settings, procedures, and nursing practice; therefore, it was essential that the fellows supplement didactic learning with observation of care being provided to patients with cancer. The experiences coincided with didactic presentations. The week that prevention, screening, and diagnosis were discussed, fellows observed various scans and other endoscopic procedures. After cancer treatments were discussed, fellows spent time in radiation and medical oncology areas to observe the administration of treatments. The last week of the fellows program consisted of day-long observational experiences with clinical nurse specialists and nurse practitioners in acute care hospitals, oncologists’ offices, and an inpatient hospice unit.
The final class allowed the participants to share their observational clinical experiences. The fellows also discussed with the center faculty and staff the benefits and challenges of the Faculty Fellows Program as a whole and their plans for incorporating their learning into the teaching and curriculum development at their schools. The fellows were especially pleased with the bond they developed with each other and thought the level of camaraderie and collaboration they experienced would serve as resources in the postfellow period. The day concluded with a summary presentation and celebratory luncheon to which the deans of the participating schools of nursing were invited.
Fellows evaluated the program at the end of each of the first 3 weeks. They also completed an overall evaluation of the entire program at the conclusion of the fourth week. Evaluations for all facets of the program were overwhelmingly positive. Fellows rated each speaker (n = 28) individually and the overall Faculty Fellows Program on a 5-point scale (5 = strongly agree). The mean score for all of the speakers was 4.75. Evaluations of the overall Faculty Fellows Program were also excellent (mean = 4.86). Top strengths were identified as the amount of knowledge gained, depth and breadth of the content, expertise of the presenters, organization of the program, and opportunity to network with faculty members from other schools of nursing.
Fellows were asked to provide input regarding ways to improve the program. Suggestions included:
- Allowing for more breaks between speakers.
- Incorporating more time for discussion to facilitate synthesis of the information.
- Shortening observational experiences.
- Allowing fellows to tailor clinical experiences to meet their learning needs.
- Increasing content on genetics, biologic therapies, and the four major cancers.
Evaluation of the Faculty Fellows Program was also done by center faculty and staff, and the same areas of improvement were identified.
Measuring Institutional Influence
At the onset of the program, fellows were expected to develop a specific project to be implemented in their school of nursing within 6 months of the experience. The fellows planned a panel presentation to each of their schools of nursing that would be a venue for ensuring broader awareness of the partnership model and would also highlight key knowledge that the fellows obtained through the program. The first presentation occurred during a continuing education program for nurse educators held at one of the partner schools of nursing. The dean of that university issued a special invitation to the fellows group to highlight the collaborative spirit of nursing. To measure institutional influence, fellows will be asked for ongoing reports of institutional level outcomes resulting from their attendance at the Faculty Fellows Program.
Future of the Cancer Nursing Faculty Fellows Program
Because of the success of the Faculty Fellows Program, there is hope it will be offered again in the future. Additional funding is needed to support the program. Anticipated changes include greater emphasis on development of personal and institutional goals. Schedule changes include having fellows attend a 1.5-day session approximately 4 months prior to the intensive summer session to meet center faculty and staff and other fellows, to present introductory content, to arrange for ONS Congress attendance, and to prepare personal and institutional goals. By creating personal goals, fellows could ascertain their own learning needs and determine the clinical experiences they perceive to be most beneficial to them. Institutional goals will emphasize the need for the fellows to implement change in the curriculum and allow center staff to measure institutional influence. In addition, more content on integration of content into the curriculum will be included.
Most nurses encounter patients with cancer regardless of the area in which they work. Incorporating content related to care of patients with cancer into curricula of schools of nursing is imperative to assure that nurses have the knowledge to meet the care demands of these patients and survivors. Nursing faculty are agents of change for the future of the profession, and their influence will elevate the importance of cancer care in their educational settings. It is only through knowledgeable faculty that future nurses will learn how to provide quality care to patients with cancer. The Faculty Fellows Program is a model of a program that helps nursing faculty integrate cancer care throughout the curriculum.
- American Cancer Society. 2008. Cancer facts and figures 2008. Retrieved April 24, 2008, from http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf
- Boyle, DA, Bruce, SD, Iwamoto, RR & Summers, BL2004. Statement on the scope and standards of oncology nursing practice. Pittsburgh, PA: Oncology Nursing Society.
- Jemal, A, Clegg, LX, Ward, E, Ries, LA, Wu, X & Jamison, PM et al. 2004. Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer, 101, 3–27. Retrieved September 21, 2005 from http://www3.interscience.wiley.com/cgi-bin/fulltext/108567706/PDFSTART doi:10.1002/cncr.20288 [CrossRef]
- Mundt, MH, Hermann, CP & Conner, AL2005. Prevalence of cancer nursing care by registered nurses in greater Louisville [Abstract]. Oncology Nursing Forum, 321, 194–195.
- Mundt, MH, Hermann, CP, Conner, AL & Von Ah, DM2006. A community partnership model for developing a center for cancer nursing education and research. Journal of Professional Nursing, 22, 273–279. doi:10.1016/j.profnurs.2005.11.005 [CrossRef]
- Satryan, MA2001. The oncology nursing shortage and its impact on cancer care services. Oncology Issues, 161, 21–23.