Internal medicine nurse shadowing program

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Abstract

Professional identity formation is a fluid process, which evolves throughout one's medical education. Residency is an ideal time for interprofessional education because as junior physicians, they are beginning to develop their professional identity, but it is still early enough in their careers that their attitudes and habits are malleable. We implemented a nurse-shadowing pilot program for internal medicine (IM) residents. IM residents completed a six to 12-h nurse-shadowing experience. Pre- and post-exposure surveys and interviews were used to explore satisfaction, learning, reflective practice, and anticipated change in behaviour. All residents (n = 7) and nurses (n = 7) found the nurse-shadowing experience to be valuable. There was a statistically significant improvement on resident self-reported knowledge of nursing scope of practice. Qualitative analysis of participant interviews identified potential benefits, including reflective practice, attitudinal changes (increased empathy), and recognized specific actionable items to incorporate into their daily practice to improve collaboration and communication. The residents were able to compare and contrast their own roles to those of their nursing colleagues. Nurse-shadowing programs at the residency level provide a valuable interprofessional educational experience.

Section snippets

Format

IM residents participated in a six to 12-h nurse-shadowing experience with a registered nurse (RN) providing direct patient care on the general medicine wards at an academic hospital.

Target audience

Participants included IM residents during their core three-year internal medicine residency training at McMaster University. McMaster is a tertiary care, academic institution and the IM training program has 28 residents per year. A total of seven residents volunteered to participate in our shadowing experience, including four residents in post graduate year one (PGY1) and three in PGY2.

Objectives

There were two shadowing-experience learning objectives:

  • 1.

    Generate awareness of professional responsibilities of nursing colleagues;

  • 2.

    Observe nursing activities including transfer of accountability (i.e. shift handover), documentation, provision of patient care, patient assessments, and interactions with other health care professionals.

Activity description

Each participating resident shadowed a registered nurse on an IM inpatient ward for six to 12 h. Residents observed nursing activities including transfer of accountability, documentation, provision of patient care, patient assessments, and interactions with other healthcare disciplines. Residents were asked to observe and not participate in activities beyond their scope of training, such as specimen collection (e.g. blood and urine), administration of medications, and securing and/or

Evaluation

Questionnaires and qualitative data from semi-structured individual and group interviews were used to assess the resident perceptions about the experience. Reflection and self-reported changes were used to determine the success of the intervention. Data was triangulated from multiple sources to perform a multi-source evaluation of the shadowing experience.

Required materials

Coordinating a nurse-shadowing experience requires a physician and nurse lead who will orientate the participants to the goals of the experience, review allowable resident activities, and schedule the experiences. A precise list of activities which residents could and could not participate in during shadowing experience can be provided upon request. Evaluation of this experience would require administration of pre- and post-exposure surveys and post-encounter interviews. All materials are

Funding

  • 1.

    McMaster University General Internal Medicine AFP Grant

Conflicts

The authors report no conflicts of interest.

Acknowledgements

This project was made possible by the 2013-2014 McMaster University General Internal Medicine AFP Research Grant. Thank you to Dr. Shariq Haider, Kelly Drake, Kelly O'Halleran, and Heather Vandeweerd for all your support. Division of General Internal Medicine at McMaster University. Kelly Drake, Nurse Manager, Hamilton General Hospital, Hamilton, Ontario. We would also like to thank our McMaster Internal Medicine resident- and nurse-participants.

References (10)

  • S. Thorne

    Making sense of data

  • C. Barrer et al.

    Changing attitudes among nurses and physicians: a step towards collaboration

    J Healthc Qual

    (2002)
  • E. Ceppetelli et al.

    Shadowing a Nurse: An Idea for Enhancing Intraprofessional Education

    (2009)
  • A. Jain et al.

    Implementing a nurse-shadowing program for first-year medical students to improve interprofessional collaborations on health care teams

    Academic Medicine

    (2012)
  • J. Nachbur

    Medical students gain valuable insight into nurses' critical role

There are more references available in the full text version of this article.

Cited by (0)

1

Winnie Chan and Mary Salib are co-first authors.

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