Supporting Nursing Students in the Ambulatory Care Setting through Structured Orientation

Purpose: The National Academy of Medicine has recognized a shift to ambulatory care nursing over the next 10 years, triggering an up rise of nursing students entering this setting. With this new shift and the minimal exposure nursing students receive in school, a knowledge deficit has been identified related to the role of nursing in this care setting. Through a partnership with nursing scholars and a culmination of follow up dialogue with students and preceptors, a need to bridge the gap between nursing school curriculum and the role of the nursing students in clinical rotations in the ambulatory care setting was identified.

Learning outcome: Identify strategies and tools to support orienting nursing students to the ambulatory care environment.

Description: Nursing students lack familiarity on the nurse role in the ambulatory care setting and how skills performed translate to the traditional inpatient nurse role. Along with the varied level of education around ambulatory care in nursing schools, the perception of care portrays minimal hands-on skill. Providing a structured orientation, case studies, and focused plans of care, the importance of how nurses deliver high-quality care in a non-traditional care setting will help to align the focus of their clinical rotation. The program was originally established through collaboration with nursing scholars, professional development, and clinical leaders to support immersion (capstone/practicum,180 hours) rotations and has been expanded to include community health (64 hours) rotations.

Evaluation/outcome: The rollout of this orientation program started in a phased approach, targeting pilot areas with experience in hosting nursing students. The second phase included program changes, pre-rotation survey completed by the nursing student, and a post-rotation survey completed by the nursing student and preceptor. Successful outcomes are identified through formative and summative evaluations and a completed orientation plan that include action items, case studies, and plans of care.

From February to May 2023, ambulatory care departments hosted 16 nursing students. A pre-rotation survey specifically for the students was added in June to establish their baseline understanding of ambulatory care nursing. The data from this survey guided formative check-ins with the preceptor throughout the rotation. A post-rotation survey assessed the program’s value, identified gaps, and provided recommendations to further expand the program. Overall feedback from nursing students and preceptors who have used this orientation program has been positive, informative, and constructive.