The Teaching Nursing Home Movement
“In the Teaching Nursing Home, as in the teaching hospital, the goals of patient care, teaching and research need to be mutually supportive and synergistic so that all parties to the affiliation can benefit.” — Weiler, 1987 as reported in Barnett, Abbey and Eyre, 2011
Our Living Classroom concept has its roots in the Teaching Nursing Home (TNH) movement. Definitions of TNH vary (Chilvers and Jones, 1997; Mezey, Mitty and Burger, 2008; Barnett et al., 2011), but generally agree on the following fundamental concepts.
A Teaching Nursing Home:
- involves a collaboration between an academic institution and a LTC home;
- aims to improve quality of education and clinical experiences to prepare a workforce with
knowledge, skills and interest in geriatric care;
- fosters research and research integration designed to improve LTC;
- creates synergy between research, education and clinical care; and
- improves resident outcomes.
The idea of bringing students into a LTC home learning environment was first explored in the 1980’s, in the United States. Two major groups of TNHs were created, one funded by the National Institute on Aging (NIA) and another by the Robert Wood Johnson Foundation (RWJF). Both groups of TNHs had similar objectives to establish collaborations between academic institutions and LTC homes, but were focused on different disciplines: the NIA program targeted medicine students, and the RWJF program focused on nursing students. The two programs also differed in their emphasis, with the NIA program focusing on research and the RWJF program focused on workforce development.
The RWJF also funded a comprehensive evaluation of its 11 TNH programs. The results indicated that involvement in a TNH increased nursing students’ perceptions of LTC homes as a more attractive career choice and also increased professional competencies (Barnett et al., 2011). In addition, residents experienced fewer transfers to acute care hospitals, had an improved functional status and reported higher satisfaction (Lipsitz, 1995).
Although these TNHs had some laudable results, the funding to support these initiatives ended and many of the TNHs were subsequently discontinued. Among those that were sustained, several key features were evident, including adaptability to local conditions and ensuring that all parties to the collaboration benefited. For example, the provision of educational opportunities to current staff in the LTC homes, as well as students preparing for their careers benefited both the home and the academic institution, leading to improved staff retention, student recruitment, quality education, and a more positive image for LTC (Mezey et al., 2008).
There have been several international applications of the TNH movement originally conceived in the United States, including Australia, Norway, the Netherlands and recently, Canada. A comprehensive review of these programs (Barnett et al., 2011) has uncovered a number of lessons and core features for success and core features for success (see Table 2). At the same time, successful application of the TNHs varies with local contexts, the expertise brought by the collaborating organizations, and the needs of students, organizations, and residents.
The learning from these TNH programs as context-based learning environments has informed and influenced our work at Conestoga College and Schlegel Villages in creating our Living Classroom. The LC takes the best of those experiences and tailors it to our environment in Ontario, Canada. A key feature is the focus on workforce development versus research.
For more information about Living Classroom at Schlegel Villages, see About Us.