Clinical leadership development in accelerated baccalaureate nursing students: an education innovation.

Nursing faculty members are responsible for assuring competence and safety in the preparation of prelicensure students who are preparing to deliver care in diverse settings. The growing complexity of care and the rapid expansion of knowledge have challenged the adequacy of traditional educational approaches. Proposed solutions have encouraged closer integration of classroom and clinical teaching. This article describes an integrated instructional approach to developing clinical leadership competencies in a cohort of accelerated, second-degree, baccalaureate nursing students. Fifty-six students completed an intensive clinical experience in long-term care settings in which they used evidence on improving care for persons with heart failure to practice the principles of delegation and supervision with nursing staff. The pre- and postassessments indicated improvement in heart failure knowledge and increased readiness for delegation and supervision of certified nursing assistants. As one component of the learning experience, the students completed reflection journals. The entries in the students' journals revealed five themes: (a) low leadership self-efficacy, (b) managing the credibility gap, (c) flexibility in communication strategies, (d) RN accountability in delegation and supervision, and (e) knowledge dissemination with diverse nursing staff. Students and faculty judged the learning experience to be successful and supported the experience for future cohorts of students. This report is one example of how innovative learning experiences could be developed to increase the "real-world" aspects of clinical care within a multidisciplinary team context for the entry-level learner.