Population Health Internship

The Population Health Internship, or PHI, is a yearlong community-engaged learning experience for all BSN students at SUCON. It was introduced in Academic Year 2019-2020 to one cohort of 80 students. In Academic Year 2020-2021 it was offered to both the Junior Traditional Cohort and the Senior Transfer cohort and a total of 160 students took part. Each year going forward the PHI is scheduled for the Junior Traditional Cohort and the Senior Transfer cohorts. The PHI replaced an earlier version of community-embedded clinical specialty rotations which was not achieving its purposes as well as we hoped.  

The yearlong PHI has several benefits to students: 

• Students are placed with a community partner, with which they will work all year long, thus better aligning the time needed to understand population health and see effects of engagement with the reality and resources of community partners, and assuring all students have a quality, consistent experience.
• Deeper and evolving experiences with the same faculty and internship supervisors all year long.
• Students guided by population health faculty who are interested in and committed to teaching students about population health experiences.
• Deeper consideration for student skills, abilities, and preferences can be accommodated in the placement process due to the once per year placement cycle and student-agency matching process.

Finally, the PHI is innovative. It helps SUCON graduate nursing leaders who are prepared for the next generation of nursing leadership. An April 2021 change to the BSN Essentials upon which the curriculum is based created a separate Domain for Population Health. You can read more about this change here. 

In the last decade, numerous key nursing education policy papers and evidence-based practice statements have emphasized the need for all nurses to be prepared to “address population health in all settings of practice – regardless of their role” (Bekemeier, Hermer, Nyirati, et al, 2017, p. 5). Among these are sources from the American Association of Colleges of Nursing, the American Nurses Association, the National Academies of Medicine, and a paper sponsored by the Robert Wood Johnson Foundation (American Association of Colleges of Nursing, 2008; American Nurses Association, 2010; National Academies of Sciences, Engineering, and Medicine, 2016; Storfjell, J.L., Winslow, B.W. & Saunders, J.S.D., 2017).

The reasons for these calls are many. Adopting a population health lens in nursing education implies learning about care coordination, chronic disease management, determinants of health, policy development and health advocacy, and health (in)equity. All of these population level nursing practices are required to respond effectively to health care, demographic, and political changes in the U.S. and worldwide. Such concepts, and opportunities to practice them in real-world settings beyond acute care environments, require innovative rethinking of nursing education’s ‘business as usual.’ Specifically, Washington State nursing education leaders, led by Seattle University College of Nursing (SUCON), have taken a leadership role in committing to the integration of population health competencies throughout baccalaureate (and graduate) nursing curricula and the promotion of the academic-community partnerships required to accomplish this integration (Bekemeier, Hermer, Nyirati, et al, 2017).   

References: 

American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Retrieved from http://www.aacnnursing.org/Portals/42/Publications/BaccEssentials08.pdf   

American Nurses Association. (2010). Nursing’s social policy statement: The essence of the profession. Silver Spring, MD: American Nurses Association.  

Bekemeier, B., Hermer, J., Nyirati, C., Hirsch, A., Smith, S., Dotson, J.A., Murphy, L., Shirley, J., and Oneal, G. (2017). The future of nursing education: Ensuring a population health focus in nursing education in Washington State. Sponsored by Emami, A. & Swanson, K. Retrieved from https://www.wcnursing.org/wp-content/uploads/documents/reports/2017-November-WA-Deans-The-Future-of-Nursing-Education-Ensuring-a-Population-Health-Focus-in-Nursing-Education-in-WA-State-White-Paper.pdf  

National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. Washington, DC: The National Academies Press.  

Storfjell, J.L., Winslow, B.W. & Saunders, J.S.D. (2017). Catalysts for change: Harnessing the power of nurses to build population health in the 21st century.  

In the Spring Quarter prior to the Fall Quarter start of your PHI, students receive an online survey asking about their interests, skills, languages, work and volunteer experiences, transportation options, and other preference information. This information is studied closely by the PHI Co-Coordinators, who use it, along with the needs of our community partners, to make mutually beneficial PHI matches. While expressing preferences does not guarantee that students will receive all of them, the PHI Co-Coordinators do their best to assure that as many preferences as possible are honored in the context of the available placements and mix of students.

To prepare for the survey, students can think about what sorts of “sub-populations” they would like to work with (for instance, children, older people, people experiencing homelessness, families of childbearing age, etc.). Students may also want to consider what their unique knowledge, skills, and abilities are and share those. If a student has particular goals in terms of what sort of health promotion or disease prevention initiatives they would like to be involved with, they are encouraged to share those as well. 

For Fall Quarter, students will register for NURS 4401. In the Spring Quarter prior to your PHI start, go ahead and register for any section and the nursing department will rearrange you into the correct section once the PHI placements have been finalized closer to the start of Fall Quarter.   

During the year you take the PHI, students will ALWAYS register for the SAME SECTION as they were assigned in fall. For instance, if you are in NURS 4401-03 in Fall Quarter, you will register for NURS 4402-03 in Winter Quarter and NURS 4403-03 in Spring Quarter. 

Yes! Your section of the PHI course has up to 15 students assigned to one faculty member. That faculty member supports students who are assigned to a selection of community partners. Your faculty member also opens and updates the course Canvas site, grades your academic assignments, and holds PHI seminars for your section throughout the quarter.

Sort of. You will probably have a peer assigned to the same community agency as you. Many agencies host more than one student. This is great because you get to collaborate with peers to work on assignments in a group and to brainstorm and problem-solve together when needed. More heads are better than one!

Your PHI faculty will not be with you when you do your internship hours on-site, like they are in other clinical experiences. Instead, you’ll be working with your primary agency preceptor/mentor, other agency employees, agency clients, and any peers assigned to the same agency. Resources are available on the course Canvas site. Your faculty is always available in person or via email, text, or Zoom to answer questions and provide guidance.

In addition, faculty will host three PHI Seminars per quarter. As part of your course grade, you are required to attend at least two out of these three seminars (though you are welcome to attend all three!). The purpose of the Internship Seminar is to provide a regular meeting space for students and their faculty to:

• check-in about issues relating to their PHI,
• understand how to apply key population health concepts to their internship work,
• support one another in problem-solving,
• debrief difficult situations and conversations,
• celebrate successes, and
• solicit and receive feedback.  

Each course in the PHI series (NURS 4401, 4402, and 4403) is 1 credit. One credit translates to 30 internship hours per quarter with your assigned agency. While this will be explained in more detail at the Fall Quarter Kick-Off Event, once you are assigned to your community site, you will make your own schedule, in collaboration with your assigned preceptor/mentor. You will do that at the start of each quarter and report the planned schedule to your PHI faculty as the first graded assignment of the quarter (see Canvas).  

Since there are so many students and community partners involved, it’s impossible to dictate a single day of the week or time for each student to do their PHI hours. It’s a lot like Senior Practicum: you confer with your preceptor or mentor and then agree upon a schedule. You are to prioritize and honor their PHI schedule just as you would any other clinical which happens on a fixed day of the week. This provides you with flexibility and autonomy while also being sure you are serving the community agency on terms that are meeting the clients’ needs.

This means you will need to work around your UCOR (and other class schedules) to schedule your PHI hours. You do not have to do a fixed 3 hours per week x 10 weeks to equal 30 hours. You can have some weeks with fewer hours and some weeks with more hours, if needed, so long as you make these arrangements with the coordination and approval of their agency preceptor/mentor. We expect that you prioritize PHI hours over work and other obligations, just like we expect you to do for that other assigned clinical schedules. 

Students wear professional dress (regular clothes) to the community, so nothing special is needed in terms of wardrobe. Wear your nursing student nametag. Ask at your assigned site during orientation whether they have any specific dress code.

Community agencies are required to provide COVID-related PPE for students when they are on-site.

Very rarely, an agency (such as those working with vulnerable children) will require fingerprinting in addition to your regular clinical passport-type info. When this happens, the students are informed on this onboarding requirement far in advance so they can have time to use the least expensive option to complete the requirement. If the requirement poses an undue financial burden, you should let us know so that we can work with them.

You are required to arrange your own transportation to and from PHI sites, just as you do other clinical sites. We ask questions about transportation availability and geographic preferences on the preference survey and the PHI Coordinator does her best to take those into consideration (among all the other preferences and the student’s ranking of them) when making the placements.