The Independence Blue Cross Foundation’s Nursing Internship Program is an innovative approach to preparing nurses to be future leaders in healthcare. Through its unique model that emphasizes experiential learning and competency-building, the Nursing Internship Program provides undergraduate nursing students with experiences and skills to not only provide exceptional patient care, but to lead efforts to change the way healthcare is delivered.
In today’s evolving healthcare environment, there is one constant: nursing. As the largest profession in the healthcare workforce, nearly three million registered nurses are the backbone of the healthcare system.1 They are often the first point of contact for patients, coordinating and providing direct care at the hospital, in primary care offices, at community health centers, and everywhere in between. Their knowledge of the healthcare system and diverse practice settings make them well positioned to lead changes to improve the way care is delivered. That’s why in its landmark 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine recommended that nurses be part of a collaborative, interdisciplinary effort, alongside physicians and other healthcare professionals, to reform healthcare.2
Nurses as Leaders
It is not easy to change a system as large and complicated as healthcare and nurses who join the effort must be prepared to take on leadership roles and new responsibilities. Nursing education programs prepare nurses for patient care and are focused primarily on the development of clinical skills, as they should be. However, nurses need opportunities for leadership development, as well. The Institute of Medicine recommended that leadership competencies be integrated into nursing curricula and that supplemental opportunities be made available to nurses at all levels.
Independence Blue Cross Foundation Supports Nurses
A longtime supporter of nurses, the Independence Blue Cross Foundation (Foundation) understands the important role nurses play and has several programs that advance their education and professional development. Since 2011 through its Nurses for Tomorrow scholarship program, the Foundation has awarded more than $8 million to 23 accredited nursing schools in the Southeastern Pennsylvania region to support scholarships for undergraduate, graduate, and doctoral nursing students. The Foundation also supports a Nurse Practitioner Residency Program and will focus on increasing diversity in nursing in future programs. However, the program that has the greatest impact on the next generation of leaders in nursing is the Foundation’s Nursing Internship Program.
An Innovative Internship Program for Future Nurse Leaders
The Foundation’s Nursing Internship Program (Program) immerses undergraduate nursing students in two unique practice settings. For 10 weeks during the summer, nurse interns are placed either in a community health center (supported through the Foundation’s Blue Safety Net grant program) or in a business area (i.e. Clinical Services, Risk Analytics, etc.) at Independence Blue Cross, and are supervised by registered nurses. Through these practice settings, nurse interns are exposed to career paths that are beyond hospital floors, in the communities where patients live. This experience alone is exceptional for nursing students who spend many of their clinical hours in traditional healthcare settings. What makes the Program truly innovative, though, is the competency-building opportunities weaved throughout it.
The COPA Model
In 2015, using the Institute of Medicine’s report as a strategic guide, the Foundation aligned the Program with the Competencies, Outcomes, and Performance Assessment (COPA) Model of nursing education to provide a more enriching, competency-building experience to its nurse interns. The COPA Model is a conceptual framework that was created as a way to build competencies in pre-licensure nursing students. The framework emphasizes eight core practice competencies, including communication, critical thinking, human caring and relationships, leadership, and knowledge and integration.3 To help the nurse interns build these competencies, the Foundation began convening them outside of their practice settings by facilitating Leadership Labs.
The Leadership Labs, which occur three times throughout the Program, are full-day sessions related to core practice competencies listed in the COPA Model framework. For example, in a public speaking session, the nurse interns share a significant moment or lesson learned from their internship experience in front of an audience, and receive constructive feedback. In another session the nurse interns learn techniques to building a professional network. Through the Leadership Labs, nurse interns also learn how to further their education and find their nursing passion, learn how to care for patients in a culturally competent manner, are paired with a mentor, and complete a group volunteer project with a local non-profit organization.
Outside of the Leadership Labs, nurse interns build their critical thinking skills through an informal, observational research poster project in which they identify a problem or issue at their practice setting, conduct a brief literature review, gather information through observation and informal interviews with staff, and make a recommendation. Nurse interns then present their research posters at a recognition event attended by Independence Blue Cross leadership, Foundation staff and leadership, nursing school leadership and faculty, mentors, and their nurse supervisors. The research posters are highly admired and have led to opportunities for nurse interns to present at events like the Children’s Hospital of Philadelphia’s Nursing Research and Evidence-Based Practice Day.
Validating, Scaling, and Replicating
The Program was evaluated in 2017 by Widener University’s Leadership Center for Nursing Education Research to evaluate its model, impact, and the potential to scale and replicate it. The evaluation resulted in numerous outcomes including:
- The leadership building experiences provided throughout the program are unique compared to those in traditional nursing education programs.
- Many of the experiences are transformative, and influence nurse interns’ attitudes about their leadership capabilities.
- Supervisors who have been a part of the Program for many years are highly supportive of and dedicated to its continued success.
With the model validated, the Foundation seeks to expand the Program and replicate it on a national level.
Why it works
The Foundation’s Nursing Internship Program works for three reasons: strong partnerships, invested staff, and a meaningful purpose. The Foundation is fortunate to have a network of community health center partners and partners at Independence Blue Cross who provide exceptional practice settings for the nurse interns, and dedicated supervisors to work with the nurse interns day-to-day. The Foundation also has a staff that is highly invested in the nursing profession. Most importantly, The Foundation has yet to come across another internship program that provides a meaningful experience to undergraduate nursing students through both diverse practice settings and leadership development opportunities. Many nurse interns who have completed the program are already leading local efforts to improve the health and wellbeing of communities in the region, including a health literacy program in Philadelphia’s public libraries, and an after-school program for Latino youth in South Philadelphia that addresses the social determinants of health. The Foundation is proud of their accomplishments, and is looking forward to seeing them and all of its nurse interns become the next leaders not only in nursing, but in healthcare.
1”Registered Nurses: Occupational Outlook Handbook." U.S. Bureau of Labor Statistics. Accessed January 02, 2018. Link.
2“The Future of Nursing: Leading Change, Advancing Health,” Institute of Medicine (2011), accessed January 2, 2018, Link.
3Lenburg, Carrie B., EdD, RN, FAAN. "The Framework, Concepts and Methods of the Competency Outcomes and Performance Assessment Model." The Online Journal of Issues in Nursing 4, no. 2 (September 30, 1999). Accessed January 02, 2018. Link.
Zaynah Henry joined the Independence Blue Cross Foundation in 2016 as a program specialist. In her role she works with the Foundation’s nursing programs, which advance the healthcare workforce through supporting the education and professional development of nurses. Prior to joining the Foundation, Zaynah worked for the President’s Cancer Panel at the National Cancer Institute. Zaynah received her BS in Health Behavior Science and MS in Health Promotion from the University of Delaware.