School of Nursing–VA partnership nationally recognized

The UT Health San Antonio School of Nursing and Audie L. Murphy Memorial Veterans' Hospital have received national recognition with the Exemplary Academic-Practice Partnership Award from the American Association of Colleges of Nursing (AACN).

From left to right: Jean Giddens, PhD, RN; Cynthia O'Neal, PhD, RN; Celida Martinez-Vargas, DNP, RN; Wesley Richardson, PhD, MSN, RN, CNL; and Deborah Trautman, PhD, RN

The honor highlights their enduring and dynamic partnership, which has continually enhanced nursing practice, education and veteran care in San Antonio.

Since the partnership's inception in 1997, the collaboration has evolved into a seamlessly integrated network of programs that focus on sustaining a resilient nursing workforce, promoting educational excellence and advancing veteran health through quality care and research.

An immersive pathway

Key to this focus is nursing students' ability to move through various experiences. Baccalaureate nursing students enrolled into the program begin their journey in the Dedicated Education Unit model, called DEU. Over 400 students have participated in the model since 2012.

These units, housed on medical-surgical floors at the veterans' hospital, offer a unique experience for students to work directly alongside Department of Veterans Affairs staff nurses who volunteer as "lead teachers." These lead teachers follow lesson plans created by health science center faculty, gaining professional development in clinical teaching. In the process, they help create a pipeline of highly qualified faculty for the School of Nursing for those interested in pursuing a career in education.

Cynthia O'Neal, PhD, RN

"Cora Brown, MSN, RN, is an example of how the DEU model creates a pipeline for those nurses interested in becoming faculty," said Cynthia O'Neal, PhD, RN, associate dean for undergraduate studies in the School of Nursing. "Over a period of 14 years, Ms. Brown had a journey that included every role related to the DEU - from student to staff nurse to lead teacher to faculty."

Brown is a clinical assistant professor who coordinates with the VA for the DEU program.

In this model, students are immersed in real-world care, building strong relationships with experienced RNs and gaining critical skills from the start of their clinical education.

Students in their final year of nursing school may then apply for the VA Student Trainee Experience Program, known now as VA-STEP, formerly as VALOR. This highly competitive summer program, co-coordinated by Wesley Richardson, PhD, RN, CNL, and Vicky Dittmar, MSN, RN, provides 400 hours of paid, hands-on clinical experience with veterans, enhancing students' confidence, critical thinking and nursing proficiency.

Upon graduation from the School of Nursing, VA-STEP preceptors are seamlessly transitioned into the VA's Registered Nurse Transition to Practice Residency Program. The post-licensure program provides them continued professional support and development during their first year as nurses. In addition, graduates of the school's nurse practitioner program can apply for the Nurse Practitioner Residency Program for further training in one of three specialized tracks: geriatrics, mental health and primary care.

Practice-ready nurses

This educational continuum minimizes the gap between education and practice.

Wesley Richardson, PhD, RN, CNL

"By the time our students graduate, they are practice-ready nurses," said Richardson. "Through their DEU experience, VA-STEP rotations and the residency program, we've created a clear pathway that supports their growth from student to full-time RN."

The educational model has led to exceptional retention rates. Since 2017, 100% of VA-STEP preceptors were offered employment within the VA system. After one year, 100% of those hired remained with the system, and 89% remained after three years.

The collaboration between the school and the VA ensures over 200 clinical placements annually, making the hospital a critical training site for nursing students and a conduit for their future employment.

A workforce in community care

The partnership has also supported nursing students committed to working in underserved areas through the Advancing Community Oriented Registered Nursing (ACORN) grant program, funded by a Health Resources and Services Administration grant, awarded to Norma Martínez Rogers, PhD, RN, FAAN.

The ACORN initiative provided a pathway for primary care nurses to work in medically underserved areas and health professional shortage areas. This focus on primary care complemented the DEU and VA-STEP programs, stressing community health, prevention and education.

In the past six years, 26 BSN graduates have been trained through ACORN. The program's success prompted the hospital to update its hiring practices for primary care, enabling the employment of 14 new graduate BSNs into the VA system. The grant recently ended.

Collaborating in research

The partnership between the school and the VA has led to significant advancements in veteran care through joint research initiatives.

Sara Mithani, PhD, RN (left), works with nursing students in the Biobehavioral Laboratory and biobank.

Bertha E. Flores, PhD, RN, WHNP-BC, associate professor, co-leads the Geriatric Research Education and Clinical Centers Connect program, improving geriatric care for veterans in rural areas by connecting providers with specialists via telehealth.

Nationally funded nurse scientist Sara Mithani, PhD, RN, assistant professor, has been able to study the sleep and behavioral health for veterans with brain injuries, mentoring students and publishing extensively.

Having developed a 12-module curriculum for the VA-SPiRE study, Rozmin B. Jiwani, PhD, RN, associate professor/clinical, is able to address diet, physical activity and stress management, and to mentor students on quality improvement projects like the GEROFIT, an exercise program that promotes health and wellness for veterans.

These sustainable collaborations are further supported by shared resources such as librarian workshops on evidence synthesis and faculty-led sessions on evidence-based practice, which drive innovation and patient outcomes for veterans.

A model for success

The AACN presented the award at its Academic Nursing Leadership Conference on Oct. 16 in Washington, D.C., to recognize the partnership between the UT Health San Antonio School of Nursing and Audie L. Murphy Memorial Veterans' Hospital as a model of academic-practice collaboration.

"We are very proud to receive this distinguished award," O'Neal said. "This national award acknowledges the enduring relationship we have had with the Audie L. Murphy Veterans' Memorial Hospital and is evidence of the excellence embraced by all of the individuals whose contributions sustain this exemplary partnership."

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