title: A care improvement program acting as a powerful learning environment to support nursing students learning facilitation competencies.
abstract: Change management is an important area of training in undergraduate nursing education. Successful change management in healthcare aimed at improving practices requires facilitation skills that support teams in attaining the desired change. Developing facilitation skills in nursing students requires formal educational support. A Dutch Regional Care Improvement Program based on a nationwide format of change management in healthcare was designed to act as a Powerful Learning Environment for nursing students developing competencies in facilitating change. This article has two aims: to provide comprehensive insight into the program components and to describe students' learning experiences in developing their facilitation skills. This Dutch Regional Care Improvement Program considers three aspects of a Powerful Learning Environment: self-regulated learning; problem-based learning; and complex, realistic and challenging learning tasks. These three aspects were operationalised in five distinct areas of facilitation: increasing awareness of the need for change; leadership and project management; relationship building and communication; importance of the local context; and ongoing monitoring and evaluation. Over a period of 18 months, 42 nursing students, supported by trained lecturer-coaches, took part in nine improvement teams in our Regional Care Improvement Program, executing activities in all five areas of facilitation. Based on the students' experiences, we propose refinements to various components of this program, aimed at strengthenin the learning environment. There is a need for further detailed empirical research to study the impact this kind of learning environment has on students developing facilitation competencies in healthcare improvement.
authors.affiliation: Windesheim University of Applied Sciences, Research Group for Innovations in Care of Older Adults, Centre of Expertise in Health Care and Social Work, P.O. Box 10090, 8000 GB Zwolle, The Netherlands. Electronic address: js.jukema@windesheim.nl.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jukema
authors.affiliation: Windesheim University of Applied Sciences, Research Group for Innovations in Care of Older Adults, Centre of Expertise in Health Care and Social Work, P.O. Box 10090, 8000 GB Zwolle, The Netherlands. Electronic address: ae.harps-timmerman@windesheim.nl.
authors.forename: Annelies
authors.initials: A
authors.lastname: Harps-Timmerman
authors.affiliation: Dept. of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Electronic address: stoopendaal@bmg.eur.nl.
authors.forename: Annemiek
authors.initials: A
authors.lastname: Stoopendaal
authors.affiliation: Windesheim University of Applied Sciences, Research Group for Innovations in Care of Older Adults, Centre of Expertise in Health Care and Social Work, P.O. Box 10090, 8000 GB Zwolle, The Netherlands. Electronic address: chm.smits@windesheim.nl.
authors.forename: Carolien H M
authors.initials: CH
authors.lastname: Smits
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003479:Curriculum; D004508:Education, Nursing, Baccalaureate / Q000379:methods*; D055318:Evidence-Based Nursing; D006801:Humans; D007857:Leadership; D009426:Netherlands; D015402:Nursing Education Research; D018794:Problem-Based Learning; D058996:Quality Improvement; D013338:Students, Nursing
keywords: Facilitator; Learning environment; Quality improvement