Victoria's La Trobe University has developed a ground-breaking new role, designed to enable advanced nursing clinicians to move seamlessly between a health care provider and an educational provider, in order to eliminate the theory practice gap.

The lecturer-practitioner role was developed as a result of the formation of clinical partnerships between the university and health care providers, during which time the provision of specialist postgraduate education was identified as an area for further development.

"The role is designed to be undertaken by someone wishing to maintain a strong senior clinical presence while also working in academia," says Assoc Prof Bill McGuiness, Director, Alfred La Trobe Clinical School, School of Nursing and Midwifery.

"Holding senior positions in clinical practice and academia can be challenging, however a wider understanding of how the curriculum needs to work in clinical practice and providing transparency is invaluable to the success of the course and its graduates.

"The long term vision for the role is a candidate recognised clinically as an independent practitioner within their field of nursing, and recognised academically as a professor."

The Theory Practice Gap

The Theory practice gap is a natural drift occurring as a result of nurse education moving from bedside apprenticeships to academic degrees.

"The shift in learning environment altered nurse education priorities and created a divide from what was taught in theory and what was practiced clinically," says Assoc Prof McGuiness.

"This is intrinsically linked to the contrast of the academic and clinical environments. It is recognised the throughout nursing education, students report what they are taught in university not always aligning to the reality of clinical practice, this undermines the quality of nursing education in relation to clinical relevance and preparation to practice.

"The gap is a reflection of the propensity for nursing academics to no longer practice or provide a clinical services. This differs from the medical education model where the academics still are active practitioners."

The LP Role

An LP is an expert in their field and clinically current. The role, encompassing both theory and practice elements, ensures common ground on which to build the curriculum and deliver it.

"Health care providers require an array of specialist education to upskill personnel in these area and to act as an incentive for staff recruitment," says Assoc Prof McGuiness.

"Education providers require clinical experienced personnel currently practicing to teach the programs and a fees structure that is attractive to potential students. 

"An LP's total EFT is paid for by the health care provider with an agreed fraction of their salary paid reimbursed by the education provider.

"The fraction of their role dedicated to either clinical or educational duties is determined by an annual discussion between the health care and education provide.

"In summary the model facilitates high quality care and education for the specialised areas by sharing of a very valuable resource; the experienced specialist."

The future

"The role is designed to eliminate the theory practice gap and deliver a course which is transparent, responsive and clinically valid thus improving the postgraduate education standard," says Assoc Prof McGuiness.

"Maintaining a profile both clinically and academically, the role allows the lecturer practitioner to have access to resources in both areas to inform teaching and student experience."

The role is continually evaluated by the head of the clinical school and the head of education for the hospital to ensure it is working well for all partners.

With dual lines of reporting, individual candidates have annual performance reviews from both areas and are encouraged to continually seek feedback from students, peers and industry partners.

"The role is evolving and it is hoped by promoting the La Trobe model and undertaking research to prove its efficiency it will be adopted by other courses and universities."

The challenge for the role moving forward though is the ongoing understanding of the expectations.

"At times the partners try to establish a separation of health care provision from education provision, such as days of weeks on each area.

"This prevents maximisation of the role, as it is able to meet both agendas when the LP has the flexibility to move between both environments on a needs basis."

Assoc Prof McGuiness says he hopes the graduates undertaking courses overseen by lecturer practitioners are delivered a course that is clinically relevant and prepares them for the practice roles they will undertake.

“The model is also supporting of research projects spanning academia and clinical practice which will encourage graduates to undertake research in their clinical areas supported by the University.

“It enables the incumbent to continue their personal development as a clinician, researcher and teacher. Such development can only value add to both health care provision and educational programs.”