UMass Dartmouth takes new approach to theses

The way it used to be, nursing graduate student Andrea Riiska would have been forced to toil for countless hours on a thesis paper before earning her master’s degree. But the research document, typically hundreds of pages long, would have never gone much farther than her professor’s desk.
Instead, Riiska says, she did something that made a difference.
Riiska and three other students recently completed a master’s degree project that helped nurses at Charlton Memorial Hospital in Fall River identify whole new groups of high-risk patients who should receive vaccinations to prevent potentially fatal pneumococcal infections.
“It was a huge amount of work, but it was worth all of it,” Riiska said. “There’s a sense of satisfaction.”
In a break from traditional ways, the University of Massachusetts Dartmouth has discarded the thesis model for nursing graduate students, instead teaming them with local hospitals, clinics and nursing agencies to tackle real problems faced by nurses and ensure the solutions are put to use.
The semester-long “Translating Knowledge to Practice” course at the College of Nursing “embeds” students in the medical community and is unusual in a field of study that in the past has put a lot of emphasis on theoretical research, said Sharon Sousa, associate professor in community nursing at UMass Dartmouth.
Before, students “had to be put through the mill before they could get their degree,” Sousa said. “Now they love it. They’re able to do things they wouldn’t be able to do otherwise.”
The strength of the program, which is about to start its sixth semester, is the relationships the school has with medical facilities in the surrounding area, according to UMass-Dartmouth nursing professor Nancy Dluhy.
“We have a lot of relationships to draw on,” she said. “We’re the only game in town.”
Projects have ranged from educating the public about the importance of colonoscopy screenings in conjunction with the American Cancer Society to teaching asthmatic patients at the Greater New Bedford Health Center about the proper use of nebulizers.
A “Back to Sleep” project at Charlton emphasized to parents and the medical staff the importance of placing babies on their backs to sleep rather than on their stomachs. Research shows that the practice reduces the occurrence of sudden infant death syndrome.
The students’ work will now expand from Charlton to St. Luke’s Hospital and Tobey Hospital, according to Karen Pehrson, psychiatric clinical nurse specialist for Southcoast Hospitals, which operates all three facilities.
Another project, in conjunction with the Visiting Nurses Association of Southeastern Massachusetts, had students identifying which combinations of medications increase the likelihood of a fall by an elderly person.
The students developed plastic reference cards for visiting nurses listing medications that are problematic at certain dosage levels.
These projects are quite different from a traditional master’s degree project, UMass faculty members said.
Researching and writing a thesis paper was more hypothetical than practical, Dluhy said, using an example of one thesis that developed ways to diminish smoking in young women.
“There were a lot of what-if strategies, but it didn’t take into account real issues,” she said. “The ideas are wonderful, but it didn’t change smoking one bit among women in the region because it didn’t get past my eyes.”
In contrast to working alone on a paper, nursing graduate students at UMass work in teams of three or four, and collaborate with another team of leaders at their assigned medical facility. “They learn the importance of teamwork,” Dluhy said. “You can’t accomplish anything on your own.”
Students also get a lesson on leadership, too, and on how to deal with reluctant staff members, get them to “buy in” to the changes, and make those changes stick. “Change is painful,” Sousa said. “They’re learning the best way to work with people to move an organization.”
They may be students, but most in the two-year master’s degree program are working in the field while studying for their advanced degree. Graduate students must have a bachelor’s degree and at least one year of work experience. Some have decades on the job.
With an advanced degree in hand, graduate students are eligible to become adult nurse practitioners, a mid-level medical position in which they can treat some conditions and prescribe medications.
In Riiska’s case, she worked with fellow students Linda Adelberg and Theresa Souza and teamed with pulmonary nurse leaders at Charlton to examine the way the pneumococcal vaccinations were administered.
Before the project, Riiska said, nurses dispensing the vaccine focused on a population over age 65, but the students’ research showed that many under 65 are also susceptible to pneumococcal infections, including those with chronic heart or lung problems.
The students collected all available scientific data on the pneumococcal vaccine and on the disease itself – “a really big job.” Riiska said. Then they used those findings to push for revisions to the way patients were screened for the pneumococcal vaccine.
Also, the students identified their “champions,” members of the staff who could ensure that those changes would be sustained even after the project was over.
The students, along with the nurse leaders, went so far as to develop a “train the trainer” program for the hospital’s resource nurses, so they could properly disseminate the protocol revisions to the staff. “We wanted to make sure it got to the bedside nurses,” Riiska said.
For student Linda Adelberg, the project was a refreshing change.
“We write so many papers; sometimes it seems like we write too many papers,” she said. “This experience was real world. It was much more valuable.” •