“Adapting Clinical Microsystems as an Evaluation Framework for Community-Based Nursing Education” by Kathleen M. Thies and Lea Ayers

The article entitled “Academic Microsystems: Adapting Clinical Microsystems as an Evaluation Framework for Community-Based Nursing Education” by Kathleen M. Thies, and Lea Ayers discusses and analyzes some major aspects of a partnership between a clinical agency, academic nursing program, and the community. The analysis reflects the above partnership from different points of view, such as the general effectiveness of the collaboration, educational processes, and outcome for the students, as well as student-related results that benefit the community. The article gives a brief overview of the Clinical Microsystems concept. It defines Clinical Microsystem as a group of people that are in a state of constant collaboration to provide a certain subpopulation of patients with quality healthcare and to produce performance outcomes. The work demonstrates a one-year-long five-credit Community Capstone course, as a tool in the framework of which the students are able to assess results and processes for the nursing program and for the community by adapting the Clinical Microsystems model to the Academic Microsystems model.

The article characterizes this course by briefly depicting the cooperation of the students and the nurse mentors in order to evaluate the community population’s healthcare needs, identify its health nursing diagnosis, and generate a corresponding intervention. Later on, these evaluations are implemented and evaluated, and results are presented to the community, together with suggestions for future improvement. Afterward, this initiative is passed on to the next class in order to create a nursing program presence within the community. Thus, this study draws a parallel of common practice structure between the Academic and Community healthcare Microsystems. Providing a brief overview of Microsystems in general this article uses a model of the Clinical Value Compass, which characterizes either individual or aggregate patient information through evaluating pre-intervention and post-intervention patient data. The graphical interpretation of the Clinical Value Compass gives an idea of the student’s educational needs and community’s healthcare service needs, and what activities/direct processes both parties have to go through in order to meet those requirements and obtain satisfaction.

The study indicates the results of the Community Capstone course and proves that this course is an effective stimulus for cooperation between students and the community. It is also revealed that the lack of continuity of this program at one of the community sites caused an increase in participant dissatisfaction, and induced the Microsystem to fall out of its balance. This occurred for the reason of a staffing change at one of the communities, as well as the simultaneous sabbatical year of one of the key faculty members. The above fact proves the collaborative relationship to be of much significance, as when the faculty member had returned from his sabbatical year, the clinical Microsystem regained its stability, and the satisfaction levels of students, faculty, and community were reestablished, which in its turn favored positive relations between the nursing department and the community. The summary stresses the matter of constant nurturing attention within the Microsystem towards direct and indirect processes, so that the students may succeed in their strive to meet the expected academic outcomes, as well as the community, may continuously sustain its initiatives over long periods of time. The outlined model is summarized as being a nursing education evaluation framework, and also a partnership between the community, clinical service agencies, and most of all nursing education. It is highlighted that the use of this model is essential for developing nursing education programs of high performance.


Thies, K. M. & Ayers, L. (2007). Academic Microsystems: Adapting Clinical Microsystems as an Evaluation Framework for Community-Based Nursing Education. Journal of Nursing Education, 46(7), 325-29.