Changes in Political Astuteness Following a Graduate Course in Health Systems and Policy

1. Changes in political astuteness following a graduate course in health systems and policy Janet Primomo, PhD, RN jprimomo@u.washington.edu • Findings: • Items with the greatest change included: • knowing the legislative committees that deal with health-related issues • knowing the process by which a bill is introduced in the state legislature • knowing whom to contact for information about health-related issues at the state or local level • knowing 2 issues related to the nursing profession that are currently under discussion at the state or national level. • knowing which elected officials are supportive of nursing. • knowing 2 health-related issues that are currently under discussion at the local, state or national level. • using a governmental, professional nursing or health organization’s website to obtain information • staying abreast of current health issues • knowing the name of one’s state senator • writing, telephoning, emailing or communicating via a website with a policy-maker on a nursing or health issue • Comments from Course Evaluations: • The course helped me to see the bigger picture and forced expansion into an area of nursing and health care I had not previously examined. •  It was helpful to read bills and examine current issues in health care. •  Thinking about policy expanded my understanding of health systems from the hospital, to the city, county, state, country and world. It takes the focus off of my little hospital floor and helped me see outside the "clinical box." •  The course forced me to dig deeper into the political process and opened my eyes to health-related policies and the policy making process. • It helps to understand the system if you want to change it. •  I am more involved in political issues now and will take action. • Discussion: • MN students tended to be only slightly aware of the implications of politics for nursing prior to completing the course. However, all reported being registered to vote and 95% voted in the previous election at baseline. • Following a health policy course, students increased their scores and showed a beginning political astuteness. • Academic course work in health policy significantly increased political astuteness. • Results are consistent with Conger & Johnson (2000), Faulk & Morris (2001), and Rains & Carroll (2000). • Limitations: • 1) Small, convenience sample at one university 2)Reliability and/or validity not yet addressed • Conclusions: • The PAI is an excellent learning tool that raises awareness about the policy process and advocacy. The inventory was useful as an outcome measure for a health policy course in nursing curricula. • Academic preparation in health policy can increase nurses' political astuteness and should be required. “ • Problem:Involvement in health policy is a crucialaspect of the professional nursing role, especially for nurses prepared at the masters level. The AACN Essentials of Masters Education and the PHN Standards of Practice address the importance of policy development and advocacy in curricula and practice. However, nurses tend to unaware of health policy and how to influence it. Little is known about whether students increase their political astuteness, knowledge of health policy, or their involvement in policy advocacy as a result of academic course work. • Political Astuteness encompasses: • Awareness ofhealth care policy issues • Understanding legislative and policy processes • Political skills (ie. knowing who policy makers are and how to communicate with them) • Involvement in the political process (ie.voting; providing testimony; contributing to campaigns; participating in professional organizations) • Purpose of study: To determine if political astuteness changes after students complete a 10-week graduate course in health systems and policy, a required course for all MN students. • Health Care Systems and Health PolicyCourse (3 credits) Content: • Health care organization and financing • Policy and legislative processes • Policy development and +analysis • Policy advocacy • Roles of stakeholders and special interest groups • Guest lecture with nurse legislator or field trip to state capital • Study Instrument: The Political Astuteness Inventory (PAI) was developed by Philip Clark (1981) and published in Mary Jo Drummer Clark’s Community Nursing: Health Care for Today and Tomorrow (1984). The PAI was updated and adapted, with permission, for this study. The PAI is a 40-item structured inventory that takes 10 minutes to complete. Sample items include: “I know the names of my representatives in Washington, DC.,” and “I have written a letter to the editor of a newspaper on a health-related issue.” A total score is calculated by counting the items checked, providing a level of political astuteness (unaware; slightly aware; beginning political astuteness; astute). • Protection ofHuman Subjects: The study was approved by the University of Washington Human Subjects Review Board. • Study Design: 56 MN students enrolled in two required health care systems and policy courses were invited to complete the PAI twice: during the first class and again during the last class. 40 students (71% participation rate) voluntarily participated in the study and submitted both PAI's for this study. Data analysis included descriptive statistics, t-tests and chi-square. • Sample: N=40; demographics based on n=36 • Age groups n/%___ • 20-29 years 3 / 8% • 30-39 years 2 / 6% • 40-49 years 19 / 53% • 50 or more years old 12 / 33% American Public Health Association 134th Annual Meeting Session #4282.0: Tuesday, November 7, 2006 There was a significant increase in political astuteness at the end of the course (M = 23.1, SD = .5.7) as compared to the first class (M =13.6, SD = 5.2), t = - 16.2, df = 39, p =.000. • Basic RN education n/%___ • ADN or Diploma 9 / 25% • BSN 27/ 75% • Years as RN n/%__ • < 5 years 5 / 14% • 5 - 9 years 1 / 3% • 10 - 19 years 14 / 39% • 20 or more years 16 / 44%