Health care needs innovation to advance health equity and support nurses' specialized skill sets and critical thinking. However, the nursing curricula are structured and programs may not offer student opportunities to learn and acquire skills to design and implement innovative approaches, products, and interventions. Therefore, a large urban Midwestern university's college of nursing (CON) piloted an innovation and design thinking (I&DT) workshop for incoming doctor of nursing practice (DNP) and masters of sustainable peacebuilding (MSP) graduate students. MSP graduates apply systems thinking, conflict analysis, and tools for structural change to complex problems such as food security, homelessness, and health disparities, contributing to social innovation. The purpose of the workshop was to expose incoming graduate students to design thinking1 (DT) and empower them to use creativity and innovation during their graduate program and practice. We present the orientation session, results, and recommendations of this session.

Innovation Workshop Planning

We used the 5e (engagement, exploration, explanation, elaboration, and evaluation) instructional model2 as the guiding pedagogy. The 5e's are designed as an iterative sequence to organize educational sessions, where experiential learning (ie, exploration) occurs before concepts are labeled and defined (ie, explanation). Reflection is also core to the model to link new and existing knowledge and experiences. The objectives of the workshop were for students to (1) develop a flexible mindset and (2) envision themselves as innovators and design thinkers.

We used the I3 (Inquiry, Improvement, and Innovation) Model for Advancing Quality Patient-Centered Care3 as a foundation of the workshop. The model provides an algorithm depicting the interconnected and unique steps of research, quality improvement, and innovation, placing innovation as a strategy to address health care issues with its own methodology. A coaching team of 8 experienced educators and curriculum designers co-facilitated the workshop with the teaching team of 4 faculty members. Forty-two DNP and MSP students participated.

Innovation Workshop Implementation

The session was held in the university's entrepreneurship center, a 24 000-sq ft building with flexible learning spaces, for the 150-minute workshop. The first activity, in a large open learning space, began with a warm-up activity. Students were asked to draw an image of someone sitting next to them without looking at the paper. Then, the same student pair reimagined their partner's transition to graduate school. Their challenge was to reduce their partner's stress during the transition based on perspective gathered through careful listening. This fast-paced activity started with students interviewing each other, framing a more specific and concrete problem statement ("How might we help someone to feel...?"), brainstorming solutions, sketching one idea on paper, and getting immediate feedback from their partner on both the design question and the proposed solution. Students experienced elements of the design process (understanding the problem space and exploring the solution space) and various modes of thinking (convergent, divergent, abductive). Students were engaged in a DT process (empathy, define, ideate, prototype, test),1 followed by the reflection and labeling of the DT concepts.

Next, students moved to the entrepreneurship center's atrium to work in small groups with a coach to approach "big questions" first as designers and then as innovators; for example, "How to empower people to live their healthiest lives?" "What role can technology play to stay healthy in the community?" As designers, the groups first shared their experiences with the challenge using Post-it notes and a large whiteboard. Next, they selected one experience and framed a design question around this experience. Finally, the groups brainstormed ideas and chose one idea that they thought was the most viable, desirable, and feasible to prototype as a solution.

Coaches then prompted the students to "put on innovators hats" and explore turning their ideas into reality. We used the Mission Model Canvas4 as the innovator's framework. First, the coaches assisted the groups to identify the key beneficiaries of the innovation (stakeholders) and value propositions offered by the solution to each stakeholder group (what challenges the idea might solve? or what gains might be provided?). Students then used low-resolution materials (eg, foam, tape, wire) to build a prototype of their solution. For example, to respond to the question, "What role can technology play to stay healthy in the community?" one group designed a wheelchair with sensor technology that reacted to a person falling by deploying airbags to prevent injuries from the fall. Finally, each group paired with another group to demonstrate their solution and gather feedback.

The final phase of the workshop brought everyone together. First, the workshop faculty debriefed with the students to emphasize the connections between innovative- and design-thinking mindsets and skillsets and graduate education. Next, they highlighted why these abilities are critically important for advancing health equity. We also provided examples of how the concepts will surface in their studies. Finally, we administered a reflection survey.

Workshop Reflections

After the workshop, we asked the students to complete a reflection survey. The survey prompts were, Reflecting on the innovation orientation session, I used to think..., now I think..., I liked..., I wish..., and I wonder.... The following are a sample of the students' responses:

I used to think entrepreneurial brainstorming was intimidating, and now I think it's exciting and evokes a lot of curiosity!

I used to think I am not creative at all, and now I think I've got the ability. I just need to nurture it.

I liked how interactive it was and the support we got from the staff, coaches as well as our peers.

I liked how we put multiple minds together to improve outcomes and solutions.

I wish I can continue to practice design thinking in my future work.

I wish I could have more of these pop-ups during my graduate schooling.

I wonder if we can actually make it happen. I also wonder how I can utilize this space and program more often.

I wonder how I can further incorporate entrepreneurship and innovation into my degree and professional journey.

Discussion

We implemented an interprofessional I&DT workshop during the graduate students' orientation day. Through the activities in the workshop, we hope to empower nurses and peacebuilders to become innovators and design thinkers by first raising awareness of the value of a divergent mindset. Familiarizing students with DT terms and processes empowers nurses and peacebuilders to communicate their ideas. Critical to the success of this workshop was the University's Entrepreneurship Center, which provided space and a network for interprofessional collaboration (coaches), flexible instruction, and tools for prototyping.

The students' reflections illustrated their engagement in the workshop and interest in learning more about I&DT methodologies. We strategically placed the workshop during orientation to jump-start their thinking, make interprofessional groups possible, and set the tone of innovation for the graduate programs. Our next steps are to thread I&DT across several DNP courses and to strengthen them in the MSP curriculum.

Conclusion

We believe that nurses and peacebuilders can lead the move toward a just and equitable health care system and society through innovation, creativity, and DT. It is critical for advancing health and health care that graduate students become creative and flexible thinkers. Setting the tone of innovation at the beginning of their graduate studies is an ideal place to start.

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