New Model of Nursing Education Introduction
The evolution of nursing education reflects broader societal changes and advancements in healthcare. This article provides an in-depth historical overview of new models of nursing education, with a focus on the development of associate degree programs, the emergence of controversies surrounding these programs, and the ongoing evolution towards baccalaureate and advanced nursing education. Understanding these historical shifts helps contextualize current practices and future directions in nursing education.
New Models of Nursing Education
The Emergence of Associate Degree Nursing Education
The concept of associate degree nursing education emerged as a response to the nursing shortage following World War II. Isabel Stewart’s observations in 1943 highlighted the need for new educational models in nursing, prompting experimentation with different approaches. One such model was the associate degree program, which gained traction following the Ginzberg Report (1949). This report advocated for a two-year course of study in nursing as a more efficient and economical alternative to traditional four-year programs.
Ginzberg argued that not all nurses required baccalaureate education to deliver competent patient care. He believed that a two-year program could adequately prepare nurses for clinical practice, thus addressing the nursing shortage more effectively. Mildred Montag (1951) further expanded on this concept, proposing that associate degree programs housed in community colleges could produce “semiprofessionals” equipped to meet the demand for nursing care without the extensive training required for baccalaureate-prepared nurses.
Montag’s research in 1959 demonstrated that associate degree nurses performed comparably to their baccalaureate-prepared counterparts in clinical settings. This finding suggested that the associate degree model was effective in preparing nurses for bedside care. Despite the initial success of these programs, some critics argued that the focus on practical skills rather than a broader educational foundation could limit the scope of nursing practice (Smith, 1960; Lewis, 1964). However, the accessibility and affordability of associate degree programs through community colleges marked a significant shift, providing opportunities for individuals who might otherwise be excluded from nursing education (Hassenplug, 1965).
Historical Impact of Associate Degree Nursing Education
The introduction of associate degree programs represented a significant shift in nursing education, aimed at addressing the post-war nursing shortage. These programs provided a practical and cost-effective pathway to becoming a registered nurse, aligning with the growing need for skilled healthcare professionals. By the mid-20th century, associate degree programs had become a prominent feature of nursing education, offering an alternative to the more traditional diploma and baccalaureate programs.
Emerging Controversies in Associate Degree Nursing Education
Despite their advantages, associate degree nursing programs have faced controversies, particularly regarding their role and effectiveness compared to baccalaureate programs. In 1965, the American Nurses Association (ANA) published a position paper advocating for baccalaureate education as the minimum preparation for professional nursing. This stance suggested that associate degree nurses might be less qualified for certain aspects of nursing practice, potentially affecting their professional standing and licensure requirements.
The ANA’s position paper sparked debate about the relative value of different nursing education models. Critics argued that the focus on academic degrees could undermine the contributions of associate degree nurses, despite evidence indicating that their performance in clinical settings was comparable to that of baccalaureate-prepared nurses (Bullough, Bullough, & Soukup, 1983; Bullough & Sparks, 1975). Research in the 2000s began to highlight a correlation between baccalaureate education and improved patient outcomes, leading to a preference for baccalaureate-prepared nurses in some healthcare settings (Graf, 2006).
Nevertheless, associate degree programs remain relevant, particularly in addressing the immediate needs of the nursing workforce. They continue to provide a viable pathway to nursing practice, and mobility programs that facilitate further education for associate degree nurses have gained importance in bridging the gap between different levels of nursing preparation.
Understanding Associate Degree Nursing Education Today
Current Landscape and Challenges
As of recent reports, approximately 52.8 percent of individuals pursuing nursing careers enter associate degree programs (US Department of Health and Human Services Health Resources and Services Administration, 2006). These programs are a practical and accessible option for many aspiring nurses, offering a pathway to becoming a registered nurse while addressing the nursing shortage. ADN and ASN programs emphasize essential nursing skills and competencies, including advocacy, leadership, professional involvement, lifelong learning, and evidence-based practice (National Organization for Associate Degree Nursing [N-OADN], 2006).
Despite their success, associate degree programs face challenges, particularly regarding the low rate of further education among graduates. Only 20.7 percent of associate degree nurses pursue baccalaureate or higher degrees (US Department of Health and Human Services, 2006). This low rate of continuation raises questions about barriers to further education and highlights the need for supportive measures to encourage advanced study among associate degree nurses.
Addressing Barriers to Further Education
Understanding why associate degree nurses may be reluctant to pursue additional degrees is crucial for developing strategies to support their educational advancement. Factors such as financial constraints, work commitments, and limited access to educational opportunities can contribute to the low rates of further education. To address these barriers, nursing education advocates and policymakers must work to provide incentives, resources, and flexible options for associate degree nurses seeking to advance their education and career prospects.
Bachelor of Nursing Education
Historical Context and Evolution
The evolution of baccalaureate nursing education is deeply rooted in the advocacy for higher standards of nursing education. Dr. Richard Olding Beard, a proponent of baccalaureate education, echoed the sentiments of Florence Nightingale, who championed the idea of nursing education occurring outside the hospital setting. Nightingale’s philosophy emphasized a comprehensive educational framework that included theoretical knowledge in subjects such as anatomy, physiology, and public health, coupled with practical training under experienced mentors (Stewart, 1943).
In the early 20th century, the Bellevue School of Nursing in New York adopted Nightingale’s model, marking an initial attempt to integrate nursing education into higher education institutions. Despite facing resistance from proponents of diploma programs, who argued that extensive academic training was unnecessary and that hospitals required immediate service, the push for baccalaureate education continued to gain momentum.
Advocacy for University-Based Nursing Education
The advocacy for university-based nursing education persisted through the efforts of nursing education leaders like Ethel Gordon Bedford Fenwick and Dr. Richard Olding Beard. Fenwick, in 1901, argued for university education for nurses, emphasizing the need for skilled practitioners capable of addressing health issues on a broader scale (Fenwick, 1901). Similarly, Beard’s efforts to establish a nursing program at the University of Minnesota in 1909 represented a significant step towards integrating nursing education into higher education.
Although the early nursing programs at universities resembled diploma programs in some aspects, they laid the groundwork for the eventual transition to baccalaureate education. These efforts reflected a growing recognition of the need for a more comprehensive and academically rigorous approach to nursing education.
The Baccalaureate Model and Its Impact
The shift towards baccalaureate nursing education brought about significant changes in the field. Baccalaureate programs, typically spanning four years, provide a more extensive educational foundation, including coursework in nursing theory, research, and leadership. These programs prepare nurses for a broader range of responsibilities and roles within the healthcare system.
The emphasis on academic education and research in baccalaureate programs has been associated with improved patient outcomes and enhanced professional development. Hospitals and healthcare organizations increasingly prefer to hire baccalaureate-prepared nurses, reflecting a trend towards valuing higher levels of education in nursing practice (Graf, 2006).
Contemporary Trends and Future Directions
As the nursing profession continues to evolve, the role of baccalaureate education remains pivotal. The integration of advanced educational standards into nursing practice aligns with the increasing complexity of healthcare and the demand for highly skilled professionals. Baccalaureate programs are expected to continue playing a critical role in shaping the future of nursing education and practice.
In addition to traditional baccalaureate programs, there is a growing emphasis on accelerated and bridge programs that allow nurses to advance their education efficiently. These programs cater to the needs of working professionals and provide pathways for career advancement while addressing the evolving demands of the healthcare system.
Conclusion
The historical evolution of nursing education reflects a dynamic interplay between practical training and academic preparation. From the early apprenticeship models to the development of associate and baccalaureate degree programs, nursing education has undergone significant changes to meet the demands of a rapidly evolving healthcare landscape.
Associate degree nursing programs emerged as a practical solution to address the post-World War II nursing shortage, providing a viable pathway to becoming a registered nurse. Despite facing controversies and challenges, these programs remain a crucial component of nursing education, offering accessibility and affordability to aspiring nurses.
Baccalaureate nursing education, driven by advocates such as Florence Nightingale and Dr. Richard Olding Beard, represents a shift towards a more comprehensive and academically rigorous approach. The emphasis on higher education in nursing aligns with the increasing complexity of healthcare and the need for skilled professionals capable of addressing diverse patient needs.
As nursing education continues to evolve, it is essential to support and enhance both associate and baccalaureate programs, address barriers to further education, and adapt to the changing demands of the healthcare system. By understanding the historical context and current trends in nursing education, we can better appreciate the diverse pathways available for individuals pursuing careers in nursing and work towards advancing the profession for the benefit of patients and communities.