Role of the Nurse Educator in the 21st Century. Emphasis on Student Learning. Promotion of Evidence-Based Practice. Emphasis on Authentic Student-Teacher Relationships
Role of the Nurse Educator in the 21st Century: Nursing As A Career
Role of the Nurse Educator in the 21st Century
There are many national reports indicating the need for change in health care and in the education of health-care professionals in particular. In its report entitled crossing the Quality Chasm: A New Health System for the 21st Century, the Institute of Medicine (IOM, 2001) acknowledges that the education of health professionals is in need of major change and asserts that the clinical education of health professionals is outdated and not responsive to the present or future needs in health care.
As its guiding vision, the IOM (2003) makes the recommendation that health professionals should be educated to deliver patient-centered care within an interdisciplinary team that emphasizes evidence-based practice, quality improvement approaches, and informatics. Furthermore, the IOM (2003) recommends that all health professionals should have core competencies that are shared across disciplines in order to improve the quality of patient care.
This backdrop of needed change will serve as the starting point for discussions regarding essential attributes needed in nursing education. Emphasis on student learning, promotion of evidence-based practice, and development of authentic student-teacher relationships are those attributes that are foundational to effective teaching.
Emphasis on Student Learning
Over the past decade, American higher education has shifted from a teacher-centered to a student-centered approach (Barr & Tagg, 1995). Such changes are aimed at the development of intellectual inquiry and the promotion of critical thinking attributes necessary to solve problems in a world characterized by escalating ambiguity and complexity.
Understanding and facilitating student learning must be a priority for the nursing educator of the 21st century. In a world where information increases exponentially, “covering content” needs to be replaced with teaching students how to learn both effectively and efficiently. In order to do this, educators need to understand how learning occurs and how to create learning environments in which students become active participants in learning.
In nursing education research, there always has been a greater focus on the outcomes of learning, rather than on understanding the processes involved in teaching (Tanner, 2001). But research aimed at understanding how students learn may result in the development of best practices in teaching. For example, there is some empirical support for the use of concept mapping as a strategy that promotes critical thinking (August-Brady, 2005; Daley, Shaw, Balistrieri, Glasenapp, & Piacentine , 1999).
More educational research is needed to establish a strong evidence base in teaching and learning. In order to facilitate learning, nurse educators must be cognizant of a variety of factors that students bring to the learning setting. Individual student characteristics, such as culture, age, gender, previous educational or life experiences, and socioeconomic factors, influence how they learn. Demographic changes in the student population also require that educators fully understand generational differences in teaching and learning.
For example, a typical classroom may consist of second-degree students or second-career students (Boomers), returning or transfer students who may be in their mid-20s and 30s ( Genexers ) or students who attend college immediately after graduating from high school (Millennials).
The nurse educator of the future needs to be sensitive to a growing array of factors that influence how one learns and must use a variety of pedagogical approaches that meet the needs of this diverse population of student learners. Skillful assessment of student learning outcomes is also needed in order to evaluate how students learn and the degree to which teaching strategies encourage meaningful learning.
Nursing education offers many opportunities for individuals to use their creativity and innovative thinking as they design curricula that prepare nursing students for the complexities of the contemporary health-care environment. Fitzpatrick (2005) suggests that what has been done in nursing education is based on past practices and tradition and not based on research.
A recent survey of nursing students suggests that the content demands of the nursing curricula are so great that little time is left for students to assimilate that content into useful clinical knowledge (Norman, Buerhaus , Donelan, McCloskey, & Dittus, 2005). Del Bueno (2005) supports the assertion that content-laden nursing education curricula may be the root cause of students not being able to translate knowledge learned in the classroom into clinical judgment needed in practice.
Novice nurses are less aware of their thinking and learning processes when compared with experienced nurses (Daley, 1999) and one may question whether the educational programs emphasizing content mastery have allowed students time to process learning. Nurse educators will be challenged to develop newer models of teaching when students are to learn how to be thoughtful, reflective practitioners. This is an area of much needed research in nursing education.
Promotion of Evidence-Based Practice
The primary focus of health-care institutions today is on the provision of quality care within a cost-effective framework. This emphasis on outcomes has led to a national movement requiring evidence-based care. Much work remains to be done, however. Pravikoff , Tanner and Pierce (2005) conducted a survey to determine the readiness of US nurses for evidence-based practice and found that respondents reported a lack of value for research in practice.
The value of research to practice may not have been highlighted in these respondents’ educational programs. The movement toward evidence-based practice requires that educators and practitioners engage in collaborative research. The formation of partnerships between academic institutions and health-care institutions provides opportunities for research and improved practice.
Such endeavors offer exciting opportunities for educators to work with practitioners through research projects designed to assess the evidence base for quality nursing interventions. The nurse educator of the future must form collaborative relationships not only with practicing nurses but also with other members of the health-care team. Fluidity must characterize disciplinary boundaries as all team members seek to provide quality outcomes for health care.
With patient-centered care as its focus, nursing and medicine, for example, need to collaborate in clinical studies in order to improve outcomes of care. Most importantly, nurse educators must role model this behavior for students so that students learn that practice and research coexist and cannot be seen as separate entities. The nurse educator of the future needs to design learning opportunities that are grounded in nursing practice in which students critically evaluate practice from a process and outcome perspectives.
For example, undergraduate students need to experience the process of research that is linked to clinical practice in order to appreciate its central role in shaping practice (August-Brady, 2005). In this way, research becomes meaningfully grounded in practice rather than a theoretical topic unrelated to the practice setting. Evidence-based practice is here to stay and discussions centering on nursing education and nursing practice must be strongly grounded in nursing research.
Emphasis on Authentic Student-Teacher Relationships
Historically, teachers derive much satisfaction from working with students. Nurse educators often have a passion for teaching students and are privileged to be able to influence the professional and personal development of students. Hence, most educators stay in nursing education because of the rewards involved in seeing students learn and grow into their nursing identity.
There is mounting evidence to suggest that a thoughtful student-teacher relationship is essential for students to develop and grow. A move from a behaviorist approach to the humanistic approach in nursing education began in the late 1980s with the landmark work of Bevis and Watson (1989). The traditional behaviorist model viewed students as empty vesicles who were eager to receive knowledge transmitted from the teacher.
The humanistic approach recognizes that students have their own experiences that enrich learning while also viewing the student as a participant in learning. Since that time, others have carefully examined the centrality of the student-teacher connection in promoting learning. Gillespie (2002) found that a connected student- teacher relationship allowed students to focus on not only learning, the development of clinical judgment, communication and organizational abilities, and the ability to synthesize and use nursing knowledge, but also fostered the development of students’ professional identity.
Diekelmann (2001) suggests “knowing and connecting” and “creating places: keeping open a future of possibilities” as central experiences for teachers and learners (p. 57). Connecting with students and knowing them as individuals is central to effective teaching and learning. What does this mounting evidence on student-centered an approaches to teaching and learning suggest to aspiring nurse educators?
The current research suggests that learning and student development are promoted through strategies aimed at getting to know students and connecting to students through more thoughtful, concerted means. Gillespie (2005) asserts that a connected student-teacher relationship is characterized by the teacher nursing with students so that students “experience self-confirmation of their existing capacities and, prompted by the example of the clinical teacher, become aware of potential capacities” ( p. 215).
When investigating student perceptions of effective and ineffective clinical instructors, Tang, Chou, and Chiang (2005) found that students perceived that the most effective clinical instructors were those having strong interpersonal relationships with students and rated “solves problems with students” as the highestrated item within that category (p. 190). This would suggest that working together with students and role modeling professional behaviors are powerful determinants of effective teaching.
The nurse educator of the future will need to establish authentic relationships with students grounded in mutual trust and respect so that students gain the self-confidence to achieve their potential. The humanistic paradigm offers opportunities to relate to students as mentors and role models rather than primarily as evaluators. Such an approach is necessary in order to educate a student population that is far more heterogeneous than in past decades.
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