Nursing  Education Concept By Angela Barron McBride

Who is Angela Barron McBride

    Dr. McBride received her bachelor’s degree in
nursing from Georgetown University, her master’s degree in psychiatric mental
health nursing from Yale University, and her PhD in developmental psychology
from Purdue University. 

    She is a Distinguished Professor and University Dean
Emerita at Indiana University School of Nursing. Dr. McBride has authored 4
books and has contributed to over 40 other books. She has published her work in
over 70 professional journals and in several popular magazines.

    Dr. McBride was given a Distinguished Alumna
Award by Yale University and by Purdue University. She was elected as a Fellow
of the American Academy of Nursing, and a Distinguished Practitioner of the
National Academies of Practice, and was chosen to be a National Kellogg Fellow.

    She received honorary doctorates from the
University of Cincinnati, Eastern Kentucky University, Georgetown University,
Medical College of Ohio, University of Akron, and Purdue University.

Journey to Education

    Dr. Angela Barron McBride has a deep commitment
to facilitating career development of doctoral students and faculty in nursing.
She believes that academic administrators maintain moral authority by
continuing to teach and to publish. She views her relationship with Virginia
Henderson as having a profound influence on her life.

Interest in Teaching

    She doesn’t know that she made a conscious
decision to go into nursing education. When she finished her master’s at Yale, She
was invited to stay on and join the faculty. Her decision to become a teacher was
made for her in some ways because it was a very attractive environment. 

    This was
the decade of the 1960s, when the Yale School of Nursing was taking the lead in
developing clinical research in nursing. Dickoff and James were at Yale writing
about what it meant to be in a practice profession. 

    It was an enormously
stimulating environment. She shared an office with Donna Diers, next door was
Jean Johnson and Rhetaugh Dumas, and Ernestine Wiedenbach and Elizabeth Sharp
were on the other side.

    The initial decision to take the teaching
position was an opportunity that she thought she could not refuse. She worked
full time at the beginning and found academia to be flexible when you had small
children. 

    Yale allowed her to work part time then, and she will always be
grateful that she had interesting part-time work that was career building. So, she
was not overwhelmed with juggling 3,000 things as a new mother. 

    During her last
years at Yale, 1 managed a National Institute of Mental Health (NIMH) grant
focused on development of Psychiatric Nurse Institutes for Graduate Programs in
the Northeast. 

    There were 15 or 16 graduate programs involved in the grant. The
Institutes were designed to take on cutting edge topics in psychiatric nursing.
It was a wonderful opportunity to think through new trends in psychiatric
nursing. Much networking with leaders in that specialty was done during that
time. 

aShe was fortunate to have a facilitation and understanding Department
Chairperson, Rhetaugh Dumas, who was mindful of her career development (She was
the Principal Investigator of the grant imanaged). 

aThe faculty at Yale took
their work very seriously and that really had a transforming effect on me. It
helped her to take her work seriously and to become engaged with new developments
in the field.

Readiness for Teaching

    There was no great push in that environment to
get a doctorate; but there was a great push to do research and to publish. she subsequently
got a doctorate at a Big Ten University and found that environment more
concerned with making sure that you did all the right things on the way to the
doctorate. 

    In some ways the Yale environment had the notion that you were
accomplished and expected you to go forth and do scholarship. It was an
environment full of great expectations that has direct consequences for her thinking
today. 

    She is big on the importance of socialization. We sometimes do not
challenge people enough, simply expect them to perform, and sort of run with
it. Sometimes people surprise you in their capabilities if you stop fretting about
what they can do.

    When she was a master’s student, there was the
option, in addition to your clinical major, to also choose a functional area.
It was possible to combine teaching and research so she took a clinical
research course and a teaching course. 

    The professor in the education course
was an educational psychologist and she was probably his most difficult
student. It was the least good grade she earned in her master’s program because she
found pedagogy extremely boring, and formulaic. She knew learning was not a
formal process. 

    It was engaging people in the possibilities of their field and
in their work. She thinks she might have been too young for that course. 

    She was
still at the level of engaging students, while that course was aimed at the
particulars of putting together a curriculum and lesson plans. she understood
you needed some planning and ought to know what you were doing in class; but she
found the course focused too much on pedagogy and not enough on the meaning of
the subject matter. 

    She must admit that she was a difficult pupil and did not
show good will. What were driving her work were the development of clinical
research and the excitement of the clinical field. So, she found disconnect
between the stilted nature of the pedagogy and the dynamic nature of what we were
teaching. 

    Clinical teaching made use of process recordings and reflective
thinking about what was going on with patients, and that was disconnected. Most
of what the professor said pedagogically equated teaching with lecturing. 

    Even
his model for teaching about teaching was not relevant to how she thought she was
going to teach.

Training For Teaching

    She regards Virginia Henderson as her mentor, but she
did not mentor her in ways currently considered mentoring. A mentor typically
gives you tips, helps you with socialization, gives advice, recommends you for
opportunities, and helps you move to the next level. 

    That was not the way
Virginia Henderson helped me. She helped her because she was open and interested
in young people. She became a friend, saw what She did, and wrote chapter 49
for the last edition of The Principles and Practices of Nursing. 

    We started
working on that at least 8 years before it was in print. To see her
thoroughness and her requirements for scholarship was enlightening. She remembers
giving her her chapter on the pain experience, which was a new chapter in the
book. 

    Previous editions had not focused on that topic, and her master’s study
had been on pain management. She remembers getting the chapter done on time. 

    And while she waited for other chapters to come in, she would regularly say to
me, “Do you want to update it?” she thought she was finished and did not want
to do anything more. 

    She would keep after her to expand her work to include the
latest literature and theories. She came to understand that she was a masterful
individual, and she was the kind of thorough scholar she should aspire to be.

    When she talks about mentoring, she thinks about
it broadly. It is anything from a formal mentoring program to informal
coaching/advising/counseling. She believes one has an obligation to facilitate
the learning of subsequent generations. 

    When a person is in a formal education
program, he/She learns to read the lines. Mentoring and socialization
experiences help one to read between the lines. The latter typically involves information
that is not part of a formal education process. 

    Students and new faculty need
this type of mentoring. Schools of Nursing should be communities of learning,
which means that everyone in that organization is learning and confronting what
they do not know and need to get better at. 

    A learning environment is one that
is nurturing, and helpful in moving its members through key career transitions.
Her belief is that even curmudgeons have an obligation to mentor because that
is part of what it means to be a professional in a community of learning. 

    There
is a whole literature on mentoring that is much more specific and talks about
the components of formal mentoring programs. She believes it is equally
important to encourage all to have a broad commitment to facilitate transitions
and development of new generations.

Developing as A Teacher

    Her first position was as an instructor in
psychiatric mental health nursing, teaching graduate students. She was in her twenties
and what she remembers most vividly was the fact that she had a number of
students who were older than she was. 

    She was concerned about developing her own
authority and style as a teacher, but she was relating to people who had
considerably more life experience. Over time, she did adjust and got over being
self-conscious, sort of the “imposter phenomenon” where you think your
ignorance and ineptness is always on the verge of being exposed. 

    She was
actually the youngest member of the faculty for probably 2 or 3 years. Yale
School of Nursing was then a youthful enterprise and many of us felt like
pioneers; that sense of being in an exciting place went a long way in easing
the awkwardness. 

    In the 1960s, you were unique if you had a master’s degree and
were expected to go forth and do good things. She handled many of her own anxieties
and became part of that overall learning community by just talking to people
who were more experienced than she was. 

    She would stop by and chat with
Virginia Henderson and others who were enlarged in their research. We would
talk about a broad array of things. It was a time of listening to their
thinking. The enrichment of our talks gave her confidence, and a sense of where she
was headed, and where she wanted her students to be headed.

    She would say that her next trans formative period
of change came after she earned a doctorate in developmental psychology, which
complemented her background as a psychiatric nurse.

    She obtained the PhD in 1978 and her first position
afterwards were at Indiana University School of Nursing where she was hired to
develop a doctoral program in psychiatric nursing. She arrived in the fall when
the first doctoral students matriculated. 

    They took core requirements the first
semester, and the first course in the psychiatric nursing major was to begin in
the second semester. She went on to develop all of the 15 credits in
psychiatric-mental health nursing just one semester before teaching them. 

    In
the beginning, she also wound up being the main person delivering those 15
credit hours.Designating a sequence of doctoral courses right
after completing a doctorate was a challenge. 

    The sequence was expected to
prepare students to be able to do a really high quality dissertation in an area
of concern to psychiatric mental health nursing. 

    At that point, she had done a
great deal of broad reading about graduate education and the philosophy of
science. She had already had experience with training grants, because she had
written her own training grant for her doctoral program, which enabled her to get
2 years of support from NIMH. 

    Indiana University had already obtained a training
grant for the doctoral program in psychiatric mental health nursing and she put
the flesh on the bones, which she did with the help of a lot of experts. She has
always been interested in effective people, figuring out how and why they are
effective. 

    She looked at what was good practice in education and psychiatric
nursing, what prepared one to develop a program of research, and then tried to
do a replication.

Give Fifteen Credits of Doctoral Study

    She had definite ideas about what should be
included in the courses. There had been 14 years between when she earned
her master’s degree and doctoral degree. By this time, she had written several
articles and two books and had grantsmanship experiences, so she had been
productive and arrived full of ideas. 

    The most important thing that she kept in
mind in designing the courses was that she did not want any student to get to
the point of dissertation unprepared. No one should ever get to her or his
dissertation and say, “Now, what will she work on?” 

    We would have failed
completely if students were not prepared for the dissertation. So, that was the
driving theme of the 15 credits.

    The first 3-credit course focused on the history
of psychiatric-mental health nursing, current trends, and broad concepts. If a
person was being prepared to be a leader in psychiatric mental health nursing, He/She should be knowledgeable about the past and have a sense of where the
specialty is headed. 

    The main assignment was that the students had to come to
terms with what subject matter they were interested in studying for their
dissertation. They had to do a critical review of the literature in that area,
which could also serve as the literature review part of the dissertation. 

    If
everything went well in that course, students would be well on their way to
completing the first chapter of the dissertation and would have developed the
ability to do a critical review of the literature. Students read articles on
what it meant to do a good critical review. 

    The course sort of loosened up the
student’s thinking in understanding the practice problems that needed to be
addressed.

    In the second 3-credit course, students had to
specify the phenomenon they were going to study, explore it further for key
concepts, and figure out the theoretical underpinnings that would guide their
future work. 

    For example, one student interested in family adaptation to
childhood epilepsy immersed herself in models of family adaptation and attitude
theory because she was interested in how attitudes shaped behaviors and
adaptation.

    In the third 3-credit course, students built on
the work of the previous course and planned 6 credits of internship. The
internship had two aims. 

    Students were expected to implement and evaluate an
intervention, and they were also expected to do some formal pilot work for the
dissertation (eg, testing the validity of an instrument never before used with
this specific patient population). 

    In order to do the pilot work, students had
to go through all the clinical and research clearances, a process which was
both time consuming and a great learning experience.

    After completing these 15 credits, students then
took 9-18 hours of dissertation credit. She is particularly proud of the fact
that all of her dissertation students met her criteria for academic success,
which is that they all presented their work at professional meetings and published
their dissertation findings. 

    At least half of the people whom she advised are
now fellows in the American Academy of Nursing. She is very proud of their
continuing success.

Comfortable As a Teacher

    Early on when she was doing clinical instruction
with students at the Yale Psychiatric Institute, She changed the clinical
experience from a model where the instructor sat waiting for students to have
problems, to one where students managed patients and the instructor helped them
use the resources of the setting in addressing problems. 

    We relied on process
recordings to help students think differently about ways of looking at what people
were saying. The saving grace in both practice and research for her was that she
has always been somewhat logical even before she had great skill. 

    She was good
at sorting out problems and thinking through approaches. When she was a
fledgling teacher, there were no mentoring programs. Today, at least if a
person came to her school, they would have mentoring as a junior faculty member
and access to an array of both research and teaching opportunities.

Challenges 

    Juggling work and family has been a challenge. She
is married with children and grandchildren. For 12% years, she commuted 125
miles round trip. She has not lived and worked in the same community as her husband
for 26 years. 

    And, thankfully, she married to someone who does not think this
is a peculiar thing to do. When asked how she has managed, she cannot offer any
answers. She managed these challenges differently in different decades. 

    She made
different decisions in different decades because it made sense. She could never
have been University Dean of Indiana University School of Nursing with children
still living at home with all the commuting and everything else. 

    During the
intense years of parenting, she held positions that allowed her to set some
boundaries regarding her availability, which was not the case as dean. Juggling
is difficult, but she have also turned that experience into an as set. 

    She probably
does more talks now about career development at different stages than anything
else. In those talks, she reminds the audience that there are no career
opportunities in nursing that you have only once. 

    Nursing is rich with
opportunities. She encourages people to think through the fit between where
they are in their personal lives and where they are career wise. There is no
one right way to handle living with contradictions; one of her books focused on
the contradictions she has experienced as “a married feminist.” 

    I’ve
actually used her own experience with “juggling” as a spring board for
analyzing the growth and development struggles many women encounter, because
these explorations fit with her professional identity as a psychiatric nurse.

Memorable Teaching Moments

    She remembers many awkward moments, but cannot
think of a specific embarrassing situation in the classroom. She can give you
her favorite story of being an after dinner speaker. They wanted her to talk for
an hour, which is not a wise thing to do after dinner. 

    They seated her next to a
man who was head of the Medical Center and who was near retirement. As soon as she
started talking, he started sleeping. His snoring was not modest; it was loud
and sawing. 

    To add to the situation, as he snored, he shifted back and forth
and people were worried that he would fall off the chair. She talked for the
requested hour; the applause at the end woke him up. He said goodbye on leaving
adding, “You know that is the very best talk I’ve ever heard on women’s
health.”

    Another situation was an after dinner speech
honoring a retiring vice president for nursing. It was a good crowd and the
wine flowed. As she talked, people did not stop talking among themselves. 

    There
were times when she would actually say, “ Shhhhhh , they paid her to give this
speech, and if you listen hard some of it is even funny” They would quiet
down, then begin talking again. 

    She kept shortening her remarks to get through
the evening as quickly as possible. Thankfully, wine isn’t served in the
classroom, but evening classes can make for sleepy students!

Rewarding Aspects

    Being University Dean of the Indiana University
School of Nursing provided her with wonderful opportunities to facilitate
teaching, and that has been enormously rewarding, even more so than her personal
success as a teacher. 

    On the Indianapolis campus, we developed a Center for
Teaching and Lifelong Learning, and we established new awards to honor master
teachers and mentors statewide.

    Every time a faculty member or graduate of the
School gets into the American Academy of Nursing or receives some other honor,
it is personal for me. That her colleagues are successful, particularly when
they are honored for their teaching, she find enormously rewarding.     

    Her line
used to be l want everybody in the building to be famous. One of the things she
regularly asked in the annual review of the people who reported to her directly
was. “What can she do to facilitate your career?” her goal was to make
sure faculty had as much career success as possible because that would reflect
on our school, and students would want to attend.

Least Rewarding Aspects

    When she thinks of her whole career, she thinks
the last years of being University Dean were the “least rewarding.” That
was the case because the things that give her the most satisfaction were not as
possible. 

    During the years she served as University Dean, she necessarily
became less engaged in her own field, because her time was taken in representing
the School to the rest of the University and the larger community. 

    Her job was
to keep the resources coming into the School of Nursing by helping the
community understand that the School of Nursing was a treasure and having the
University care about the School. 

    She worked to make sure the President,
Chancellor, and influential people with resources in the community understood
that the School of Nursing was wonderful. So, she was heavily engaged in many
activities that do not have immediate outcomes attached to them, or that do not
provide the pleasure of associating with other nurses. 

    You do a number of
things that are “friend” rising in the hope that friend raising will
eventually lead to fund raising.

Maintaining Excellence

    Keeping up with your field is basic to
maintaining excellence. One way to keep up is to teach. She taught a course
every year that she was University Dean. This was very important because when
you don’t use skills you get scared to use them. 

    One of her policies as
University Dean was to say that no one was 100% in administration. She has seen
people become administrators and do not teach, and then when they leave
administration, they do not have a role in the school. 

    They’ve lost the level
of mastery necessary for teaching. She thinks it is very important, as an
educational administrator, that one retains moral authority. Moral authority is
kept when you continue to do, although not at the same level as other people,
what other people are expected to do. 

    If an administrator is telling faculty to
research, publish, and teach and they never see you do any of that, you really
do lose credibility over time. People believe that you do not walk the talk.
Keeping up with the growing knowledge base and doing presentations and
publications are terribly important. 

    Within 1 year of being at Indiana
University, she became an administrator and was a Department Chair, then
Associate Dean of research, and then University Dean of the school. So, how to
keep up excellence along the way is something she has struggled with

    In the last 2 years of her career in
administration, she got into so many things that keeping up became more
difficult. For a time, she didn’t publish anything professionally, which
bothered her enormously. 

    She did publish “think pieces” in our school’s
magazine, wrote grant proposals, and got increasingly involved in leadership
positions in the community and in the university. She realized that if she worked
all the time, it was getting impossible to do anything that was beyond what she
had to do for the job. 

    That was one reason why she decided to leave
administration. After 23 years of academic administration, she decided that she
wanted to do other things.

    During the majority of those 23 years, she combined
teaching and research in several ways. She developed a Women’s Health course,
which she taught for years. Then she wrote an institutional research training
grant, for which she served as Program Director. 

    We added a course to promote
research socialization and anyone who was on the training grant had to take
this course. She taught it annually for 13 years. 

    The formal goals of the
course were not unlike those of the first course in the psychiatric mental
health nursing program she had earlier developed, but the real goal was to
inure the students to failure. By the end of the course, students knew that
failure was to be expected and dealt with. 

    To be successful in a career, the
student had to learn to become like those sock ‘ emclowns that bounce back up
when you punch them (the “punch” typically is being told that your work
is not yet. the incarnation of perfection). All students were expected to put
together a 3-year statement regarding their research goals. 

    Students regularly
said that to get the degree was their goal. her response was always that if the
only thing we did was to give students a doctorate, we failed. We wanted
additional outcomes along the way. Students also wrote a contract in which they
customized their objectives. 

    If students were at the beginning of a program,
they might decide to do a critical review of literature. Or, this might be the
course where they wrote a grant proposal to obtain funding for their
dissertation research. 

    One of the things students often did was to think
through whether there was something they had done in their doctoral studies
that could be turned into a publishable paper. She urged the class to aim for
outcomes and not just a degree, for example, refereed presentations/publications.

    We even role played job interviews, particularly
the art of self presentation. These days, a leader should have favorite
websites. If you have a research idea and you are going forward to get funding,
you should know the strategic plan of the funding agency you plan to approach. 

    If the National Institute on Aging has priorities, then you as a geriatric
nurse ought to know about those areas. Guest lecturers in her course were
consequently asked to talk about their favorite websites. Related to that, she have
found it to be effective in teaching people to handle failure to have guest
lecturers discuss the failures they’ve experienced. 

    Students typically look at
the successful and assume they’ve always been successful. The successful,
however, are people who got a score on a grant application, knew that they had
to redo most of the application as a result of the feedback and they maybe even
received a worse score the next time, and then redid that one too. 

    If you think
anyone who is successful was just successful without hassles. Chances are you
simply do not know them well enough. What doctoral students need to understand
is how really successful people developed a program of study, how they went
about focusing on an area, and how they then worked to become successful over
time.

Advice for Teachers

    There are two pieces of advice she would give.
One is to really confront the notion of who is the “real nurse.” We
still have residual stereotypes that shape the whole field. For example, if you
are not at the bedside, you are assumed not to be a real nurse. 

    Therefore,
someone who is an educator may not be considered to be a real nurse. New
teachers should take this stereo-type and turn it around. What this requires is
to see the connection between what you are doing, that is, teaching, and real
nursing. 

    She used to take great umbrage when somebody would say to her as dean,
“Tell her about when you used to be a real nurse.” She would fluff up her feathers
and go on, at great length, to tell them about the connection between what she was
doing right now and what real nursing was about. 

    There was a direct
relationship between what she was doing and whether there would be a workforce
of prepared nurses in the United States. We are more and more becoming
knowledge workers. 

    New teachers should understand that they are an important
part of mainstream nursing. The second thing is that you never know what
influence you have on students. In a spirited discussion in class, you can have
fun, end the course, and have enjoyed it. 

    In teaching there is a lot of
immediate satisfaction, but there are some satisfactions that you are not
prepared for and they are even more wonderful. What touched her most was when she
was at a professional meeting and a former student told her how she had
influenced her life. 

    This individual had been chatty in class, but did not know
how to develop her ideas in depth. In her final evaluation, she told her she
was a fuzzy thinker. It turned out that she was on drugs, and, at the time,
thought it did not show. 

    The fact that she told her she was a fuzzy thinker
made her realize that it did show, and that was the beginning of her recovery. She
have forever more been empowered to tell people they are fuzzy thinkers when
that is the case. She believes most nurses who are educators have a few stories
like that.