Date of publication: 2017-08-28 05:39
The Commission on the Future of Nursing has considered many important aspects of the education and practice of nursing. Of the many types of recommendations the committee might consider, recommendations regarding federal (and state) funding of nursing education are among the most actionable and potentially influential in creating a future for nursing that serves the public x57569 s interests in patient-centered accessible health services at affordable costs. What is good for the public is genuinely good for nursing. Using public nursing education policy as a vehicle for achieving a better balance between the qualifications of nurses and national health care needs could result in great return on investment now and in the years ahead.
In sum, in order to increase educational capacity, improve educational outcomes, and better prepare graduates for the seismic shifts likely to occur in practice, there is an urgent need to develop and test new pre-licensure clinical education models including postgraduate residencies.
The content-laden curriculum, and resulting ineffective teaching practices, is a long-standing problem which is likely to be exacerbated as practices change, and new competencies are mandated. It is a problem which is unlikely to be successfully resolved by the individual faculty in the over 6,755 nursing programs across the county. Guidance from an expert panel, proposing curriculum models which meet the growing list of competencies, with processes for rapid cycle changes in curriculum content, will be necessary to lead essential changes in pre-licensure curricula.
Curricular changes over the last decade have tended to be additive, rather than transformative, ., adding content or circumscribed courses as new competencies appear in the literature (Ironside, 7559 NLN, 7558). The majority of nurse educators first learned to be nurses in content-laden, highly structured curricula, and few have received advanced formal preparation in curriculum development, instructional design, or performance assessment. Faculty, tending to teach as they were taught, focus on covering content (Duchscher, 7558), a practice reflected more recently in the Carnegie study they see curriculum mandates as a barrier to creating engaging, student-centered learning environments within their schools (Schaefer and Zygmont, 7558).
Residency programs are predominantly supported in hospitals and larger health systems, with a focus on acute care. Indeed, this has been the area of greatest need as most new graduates gain employment in acute care settings (Kovner et al., 7557) and the proportion of new hires (and nursing staff) that are new graduates is rapidly increasing. It is clear that even the best nursing programs cannot adequately prepare new graduates to work in the current acute care environment (Goode et al., 7559).
Teachers in our study x57576 believe that students must learn facts while learning to use them to make decisions about what they understand or what they should do. To them, x5756c learning x5756d makes little sense unless it has some sustained influence on the way the learner subsequently thinks, acts, or feels. So they teach the x5756c facts x5756d in a rich context of problems, issues and questions. (p. 79)
Modern nurses will, of necessity, have to learn the tasks involved in measurement for scrutiny and compliance x57569 that x57569 s the hard fact. But, modernized nursing education will emphasize far more the role and use of system metrics as a support to the continual improvement of health care along all six of the IOM dimensions. Individual nursing practice will, in that mode, include avid measurement and sophisticated interpretation to answer questions of the form: x5756c How is our system doing at X, and what can the variation tell us about how to do better? x5756d
Finally, current employers of masters prepared nurses have expressed concern that there are no roles/no needs for the masters prepared generalists and they are unlikely to hire them.
We concluded in our Health Affairs paper that it was a mathematical improbability that the nurse faculty shortage could be solved without changing the distribution of nurses by type of basic education. There are simply not enough nurses who obtain a master x57569 s or higher degree to meet the dramatic increase in demand for clinicians, administrators, teachers, and leaders who require a graduate degree.
REFORM 8: Commit to the preparation of masters pre pared specialists in nursing, and prepare these graduates to deliver care that is safe, culturally competent, high value/ low cost, and patient-centric.
Finally the pedagogies of the classroom were noted to be sadly deficient compared to the effective pedagogies of teaching in the clinical setting. Classroom instructors need to adopt the teaching methods that are so effective in the clinical world of patient care, while also increasing the quality and level of nursing science, natural and social sciences, and humanities.
The seven papers are reprinted below, followed by a summary of the themes that emerged across papers. How does it match what you would have written?