Nurse Educators: Emerging from the Podium

Delivering a stellar product of exceptionally trained professional nurses is the primary focus in nursing education. The type of learning required for nursing students is an integration of working knowledge and a hand’s on application of theory in a realistic environment (Daly, 2001).

Healthcare Simulation is now an instrumental teaching tool that provides additional support and bridges the gaps in nursing practice. Nursing education has traditionally utilized low-level simulation such as synthetic man-made models and mannequins to edify knowledge related to nursing care or to acquire a certain skill set. However, technological advancements now allow sophisticated mannequin simulators to mimic human conditions and disease states as closely as possible, which allows nursing students to explore a spectrum of patient-nurse dynamics within a safe environment (Rauen, 2004). These experiences may range from basic postoperative hip scenario to a more complicated scenario such as Adult Respiratory Distress Syndrome.

Nursing education is not exempt from the forces of change and the charge presented to today’s Nursing Educator is not just the vital need, but also a requirement to seek out opportunities to refine nursing skills and develop strategies to assess and maintain competencies for nursing professionals at a novice and/or expert level (Morton, 1997). The primary responsibility for all nursing professionals, as patient advocates, is delivering safe, effective, and prudent care.

Innovation and an infusion of new thought are essential to direct nursing education to a greater level of excellence. This will demand active reflection of current modalities, fresh ideas and integration of traditional theories with the newest technologies and methodologies.

Nursing Education

Nursing education encompasses a similar format developed over 40 years ago: an introduction to formal theory supported by a clinical practicum. It includes classroom instruction and clinical experience in hospitals and other health care institutions. Training consists of mandatory didactic and lecture component related to nursing theories combined with a clinical lab to acquire and build upon development of clinical skills (Carnegie, 1986). Each student is exposed to adult, pediatric, family health and psychiatric nursing in the classroom setting, combined with clinical time in a corresponding hospital setting.

Students are expected to master both nursing theory and practical skills. Proficiency of the subject matter is measured with exams and students receive a pass or fail for their practical clinical skills. Students are required to obtain competency in select task-oriented skills to gain confidence and proficiency of a particular task. After successful completion of nursing curriculum, the students sit for the National Council for Licensure Examination (NCLEX) so that they may finally obtain licensure from their respective state boards of nursing and apply their gained knowledge (theory and skills) in the real world work setting (Daniels, 2004).

Classroom of the Future

Developing and honing critical skills requires ingenuity and an innovative environment. Today’s educational training stresses the importance of engaged learning, psychological safety, and constructive feedback. The traditional style of healthcare training, such as, teach one-do one, miss golden opportunities for student growth. The student’s ability to gain knowledge and critical thinking skills can expand innumerably with experiential and immersive encounters (Logan & Conner, 2007).

Employing multiple teaching methods requires the nurse educator to step outside of the podium and create an interactive lecture. Medical Education & Research Institute (MERI) Medical Simulation Center of Excellence, a not-for profit training school in Memphis, Tennessee, emphasizes hands-on training with a mix of teaching modalities. These methods include the use of task trainers, fresh frozen anatomical specimens for anatomy/procedural labs, and human patient simulators.

Students are immersed in an enriched learning environment that engages the student with a combination of curiosity, feedback, and novelty. A traditional lecture (educational session) is utilized as a foundational basis but does not comprise the entire classroom time. For example, emergency preparedness and managing difficult airways are such courses conducted at MERI that permit the use of task trainers, anatomy, and simulation as the primary methodologies.

Overviews of anatomical structures allow healthcare providers to understand the importance of landmarks, procedures, and placement of clinical equipment. Participants are encouraged to practice technique and special skills until a level of comfort and confidence is attained. Certain skills lend themselves to task trainers and others to anatomical specimens, depending on the level of expertise.  However, training does not cease at demonstration of skills set. Perfecting the ability to apply that particular skill set under less than optimal condition is the primary objective. Behavioral, cognitive and technical domains are then observed and recorded during the simulated encounter to determine true understanding of concepts. Evaluation of simulated clinical experience is then discussed during debriefing period.

Clinical judgment, critical thinking, technical skills, teamwork, healthcare reasoning, and communication are some areas that are illuminated during the open dialogue with participants and content/method experts.

Conclusion

In the traditional classroom setting, the educator stands behind the podium presenting information to the students. The challenge for the profession of Nurse Educators is to ask the question, “Can the student transfer the acquired information that I have provided into their practice and lend a positive outcome for the patient?” This entails creating a transformational model that encompasses all learning styles with the understanding that more than the grade matters. The most important initiative is that the student fully comprehends key concepts and is able to utilize them in the clinical practice setting. Ultimately, the aim of an educator is to inspire healthcare professionals to seize the opportunity to enhance patient safety and impact the profession of nursing.

References

Benner P., (2001). From novice to expert: excellence and power in clinical nursing practice.  Menlo Park, California: Addison-Wesley Publication.

Carnegie M. E., (1986). The path we tread: blacks in nursing, 1854-1984. Philadelphia: J. B. Lippincott Company.

Daniels R., (2004). Nursing fundamentals: caring & clinical decision making. Clifton Park, New York: Delmar Learning.

Durham C. F. & Alden K.R., (2008). Enhancing patient safety in nursing education through patient simulation. Patient Safety and Quality: An Evidence-Based Handbook for Nurses, 6(3), 221-250.

 Logan Z., & Conner E., (2007).  Stepping out of the classroom: simulate to educate. Patient Safety & Quality HealthCare, 1-6.

About the Author: Shirley R. Brown, RN, BSN, MSN, Ed. D (c) is a nurse educator with over 17 years experience in the nursing profession.  She has served on a variety of committees for TNA, SSH and other local organizations. Her primary focus is simulation education and inter-professional training for health care professionals.

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