THE AMERICAN EXPERIENCE:A RADICAL TRANSFORMATIONOF NURSING EDUCATION  Molly Sutphen, Ph.D.  OIIQ’s Annual Convention  Octo...
Why the Recent Interest in NursingEducation?   Institute of Medicine and the Robert Wood    Johnson Foundation     Long-...
Institute of Medicine and RWJThe Future of Nursing   Two of the recommendations:     Nurses  should practice to the full...
Why the Recent Interest inNursing Education?   The Carnegie Foundation’s concern about    professions’ civic responsibili...
The Carnegie Preparationfor the Professions Program An integrated, comparative study of  education for professional under...
The Carnegie Preparationfor the Professions Program -Nursing What is needed to prepare nurses? What pedagogies are used?...
The Carnegie Preparation for theProfessions Program - Nursing   Studied all types of pre-licensure    pathways:     Comm...
The Carnegie Preparation for theProfessions Program - Nursing   National surveys of nurse educators and    nursing studen...
Review of Key Findings Uneven and often inadequate teaching of  nursing knowledge Students and faculty feel overloaded  ...
Review of Key Findings   Challenges to teaching and learning:     Limited good clinical placements for student nurses   ...
Review of Key Findings   Pedagogies of being with and responding    to suffering are excellent in clinical    teaching   ...
What Next?   Preserve the strengths and long traditions    in nursing education     Emphasis   on situated learning and ...
What Next?   Recommendations fall into several    categories:     Prerequisites for nursing school     Diversity of stu...
But . . . We need new ways of thinking about  teaching a practice We suggest students, nurses, and faculty  need to shif...
Major Paradigm Shift inNursing Education Shift from a focus on covering decontextualized knowledge                     TO ...
Teaching and LearningNursing Knowledge Catalogues Evidence-based literature searching and  questioning weak Weak across...
Teaching for a Sense of Salience Developing a sense of salience requires  situated learning that is experiential and  gai...
Situated Cognition In any learning situation knowledge  acquisition is necessary but not sufficient Students must learn ...
Situated Learning“Getting students to put the pieces togetherin a way that they can retrieve theinformation later and be a...
Signature Pedagogy: Coaching Draw out what the student or newly  graduated nurse knows in bounded  clinical situations H...
Major Paradigm Shift inNursing Education Shift from a sharp separation of clinical and classroom teaching                 ...
A Problem with SeparatingClinical and Classroom Teaching“Some students are lucky enough to obtaina clinical instructor tha...
Integration   Classroom:     Situatescience, theories, technology and ethics     in practice examples, unfolding cases, ...
Major Paradigm Shift inNursing Education Shift from an emphasis on socialization and role taking               TO An empha...
Formation Formation is an ongoing, lifelong process Every experience contributes to student  formation, from the moment ...
Formation andEthical Comportment Beyond “socialization” Experiential learning that creates new  capacities to “see” and ...
Formation andEthical Comportment   Examples of student nurses’ ethical    concerns:     Meeting  the patient as a person...
Formation“I have had the honor of being present withand learning from clients in intimate,vulnerable, scary situations. I ...
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The American experience : a radical transformation of nursing education

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Congès 2011 | Conférence présentée par :
Molly Stuphen, Ph.D.

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The American experience : a radical transformation of nursing education

  1. 1. THE AMERICAN EXPERIENCE:A RADICAL TRANSFORMATIONOF NURSING EDUCATION Molly Sutphen, Ph.D. OIIQ’s Annual Convention October 25, 2011 Montreal, Canada
  2. 2. Why the Recent Interest in NursingEducation? Institute of Medicine and the Robert Wood Johnson Foundation  Long-standing interest in nursing Northwest Health Foundation  Oregon Consortium for Nursing Education
  3. 3. Institute of Medicine and RWJThe Future of Nursing Two of the recommendations:  Nurses should practice to the full extent of their education and training  Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression
  4. 4. Why the Recent Interest inNursing Education? The Carnegie Foundation’s concern about professions’ civic responsibilities to society rather than on “technical professionalism”  Concern about error in all fields  Concern about civic responsibility
  5. 5. The Carnegie Preparationfor the Professions Program An integrated, comparative study of education for professional understanding, integrity, and practice Clergy; Engineering; Law; Medicine; Nursing; Teaching Nursing and Medicine were the only two studies conducted simultaneously and in deliberate dialogue
  6. 6. The Carnegie Preparationfor the Professions Program -Nursing What is needed to prepare nurses? What pedagogies are used? What are the signature pedagogies in nursing? What can other professions learn from nursing education?
  7. 7. The Carnegie Preparation for theProfessions Program - Nursing Studied all types of pre-licensure pathways:  Community college  Generic baccalaureate  Accelerated baccalaureate  Master’s Entry  Diploma
  8. 8. The Carnegie Preparation for theProfessions Program - Nursing National surveys of nurse educators and nursing students in collaboration with:  National Student Nurses’ Association  National League for Nursing  American Association of Colleges of Nursing Questions on teaching, learning, and transition to practice Questions for students about their experiences learning a practice
  9. 9. Review of Key Findings Uneven and often inadequate teaching of nursing knowledge Students and faculty feel overloaded  Busy work Distinct separation clinical and classroom teaching and learning
  10. 10. Review of Key Findings Challenges to teaching and learning:  Limited good clinical placements for student nurses  Heavy reliance on staff nurses for teaching without mentoring the staff nurses in teaching  Students describe transformative experiences of learning from patients but faculty do not often attend to or extend this rich source of learning
  11. 11. Review of Key Findings Pedagogies of being with and responding to suffering are excellent in clinical teaching  But almost absent in classroom teaching Strong formation of nurses who are committed to the values, goals, attitudes, and behaviors highly prized by the nursing profession
  12. 12. What Next? Preserve the strengths and long traditions in nursing education  Emphasis on situated learning and teaching practical reasoning in nursing Provide more opportunities for nurses and nurse educators to learn from each other
  13. 13. What Next? Recommendations fall into several categories:  Prerequisites for nursing school  Diversity of students and faculty  Enrich the scholarship of teaching and learning  Reorganize the paths for entry to practice  Alleviate the faculty shortage  Better integrate clinical and classroom education
  14. 14. But . . . We need new ways of thinking about teaching a practice We suggest students, nurses, and faculty need to shift their thinking about and approach to nursing education Without these, we will not be able to make change in nursing education
  15. 15. Major Paradigm Shift inNursing Education Shift from a focus on covering decontextualized knowledge TO An emphasis on teaching for a sense of salience, situated cognition, and action in particular situations
  16. 16. Teaching and LearningNursing Knowledge Catalogues Evidence-based literature searching and questioning weak Weak across all schools Too much teaching of testing-taking strategies Almost no interdisciplinary teaching
  17. 17. Teaching for a Sense of Salience Developing a sense of salience requires situated learning that is experiential and gained over time (Lave and Wenger 1991) Nurses work in complex, relatively unstructured clinical situations  Students must learn to quickly recognize and assess what is most and least important, or what is most salient  This is what experienced nurses do
  18. 18. Situated Cognition In any learning situation knowledge acquisition is necessary but not sufficient Students must learn to draw on knowledge from diverse domains to use in particular situations
  19. 19. Situated Learning“Getting students to put the pieces togetherin a way that they can retrieve theinformation later and be able to use iteffectively.”
  20. 20. Signature Pedagogy: Coaching Draw out what the student or newly graduated nurse knows in bounded clinical situations Help explore, make connections, realize what they know and how and why it is relevant to this situation Questions that cue the relevant issues in a situation
  21. 21. Major Paradigm Shift inNursing Education Shift from a sharp separation of clinical and classroom teaching TO Integration of classroom and clinical teaching
  22. 22. A Problem with SeparatingClinical and Classroom Teaching“Some students are lucky enough to obtaina clinical instructor that also teaches thecourse. Then the course objectives andcontent are better facilitated with direct"clinical setting" examples. Example mightbe an instructor teaching, "Remember wetalked about this subject in class ... here is aprime example of that lecture in the clinicalsetting." This exampling solidifies classroomtaught information.”
  23. 23. Integration Classroom:  Situatescience, theories, technology and ethics in practice examples, unfolding cases, case studies, clinical puzzles Clinical, simulation and skills lab:  Situatelearning evidence based nursing practice in care of particular patients
  24. 24. Major Paradigm Shift inNursing Education Shift from an emphasis on socialization and role taking TO An emphasis on formation
  25. 25. Formation Formation is an ongoing, lifelong process Every experience contributes to student formation, from the moment students start school through their entire career The notion honors what students bring to nursing and how nursing changes them
  26. 26. Formation andEthical Comportment Beyond “socialization” Experiential learning that creates new capacities to “see” and to “act” Students imagine ethics as abstract principles, and often do not recognize when their concerns in practice are ethical concerns
  27. 27. Formation andEthical Comportment Examples of student nurses’ ethical concerns:  Meeting the patient as a person  Preserving dignity and personhood of patient  Responding to sub-standard practice  Advocating for patients  Engaging fully in learning to do “good” nursing practice
  28. 28. Formation“I have had the honor of being present withand learning from clients in intimate,vulnerable, scary situations. I get toregularly advocate for the underserved,especially in the hospital setting. I haveaccess to environments I would haveotherwise never been exposed to and havelearned and grown and broadened my worldperspective.”
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