Increased aging populationMore people are living longer, and the number of elderly and baby boomers is increasing more rapidlyThis then increases .. Multicultural ethnic diversity which requires increased learning, respect for differences, preferences, customsThis also goes along with Community, faith based projects and service learning projectsThe number of ethnic minorities is expanding throughout the USThe number of families who become uninsured, jobless, homeless and survive in poverty is also increasingAnd The definition of “family” is radically different today as evident in the number of single individuals living with other singles, single-parent households, and same sex couplesThis also leads to the global community as a whole, and globalization health issuesThis economic and political change influences health care delivery and access to clinical experiencesAnd this multidimensional content affects client care and clinical learning sites. How a nurse responds to these multicultural hertiages, traditions, and beliefs about illness and healing may make all the difference in the therapeutic relationship and outcomes of care.
Students must learn to realize the distinct and meaningful differences among peoples, consumers, patients , and their responses to illness, treatments, and caregivers. Separating one’s own personal preferences, values, and traditions from professional care responsibilitiesEffective and compassionate nursing care is dependent on the integration of respect for these individualized differences in learning and care givingSupporting effective nursing through other areas of study: cultural diversity, sociology, psychology, ethics, history and literature.
With this trend, the increasing emphasis is on health of the family as “a whole” and on entire communities and populations.This includes interdisciplinary collaborative learningDiverse alternative health practices with different influences of various culturesA broad scope of nursing and clinical approach, increasing expereinces throughout the community, and a continuum from acute care to health promotion fr hospitals to home to rural and global settingsA community approach requires more planning, travel times, expenses, arrangements; different skills, communications, critical thinking and problem solving strategiesThis requires multiple teachers, preceptors, staff instructors and time constraints.
Consumers have become more assertive about their right to competent and prudent care and their right to privacy of informationAll expect value, quality, individual consideration, attentionThe 2002 HIPPA law mandates protection of an individual’s privacy by health care providers and throughout society which has changed many previously careless and harmful practicesThere are consumer initiative for involvement and protection which balances standards and preferencesMany internet sites, such as Quality Check and Nursinghome compare.gov, are available to inform citizens about many aspects of illness and health care. Increased litigation and medical nursing errors has lead to focus on safe competent patient careThere are now increased requirements for competency-based education and performance assessment in schools of nursing, in annual employment evaluations, and in agency accreditation criteriaAnd lastly, this all leads to increased individual responsibility and accountability for learning and practice for each nurse.
This is related to the multicultural, multiethnic population and thus patients who have different ways of responding to illness, treatment and care providersThis includes..Alternative solutions to ethical dilemmasIssues regarding diverse beliefsGray zones instead of black and white absolutesThis raises ethical issues of who is “right” and who has the “right to decide”This is relevant for freedom of choice and end of life issuesA nurse must Separate personal opinions and professional practice consequences for competenceIntegrate into professional practice acceptance of the individual’s right of choice regarding life and death issues, health care methodsThis can be done through RespectTolerance for patient’s decisions And Ethical competencies
Shortage of staff results in limitations in clinical learning which causesHeavy workloadUsing preceptorsPart time instructorsLess 1:1 help for studnetsConsequences for learning and safetyThere is also a decreasing number of qualified faculty d/t aging and retirementAnd most importantly, students need more, not less clinical learningStudents will have more responsibility for self directed learningStudents will seek more assistanceAnd are required to validate initial and continuing competence
Nurses have always worked in situations emanating from disasters and violence in families and communities. This creates new learning and skills required for major natural disaster eventsThis opens up new program options, new courses and competent skills neededCriminal acts have become more common and violence in society, work and schools has led to safety issues and putting the patient first. After the horrific terror attacks on 9/11, Nurses like all other health care personnel and first responders must become more knowledge and engaged in preparing for and responding to acts of terrorismThis includes more skillsAnd programs for first responders
Nursing is a lifelong learning process to meet professional expectationsThese trends in society, nursing, and academic programs present issues of how to incorporate this additional knowledge into the already crowded program of study. High stress arises from the competing demands of school, home, and meeting competency requirementsSo issues for students include: Knowing how to access and use expansive informationPrioritize learningImplement evidence- based practiceDeal with ethical dilemmas professionallyIncorporate learning to think critically, analytically, and ethical as essential professional skills
Programs were initially developed in the United States in late 1800s in hospitals in cities like Boston, New York, Hartford, and Philadelphia.Started as training programs taught by physicians with several weeks in lengthAs nurses graduate, they began teaching courses from nursing perspective obtain additional education as educators and administratorsFrom this programs went from several weeks, to two or three years.-Peak in 1950s and 1960s, decreases as ADN & BSN programs increased
after WWII (1939-1945) the need for RNs prepared more quickly than the diploma programs was critical.From 2 year Cadet Nurse Corp, educators realized that nurses and others could be prepared in less time and still meet RN licensure and practice requirements.After the wary, Congress made funds available to publicly fund community colleges to offer 2 year associate degree programs in many techincal fields.In addition, military benefits for college tuition allowed thousands of men and women to rise above and earn a college degree.Increasing complexity and expansion of medical care required more and better prepared RNs.Nurse educators began to create a new 2 year associate degree nursing program in community colleges which required college courses in arts and sciences and a more integrated approach to nursing content and clinical learning.
28 monthsBSN programs another first in history of nursing professionEarly nurse leaders believed that nurses provide more comprehensive, compassionate, and competent care when they get a solid foundation in the arts and sciences
In response to increased need for more qualified clinicians, educators, and administrators in nursing the federal government responded with support for development of MSN and BSN programs1960s – 1970s = BSN graduates increased, and need for more qualified clinicians, educators, and administrators in response to the complexity of health care increased.
1. Mount St. Mary’s College<br />NUR 134<br />January 24, 2011<br />MaricrisAldaba<br />Katrina Fuertes<br />Eunice Saul<br />The Influence of Contemporary Trends and Issues on Nursing Education <br />
2. After studying this chapter, the reader will be able to:<br />Integrate knowledge of the 10 current trends and issues in society and health care into a more holistic perception of their influence on nursing, nursing education, students, faculty and practitioners.<br />Integrate the knowledge of current trends and issues into a personal philosophy and plan for ongoing professional development and practice.<br />Differentiate among various types of conventional, mobility, and new nursing education programs and the issues associated with them.<br />Access and evaluate pertinent current information resources related to evolving trends and issues as a component of ongoing professional development.<br />LEARNING OUTCOMES<br />
3. Different authors identify different lists of trends related to nursing education and practice, depending on their experiences and perspectives.<br />Lenburg (2002, 2005) identified 10 trends and issues that influence nursing education which is covered throughout this chapter.<br />Introduction<br />
4. Information overload <br />virtually unlimited global content, <br />projects, and research opportunities<br /> via Internet<br />Identifying current and accurate <br /> information<br />Textbooks rapidly outdated<br />Expanded expectations, limited time, rapid response expected<br />Trend #1: Rapid Knowledge Expansion and Use of Technology and the Internet<br />
5. This ability to access and disseminate unlimited information so rapidly has enormous benefits, but also presents major issues.<br />Benefits include using websites and online journals as learning resources, online methods used by faculty for course examinations and assignments, and help preparing students more effectively for computerized licensure examinations.<br />However, students can easily be distracted by the pursuit of an intriguing web of links they encounter while they search websites to completeassignments, so they must exercise discipline to use it efficiently.<br />Trend #1: Rapid Knowledge Expansion and Use of Technology and the Internet<br />
6. Faculty and students need to work together to promote efficient and effective use of electronic learning and networking; this requires disciplined focus, clear guidelines, and expected outcomes related to assignments to minimize overload and frustration.<br />Learning from the Internet also helps students develop skills in analytic thinking, decision making, and reflective judgment.<br />Trend #1: Rapid Knowledge Expansion and Use of Technology and the Internet<br />
7. This has a powerful influence on nursing education and practice at all levels<br />Lenburg (1999) described competency outcomes as the destination students need to reach and are the measureable results of time and effort spent in learning<br />The outcomes approach requires a mental shift from trying to memorize voluminous readings and class notes to actually learning to think like a nurse, to integrate information in problem solving and decision making and providing competent patient care<br />Trend #2: Practice-based Competency Outcomes and Evidence-based Content<br />
8. This can be very stressful, and students may misunderstand the reason for such achievement standards<br />But by demonstrating competence in each course and the end of the program, students are prepared to meet the competency expectations of nursing practice with more confidence and success.<br />Often when outcome competencies are not required or validated, students and new nurses have a difficult time adjusting to actual practice demands. <br />Nurse internships and longer orientations are now used extensively to help them gain necessary skills and confidence.<br />Trend #2: Practice-based Competency Outcomes and Evidence-based Content<br />
9. Trend #3: Performance-based Competency Learning and Objective Assessment Methods.<br />Trends r/t learning and evaluation in classroom and clinical courses have changed dramatically<br />more interactivity and engagement gradually are replacing faculty lectures designed to cover traditional content<br />Students become overwhelmed with the sheer volume of content required by teachers<br />Practice-based competence requires a different approach. <br />
10. Trend #3: Performance-based Competency Learning and Objective Assessment Methods.<br />Terms used to describe this trend include:active learning, interactive learning, collaborative learning, and competency-based learning.<br />Such a trend means that the roles of teachers and students in the classroom need to change.<br />The teacher is less a “lecturer” and more of facilitator and coach, and the student is more actively accountable and responsible for achieving competence in knowledge and practice skills.<br />
11. Multiple teaching-learning methods include:<br />Interactive group work<br />Collaboration<br />In-class and out-of-class projects<br />Problem-based learning<br />Increasing self-responsibility<br />Accountability for competence<br />Interdisciplinary learning<br />Using electronic devices, media, to access resources<br />Trend #3: Performance-based Competency Learning and Objective Assessment Methods.<br />
12. Trend #3: Performance-based Competency Learning and Objective Assessment Methods.<br />Through such exercises, students learn tomake realistic decisions, collaborate in group process, and manage time and resources.<br />It may cause some anxiety, but performanceexaminations that require 100% accuracy of required critical elements provide more reliable evidence of practice competencies.<br />The increase in reported medical-errors vividly emphasizes the need for more effective validation of performance competence in schools and the workplace.<br />
13. Trend #4: Sociodemographics, Cultrual Diversity, and Economical and Political Change<br />Increased aging population<br />Increasing multicultural, ethnic diversity requires increased learning, respect for differences, preferences, customs<br />Community, faith-based projects, service-learning projects<br /><ul><li> Global community, globalization health issues
14. Economic and political change influences health care delivery and access to clinical experiences
15. Multidimensional content, client care, clinical learning sites</li></li></ul><li>Students must learn to realize the distinct and meaningful differences among peoples, consumers, patients , and their responses to illness, treatments, and caregivers. <br />Separating one’s own personal preferences, values, and traditions from professional care responsibilities<br />Effective and compassionate nursing care is dependent on the integration of respect for these individualized differences in learning and care giving<br />Supporting effective nursing through other areas of study: cultural diversity, sociology, psychology, ethics, history and literature.<br />Cont. Trend #4: Sociodemographics, Cultrual Diversity, and Economical and Political Change<br />
16. The increasing emphasis is on health of the family as “a whole” and on entire communities and populations.<br />Interdisciplinary collaborative learning<br />Diverse alternative health practices, influences of cultures<br />Broad scope of nursing; clinical approach; increasing use of experiences throughout community; continuum from acute care to health promotion from hospitals to home to rural to global settings<br />Requires more planning, travel times, expenses, arrangements; different skills, communications; critical thinking, problem solving strategies<br />Multiple teachers, preceptors, staff instructors, part-time, with varying abilities; time constraints<br />Trend #5: Community-Focused Interdisciplinary Approaches<br />
17. Consumers have become more assertive about their right to competent and prudent care and their right to privacy of information<br />All expect value, quality, individual consideration, attention<br />Consumer initiatives for involvement and protection; balance standards and preferences<br />Increased litigation, medical-nursing errors; focused on safe competent patient care<br />Increased individual responsibility, accountability for learning and practice<br />Trend #6: Consumer-Oriented Care: Engagement, Safety, and Privacy<br />
18. Trend #7: Ethics and Bioethical Concerns<br />This is related to the multicultural, multiethnic population and thus patients who have different ways of responding to illness, treatment and care providers<br />Alternative solutions to ethical dilemmas<br />Issues regarding diverse beliefs<br />Gray zones instead of black and white absolutes<br />Separate personal opinions and professional practice consequences for competence<br />Integrate into professional practice acceptance of the individual’s right of choice regarding life and death issues, health care methods<br />Respect<br />Tolerance for patient’s decisions<br />Ethical competencies for students<br />
19. Shortage of staff results in limitations in clinical learning<br /> heavy workload<br />using preceptors<br />part-time instructors<br />less 1:1 help for students<br />consequences for learning and safety<br />Decreasing number of qualified faculty<br />Aging, retirement<br />Students need more, not less, clinical learning<br />More responsibility for self-directed learning<br />Seeking assistance<br />Required to validate initial and continuing competence<br />Trend #8: Increasing Shortage of Nurses & Faculty<br />
20. New learning, skills required for major natural disaster events<br />new program options, new courses and skills needed<br />Violence in society, workplace, schools > safety issues<br />Preparedness for terrorism<br />Skills<br />Programs for first responders<br />Trend #9: Disasters, Violence & Terrorism<br />
21. Lifelong learning to meet professional expectations<br />High stress from competing demands of school, home, meeting competency requirements<br />Issues for students include:<br />Knowing how to access and use expansive information<br />Prioritize learning<br />Implement evidence- based practice<br />Deal with ethical dilemmas professionally<br />Incorporate learning to think critically, analytically, and ethical as essential professional skills<br />Trend #10: Increasing Professional & Personal Responsibility<br />
23. Licensed Practical or Vocational Program<br /><ul><li>Shortest & most restricted license for nursing
24. Program = 9 – 12 months
25. Institution: high school, hospitals, vocational and proprietary schools.
26. Required to work under supervision of RN
27. Scope of practice focus on technical nursing procedures
28. Basic technical bedside care; hospitals, nursing homes, home care, offices in LPN positions.</li></li></ul><li>Hospital Diploma Programs<br />Oldest and most traditional type of program that prepares RN for license<br />Program = 2-3 years<br />Institution: Hospitals<br />Purpose & Scope: Basic RN positions; hospitals and agency care.<br />
29. Associate Degree Programs<br /><ul><li>Late 1950s, emerged as a response to social, political, and educational changes in society
30. 2 year Cadet Nurse Corp (quicker than hospital diploma)
31. Program = 2 years
32. Institution: Community & Junior College
33. Basic technical care in RN position, primarily in institutions
34. ADN education = “first” by making it possible for all RN programs to be offered in a college setting and for all nurses to earn college degree.</li></li></ul><li>Baccalaureate Degree Nursing Program<br /><ul><li>1924
35. Yale = separate department of nursing whose graduates earned baccalaureate degree (28 months)
36. Western Reserve University = 4 year nursing program
37. BSN programs another first in history of nursing profession
38. Early nurse leaders believed that nurses provide more comprehensive, compassionate, and competent care when they get a solid foundation in the arts and sciences</li></li></ul><li>Baccalaureate Degree Nursing Program<br /><ul><li>Program = 2-4 years (depends on type of option)
39. Institution: Colleges and Universities
40. BSN courses - focus on care of patients with medical, surgical, pediatric, obstetric, and psychiatric conditions.
41. BSN programs – emphasis on family and community and health promotion and illness prevention
42. Other requirement courses: research, management, leadership, statistics</li></li></ul><li>Master’s Degree Nursing Programs<br />Until late 1960s, MSN programs primarily focused on preparing educators and administrators emphasis on clinical practice<br />Designed to prepare advanced nurse practitioners and clinical specialists in array of specialty areas<br />Nurses won battles to change state laws to permit nurse practitioners to write prescriptions, receive reimbursement for care, and operate independent nurse practices and health centers. <br />
44. Clinical Nurse Leader<br /><ul><li>2000 – 2005 AACN = two major task forces
45. 1st = programs require increased focus on arts and sciences, evidence-based practice, and internships
46. 2nd = focus on nurse competencies needed in current and future health care systems to improve patient care and what the “new nurse” role might look like.
47. CNL: oversees care coordination of a distinct group of patients and actively provides direct patient care in complex situations, evaluates patient outcomes, and has the decision-making authority to change care plans when necessary.</li></li></ul><li>Doctoral Programs<br /><ul><li>Three types of doctoral degrees in nursing:
48. Doctor of philosophy (PhD) research
49. DNS or DNSc advanced clinical practice
50. Doctor of nursing (ND) nursing leadership
51. 2000-2006 new clinical doctorate degree: DNP
52. Preparation for contemporary advanced nurse practitioners
53. Viewed as clinical equivilentto research-oriented PhD degree.</li></li></ul><li>Flexible Education, Mobility, and Distance Learning Programs<br /><ul><li>Distance or mobility programs include:
54. LPN or LVN ADN and BSN
55. Diploma and ADN BSN and MSN
56. BSN MSN or doctoral programs
57. With the shortage of nurses and nurse educators some schools are finding ways to streamline RN BSN programs.
58. Escalating nursing shortage and the aging of the current nursing workforce and nurse educators have prompted more schools to offer flexible, mobility options and types of programs.</li></li></ul><li>Flexible Education, Mobility, and Distance Learning Programs<br />Trends and issues that influence nursing education make it even more important to comply with quality standards that emphasize competency for students and graduates<br />Students must have discipline and determination to pursue courses and clinical learning when a teacher is not physically present or accessible<br />
59. Cherry, B., & Jacob S. R. (2008). Contemporary nursing: Issues, trends, & management. St. Louise, Missouri: Mosby Elsevier pp. 43-70 <br />Introduction to Nursing Trends and Issues<br />http://www.youtube.com/watch?v=3VBfH_qEXCs<br />Nursing Trends Video 001<br />http://www.youtube.com/watch?v=7eFdSeLIzAk<br />References<br />