1. Tenured nursing faculty should
participate in relevant clinical
practice
Opening Position
N. Ritz
NURS 609
2. Introduction
“Universities are the wellspring of knowledge and understanding. And as
long as scholars are free to pursue the truth, wherever it may lead, there
will surely continue to be a flow of new scientific knowledge” (Vannevar
Bush, as cited in Boyer, 1992).
•Nursing is a science rooted in praxis and committed to meeting the
health needs of Canadians while schools of nursing are the gatekeepers
of this scholarship (Bosold & Darnell, 2012; Gazza, 2009).
•However, several scholars are questioning why the role of tenured
nursing faculty would be any different than the role of front-line nurses
(Bosold & Darnell, 2012). If research is the key element of academic life,
then how can tenured nursing scholars vigorously advance clinical
nursing research if they are not engaged at the bedside (Boyer, 1992)?
Over the next few days, my esteemed opponent and I will present our
differing positions on whether tenured nursing faculty should participate
in relevant clinical practice.
3. Raising the issue
Whether tenured nursing faculty should participate in relevant clinical
practice has been the focus of much debate over the years and continues
to this day to be a contentious topic.
•With the advent of shifting nursing education from hospitals to the
tertiary sectors such as colleges and universities (McFarland, 2003, p.
257; Elliott & Wall, 2008; Newland & Truglio-Londrigan, 2003), many
postulate a theory-practice gap is ostensible (Andrew et al., 2010; Billings
& Kowalski, 2006; Diem et al., 2004; Dracup, 2004; Elliott & Wall, 2008;
Krafft, 1998; Kramer, Polifroni & Organek, 1986; Little & Milliken, 2007;
Sherwen, 1998).
•As some suggest, it would appear that nursing faculty has lost touch
with the “real” world of nursing (Andrew et al., 2010; Dracup, 2004; Krafft,
1998; Little & Milliken, 2007) as they seem to have been assimilated into
academic life driven by aspirations of promotion, faculty tenure and
dreams of recognition and respect from their peers (Blair, 2005; Bosold &
Darnell, 2012; Sherwen, 1998).
4. Theory-Practice gap – a bad thing?
Many would ask “Is the theory-practice gap a bad thing?”
•I concur with Haigh (2008) when she suggested a theory-practice gap is
rather healthy as it implies that a discipline such as nursing is changing
and evolving therefore new theories and techniques are constantly being
developed revolutionizing how we provide nursing care. This is indicative
of a vibrant, dynamic profession who is challenging the status quo and
moving forward (Haigh, 2008).
•However, this also means that tenured nursing scholars must remain the
gatekeepers of nursing scholarship and bridge the theory-practice gap to
ultimately eliminate the fragmentation that currently exists between
theory and praxis (Billings & Kowalski, 2006). To do so, tenured nursing
faculty must be engaged in clinical practice (Blair, 2005; Elliott & Wall,
2008; Krafft, 1998).
5. Clinical practice … good or bad?
My esteemed opponent will undoubtedly posit that in light of demanding
expectations associated with academic life of tenured nursing faculty,
most universities do not recognize clinical practice as a mandatory
requirement to secure and maintain one’s tenure (Blair, 2005; Bosold &
Darnell, 2012; Dracup, 2004; Elliott & Wall, 2008; Newland & Truglio-
Londrigan, 2003; Paskiewicz, 2003; Sherwen, 1998).
However, I counter, that if nursing is a profession fundamentally based
on practice, and if nursing scholars are responsible to research nursing
practice … then let me ask you, members of the audience, how can they
do so without engaging in clinical practice? How can they propose
evidence-based practice (EBP) if they are not engaged at the bedside?
6. Clinical practice is beneficial
Granted, clinical practice is demanding and consumes valuable time that
might otherwise be dedicated to teaching and publishing one’s research
(Krafft, 1998), but there are a number of benefits also associated with
clinical practice that ultimately enhances nursing scholarship.
Perks might include:
a) enriched teaching with the advantage of contemporary clinical examples;
b) generation of clinical nursing research theories;
c) improved faculty credibility with students and staff;
d) heightened understanding of contemporary nursing conditions;
e) offers logical foundations for curriculum content;
f) recommends EBP nursing care for Canadians;
g) extends opportunities to shape nursing praxis and its application;
h) promotes currency in clinical proficiencies;
i) offers a living laboratory to analyse theory in practice; and,
j) provides for some personal job satisfaction (Blair, 2005; Kramer et al.,
1986; Lang & Evans, 2004; Lent-Becker et al., 2007; Newland & Truglio-
Londrigan, 2003).
7. Bringing reality to the classroom
There is a need to bring reality to the classroom to reflect contemporary
nursing practice (Andrew et al., 2010).
•Proficiency to elucidate theoretical paradigms by illustrating them with
real narratives of patients and circumstances that mirror modern clinical
encounters can shift what students may construe as ideals into lasting
influences (Bosold & Darnell, 2012; Elliott & Wall, 2008; Kramer et al.,
1986; Little & Milliken, 2007; Newland & Truglio-Londrigan, 2003).
•To bridge the theory-practice gap, bringing reality to the classroom,
grants faculty the ability to dissipate academic “ivory tower” perceptions
held by students and nurses (Andrew et al., 2010).
•Linking with reality affords opportunity for faculty to convey their
intelligence to nursing curriculum and conceivably modify teaching
policies within nursing programs (Bosold & Darnell, 2012; Elliott & Wall,
2008).
•Nursing theory is studied, understood, and applied synergistically
(Kramer et al., 1986).
8. Relevant nursing clinical research
• With emphasis on EBP, practice settings can become mediums for
clinical research whereby tenured nurse faculty can substantiate
nursing process effectiveness; assess new learning concepts and
nursing theories (Blair, 2005); and, inspire nursing staff to engage in
clinical nursing research (Elliott & Wall, 2008).
• Clinical settings offer fertile backdrops to monitor perceived theory-
practice gaps and facilitate quality patient care through EBP
implementation (Bosold & Darnell, 2012).
• Essentially, practice settings become a “living laboratory” for EBP
advancement and refinement (Bosold & Darnell, 2012).
• Testing clinical nursing research breakthroughs can result in instant
application of these breakthroughs in clinical praxis, and ultimately
dispel perceptions of academic “ivory towers” (Paskiewicz, 2003).
So let me ask you this … if faculty is not involved in current nursing
practice, how can they validate the effectiveness and validity of EBPs?
9. Credibility – student’s point of view
• Regardless of didactic motivations for nurse faculty to participate in
clinical practice, students anticipate getting value for their money
(Elliott & Wall, 2008; Krafft, 1998).
• Expectancy for expert edification in the classroom in return for time
and money spent is consequently high (Elliott & Wall, 2012).
• Credibility from students’ standpoint incorporates wisdom and
capacity to relate to or operationalize wisdom (Blair, 2005; Bosold &
Darnell, 2012; Little & Milliken, 2007).
• Proficient nurse educators in “practic[ing] what they preach” are
considered credible leaders, remarkable tutors, and compassionate
peers (Bosold & Darnell, 2012).
• While students may not witness faculty practice they perceive values
this practice has on: staff and staff-faculty interactions; patients and
patient care; faculty-generated nursing care plans; and nurse-
physician rapports (Kramer et al., 1986).
Students know if faculty practices and in their eyes those who practice
are saying “nursing is ok” (Kramer et al., 1986).
10. Credibility – staff’s point of view
• Visibility in clinical settings fosters credibility of faculty members and
presents openings to keep in touch with political moods and
administrative concerns (Fisher, 2005).
• Nursing staff, physicians and managers are most apt to relate to
practicing faculty as greater credibility and competency is associated
with practice (Kramer et al., 1986).
• Consequently, clinical staff are more amenable to facilitate clinical
student placements (Kramer et al., 1986).
• Collaborative clinical nursing research projects nurture a valuable
pragmatic culture of learning for both clinical staff and students
(Billings & Kowalski, 2006; Sherwen, 1998) and, facilitates curriculum
alignment with clinical needs (Diem et al., 2004; Krafft, 1998).
As most schools of nursing strive to be recognized as credible agents of
scholarship, doesn’t faculty practice seem like a viable option?
11. Being in the know
• Nursing scholars must consider revising policies and procedures
conceived during a period of nursing surplus for a period of nursing
shortage (Villeneuve & MacDonald, 2006, p. 78).
• By 2020, two-thirds (2/3) of nurses will be employed in community
settings (Villeneuve & MacDonald, 2006, p. 98).
• Nursing scholarship embodies an array of academic and innovative
activities that incorporate creation, authentication, synthesis, and/or
application of intelligence to advance the edification, research and
praxis of nursing (Laryea et al., 2006).
12. Being in the know
Let me ask you … if faculty is not engaged in community practice,
1.Are they prepared to flip the curriculum from acute to community care?
2.How will they modify curriculum contents to reflect nursing realities?
3.Will they be able to negotiate clinical placement opportunities for the
next generation of nurses?
13. Nursing care proficiency
• Nursing faculty agree clinical praxis is an integral part of their
mentoring and educator roles, therefore as today’s healthcare systems
are forever changing and students demand competent mentors,
maintaining competency is critical (Bosold & Darnell, 2012; Dracup,
2004; Kramer et al., 1986; NONPF as cited in Blair, 2005).
• Although faculty is familiar with the curriculum, can situate learning
experiences and promote student learning (Diem et al., 2004), not
maintaining nursing skills competency can pose serious professional
and ethical challenges when teaching nursing theory and safe clinical
praxis (Milliken & Little, 2007).
• Ultimately, Canadians receive better care when nursing faculty model
nursing skills proficiently and competently for the next generation of
nurses (Bosold & Darnell, 2012).
14. Personal job satisfaction
A few anecdotes:
“I had a long, critical look over the edge of theory-practice gap and saw
where and why some places were better for bridge-building than others.
Most satisfying was the chance to really nurse again and discover that I
still had a passion for providing quality client care. My respect for nurses
in clinical practice grew tremendously and they also expressed their
appreciation of my efforts to truly understand their challenges” (Maureen,
as cited in Little & Milliken, 2007).
“In the classroom, I can enliven discussion and illustrate theoretical
concepts with my new stories, however, when teaching students in acute
care practice, I am able to collaborate with experienced nurses to teach
the nuances of their context-specific knowledge and skills” (Jane, as
cited in Little and Milliken, 2007).
15. Counterpoints …
I suspect my esteemed opponent will present the following views:
1.Canadian Association of Schools of Nursing (CASN) sustains nurse
scholars are not responsible to every facet of scholarship however each
school of nursing is.
2.Tenured faculty’s role is to work in partnership with and mentor
clinically credible partners to engender innovative theoretical and
practical advances and not to be engaged clinical praxis.
3.There are multiple ways of remaining current without engaging in
clinical praxis.
4.Universities does not place equal value on clinical practice therefore it
is not mandatory to maintain tenure.
5.Part-time faculty and preceptors are current in nursing praxis and
responsible for student clinical placements.
6.The theory-practice gap is at the front-line level where staff have not
maintained theoretical currency, not at the academic level.
16. Counterpoints …
7. There are too many competing priorities and no time to engage in
clinical practice.
8. The primary focus is teaching therefore nursing faculty’s praxis is
that of teaching the fundamentals of nursing and not expert levels of
nursing.
9. Being engaged in clinical praxis does not necessarily mean
knowledge transfer will occur in the classroom nor does it mean new
knowledge and competency will incur.
10. It is unrealistic to expect tenured faculty to keep up with rapidly
changing healthcare.
17. In my defense …
Some of you are engaged in both clinical praxis and teaching nursing
students whether it is as part-time sessional teachers or as preceptors. A
few of you may aspire to pursue faculty tenure and in order to do so you
will be unavoidably sucked into academia whereby nursing clinical
practice is not considered an asset to promotion and tenure.
As you have so patiently sifted through this presentation, some will agree
with my esteemed opponent that tenured faculty should not be required
to engage in relevant clinical practice. At a minimum, all nursing faculty
staff are graduates, while most have a doctorate degree. Being
considered experts, their primary focus is teaching, curriculum
development, research and publishing, not clinical practice.
However, I ask you, at which point in time, does one lose nursing clinical
competency? And once lost, is there not a dissonance between theory
and practice?
18. In my defense …
Some of you may argue that there are multiple ways of remaining current.
Many will argue that reading peer-reviewed research literature, attending
conferences and perhaps even attending refresher courses are effective
ways of remaining current.
However, if every nurse scholar decided to just “read about it”, who will
generate the “new” stuff? Do we not owe future generations of nurses
vigorous clinical nursing research to guide their practice?
After all, nursing care is shifting to the community. Is your curriculum
able to accommodate the learning needs of the next generation? If you
are not involved in relevant clinical praxis, how will you even know what
the future nursing trends are and how will you address them?
19. In conclusion…
I leave you with the following message,
“Faculty who are not actively and concurrently involved in
practice cannot and do not model the nurse role; they can effectively
model only the teacher and person roles, while faculty who practice
do model all three (nurse role, teacher role and person role)” (Kramer
et al., 1986).
As a faculty member, would you not aspire to model all that you can be?
Thank You!
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