Chapter 3: The Influence of Contemporary Trends on Nursing Education PDF

Chapter 3 The Influence of Contemporary Trends and Issues on Nursing Education Copyright © 2019 by Elsevier, Inc. All rights reserved.  Trends and Issues in Contemporary Nursing Education  Knowledge expansion, use of technology, the Internet  Unlimited information...

Chapter 3 The Influence of Contemporary Trends and Issues on Nursing Education Copyright © 2019 by Elsevier, Inc. All rights reserved.  Trends and Issues in Contemporary Nursing Education  Knowledge expansion, use of technology, the Internet  Unlimited information is available Use of digital technology to guide patient care  Requires more time and skill to navigate the web, even though most students have less time for study Peer-to-peer learning  Faculty revising curriculum and courses  More courses and degree programs delivered online Simulation to evaluate competency  Increase in social media Codes of ethics being developed by employers and professional nursing organizations  Informatics competencies developed ANA QSEN NONPF Copyright © 2019 by Elsevier, Inc. All rights reserved. 2  Trends and Issues in Contemporary Nursing Education (Cont.)  Practice-based competency outcomes  Students (nurses) must achieve the competency outcomes that develop the skills actually needed in practice  Competence in realistic, practice-based outcomes is the target  Outcomes approach is very different for students and teachers  Students must change from memorizing class notes and readings to learning to integrate knowledge, make decisions, and be competent and confident in the abilities contained in course outcomes Copyright © 2019 by Elsevier, Inc. All rights reserved. 3  Trends and Issues in Contemporary Nursing Education (Cont.)  Performance-based learning, assessment methods  Related issues Refocusing responsibility and accountability Shifting students from passive receivers to active learners  Skills required of nurses Assessment Critical thinking Communication Patient teaching Caring Advocacy Copyright © 2019 by Elsevier, Inc. All rights reserved. 4 Trends and Issues in Contemporary Nursing Education (Cont.)  These skills are most effectively learned through activities such as: Problem-based learning Case studies Diverse projects in many community agencies  Evaluation is based on documenting competence Performance-based examinations Developing a structured portfolio  Faculty issues Creating interactive learning strategies Creating performance examinations Copyright © 2019 by Elsevier, Inc. All rights reserved. 5  Trends and Issues in Contemporary Nursing Education (Cont.)  Sociodemographics, cultural diversity, economic, and political changes  Aging population—people living longer  Diverse population Use of traditional practitioners and treatments other than traditional Western medicine Illegal Immigrants  Increasing number of people living in poverty, homeless, and/or uninsured  Disrespect for others  Domestic abuse of women and children  Substance abuse; opioid epidemic  Various forms of violence in homes, schools, and public places  Obesity epidemic  Nontraditional families Copyright © 2019 by Elsevier, Inc. All rights reserved. 6  Trends and Issues in Contemporary Nursing Education (Cont.)  Community-focused, interprofessional approaches  Interprofessional emphasis  Influenced by efforts to reduce health care costs  Shift from “illness care” to “health promotion”  Challenge for faculty to prepare students to care for critically ill patients in acute care, as well as culturally diverse clients in community settings  Global health Copyright © 2019 by Elsevier, Inc. All rights reserved. 7  Trends and Issues in Contemporary Nursing Education (Cont.)  Consumer-oriented care: engagement, safety, and privacy  Shift from “giving care” to “working with” the patient as a member of the health care team  Increased number of medical errors leading to lawsuits have supported the need to insist on competency-based performance examinations in schools of nursing and as part of employer evaluations and accreditation  Ethics and bioethical concerns  Different ways of responding to illness, care providers, and therapies raise ethical issues of who is right and who has the right to prevail Copyright © 2019 by Elsevier, Inc. All rights reserved. 8  Trends and Issues in Contemporary Nursing Education (Cont.)  Diversity in backgrounds conveys diversity in interpretation of behaviors, events, and language  Faculty must teach ethical concepts, use case studies, guide learning experiences, and focus discussions to explore ways of interacting with patients who present behaviors that are very different from the norm  Shortage of nurses and faculty  Trend over past decades  Consequence is medical errors  Current workforce is older, with fewer nurses available  Nursing workforce does not mirror the population Copyright © 2019 by Elsevier, Inc. All rights reserved. 9  Trends and Issues in Contemporary Nursing Education (Cont.)  Disasters, violence, and terrorism  Domestic violence has increased  Violence in the workplace and schools  More mass disasters such as hurricanes, floods, and earthquakes  Nurses need to be prepared to function effectively with other first responders Copyright © 2019 by Elsevier, Inc. All rights reserved. 10  Increasing Professional and Personal Responsibilities  Explosion of new information and technology  Interactive out-of-class learning  New health information technology  Multiple care settings  Increasing responsibilities for aging parents and children  Professional requirements to stay current and pursue professional development  Higher stress related to personal and professional demands  Importance of self-care and “caring communities” Copyright © 2019 by Elsevier, Inc. All rights reserved. 11  Critical Thinking Question 1. A nurse is preparing to talk at a community meeting about current trends that affect nursing and nursing education. Which of the following should be included in this discussion? A. Citizens are living longer, resulting in a shift in nursing practice from community-based care to the acute care setting. B. As our population is becoming more diverse in ethnicity, sexual preference, and how family is defined, ethical decisions are less clear because the values and preferences of the individual who is seeking care must be taken into consideration. C. Fewer individuals are choosing and entering nursing, which is causing a near-crisis situation in terms of the nursing shortage. D. The focus of caring for individuals suffering from domestic violence continues to decrease, with an increase in the need to be competent in biochemical containments in the event of terrorist acts. Copyright © 2019 by Elsevier, Inc. All rights reserved. 12  Major Types of Education Programs  Licensed practical nurse/licensed vocational nurse (LPN/LVN) programs  Shortest programs that prepare students for licensure  LPN/LVN programs are 9-12 months long and focus on technical aspects of nursing care  State boards of nursing set scope of practice in each state  Hospital diploma programs  Length of the program typically 1 to 3 calendar years  Number has drastically declined Copyright © 2019 by Elsevier, Inc. All rights reserved. 13  Major Types of Education Programs (Cont.)  Associate degree programs  Developed in the 1950s to shift nursing education from the vocational and apprenticeship orientation of LPN/LVN and hospital diploma schools to the college environment  Require 2 years of academic study with two semesters of liberal arts and sciences  Today largest percentage of nurses are ADN graduates Copyright © 2019 by Elsevier, Inc. All rights reserved. 14  Major Types of Education Programs (Cont.)  Baccalaureate degree programs  First nursing program in a collegiate setting opened in 1909 at University of Minnesota as a diploma school under the College of Medicine; completion did not result in a college degree  In 1924, Yale University had first separate department of nursing and offered the first BSN degree  BSN programs were developed on the premise that nurses could provide more comprehensive and compassionate care if they had a foundation in the arts and sciences  BSNs require 2 years of arts and sciences, 2 years of nursing course, and completion of 126-136 credits Copyright © 2019 by Elsevier, Inc. All rights reserved. 15  Major Types of Education Programs (Cont.)  Master’s degree nursing programs  Developed because of increasing complexity of health care and need for nurse educators, administrators, and expert clinicians  National and federal recognition of the shortage of master’s- and doctorate-prepared nurses led to increased funding for programs and individual students Health Amendment Act of 1956 provided education funds for RNs to prepare for positions in teaching, supervision, and administration Nurse practice act of 1964 provided construction costs for nursing school buildings, funds for traineeships, and fellowships for nurses to obtain advanced degrees for positions in education, administration, practice, and research Most MSN programs prepare advanced nurse practitioners and clinical specialists Copyright © 2019 by Elsevier, Inc. All rights reserved. 16  Major Types of Education Programs (Cont.)  LACE Report—Model of Regulation  Licensure, accreditation of programs, certification, and education programs  4 APRN roles Nurse anesthetist Nurse midwife Clinical nurse specialist Nurse practitioner Copyright © 2019 by Elsevier, Inc. All rights reserved. 17  Major Types of Education Programs (Cont.)  Clinical nurse leader program  New role  White paper on CNL 2007  2007 AACN began certifying CNL’s  Academic and practice partners are working together to develop academic programs and to integrate CNLs into health care systems  Master’s prepared generalist clinician As of 2014 there were 94 colleges and universities offering CNL programs By August 2014 more than 3000 earned CNL certification Copyright © 2019 by Elsevier, Inc. All rights reserved. 18  Major Types of Education Programs (Cont.)  Types of MSN programs  Most require BSN for admission  Accelerated  Second degree programs (bachelor’s degree in any field)  RN to MSN Copyright © 2019 by Elsevier, Inc. All rights reserved. 19  Major Types of Education Programs (Cont.)  Doctoral degree programs  Undergone major changes during the past four decades  For many years the only program was offered by Teachers College, Columbia University; the first nurse graduated in 1932 with an EdD degree in nursing education  More than 30 years elapsed before doctoral programs in the discipline of nursing were offered, resulting in the doctor of nursing science degree (DNS, DNSc)  By the 1990s, the number of universities offering the EdD degree declined and the number of nursing doctoral degree programs increased to more than 50 Copyright © 2019 by Elsevier, Inc. All rights reserved. 20  Major Types of Education Programs (Cont.)  Two doctoral degree options Doctor of Philosophy (PhD)—for students interested in research and generating new knowledge Doctor of Nursing Practice (DNP)—for students interested in advanced clinical nursing practice and clinical leadership  As of 2016, there were 313 programs AACN position statement —AACN recommended that by 2015 DNP all advanced practice nursing education programs move from the master’s to the doctoral level Copyright © 2019 by Elsevier, Inc. All rights reserved. 21  Flexible Education Mobility and Distance Learning Programs  Distance mobility programs  External degree model  Makes it possible for experienced adult learners to earn one of many degrees, including ADN and BSN, by taking college level examinations or by combining college coursework with specialized standardized and performance examinations without attending class  Known as “classroom without walls” Excelsior College: previously known as the New York Regents College University of Phoenix Online Copyright © 2019 by Elsevier, Inc. All rights reserved. 22  Critical Thinking Question 2. An RN received a diploma as entry into professional nursing. The RN was able to progress to an academic degree by completing an RN-to-BSN program. This progression from diploma preparation to an academic degree is known as: A. performance-based assessment B. educational mobility C. practice-based competency D. continuing education Copyright © 2019 by Elsevier, Inc. All rights reserved. 23  Flexible Education Mobility and Distance Learning Programs (Cont.)  Challenges for students  Access to current technology and the time, money, and ability to use it  Students must have discipline and determination  Career ladder programs  Systems that offer a stepwise progression within a single school Copyright © 2019 by Elsevier, Inc. All rights reserved. 24