Mount St. Mary’s College

NUR 134

January 24, 2011

Maricris Aldaba

Katrina Fuertes

Eunice Saul

The Influence of Contemporary Trends and

Issues on Nursing Education

After studying this chapter, the reader will be able to: 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.

Integrate the knowledge of current trends and issues into a personal philosophy and plan for ongoing professional development and practice.

Differentiate among various types of conventional, mobility, and new nursing education programs and the issues associated with them.

Access and evaluate pertinent current information resources related to evolving trends and issues as a component of ongoing professional development.

LEARNING OUTCOMES

Different authors identify different lists of trends related to nursing education and practice, depending on their experiences and perspectives.

Lenburg (2002, 2005) identified 10 trends and issues that influence nursing education which is covered throughout this chapter.

Introduction

Information overload virtually unlimited global content, projects, and research opportunities via Internet

Identifying current and accurate informationTextbooks rapidly outdated

Expanded expectations, limited time, rapid response expected

Trend #1: Rapid Knowledge Expansion and Use of Technology and the Internet

This ability to access and disseminate unlimited information so rapidly has enormous benefits, but also presents major issues.

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.

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.

Trend #1: Rapid Knowledge Expansion and Use of Technology and the Internet

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.

Learning from the Internet also helps students develop skills in analytic thinking, decision making, and reflective judgment.

Trend #1: Rapid Knowledge Expansion and Use of Technology and the Internet

This has a powerful influence on nursing education and practice at all levels

Lenburg (1999) described competency outcomes as the destination students need to reach and are the measureable results of time and effort spent in learning

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

Trend #2: Practice-based Competency Outcomes and Evidence-based Content

This can be very stressful, and students may misunderstand the reason for such achievement standards 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.

Often when outcome competencies are not required or validated, students and new nurses have a difficult time adjusting to actual practice demands. Nurse internships and longer orientations are

now used extensively to help them gain necessary skills and confidence.

Trend #2: Practice-based Competency Outcomes and Evidence-based Content

Trends r/t learning and evaluation in classroom and clinical courses have changed dramatically more interactivity and engagement gradually are

replacing faculty lectures designed to cover traditional content

Students become overwhelmed with the sheer volume of content required by teachers

Practice-based competence requires a different approach.

Trend #3: Performance-based Competency Learning and Objective

Assessment Methods.

Terms used to describe this trend include:active learning, interactive learning, collaborative learning, and competency-based learning.

Such a trend means that the roles of teachers and students in the classroom need to change.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.

Trend #3: Performance-based Competency Learning and Objective

Assessment Methods.

Multiple teaching-learning methods include:Interactive group workCollaborationIn-class and out-of-class

projectsProblem-based learningIncreasing self-responsibilityAccountability for competenceInterdisciplinary learningUsing electronic devices, media, to access

resources

Trend #3: Performance-based Competency Learning and Objective Assessment Methods.

Through such exercises, students learn tomake realistic decisions, collaborate in group process, and manage time and resources.

It may cause some anxiety, but performanceexaminations that require 100% accuracy of required critical elements provide more reliable evidence of practice competencies.

The increase in reported medical-errors vividly emphasizes the need for more effective validation of performance competence in schools and the workplace.

Trend #3: Performance-based Competency Learning and Objective

Assessment Methods.

Increased aging populationIncreasing multicultural, ethnic

diversity requires increased learning, respect for differences, preferences, customs

Community, faith-based projects, service-learning projects

Trend #4: Sociodemographics, Cultrual Diversity, and Economical and Political Change

• Global community, globalization health issues• Economic and political change

influences health care delivery and access to clinical experiences• Multidimensional content, client

care, clinical learning sites

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 responsibilities

Effective and compassionate nursing care is dependent on the integration of respect for these individualized differences in learning and care giving

Supporting effective nursing through other areas of study: cultural diversity, sociology, psychology, ethics, history and literature.

Cont. Trend #4: Sociodemographics, Cultrual Diversity, and Economical and Political Change

The increasing emphasis is on health of the family as “a whole” and on entire communities and populations. Interdisciplinary collaborative learningDiverse alternative health practices, influences of

culturesBroad 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

Requires more planning, travel times, expenses, arrangements; different skills, communications; critical thinking, problem solving strategies

Multiple teachers, preceptors, staff instructors, part-time, with varying abilities; time constraints

Trend #5: Community-Focused Interdisciplinary Approaches

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,

attentionConsumer initiatives for involvement and

protection; balance standards and preferences Increased litigation, medical-nursing errors;

focused on safe competent patient care Increased individual responsibility, accountability

for learning and practice

Trend #6: Consumer-Oriented Care: Engagement, Safety, and Privacy

Alternative solutions to ethical dilemmas

Issues regarding diverse beliefs Gray zones instead of black and

white absolutesSeparate personal opinions and

professional practice consequences for competence

Integrate into professional practice acceptance of the individual’s right of choice regarding life and death issues, health care methods Respect Tolerance for patient’s decisions Ethical competencies for students

Trend #7: Ethics and Bioethical ConcernsThis is related to the multicultural, multiethnic population and thus patients who have different ways of responding to illness, treatment and care providers

Shortage of staff results in limitations in clinical learning heavy workloadusing preceptorspart-time instructors less 1:1 help for studentsconsequences for learning and safety

Decreasing number of qualified facultyAging, retirement

Students need more, not less, clinical learningMore responsibility for self-directed learningSeeking assistanceRequired to validate initial and continuing competence

Trend #8: Increasing Shortage of Nurses & Faculty

New learning, skills required for major natural disaster eventsnew program options, new courses and skills

neededViolence in society, workplace, schools >

safety issuesPreparedness for terrorism

SkillsPrograms for first responders

Trend #9: Disasters, Violence & Terrorism

Lifelong learning to meet professional expectations

High stress from competing demands of school, home, meeting competency requirements

Issues for students include:Knowing how to access and use expansive

informationPrioritize learning Implement evidence- based practiceDeal with ethical dilemmas professionally Incorporate learning to think critically,

analytically, and ethical as essential professional skills

Trend #10: Increasing Professional & Personal Responsibility

Diversity in Nursing Education

ProgramsPresented by: Katrina Fuertes

Licensed Practical or Vocational Program

• Shortest & most restricted license for nursing• Program = 9 – 12 months• Institution: high school, hospitals,

vocational and proprietary schools.• Required to work under supervision of RN• Scope of practice focus on technical

nursing procedures– Basic technical bedside care; hospitals,

nursing homes, home care, offices in LPN positions.

Hospital Diploma ProgramsOldest and most traditional type of

program that prepares RN for licenseProgram = 2-3 yearsInstitution: HospitalsPurpose & Scope: Basic RN

positions; hospitals and agency care.

Associate Degree Programs• Late 1950s, emerged as a response to social,

political, and educational changes in society– 2 year Cadet Nurse Corp (quicker than hospital

diploma)• Program = 2 years• Institution: Community & Junior College• Basic technical care in RN position, primarily in

institutions•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.

Baccalaureate Degree Nursing Program• 1924 – Yale = separate department of nursing whose

graduates earned baccalaureate degree (28 months)– Western Reserve University = 4 year nursing program

• BSN programs another first in history of nursing profession– Early nurse leaders believed that

nurses provide more comprehensive, compassionate, and competent care when they get a solid foundation in the arts and sciences

Baccalaureate Degree Nursing Program

• Program = 2-4 years (depends on type of option)

• Institution: Colleges and Universities

• BSN courses - focus on care of patients with medical, surgical, pediatric, obstetric, and psychiatric conditions.

• BSN programs – emphasis on family and community and health promotion and illness prevention

• Other requirement courses: research, management, leadership, statistics

Master’s Degree Nursing Programs

Until late 1960s, MSN programs primarily focused on preparing educators and administrators emphasis on clinical practice

Designed to prepare advanced nurse practitioners and clinical specialists in array of specialty areas

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.

Master’s Degree Nursing ProgramsProgram = 1 – 2 years beyond BSN degreeInstitution: UniversitiesPurpose & Scope: Advanced clinical practice,

management, education, and leadership positions

Clinical Nurse Leader• 2000 – 2005 AACN = two major task forces– 1st = programs require increased focus on arts

and sciences, evidence-based practice, and internships

– 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.

• 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.

Doctoral Programs• Three types of doctoral degrees in nursing: – Doctor of philosophy (PhD) research– DNS or DNSc advanced clinical practice– Doctor of nursing (ND) nursing leadership

• 2000-2006 new clinical doctorate degree: DNP– Preparation for contemporary advanced nurse

practitioners– Viewed as clinical equivilent

to research-oriented PhD degree.

Flexible Education, Mobility, and Distance Learning Programs

• Distance or mobility programs include:– LPN or LVN ADN and BSN– Diploma and ADN BSN and MSN– BSN MSN or doctoral programs

• With the shortage of nurses and nurse educators some schools are finding ways to streamline RN BSN programs.

• 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.

Flexible Education, Mobility, and Distance Learning Programs

Trends and issues that influence nursing education make it even more important to comply with quality standards that emphasize competency for students and graduates

Students must have discipline and determination to pursue courses and clinical learning when a teacher is not physically present or accessible

Cherry, B., & Jacob S. R. (2008). Contemporary nursing: Issues, trends, & management. St. Louise, Missouri: Mosby Elsevier pp. 43-70

Introduction to Nursing Trends and Issueshttp://www.youtube.com/watch?v=3VBfH_qEX

CsNursing Trends Video 001

http://www.youtube.com/watch?v=7eFdSeLIzAk

References