NUR4153CB Lifelong Learning is Part of Nursing Practice HW

NUR4153 Clinical Deliverable 6 Material Transforming Education Key Message #2: Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Major changes in the U.S. health care system and practice environments will require equally profound changes in the education of nurses both before and after they receive their licenses. Nursing education at all levels needs to provide a better understanding of and experience in care management, quality improvement methods, systems-level change management, and the reconceptualized roles of nurses in a reformed health care system. Nursing education should serve as a platform for continued lifelong learning and include opportunities for seamless transition to higher degree programs. Accrediting, licensing, and certifying organizations need to mandate demonstrated mastery of core skills and competencies to complement the completion of degree programs and written board examinations. To respond to the underrepresentation of racial and ethnic minority groups and men in the nursing workforce, the nursing student body must become more diverse. Finally, nurses should be educated with physicians and other health professionals as students and throughout their careers. Page 164 Suggested Citation:”4 Transforming Education.” Institute of Medicine. 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press. doi: 10.17226/12956. × Save Cancel Major changes in the U.S. health care system and practice environments will require equally profound changes in the education of nurses both before and after they receive their licenses. In Chapter 1, the committee set forth a vision of health care that depends on a transformation of the roles and responsibilities of nurses. This chapter outlines the fundamental transformation of nurse education that must occur if this vision is to be realized. The primary goals of nursing education remain the same: nurses must be prepared to meet diverse patients’ needs; function as leaders; and advance science that benefits patients and the capacity of health professionals to deliver safe, quality patient care. At the same time, nursing education needs to be transformed in a number of ways to prepare nursing graduates to work collaboratively and effectively with other health professionals in a complex and evolving health care system in a variety of settings (see Chapter 3). Entry-level nurses, for example, need to be able to transition smoothly from their academic preparation to a range of practice environments, with an increased emphasis on community and public health settings. And advanced practice registered nurses (APRNs) need graduate programs that can prepare them to assume their roles in primary care, acute care, long-term care, and other settings, as well as specialty practices. This chapter addresses key message #2 set forth in Chapter 1: Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. The chapter begins by focusing on nurses’ undergraduate education, emphasizing the need for a greater number of nurses to enter the workforce with a baccalaureate degree or to progress to this degree early in their career. This section also outlines some of the challenges to meeting undergraduate educational needs. The chapter then turns to graduate nursing education, stressing the need to increase significantly the numbers and preparation of nurse faculty and researchers at the doctoral level. NUR4153CB Lifelong Learning is Part of Nursing Practice HW

The third section explores the need to establish, maintain, and expand new competencies throughout a nurse’s education and career. The chapter next addresses the challenge of underrepresentation of racial and ethnic minority groups and men in the nursing profession and argues that meeting this challenge will require increasing the diversity of the nursing student body. The fifth section describes some creative solutions that have been devised for addressing concerns about educational capacity and the need to transform nursing curricula. The final section presents the committee’s conclusions regarding the improvements needed to transform nursing education. The committee could have devoted this entire report to the topic of nursing education—the subject is rich and widely debated. However, the committee’s statement of task required that it examine a range of issues in the field, rather than delving deeply into the many challenges involved in and solutions required to advance the nursing education system. Several comprehensive reports and analyses addressing nursing education have recently been published. They include a 2009 report from the Carnegie Foundation that calls for a “radical transforma- Page 165 Suggested Citation:”4 Transforming Education.” Institute of Medicine. 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press. doi: 10.17226/12956. × Save Cancel tion” of nursing education (Benner et al., 2009); a 2010 report from a conference sponsored by the Macy Foundation that charts a course for “life-long learning” that is assessed by the “demonstration of competency [as opposed to written assessment] in both academic programs and in continuing education” (AACN and AAMC, 2010); two consensus reports from the Institute of Medicine (IOM) that call for greater interprofessional education of physicians, nurses, and other health professionals, as well as new methods of improving and demonstrating competency throughout one’s career (IOM, 2003b, 2009); and other articles and reports on necessary curriculum changes, faculty development, and new partnerships in education (Erickson, 2002; Lasater and Nielsen, 2009; Mitchell et al., 2006; Orsolini-Hain and Waters, 2009; Tanner et al., 2008). Additionally, in February 2009, the committee hosted a forum on the future of nursing in Houston, Texas, that focused on nursing education. Discussion during that forum informed the committee’s deliberations and this chapter; a summary of that forum is included on the CD-ROM in the back of this report.1 Finally, Appendix A highlights other recent reports relevant to the nursing profession. The committee refers readers wishing to explore the subject of nursing education in greater depth to these publications. Lifelong Learning Impact Clinical reasoning and clinical judgment are dynamic processes influenced by education and experience. These cognitive and behavioral practices grow throughout the lifespan of a professional nursing career (Schub and Heering, 2018). To support lifelong learning and promote refined abilities necessary for clinical nursing reasoning and clinical judgment nurses participate in many types of professional development. The American Nurses Association has proclaimed nurses have an ethical responsibility to maintain continued competence and professional growth (Brunt, 2014). Nursing Professional Development Nursing professional development is, “The lifelong process of active participation by nurses to develop and maintain competence, enhance professional nursing practice, and support achievement of their career goals (Brunt, 2014, p. 4).” The two most frequent types of professional development for nurses are staff development and continuing education. Nurses recognize that lifelong learning through formal methods produces significantly better results for client care, increased confidence in the ability to practice nursing and ongoing increase in the knowledge base (Wellings, Gendek and Gallagher, 2017). Continuing Education Continuing education is “The lifelong process of active participation by nurses to develop and maintain competence, enhance professional nursing practice, and support achievement of their career goals (Brunt, 2014, p. 4).” Results of studies showed nurses viewed continuing education as a necessary tool to stay up to date with nursing practice and promote self-confidence in the healthcare setting (Shcneider and Good, 2018). In 1975 the American Nurses Association (ANA) created a system of formal measure and classification for nursing continuing education recognizing the relationship of continued practice competence and lifelong learning. Barriers Even though professional development is critical to continued competence with clinical reasoning and judgment, actual and perceived barriers to access and involvement with continuing education exist (Shcneider and Good, 2018). • • Extrinsic barriers: o Lack of time o Staff perception of value o The expense for development and access o Staff shortages o Inconvenience o Lack of interest and variety in topics o Deficient administrative and peer support for culture change o Unique generational needs o Unprepared Educators o Inadequate assessment and planning Intrinsic barriers: o Lack of motivation to learn o Inability to maintain self-direction o Diminished accountability o Prior experience with negative or inadequate content Facilitators Even though numerous possible barriers to lifelong learning in nursing exist, many facilitators support continuing education to maintain and build competence with clinical reasoning and clinical judgment (Agyepong and Okyere, 2018). Three prominent facilitators supporting the process of professional development include self-development with intrinsic desire to improve, funding and awareness of access. As a profession in a rapidly evolving healthcare environment with unpredictable future client needs, the time is now to follow through on the commitment to lifelong learning for the pursuit of practice excellence. .