Ekibbey.weebly.com



Role Challenges and Plan Group PaperLori Conn, Erin Kibbey, Stephanie MonroeFerris State University AbstractChallenges for nurse educators related to fulfillment of curricular change requirements are compounded by difficulties with collaboration, nursing and faculty shortages, limited time and resources, increased work demands, and retention. This paper addresses these challenges at the forefront of nursing education today. Solutions and a plan to overcome these challenges are also presented. Some of these important resolutions include the use of more effective collaborative communities and partnerships, strengthening of relationships and implementation of mentoring programs, changing of curriculum to a concept based approach as well as the addition of simulation labs in order to increase class sizes.Role Challenges and Plan Group PaperIn nursing, like most careers, there are many challenges one is likely to encounter in order to fulfill the professional scope of practice. The purpose of this paper is to address a few specific challenges related to meeting one of the standards of professional performance for the specialty role of a nurse educator. In 2005 the National League for Nursing (NLN) outlined the responsibilities of the nurse educator by developing eight core competencies. In particular, this paper will examine the fourth competency, which describes participation in curriculum design and evaluation of program outcomes. Specific challenges nurse educators are faced with in trying to achieve this professional standard include faculty shortages as well as limited time and resources within a rapidly changing health care environment. This paper will examine these particular challenges in the context of the fourth professional competency defined by the NLN, as well as provide a plan for addressing the challenges. Identification of Role ChallengesThe role of the nurse educator is multi-dimensional with three distinct focuses including that of a teacher, scholar, and collaborator (Southern Regional Education Board [SREB], 2002). As a collaborator the nurse educator uses knowledge and skills associated with teamwork to endorse and improve best practices (SREB, 2002). In other words, nurse educators should be able to collaborate with peers, students, administrators and other diverse constituencies in order to fully express their role. Additionally, this role can be viewed as essential in the fulfillment of the NLN’s (2005) fourth competency, participation in curriculum design and evaluation of program outcomes. To know whether a nurse educator is participating effectively in the fourth competency the NLN (2005) formulated several task statements, which are included in The Scope of Practice for Academic Nurse Educators. Many of these task statements can be viewed as difficult to achieve without the help of other nurse educators, through a collaborative effort. For instance, the last four task statements are not likely to be achieved by one nurse educator alone as they include:Implements curricular revisions using appropriate change theories and strategies,Creates and maintains community and clinical partnerships that support educational goals,Collaborates with external constituencies throughout the process of curriculum revision, andDesigns and implements program assessment models that promote continuous quality improvement of all aspects of the program. (NLN, 2005, p. 19-20)Research by Chiang, Chapman, and Elder (2011) sites numerous articles recognizing the importance of collaboration in order to formulate new ideas and better solutions and also states, “…when teachers work collaboratively to achieve a shared purpose, they are able to change their teaching practices in significant ways” (p. 27). Although collaboration is viewed as essential in order to achieve new curricular outcomes, the issue of collaboration itself has its own challenges. In the same study by Chiang et al. (2011) the goal was to use collaboration in order to create curriculum change for a school of nursing in Taiwan. One of the main issues in this process, however, was the challenge of time. According to Chiang et al. (2011) faculty were already faced with heavy workloads and limited openings left in their schedules to coordinate extra time for meetings and other collaborative activities required for the change process. In a study by McAllister, Williams, Gamble, Malko-Nyhan, and Jones (2011), this theme was also depicted. In their research investigating curricular change and the rapidly changing health care environment it was found that:Lack of time, competing demands and information overload arising from change were identified across all groups. Participants indicated that these factors result in a restriction on the ability to search for new information or resources and to satisfy the ongoing research and curricular requirements of the profession. (p. 11)Another difficulty with collaboration for curricular change described by Chiang et al. (2011) was based on a culture of educators that were used to working alone and had little experience in working with others. The importance of this idea was cited in their research, which supported the notion that professional isolation contributed to educators rarely changing their practice, thus many viewed curriculum change as risky and doubted the risk was worthwhile. McAllister et al. (2011) also discussed difficulties with professional isolation in order to inflict curricular change. They stated, “The isolation also relates to geographical location, lack of communication with mentoring from other educators, lack of support or opportunity to network with educators in the same area of expertise and/or feeling removed from and devalued by non-education staff” (p. 11). Based on this information, it can be concluded that when faced with the larger and overarching challenges of faculty shortages and limited resources it can be difficult to promote innovative curricular changes and achieve the fourth competency as a nurse educator. Not only are faculty shortages a problem when it comes to participating in curricular change processes, shortages also have an impact on teaching and instruction while faculty are immersed in the change process and faced with evolving health care trends and limited resources. In an article by Paulson (2011) it was stated that:Workforce shortages and health care financing woes factor into the reform efforts currently under way in health professions education. Nursing education programs are impelled to respond to expanded enrollments through the efficient use of resources and management of the educational process while maintaining, if not enhancing, the quality of graduates. (p. 395)Therefore, research by Paulson (2011) set out to examine how substantive curriculum reform complicated by a shortage of qualified faculty and limited resources, effected faculties adaptation to curriculum change as well as its effect on teaching and instructing. One unfortunate result of the new curriculum change was the creation of a hardship in hiring adjunct faculty as clinical instructors due to the compressed structure of rotations. Furthermore, the structure of the new model added more complexity to coordination among and between courses, requiring additional collaboration and resources. Curriculum change was complicated even further with the implementation of technology and the need to change faculty mindsets regarding this transition. In the end Paulson (2011) noted that her research results were consistent with challenges facing nursing education today and although the curriculum change initially set out to decrease staffing concerns, unanticipated problems finding adjunct faculty ended up raising future concerns. Finally, Paulson (2011) concluded, “The data reflected possible implications for permanent faculty workloads and job satisfaction through its potential for inducing stress while members attempted to balance multiple job responsibilities” (p. 399) and that “…participants maintained their teaching strategies had not changed appreciably with the new curriculum…” (p. 399). So although this research set out to revise curriculum as nurse educators are called to do under the fourth competency from the NLN (2005), many challenges related to problems with faculty shortages and limited resources were faced in pursuit of this endeavor. Now that it is possible to see how the major issues of faculty shortages and limited resources have created challenges in the participation of curriculum design and evaluation of program outcomes, the NLN’s (2005) fourth competency, it is important to take a closer look at these major issues. According to the AACN (2012) “U.S. nursing schools turned away 75,587 qualified applicants from baccalaureate and graduate nursing programs in 2011 due to insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, as well as budget constraints” ( p.2). The AACN is predicting the shortage in nursing faculty is going to get worse before it gets better. The current average age of the working nurse is around 45 years old and one quarter of working nurses are over the age of 50 (AACN, 2012). A study on the future of nursing concluded that the shortage in nurses was also related to the lack of federal, state, and public support to nursing programs and students (Livsey, Campbell & Green, 2007).? In addition to the United States facing a shortage of nurse faculty members they are seeing a shortage of nurses in general. Reasons behind this shortage are work environment, wages, stress, aging of current nurses, and wait lists for nursing programs (Veltri & Warner, 2012).? These statistics pose a challenge to future nurse educators. It is imperative that a plan be in place to increase both the number of nurse educators and nursing students in order to meet the demands of our growing healthcare community. In addition to a nursing shortage, nurse educators face challenges that stem from the push for nurses to seek higher levels of education. The Institute of Medicine’s (2010) Future of Nursing Report states there is a need for higher standards in nursing. One of the biggest needs that the report addresses is for more qualified nursing faculty. This means increasing the number of nurses with higher degrees. A survey from 2008 found that nurses with associate’s degrees made up 45.4% of nurses in the United States and only 32.4% of nurses held bachelor’s or master’s degrees (Department of Health & Human Services, 2010). The report also pointed out that the patient population is older and more sick (Institute of Medicine, 2010). The World Health Organization (2012) is estimating that the number of people over the age of 60 will double and the number of people over the age of 80 will quadruple between 2000 and 2050. As a consequence of the changing patient population more emphasis will need to be placed on nursing education and the restructuring of nursing education curriculum. The advancements in technology and in medicine are changing the dynamics of the patient population. The increasing age of the patient population will ultimately affect all levels of health care including nursing education. To this end, there will be an increasing need for nurse educators in order to keep up with societies demand for more nurses with higher levels of education. ? Plan to Address ChallengesThe challenges of curriculum change, in both keeping curriculum up-to-date with current health care trends and implementing new curriculum is daunting. Strategies to meet these challenges need to be multifaceted. Nurse educators need to find innovative ways to meet these challenges, especially in regards to collaborative efforts and retention of nursing faculty. Traditional teaching methods need to be replaced with evidence-based practice models of teaching. Increased use of technology and development of collaborative arrangements will help educators to work smarter and not harder.Curriculum revision and development is a key responsibility of nurse educators. Nurse educators are making curriculum adjustments constantly in order to keep it current and ensure quality. Literature supports contemporary curriculum and studies have found a variety of ways to accomplish this. Boland (2012) states schools should use comprehensive assessments and outcome assessments as tools to keep their curriculum current. Kantor (2010) also describes a curriculum based on concepts and outcome assessments. In this curriculum, educators are not tied to covering all content areas and are not reliant on memorization to be successful. In a concept-based curriculum, active learning methods are utilized to engage students in the learning process. In 2011, an associate’s degree nursing program redesigned their curriculum based on the fact that many of their students were not able to pass the NCLEX. One very important aspect they incorporated into their framework was a process for curriculum review every three years (Davis, 2011). This is one example of taking an outcome, in this case failing the NCLEX, as developing a curriculum plan to improve that outcome. Patient safety and quality outcomes are essential components to nursing curriculums and should be included in curriculum review. Typically, nursing students rotate through many clinical sites throughout their education. Clinical agencies, namely hospitals, often have concerns regarding quality and patient safety provided by students and blame nursing programs for not providing this education (Debourgh, 2012). Often times student’s clinical practice is restricted based on agencies’ concerns. Debourgh (2012) describes a model of synergy between academia and hospitals. Through this partnership, education and hospitals can share information regarding safety and quality issues. Material already developed by the hospital, such as those pertaining to quality and safety, can be shared and incorporated in nursing curriculums (Debourgh, 2012). Debourgh (2012) states: The synergy created by academic-service partnerships supports achievement of mutual goals, provides a rich and authentic environment for continuous learning and skill development, and positions students within the agency to understand and promote their safety and quality programs, priorities, and initiatives. (p. 51) Through collaboration with clinical facilities, nurse educators are able to incorporate important clinical practice and safety outcomes into their curriculum and also improve student educational outcomes.Along these same lines, although collaboration has its own challenges as previously mentioned, there are many ways it can be used to promote the fourth competency if used and maintained effectively. According to Chiang et al. (2011), continuous working relationships with those in leadership roles can largely determine the security of continuous collaboration. Furthermore, it was stated that:Effective collaboration among team members was facilitated, sustained, and motivated through developing trust, flexibility, and democratic processes. This not only promoted commitment to and ownership of the change but also created a sense of community in which we were able to help each other to change and improve. (Chiang et al., 2011, p. 32)To this end, McAllister et al. (2011) suggested promotion of Wegner’s concept of the development of a community of practice (CoP). Outcomes of this concept include the ability to share resources and understanding of problems faced in the community, promotion of confidence and enrichment of the community, along with tools to work more efficiently and effectively (McAllister et al., 2011). A suggestion for development of a CoP is to have it resourced with cutting edge information available in life as well as online. Therefore a plan for addressing effective collaboration includes the establishment of a collaborative community with active involvement from all levels of an institution that support and promote the work involved with the change process, as well as a system that connects educators across geographical distances, in a timely and innovative fashion. As previously stated, Chiang et al. (2011) noted several challenges nurse educators were faced with as a result of working in isolation. Most nurse educators make lesson plans, grade papers, and research courses by themselves. Chiang et al. (2011) suggests faculty that work in isolation take fewer chances and tend to adhere to traditional teaching methods. One model that addresses these challenges is the partnership formed by the Greater Kansas City Area Collegiate Nurse Educators and the Kansas City Area Nurse Executives (Fetsch & DeBasio, 2011). This partnership brought together nursing faculty, nurse leaders, employers, and business and civic leaders from 17 nursing programs and 28 hospitals in an unique collaborative arrangement to identify and address workforce shortages, recruitment and retention issues, and promote the image of nursing (Fetsch & DeBasio, 2011). The main objective of this partnership was to standardize curriculum, establish uniform guidelines for sharing clinical placement sites, and to purchase and share technology collaboratively (Fetsch & DeBasio, 2011).Two initiatives that came as a result of this partnership have had a direct impact on nursing education in regards to collaboration and increasing retention of nurse educators. The first initiative was the clinical orientation agreement and handbook (Fetsch & DeBasio, 2011). A major concern of both nursing education and hospitals was to have a standard orientation for both faculty and students practicing in the hospital. Orientation materials were developed through a collaborative process between faculty and hospital staff that addressed issues such as isolation policies, fire safety, and documentation requirements. The orientation handbook negated redundancy by clinical faculty and decreased the amount of clinical time needed to review these policies each semester. The handbook is updated annually and is based on best practice guidelines from agencies such as The Joint Commission on Accreditation of Healthcare, Occupational Safety and Health Administration, and Center for Disease Control (Fetsch & DeBasio, 2011). Through a more effective and efficient collaborative process nurse educators can add this information to their curriculum and avoid extra work and duplication.A subcommittee formed from the same partnership identified the need to increase the capacity of nursing programs and recruitment of qualified clinical faculty. As a consequence of these efforts, a second initiative, the Clinical Faculty Academy [CFA], was established (Fetsch & DeBasio, 2011). The CFA provides tools for bachelor’s prepared nursing staff who want to serve as clinical faculty. Fetsch and DeBasio (2011) described the two day CFA course as a comprehensive tool to provide knowledge needed to begin the clinical faculty role. This program is beneficial in that it takes some of the workload off nurse educators to mentor new faculty. It also lessens some of the financial concerns from the academic institution in terms of paying clinical faculty, as this is negotiated between the clinical facility and the academic institution (Fetsch & DeBasio, 2011). The Missouri State Board of Nursing required clinical faculty to be prepared at the graduate level. The subcommittee obtained a temporary exemption from the Missouri State Board of Nursing to allow bachelor’s prepared nurses to fill the role of clinical faculty provided they are working towards a master’s degree (Fetsch & DeBasio, 2011). This provision addresses the nurse educator shortage by encouraging more nurses to further their education. At a time where nurse educators are faced with faculty shortages and the profound affects shortages have already had on challenges stated earlier, it is critical that methods to increase nursing retention are developed and instituted. Increasing job satisfaction is found to be one of the most effective ways to increase retention (Baker, 2010). A community college in California looked at ways to increase job satisfaction among new faculty hires. The college found that by creating an orientation process, assigning mentors, and giving new staff lighter assignments increased job satisfaction among new faculty members (Baker, 2010). Another challenge that effects job satisfaction is the multi-generational work environment. Challenges brought on in the multi-generational work environment are related to the diversity in culture, wide ranges of experience, and a worsening of the nursing shortage. As a result, Smith-Trudeau (2012) suggests that nursing organizations invest in strengthening relationships between generational groups as well as educating managers on generational differences. Generation Y makes up the largest group of new nurses in the nursing profession. Having a better understanding of this generational group may strengthen understanding about what this group desires in the workplace and aid in increasing retention. “Creating and implementing strategies and programs specific to the four generations that will convince older nurses to participate longer in the workforce and younger nurses to stay can turn silver into gold” (Smith-Trudeau, 2012, p. 3).The fact that many qualified students are turned away from nursing programs due to the lack of nursing faculty demands strategies that allow more students to be accepted without increasing the workload of faculty. Educators need to find innovative ways to teach a larger volume of students without significantly increasing their workload, jeopardizing the quality of education they provide, and increasing the challenge of fulfilling the NLN’s fourth competency with regards to curriculum development. One possible strategy is to utilize simulation labs to provide some of the clinical time students require. One university increased their enrollment over a four-year period by about 50% (Richardson, Gilmartin, & Fulmer, 2012). Instead of eight students per clinical group, they were able to assign 12 students to each clinical group. They broke the group in half, one group attended simulation lab and the other group attended a clinical site (Richardson et al., 2012). In addition, simulation scenarios have been shown to be effective in developing critical thinking skills in nursing students (Thomas & Mackey, 2012). It allows students to make decisions in an environment that is safe for patients. However, one drawback of simulation labs is that it can be very expensive to purchase simulation technology and to maintain it. Nevertheless, strategies to address these concerns have been proposed. One possibility may be to share this technology with other nearby nursing schools or hospitals (FCN, 2010). Another possible strategy is to develop interdisciplinary simulation scenarios. In this instance, financial and faculty resources could be shared from several different programs. ConclusionMeeting the NLN’s requirements of competency four poses many challenges to nurse educators. Literature supports the importance of nurse educator’s involvement in curriculum development and curriculum review. Challenges nurse educators are faced with in this process are staff shortages, limited time and resources, poor retention, and increased job demands. Though there is no easy solution to these challenges, however, development of a plan to overcome these challenges is a priority. Some strategies identified to aid in meeting the requirements of competency four are: utilizing effective and efficient collaboration methods among faculty, developing collaborative partnerships with other academic institutions and hospitals, strengthening relationships between staff, implementing mentor programs, increasing class sizes through the use of simulation labs, and transitioning to concept based curriculum. Developing and utilizing strategies to overcome these challenges is essential to the future of nurse educators and the entire nursing profession. ReferencesAmerican Association of College of Nursing [AACN]. (2012). Nursing shortage. RetrievedSeptember 6, 2012, from?, S. (2010). Nurse educator orientation: Professional development that promotes retention. Journal of Continuing Education in Nursing, 41(9), 413-417. doi:10.3928/00220124-20100503-02. Boland, D. (2012). Developing curriculum: Frameworks, outcomes, and competencies. In D. M. Billings & J. A. Halstead (Eds.), Teaching in nursing a guide for faculty (4th ed.). (pp. 138-157). St. Louis, MO: Elsevier Saunders.?Chiang, C., Chapman, H., & Elder, R. (2011). Overcoming challenges to collaboration: Nurse educators’ experiences in curriculum change. Journal of Nursing Education, 50(1), 27-33. doi: 10.3928/01484834-20101029-04.Davis, B. (2011). A conceptual model to support curriculum review, revision, and design in an associate degree nursing program.?Nursing Education Perspectives. 32(6),?Retrieved October 3, 2012, from Academic OneFile.Debourgh, G. (2012). Synergy for patient safety and quality: Academic and service partnerships to promote effective nurse education and clinical practice. Journal of Professional Nursing, 28(1), 48-61. doi: 10.1016/j.profnurs.2011.06.003??Department of Health & Human Services (2010). The registered nurse population. Retrieved September 21, 2012, from? Nurse Population.pdfFetsch, S. H. & DeBasio, N. O. (2011). Academic service partnerships: Organizational efficiency and efficacy between organizations. Journal of Professional Nursing, 27(6), e82-e89. doi:10.1016/j.profnurs.2011.07.003Florida Center for Nursing. (2010). Addressing the nursing shortage through simulation. Retrieved from: of Medicine (2010). A summary of the February 2010 forum on the future of nursing: Education. Retrieved September 21, 2012, from?, S. A. (2010). Pedagogical change in nursing education: One instructor’s experience. Journal of Nursing Education, 49(7) 414 – 417. doi:10.3928/01484834-20100331-06Livsey, K., Campbell, D., & Green, A. (2007). Yesterday, today, and tomorrow: Challenges in securing federal support for graduate nursing education.?Journal of Nursing Education,?46(4), 176-183.?McAllister, M., Williams, L. M., Gamble, T., Malko-Nyhan, K., & Jones, C. M. (2011). Steps towards empowerment: An examination of colleges, health services and universities. Contemporary Nurse, 38(1-2), 6-17. doi:10.5172/conu.2011.38.1-2.6National League for Nursing. (2005). The scope of practice for academic nurse educators. New York: author.Paulson, C. (2011). The experiences of faculty teaching in an innovative clinical immersion nursing curriculum. Nursing Education Perspectives, 32(6), 395-399. doi: 10.5480/1536-5026-32.6.395Richardson, H., Gilmartin, M. J., & Fulmer, T. (2012). Shifting the clinical teaching paradigm in undergraduate nursing education to address the nursing faculty shortage. Journal of Nursing Education, 50(4), 226 – 231. doi:10.3928/01484834-20120210-04Smith-Trudeau, P. (2012). Nurse leaders moving beyond a superficial awareness of the multigenerational workforce.?Vermont Nurse Connection,?15(3), 3. Retrieved November 12, 2012, from EBSCOhost database.Southern Regional Education Board [SREB]. (2002). Nurse educator competencies. Atlanta, GA: author.Thomas, C. & Mackey, E. (2012). Influence of a clinical simulation elective on baccalaureate nursing student clinical confidence. Journal of Nursing Education, 51(4), 236 -239. doi:10.3928/01484834-20120224-03Valtri & Warner (2012). Forces and issues influencing curriculum development. In D. M. Billings & A. J. Halstead (Eds.), Teaching in nursing: A guide for Faculty (4th?ed.). (pp. 92-105).?St Louis, MO: Elsevier Saunders.World Health Organization (2012). Ageing and life course: Interesting facts about ageing. Retrieved September 21, 2012, from? ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download