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Multigenerational Diversity and Technology Changes: Strategies for Nurse Educators Karen CollinsFerris State UniversityAbstractNursing schools face challenges with educating students from all age groups and generations. The nursing workforce currently has five generations of nurses. Up to four generations of students may be present in a classroom at any one time. Each of these generations has their own value system and work ethic, creating a challenging situation for nurse educators. Rapidly changing technology is also a challenge for nurse educators. This paper discusses these challenges, as well as offers strategies for nurse educators to practice effectively.Multigenerational Diversity and Technology Changes: Strategies for Nurse Educators In order for nurse educators to practice effectively in today’s health care environment, they must be up-to-date with technology in the classroom and at the bedside, as well as having a strong focus on producing a well-educated and professional nursing workforce. By the year 2020, the Institute of Medicine (IOM) recommends that baccalaureate level nurses be close to 80 percent of the nursing workforce (Institute of Medicine (IOM), 2010). In order to achieve this goal, more nurses need to return to school to obtain their Bachelor of Science in Nursing (BSN) degree. The manner in which nurses were educated in the past will not be adequate for the 21st century due to technology and more complex patient health care needs (IOM, 2010). Nursing schools are challenged with educating students from all age groups and generations. Additional challenges include the rapidly changing field of technology in the classrooms and at the bedside. The purpose of this paper is to discuss two challenges faced by nursing educators and offer strategies to support how educators can enhance their teaching techniques.Changes in Technology Nursing education must embrace technology, as technology is everywhere; in the classroom with multimedia computers, simulation labs, and computer-based learning tutorials, and at the bedside with electronic medical records (EMR). It is a challenge for many nurse educators to become competent in technology such as wikis and blogs, on-line learning systems, podcasts, webcams, on-line portfolios, and simulations. Technology enhances the nursing students’ learning outcomes, affects decision-making skills, and is instrumental in developing specific skills CITATION Tal13 \l 1033 (Talcott, O'Donnell, & Burns, 2013). Advances in educational technology require nursing faculty to become computer and technology savvy and address the gap that exists between nursing educators and students CITATION Tal13 \l 1033 (Talcott, O'Donnell, & Burns, 2013). In the ClassroomMany nurse educators in the classroom setting are challenged by the use of technology CITATION Axl08 \l 1033 (Axley, 2008). As the average nursing faculty age increases, many are reluctant to adopt and use the new equipment and technology, and will opt for retirement CITATION Tal13 \l 1033 (Talcott, O'Donnell, & Burns, 2013). This is detrimental to the nursing faculty shortage, the nursing student population, and thus, the nursing workforce. Younger nursing students have been raised in an era that embraces technology CITATION She13 \l 1033 (Shellenbarger & Robb, 2013). These students, born in 1992 and after, have “never known a time without computers or cell phones” CITATION Bel13 \p 205 \l 1033 (Bell, 2013, p. 205). Use of technology in the classroom setting has significantly changed teaching strategies CITATION Axl08 \l 1033 (Axley, 2008). Educators are challenged with creating innovative teaching-learning activities to facilitate learning CITATION She13 \l 1033 (Shellenbarger & Robb, 2013). High fidelity and low fidelity simulations facilitate working within a team, practicing complex skills, and allow students to learn in a safe environment where no harm will come to a real patient CITATION Gor11 \l 1033 (Gore, Hunt, Parker, & Raines, 2011). Learning to use technology in the classroom requires dedication on the part of the nurse educator. Critz and Knight (2013) report using a “flipped classroom” where students watch lectures online, read evidence-based articles posted by the instructor, and complete text readings prior to class. This type of “classroom required considerable preparation on the part of the faculty” CITATION Cri13 \p 211 \l 1033 (Critz & Knight, 2013, p. 211). Strategy. A strategy to help nursing faculty members embrace technology is for administrators/management to offer formal education to develop their skills. The American Association of Colleges of Nursing (AACN) offers a web-based program aimed to advance teaching skills, professional scholarship, and instructional improvement CITATION Edu13 \l 1033 (American Association of Colleges of Nursing (AACN), 2013). Information technology (IT) support was essential in the study by Critz and Knight (2013). Mentoring or a faculty development program is another option for success on the part of the faulty members. In a study done by Talcott, O'Donnell, and Burns (2013), objectives for their program included: a) develop a program to enhance the knowledge, skills, and abilities of nursing facility in the application of emerging heathcare technologies; b) assist nursing faculty with initiating and integrating technology strategies into nursing education programs; and c) measure changes in nursing faculty knowledge, skills, abilities, and confidence in integrating technology into their nursing curricula (p. 128). This program was successful and the authors found that “nursing faculty find value in and understand the potential impact of emerging technologies on nursing education CITATION Tal13 \p 130 \l 1033 (Talcott, O'Donnell, & Burns, 2013, p. 130). Technology can enhance learning.Traditional instructor led lecture and student note taking have been replaced by PowerPoint presentations, interactive activities, case presentations, and video vignettes CITATION Gal11 \l 1033 (Gallo, 2011). These activities have been shown to enhance the learning experience CITATION Gal11 \l 1033 (Gallo, 2011). Offering online discussion boards, self-directed learning modules, case presentations, and role playing were considered to be the best method of education across the generations in a study compiled by Gallo (2011). Nurse educators will want to add these tools to their teaching methods, if they have not already done so.At the BedsideAdvancing technology and thus, the EMR, is a part of the 2010 Health Care Reform CITATION Bro122 \l 1033 (Brooks & Erickson, 2012). The EMR supports “coordination of care by making patient information available across providers and settings, promotes the delivery of evidence-based care . . . and reduce[s] duplication of services. . .”CITATION McC11 \p 212 \l 1033 (McCarthy, 2011, p. 212). Medical stakeholders (e.g. American Nurses Association and the Institute of Medicine) support the use of the EMR to improve a culture of safe care delivered to the patient CITATION Bro122 \l 1033 (Brooks & Erickson, 2012). Information in the EMR is legible, accessible, and retrieved easily CITATION Bai13 \l 1033 (Baillie, Chadwick, Mann, & Brooke-Read, 2013). Brooks and Erickson (2012) add enhanced confidentiality, decreased errors, and improved communication as benefits of the EMR. Prior to the creation of the EMR, nursing students have been able to write on the patient’s paper chart with a mentor’s supervision CITATION Bai13 \l 1033 (Baillie, Chadwick, Mann, & Brooke-Read, 2013). Nurse educators are charged with the responsibility of preparing their students to document appropriately during their clinical rotations. For many clinical educators and their students, charting in the EMR is not possible due to their exclusion from the hospital’s EMR training programs. This training is time consuming and costly to the institution due to having to pay the class instructor. In addition, the nursing students’ clinical time is limited CITATION Bow11 \l 1033 (Bowers, et al., 2011). K. Searing (personal communication, October 25, 2013) reports that her students spend an eight-hour day in a hospital computer lab learning how to document appropriately in the hospital’s EMR. Even then, charting practices for students in different departments in the same hospital vary (K. Searing, personal communication, October 25, 2013). (Nursing students do still need a co-signature on their charting in the EMR.) Strategy. One strategy to enhance the students’ opportunities for navigating the EMR is to incorporate an EMR into their simulation situations, whether in a simulation lab or a written scenario. Having an EMR system at the nursing school level will allow students to gain proficiency prior to employment CITATION Bro122 \l 1033 (Brooks & Erickson, 2012). One of the Quality and Safety Education for Nurses (QESN) informatics competency skill is to “use high quality electronic sources of healthcare information” (QESN, 2013). Nursing curriculum must be aligned with the nursing practice environment CITATION Bro122 \l 1033 (Brooks & Erickson, 2012). Student nurses must develop confidence in their charting and documentation skills. Integrating technology into nursing simulation education will allow the students to practice in a safe learning environment while becoming familiar with this technology. With proficiency, students may then focus on direct patient care, rather than focusing on the technology CITATION Bro122 \l 1033 (Brooks & Erickson, 2012). Generational DiversityNurse educators are challenged by the diverse needs and skills of their students CITATION Wel09 \l 1033 (Wellman, 2009). Educators may have four different generations of students in their classrooms at any given time, each with different learning styles and life experiences CITATION Bel13 \l 1033 (Bell, 2013). The silent generation, while still in the workforce, probably will not be present in the academic setting as they are close to retiring. Each generation has their own set of values, beliefs, attitudes, and work habits CITATION Kra10 \l 1033 (Kramer, 2010). The challenge for nurse educators is to engage this diversity in the classroom.Silent GenerationThe Silent Generation, also called the Veterans, is cautious, conservative, and hardworking CITATION Kra10 \l 1033 (Kramer, 2010). Almost 10% of the nursing workforce is comprised of this generation, many having postponed retirement or have re-entered the workforce CITATION Bel13 \l 1033 (Bell, 2013). These nurses most likely will not be in the traditional classroom.Baby BoomersThis generation comprises 55% of the nursing workforce CITATION Bel13 \l 1033 (Bell, 2013). These nurses prefer open communication, value life-long learning as a means to improve performance, and value respect CITATION Gib09 \l 1033 (Gibson, 2009). Many baby boomers are working on advancing their career choices. Gen XThe Gen X generation is “shaped by a culture of instant results” CITATION Gib09 \p 37 \l 1033 (Gibson, 2009, p. 37). This generation is great with multitasking and look to education as a means to an end CITATION Gib09 \l 1033 (Gibson, 2009). Technology is a component of the Gen Xer’s lives. Gen Y or MillennialsThe Gen Y population has the smallest population of nurses CITATION Kra10 \l 1033 (Kramer, 2010). This generation wants structure, extensive orientation, and formal mentoring programs. This generation’s approach to learning is by executing, collaborating with teammates, and utilizing simulations CITATION Kra10 \l 1033 (Kramer, 2010). iGeneration or Gen ZThis generation of students, born in 1992 and after, has never been without computers, iPads, or cell phones CITATION Bel13 \l 1033 (Bell, 2013). As a generation, they are open to change. They like the individualized activities made possible by technology CITATION Bel13 \l 1033 (Bell, 2013). They expect technology to be incorporated into their daily lives CITATION Gib09 \l 1033 (Gibson, 2009). Nurse educators are faced with “understanding each generation’s communication preferences and frame of reference” CITATION Bel13 \p 205 \l 1033 (Bell, 2013, p. 205). Nurse educators may have students for whom the computer is a new concept and students who are technologically competent. How then to create a learning environment where all students can learn and feel safe? Strategy. Primarily, nurse educators need to consider each generation’s style of learning, being careful not to stereotype individuals or groups. Kramer (2010) lists several strategies for the nurse educator:Seek to understand each generational cohort and accommodate generational differences in attitudes, values, and behaviorsDevelop generationally sensitive styles to effectively coach and motivate all members of the healthcare teamDevelop the ability to flex a communication style to accommodate generational differencesPromote the resolution of generational conflict so as to build effective teamsCapitalize on generational differences, using these differences to enhance the work of the entire team (p. 128)Additionally, nurse educators should focus on the creation of classrooms where the strengths of each generation of students are enhanced. In the creation of group work, nurse educators may purposely place students in groups of varying generations. This intentional placing encourages students to work out and appreciate their differences, as well as work together as a team, just as in the workplace. The expertise of each generational group will bring different solutions to the problem. Learning from each other is just as valuable as learning from the educators. This “rich diversity of generational perspectives” CITATION LeD09 \l 1033 (LeDuc & Kotzer, 2009) will result in a creative learning environment. Comparing one generation to another is not new, report LeDuc and Kotzer (2009), but by recognizing shared values in the classroom and workplace, a commitment to the profession of nursing is enhanced. The American Nurses Association (ANA) has a Code of Ethics in place. This code was created as a guide for nurses to act and interact professionally in a manner consistent with quality nursing care (American Nurses Association (ANA), 2011). By appreciating the generational diversity in the nursing student population, nursing educators and students are true partners of the profession CITATION LeD09 \l 1033 (LeDuc & Kotzer, 2009). The conscious effort to understand each generation of nursing students allows educators to maximize the power of each generation. Revelant Theory and Speciality PracticeBandura’s Social Learning theory (1977) is a relevant theory for educators to model good behavior. Steps involved in this modeling theory include attention, retention, reproduction, and motivation CITATION McL11 \l 1033 (McLeod, 2011). Students will pay attention if the process is colorful and dramatic, that is engaging and not boring. In the traditional classroom, this means keeping the lecture to 20 minutes or less, and then engaging in bidirectional interaction CITATION Gal11 \l 1033 (Gallo, 2011). Retention and reproduction, the second and third steps in Bandura’s theory, can be related to students watching a demonstration and being able to copy or reproduce it when needed. An example of this is showing students how to gown and glove in a sterile technique and having them demonstrate the process. Motivation is the final step in Bandura’s Social Learning theory. Motivation for many, but not all, students is achieving a good letter grade. However, grades are important for faculty as it dictates whether or not a student passes the course. Nurse educators, by understanding what motivates each unique generational group, can impact the learning of each generation. The National League for Nursing (NLN) has created 10 evidenced-based competencies for nurse educators CITATION Hal07 \l 1033 (Halstead, 2007). Many of these competencies are incorporated into this essay. Competency One is Facilitate Learning and is enhanced by “uses information technologies skillfully to support the teaching-learning process” CITATION Hal07 \p 18 \l 1033 (Halstead, 2007, p. 18). This is supported by the use of the EMR and other healthcare technologies. Competency Two is Facilitate Learner Development and Socialization and is upheld by addressing the unique learning needs of each of the different generations present in the classrooms. Competency Three, Uses Assessment and Evaluation, is upheld by nurse educators by using simualtions in their practice. This technology “provides timely, constuctive, and thoughtful feedback to learners” CITATION Hal07 \p 80 \l 1033 (Halstead, 2007, p. 80). These three examples show that the nurse educators competencies are upheld. ConclusionNurse educators are faced with challenges as they encounter up to four different types of generations in the classroom. Although there are different generations, each with their own style of learning, nurse educators ability to use technology in the educational process will enahnce learning and bridge the generational gap. Revelant theory and realted nurse educator competencies have been discussed.References BIBLIOGRAPHY \l 1033 American Association of Colleges of Nursing (AACN). (2013). Education Scholar: Retrieved from: Nurses Association (ANA). (2011). Code of Ethics: Retrieved from , L. (2008). The integration of technology into nursing curricula: Supporting faculty via the technology fellowship program. The Online Journal of Issues in Nursing, 13(3), doi:10.3912/OJIN.Vol13No03PPT01Baillie, L., Chadwick, S., Mann, R., & Brooke-Read, M. (2013). A survey of student nurses' and midwives' experiences of learning to use electronic health record systems in practice. Nurse Education in Practice, 13(5), 437-441. doi:10.1016/j.nepr.2012.10.003Bell, J. A. (2013). Five generations in the nursing workforce. Journal for Nurses in Professional Development, 29(4), 205-210. doi:10.1097/NND.0b013e31829aedd4Bowers, A. M., Kavanaugh, J., Gregorich, T., Shumway, J., Campbell, Y., & Stafford, S. (2011). Student nurses and the electronic medical record. CIN: Computers, Informatics, Nursing, 29(12), 692-697. doi:10.1097/NCN.0b013e31822b8a8fBrooks, C. L., & Erickson, L. K. (2012). What is the solution for clinical nurse educators and the electronic medical record? Teaching and Learning in Nursing, 7(4), 129-132. doi:10.1016/j.teln.2012.06.003Critz, C. M., & Knight, D. (2013). Using the flipped classroom in graduate nursing education. Nurse Educator, 38(5), 201-213. doi:10.1097/NNE.0b013e3182a0e56aGallo, A.-M. (2011). Beyond the classroom: Using technology to meet the educational needs of multigenerational perinatal nurses. The Journal of Perinatal and Neonatal Nursing, 20(2), 195-199. doi:10.1097/JPN.0b013e3182163993Gibson, S. E. (2009). 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Integrative models and performance. In A. R. Kovener, & J. R. Knickman Eds.), Jonas and Kovner's Health care delivery in the United States (10th ed.) (pp. 205-231). New York: Springer Publishing Company.McLeod, S. A. (2011). Albert Bandura/Social Learning Theory. Retrieved from Simple Pyschology: and Safety Education for Nurses (QSEN). (2013). Informatics:Retrieved from , T., & Robb, M. (2013). Pinstructive ideas: Using a social networking bulletin board for nursing education. Nurse Educator, 38(5), 206-209. doi:10.1097/NNE.0b013e3182a0e5e7Talcott, K., O'Donnell, J. M., & Burns, H. K. (2013). Technology and the nurse educator: Are you ELITE? Nurse Educator, 38(3), 126-131. doi:10.1097/NNE.0b013e31828dc2a8Wellman, D. S. (2009). The diverse learning needs of students. In D. M. Billings, & J. A. Halstead (Eds.), Teaching in nursing: A guide for faculty (3rd ed., pp. 18-32). St. Louis, MO: Saunders/Elsevier. ................
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