Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Chapter 3 The Influence of Contemporary Trends and Issues on Nursing Education

2 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Trends and Issues in Contemporary Nursing Education   Knowledge expansion, use of technology, the Internet   Unlimited information is available   Requires more time and skill to navigate the Web, even though most students have less time for study   Faculty constantly revising curriculum and courses   Practice-based competency outcomes   Business world uses competency outcomes to set directions and goals   Students (nurses) must achieve the competency outcomes that develop the skills actually needed in practice   Competence in realistic, practice-based outcomes is the target

3 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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 Trends and Issues in Contemporary Nursing Education (Cont’d)

4 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Performance-based learning, assessment methods   Related issues Changes in roles of teachers and learners Refocusing responsibility and accountability Shifting the perception of students from passive receivers of information to active learners   Skills required of nurses Problem solving Communication Teaching Caring Management Trends and Issues in Contemporary Nursing Education (Cont’d)

5 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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 Trends and Issues in Contemporary Nursing Education (Cont’d)

6 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Sociodemographics, cultural diversity, economic and political changes   Aging population   Diverse population   Increasing number of people living in poverty, homeless, and/or uninsured   Disrespect for others   Domestic abuse of women and children   Various forms of violence in homes, schools, and public places   Obesity epidemic   Nontraditional families Trends and Issues in Contemporary Nursing Education (Cont’d)

7 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Community-focused, interdisciplinary 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 Trends and Issues in Contemporary Nursing Education (Cont’d)

8 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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 Trends and Issues in Contemporary Nursing Education (Cont’d)

9 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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   Fewer qualified preceptors for students Trends and Issues in Contemporary Nursing Education (Cont’d)

10 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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 Trends and Issues in Contemporary Nursing Education (Cont’d)

11 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. Increasing Professional and Personal Responsibilities   Explosion of new information and technology   Increasing responsibilities for aging parents and children   Professional requirements to stay current and pursue professional development

12 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. 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 to 12 months long and focus on technical aspects of nursing care   State boards of nursing set scope of practice in each state

13 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Hospital diploma programs   Linda Richards: the first nursing diploma graduate in 1873; began the movement of nurses teaching and supervising nurses rather than those functions being the exclusive domain of physicians   Length of program was 1 to 2 years in the late 1800s but subsequently changed to 3 calendar years of practice and study Major Types of Education Programs (Cont’d)

14 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   All classes/experiences were under the authority of the funding hospital   Operated as apprenticeship programs to meet staffing needs of the hospital until more recent times when education took a more primary role   Number has drastically declined because of changes in the marketplace and a new concept of nursing education   As programs are phasing out, some have partnered with community colleges to provide an associate degree, and some have become college programs   In 2008, only 75 diploma programs remained in the U.S. Major Types of Education Programs (Cont’d)

15 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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 2 semesters of liberal arts and sciences   Today largest percentage of nurses are ADN graduates Major Types of Education Programs (Cont’d)

16 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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 and 2 years of nursing courses and completion of 126 to 136 credits   In 2008 about 610 generic, 621 RN-BSN, and 218 accelerated BSN programs were available Major Types of Education Programs (Cont’d)

17 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Master’s degree nursing programs   Developed because of increasing complexity of health care and need for nurse educators, administrators, 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 and 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 Major Types of Education Programs (Cont’d)

18 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   A new role   Prepared as a master’s generalist   Academic and practice partners are working together to develop academic programs and to integrate CNLs into health care systems Major Types of Education Programs (Cont’d)

19 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Types of MSN programs   Most require BSN for admission   RN to MSN Vanderbilt University of Maryland   Bachelor’s degree in any field to MSN Yale University University of Tennessee University of Texas at Austin Major Types of Education Programs (Cont’d)

20 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Doctoral degree programs   Undergone major changes during the past 4 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 Major Types of Education Programs (Cont’d)

21 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   Three doctoral degree options Doctor of philosophy (PhD)—for students interested in research and generating new knowledge Doctor of nursing science (DNS or DNSc)—for students interested in advanced clinical practice Doctorate in clinical nursing practice (DNP)—for students interested in advanced clinical nursing practice and clinical leadership Major Types of Education Programs (Cont’d)

22 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc. 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

23 Mosby items and derived items © 2011, 2008 by Mosby Inc., an imprint of Elsevier Inc.   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 Flexible Education Mobility and Distance Learning Programs (Cont’d)