1. ToNUR512 Issues and Trends in Nursing Education

2. Who was the person(s) or learning experience that had the greatest impact on your nursing education? Why? What methods of teaching and learning did you find most effective? What were barriers, if any to you learning in the past? How does your past experience compare to current teaching-learning activities you are experiencing? What excites you about the future of nursing education? What discourages you? How would you describe the “preferred future” of nursing ecucation?

3. Nursing Staff Development Past, Present, and Future

4. “Nursing is like fashion design; stay around long enough and all of the outdated trends will come back to be the latest fashion but with a new name” (Roslyn Corasaniti) Examples? Primary vs. Team Nursing Proficiency Testing and Competency Nursing Research and Evidenced-Based Practice

5. Our Heritage Florence Nightingale’s impact Florence Nightingale’s impact - Early efforts in staff development during the Crimean War where she worked with staff to teach them how to improve the care they were providing - She encouraged nurses to continue to learn: “Let us never consider ourselves finished nurses…we must be learning all our lives.”

6. Training in early hospitals: Hospital nurses did not need much orientation since they worked there as students and were proficient in running a ward by the time they graduated. Hospital nurses did not need much orientation since they worked there as students and were proficient in running a ward by the time they graduated. Educational emphasis was on improving schools of nursing, rather than on maintaining and improving competencies of the graduate nurse. Educational emphasis was on improving schools of nursing, rather than on maintaining and improving competencies of the graduate nurse.

7. 1893 Gathering of nurses at the World’s Fair in Chicago 1893 Gathering of nurses at the World’s Fair in Chicago 1893 Establishment of the first national nursing organization, The American Society of Superintendents for Training School Nurses. 1893 Establishment of the first national nursing organization, The American Society of Superintendents for Training School Nurses. 1900 American Journal of Nursing was first published to advance professional growth 1900 American Journal of Nursing was first published to advance professional growth By 1929 articles on inservice education became more numerous By 1929 articles on inservice education became more numerous

8. 1930’s the Great Depression forces nurses to work in hospitals where they were trained to work in specialty areas. 1930’s the Great Depression forces nurses to work in hospitals where they were trained to work in specialty areas. First organized approach to staff development, especially in the areas of orientation and improvement of practice. First organized approach to staff development, especially in the areas of orientation and improvement of practice. 1930’s and 1940’s great efforts in skill training in specialty area knowledge and skills. 1930’s and 1940’s great efforts in skill training in specialty area knowledge and skills.

9. 1937 The Curriculum Guide for Schools of Nursing was published declaring that “the primary function of the nursing school was to educate students and not just to provide service for hospitals.” 1937 The Curriculum Guide for Schools of Nursing was published declaring that “the primary function of the nursing school was to educate students and not just to provide service for hospitals.” 1940’s Refresher courses were established for previously inactive nurses who returned to active duty. Incentives offered. 1940’s Refresher courses were established for previously inactive nurses who returned to active duty. Incentives offered. Orientation programs for nurses commonly seen in hospitals. Orientation programs for nurses commonly seen in hospitals.

10. 1941 Congress passed the Labor Federal Security Appropriate Act, which provided $1,800,000 for nursing education 1941 Congress passed the Labor Federal Security Appropriate Act, which provided $1,800,000 for nursing education Post World War II Post World War II - W.K. Kellogg Foundation in Chicago funded programs that: were designed to upgrade nursing practice and keep nurses informed of new developments were designed to upgrade nursing practice and keep nurses informed of new developments enlarged curriculum offerings of inservice education to nurses employed in hospitals through a variety of sources. enlarged curriculum offerings of inservice education to nurses employed in hospitals through a variety of sources.

11. 1953 The Joint Commission for the Improvement of the Care of the Patient noted that inservice education should be established for all levels of nursing personnel. More influence on training of unlicensed nursing staff and their roles in patient care.

12. 1950’s and 60’s Trend toward college degree nurses and decrease in hospital schools of nursing. Trend toward college degree nurses and decrease in hospital schools of nursing. Nurses graduating with less clinical experience and hospital needed nursing educators to prepare them for duty. Nurses graduating with less clinical experience and hospital needed nursing educators to prepare them for duty. More focus on leadership and management skills More focus on leadership and management skills

13. 1960’s Large focus on research. Heidgerken, 1965 stated, “inservice education is the vehicle by which the results of research are translated into practice”. Mid 1960’s intensive care areas expanded and needed more specialized training. Hospitals now had inservice education depts.

14. 1970 Esther Lucille Brown published a study entitled Nursing Reconsidered: A Study of Change which stated: 1. 1. Further development of formal inservice education departments was needed. 2. 2. Effect of inservice was influential on the recruitment and retention of qualified nurses. 3. 3. Nurses needed further training in therapeutic conversations with patients. 4. 4. The rise in nursing assistants, as well as practical and graduate nurses dictated more in – hospital training programs.

15. 1974 Tobin, Yoder Wise and Hull made a significant contribution to the field with their first edition of The Process of Staff Development: Components for Change This publication defined the field of staff development practice until the early 80’s

16. 1975 Malcolm Knowles first published his book, The Adult Learner: a Neglected Species.

17. 1978 ANA published a pamphlet titled Guidelines for Staff Development The Joint Commission on Accreditation of Hospitals required that a position be established for overseeing and coordinating staff development activities The Joint Commission on Accreditation of Hospitals required that a position be established for overseeing and coordinating staff development activities

18. 1980’s Publication of the Journal of Nursing Staff Development in 1985 Publication of the Journal of Nursing Staff Development in 1985 1989 Formation of the National Nursing Staff Development Organization 1989 Formation of the National Nursing Staff Development Organization www.nnsdo.org

19. 1992 American Nurses Credentialing Center (ANCC) offered its first certification examination for Nursing Continuing Education and Staff Development American Nurses Credentialing Center (ANCC) offered its first certification examination for Nursing Continuing Education and Staff Development

20. 1990’s Many hospitals expanded the Nursing Staff Development Departments to include training and staff development for all staff. Many hospitals expanded the Nursing Staff Development Departments to include training and staff development for all staff.

21. Current Staff Development Issues Emphasis on quality, efficiency, and effectiveness while assisting organizations to meet their goals. Emphasis on quality, efficiency, and effectiveness while assisting organizations to meet their goals. Need for staff development to be involved with assessment, maintenance, and development of competencies. Core and role specific (NNSDOa,1997) Need for staff development to be involved with assessment, maintenance, and development of competencies. Core and role specific (NNSDOa,1997)

22. Multi-faceted role of staff development, including:  Nurse/Professional  Educator/teacher  Consultant/counselor  Coordinator/facilitator/leader  Change Agent/Motivator  Evaluator  Researcher

23. Cross training of staff for new roles, which provide the following benefits: Seamless and consistent delivery of patient care Seamless and consistent delivery of patient care Increased efficiency Increased efficiency Cost containment Cost containment Enhanced management Enhanced management Employee and patient satisfaction Employee and patient satisfaction

24. Use of constructive feedback to help achieve and maintain a competitive advantage in the workplace. Use of constructive feedback to help achieve and maintain a competitive advantage in the workplace. Team structure with shared responsibilities, cooperation, and constructive feedback empowers workers, promotes occupational self- esteem, and increase productivity (move toward magnet status?) Team structure with shared responsibilities, cooperation, and constructive feedback empowers workers, promotes occupational self- esteem, and increase productivity (move toward magnet status?)

25. Must look at current needs of the organization as well as anticipate future needs. Recognize and plan for a changing healthcare environment including: - Changing client demographics - Cultural diversity - Changing diversity - Changing healthcare delivery systems - Individual learner characteristics - Increasing number of educational options/modalities

26. Critical Issues for Staff Development and Continuing Education identified by O’Conner (1986) but still relevant today Who is responsible for education? Who is responsible for education? How can participation in educational activities be promoted? How can participation in educational activities be promoted? What should be the content of education What should be the content of education How can adult learning principles be applied to the design of education? How can adult learning principles be applied to the design of education? Does education make a difference? Does education make a difference?

27. How does the staff educator ensure that education offerings are relevant with applicability to the professional lives of participants? How does the staff educator ensure that education offerings are relevant with applicability to the professional lives of participants? What are the best teaching strategies for education? What are the best teaching strategies for education? How can the education program most efficiently use its limited resources? How can the education program most efficiently use its limited resources? How can quality in educational programs be ensured? How can quality in educational programs be ensured?

28. What do you do when the problem is not an educational issue?

29. Need for educators to understand the needs of the workplace, and the need to teach students to: Think critically and explore solutions for themselves Think critically and explore solutions for themselves Take responsibility for their own goals and deadlines Take responsibility for their own goals and deadlines Plan and implement goals and tasks cooperatively Plan and implement goals and tasks cooperatively Apply course work to real life Apply course work to real life Consider and apply ethical and legal principles to nursing practice Consider and apply ethical and legal principles to nursing practice

30. Future Trends in Staff Development Agree on the name of this kind of practice! Agree on the name of this kind of practice! Communicate the role of the staff development specialist Communicate the role of the staff development specialist Continue to define the field, what it includes and what it does not include Continue to define the field, what it includes and what it does not include Organize programs to meet the future need of patients in our ever changing healthcare environment Organize programs to meet the future need of patients in our ever changing healthcare environment Work to build bridges to all clinical disciplines, with a shared vision and focus on patient care. Work to build bridges to all clinical disciplines, with a shared vision and focus on patient care. Conduct research about the outcome of staff development activities Conduct research about the outcome of staff development activities

31. Technological advances continue to change how staff development specialists do their work. Technological advances continue to change how staff development specialists do their work. Interactive software Interactive software Use of the World Wide Web to provide access to literature and resources Use of the World Wide Web to provide access to literature and resources Increase number of distance learning opportunities Increase number of distance learning opportunities