Educating Nurses: A Call for Radical Transformation
December 2009, Jossey-Bass
PART ONE: Transformation, Crisis, and Opportunity.
1. A Profession Transformed.
2. Teaching and Learning in Clinical Situations.
3. Teaching and Learning in the Classroom and Skills Lab.
4. A New Approach to Nursing Education.
PART TWO: Teaching for a Sense of Salience.
5. Paradigm Case: Diane Pestolesi, Practitioner and Teacher.
6. Strategies for Teaching for a Sense of Salience.
PART THREE: Integrative Teaching for Clinical Imagination.
7. Paradigm Case: Lisa Day, Classroom and Clinical Instructor.
8. Developing a Clinical Imagination.
9. Connecting Classroom and Clinical Through Integrative Teaching and Learning.
PART FOUR: Teaching for Moral Imagination.
10. Paradigm Case: Sarah Shannon, Nurse Ethicist.
11. Being a Nurse.
12. Formation from a Critical Stance.
PART FIVE: A Call for Radical Transformation.
13. Improving Nursing Education at the Program Level.
Appendix: Methods for the Carnegie National Nursing Education Study.
Molly Sutphen is on the faculty at the University of California, San Francisco and codirector of ?The Carnegie Foundation's Study of Nursing Education. She is a historian who has published widely on nursing education and the history of international health.
Victoria Leonard is a former nurse educator in maternal child nursing and health policy. Currently, she is a family nurse practitioner and child care health consultant at the UCSF California Childcare Health Program.
Lisa Day is a former nurse educator in critical care, acute care nursing, and ethics. Currently, she is a clinical nurse specialist for neuroscience and critical care at UCSF Medical Center. She authors the ethics column for the American Journal of Critical Care.
The shortage of well-educated nurses has been part of the nation’s health care conversation, with policy leaders as well as President Obama noting the essential role nurses play in ensuring patient safety. The President called them “the bedrock” of health care. Now, The Carnegie Foundation for the Advancement of Teaching is calling for changes in how we educate nurses, referring both to the current nursing shortage and that nurses are ill-prepared for the profound changes in science, technology and the nature and settings of nursing practice. Informed by the results of three national surveys and extended site visits during a multi-year study, the authors of Educating Nurses: A Call for Radical Transformation recommend essential changes in policy, curriculum and in the way nursing programs approach student learning.
“We believe that the enormous pressures on today’s nursing profession—the chaotic U.S. health care system and the economic forces that drive it, shortage in the ranks of nurses, shortage of nursing educators, multiple pathways to the profession that discourage rather than encourage practicing nurses to complete post licensure degrees—threaten to compromise nurses’ ability to practice state-of-the-art nursing and enact the profession’s core values of care and responsibility,” the authors write.
Among the recommendations are:
- that the baccalaureate degree in nursing should be the minimal educational level for entry into practice and that within ten years after graduation that all nurses complete a master’s degree in nursing
- that nursing program capacities have to be expanded so that students can complete nursing programs in a reasonable amount of time and that the associate of nursing degree from community colleges be re-evaluated in light of the extended amount of time most student nurses spend in completing these nursing programs
- that coursework be tied to what actually happens in patient care rather than in the abstract, helping students make the connection between acquiring and using knowledge, integrating the classroom with clinical practice
- that nurses are prepared for the myriad contexts in which they will work, not merely a hospital setting.
“Redesigning nursing education is an urgent societal agenda," the authors write. "The profound changes in nursing practice and health care call for equally profound changes in the education of nurses and the preparation of nurse educators. Unfortunately, the current climate rewards short-term focus and cost-savings over the quality of nursing education and patient care.”
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