Nursing faculty integrate simulation instruction into their teaching practice: A phenomenological study

Clinical placements in the nursing profession are becoming more difficult to secure. To help meet the demand, nursing education programs are threading simulation instruction into the curriculum, providing nursing students with real-world scenarios. The aim of this phenomenological qualitative study was to explore the experiences of faculty as they integrate simulation into their teaching practice. Data analysis through an iterative and inductive process resulted in five core themes: faculty motivation, training and coaching, best simulation experience, differences in teaching with and without simulation, and challenges integrating simulation into teaching practice. Findings from this study can be used to guide faculty in the use of simulation as an innovative approach to clinical instruction.     

Cognitive dissonance experienced by nurse practitioner faculty

Purpose: The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. Data sources: Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. Conclusions: The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid. Implications for practice: Expecting all faculty members to excel in practice, research, teaching, and service may create unrealistic workloads for NP faculty members. Examining expectations and considering creation of a clinical track for faculty who practice may be options administrators of NP programs might explore.     

Evaluation of the clinical hour requirement and attainment of core clinical competencies by nurse practitioner students

Purpose: The purpose of this study was to analyze the national practice of fulfilling 500 clinical hours as a requirement for graduation from nurse practitioner (NP) programs at the master's level and to compare this standard to a comprehensive approach of evaluating attainment of clinical competencies. Data sources: The National Organization of NP Faculties (NONPF) and specialty accreditation bodies publications were used for references to clinical hour and core competency requirements for graduation from NP programs. Data from one university from student documentation on a commercial electronic tracking system were also analyzed. Conclusions: Data analysis revealed that the 500 clinical hours correlated to populations, skills performed, required levels of decision making, and expected diagnoses. However, assurance that these clinical hour requirements translated to exposure to all core competencies for entry into practice could not be established. Implications for practice: A more comprehensive approach to the evaluation of student core competencies by implementing one or more performance-based assessments, such as case-based evaluations, simulations, or objective structured clinical examinations (OSCEs), as a strategic part of NP evaluation prior to graduation is proposed. This change is viewed as critical to the continued success of NP programs as master's level education transitions to direct BS to DNP educational preparation for advanced nursing practice.     

Preparing nursing faculty for baccalaureate-level and graduate-level nursing programs: role preparation for the academy

This article explores the multiple roles expected of nursing faculty teaching in baccalaureate and graduate programs, as well as the preparation required to accomplish those roles. The educational preparation for the challenging roles nurse educators are required to assume is explored, along with suggestions on how to support faculty in their roles to ensure they are both productive and retained in their work. Although the research mission remains an important priority role for faculty today, it can easily overshadow and conflict with the equally compelling faculty roles needed to address the holistic development of the next generation of the profession: teaching; service, and practice. Boyer's dimensions of scholarship are used to suggest a structure for the roles that baccalaureate and graduate faculty in nursing programs need to be prepared to assume: the scholarship of discovery, the scholarship of integration, the scholarship of application, and the scholarship of teaching.     

Clinical nurse specialist and nurse practitioner core curricula survey results

The American Nurses' Association's Council of Clinical Nurse Specialists and Council of Primary Health Care Nurse Practitioners conducted a survey of all graduate nursing programs in the United States that prepare nurse practitioners and/or clinical nurse specialists. One hundred eight schools responded (73.5 percent), yielding data on 317 programs that could be further analyzed. For the 60 NP and 195 CNS programs analyzed, information was obtained on the following: required courses, number of hours of the required courses, students' clinical training settings and graduates' employment settings. Findings revealed marked similarity between the core curricula of NP and CNS graduate programs. The only significant differences found were that NP programs placed greater emphasis on pharmacology, primary care, physical assessment, health promotion, nutrition and history-taking in their curricula. In both the student clinical settings and graduate employment settings, NPs focused on primary care settings while CNSs focused on secondary or tertiary care settings. Based on the marked similarities between the core curricula of NP and CNS graduate programs, it is suggested that further investigations be conducted to determine whether objectives and/or teaching methods differ, and to further investigate the effects of practice setting on role development. Further, it is suggested that NPs and CNSs continue to interact through forums and conferences to continue the evolution and definition of graduate nursing education and advanced practice.     

Reconceptualizing the core of nurse practitioner education and practice

Purpose: The movement to the doctor of nursing practice (DNP) is progressing rapidly with new programs emerging and curricular documents being developed. We argue that the implementation of the DNP is a good move for nursing, provided that we use the opportunity to reconceptualize the core of advanced practice nursing, especially nurse practitioner (NP) practice.
Data sources: Theory and research articles from nursing focused on advanced practice nursing, NPs, and doctoral education.
Conclusions: The foundation of NP education is currently based essentially on borrowed or shared content in assessment, pharmacology, and pathophysiology. We argue that the heart and soul of nursing is in health promotion, both in healthy persons and in those dealing with chronic illness. Current master's programs do not prepare NPs to assume high-level practice focused on health promotion and disease management using the latest theoretical developments in health behavior change, behavioral sciences, exercise physiology, nutrition, and medical anthropology. Although these are touched upon in most NP programs, they do not represent the core science of NP education and need to be a critical part of any DNP program.
Implications for practice: Ultimately, our vision is for NP care to be consistently "different," yet just as essential as physician care, leading to positive outcomes in health promotion and disease management.     

How baccalaureate nursing programs teach writing

BACKGROUND. Written communication skills are critical for nursing practice. However, nursing faculty often find students unprepared to communicate clearly and effectively in writing. This integrative review identifies and discusses specific approaches used in baccalaureate programs to teach writing skills to prelicensure nursing students. METHODS. Electronic databases PubMed, CINALHL, and ERIC were used. Nine articles were found describing programs that taught writing skills to prelicensure nursing students in baccalaureate programs. All articles were published since 1990 and met inclusion and exclusion criteria. Writing programs were divided into two categories: stand‐alone programs and programs integrated across a nursing curriculum. Instructional strategies were analyzed to identify common elements. FINDINGS AND DISCUSSION. Five common elements of such programs were identified: short writing assignments, faculty training, sequential writing assignments, giving students examples of successful writing or explaining grading rubrics, and revision after faculty or peer feedback. Across‐curriculum programs appeared to include these components more often than stand‐alone programs. CONCLUSION. Writing programs implemented across a nursing curriculum may be more likely to include certain common components than are stand‐alone programs. There is a critical need to measure both short‐ and long‐term outcomes of these writing programs.     

Baccalaureate nursing faculty performance of nursing computer literacy skills and curriculum integration of these skills through teaching practice.

This article describes a cross-sectional survey research study designed to collect data from nurse educators regarding their self-reported competence in the performance of 60 nursing computer literacy skills, as well as self-reported levels of integration of these skills, through teaching practice, into the curricula of their respective baccalaureate nursing programs. Data were received from 184 respondents representing 18 publicly funded, National League for Nursing-accredited, college and university generic baccalaureate degree programs in the New England region of the United States. Study findings revealed that 21 of the 60 skills were being performed "well" or "very well" as reported by 50% or more of respondents, while in the area of curriculum integration through teaching practice, only 3 of the 60 skills were being integrated into teaching practice either "moderately" or "extensively" as reported by 50% or more of respondents. Another major finding of this research study strongly suggested that faculty who have the ability to perform requisite nursing computer literacy skills comfortably are more likely to integrate these skills into the curriculum through their teaching practices (r = .76; p<.01). This article concludes with a discussion of the implications of the study findings for nursing education.     

Faculty members' perceptions of medical genetics and its integration into nurse practitioner curricula

This study assessed faculty members' perceived knowledge of medical genetics concepts and conditions, the importance of integrating this content into NP curricula and how this was being done. During a national NP conference, 40 NP faculty voluntarily completed surveys. Participants' perceived knowledge of genetics varied; 35% noted low or very low knowledge, and only 5% reported high or very high knowledge. Most participants (95%) believed genetics is important, but only 10% reported having separate genetics courses in their NP programs. Approximately half of the participants reported personal involvement in genetics NP education, and 50% reported barriers to implementing it into their curricula. Most faculty indicated they did not feel comfortable teaching genetics, nor did they have formal training in the area. Advancing medical genetics into NP curricula will require ongoing faculty development and training to sustain and build genetics skills and competencies for advanced practice nurses.     

Nursing students' and faculty members' knowledge of, experience with, and attitudes toward complementary and alternative therapies

This study was designed to describe and compare the knowledge, experience, and attitudes of nursing faculty and students (undergraduate and graduate) regarding complementary and alternative therapies (CAT). A cross-sectional survey (N = 153) of undergraduate (n = 41) and graduate (n = 57) students and faculty (n = 55) was conducted in one school of nursing. Most participants were White (87%) and female (78%). More than 70% of the students and faculty agreed that clinical care should integrate the use of CAT. More than 85% desired more education about CAT, especially in undergraduate nursing curricula. More than 65% agreed that the clinical nurse specialist or nurse practitioner role should include the use of CAT in their practice, and more than 50% agreed that they had some knowledge of CAT, but only approximately 30% had some experience with CAT. Faculty and students expressed positive attitudes toward integrating CAT into the undergraduate nursing curriculum and nursing practice. Faculty development and nursing research are needed to facilitate curriculum change and integrate CAT into nursing programs at all levels.     

Curriculum as environment: a focus group study

Curricula development is critical for the advancement and evolution of holistic nursing education. Although the American Holistic Nurses Association offers advanced practice board certification for graduate nurses, there is a scarcity of available graduate holistic nursing courses and curricula. The researchers developed a curriculum for an advanced holistic nursing program at a university college of nursing in South Florida. The curriculum and process of development were presented at a workshop during a national holistic nursing conference. A portion of the workshop included an opportunity for attendees to voluntarily participate in a focus group research study. The specific aim of the research was to determine the best approaches for the development of curricula for the promotion of graduate holistic nurse education based on the insights of holistic nurses, nurse educators, nurse practitioners, and scholars. A content analysis identified 3 themes that addressed holistic nursing curriculum: (1) consider curriculum as an evolving blueprint for personal and professional growth; (2) embrace the uniqueness of students; and (3) encourage faculty to co-create the learning environment.     

Competency-Based Nurse Practitioner Education: An Overview for the Preceptor

Many health care disciplines, including advanced practice nursing, are moving to competency-based curriculum designs for preparing their future professions. Moving from content-based to competency-based infers a shift from a focus on teaching and imparting faculty or preceptor knowledge to a focus on students and outcomes of their learning. Preceptors are key to the success of student learning in competency-based frameworks. This article orients the preceptor to the drivers of a competency-based curriculum and provides tips for preceptor success as a partner in educating NP students within programs that have adopted a competency-based approach.     

Complementary and alternative medicine: core competencies for family nurse practitioners

Recent surveys demonstrate substantial use of complementary and alternative medicine. This growth presents a challenge for family nurse practitioner programs that already have dense curricula due to the explosion of biomedical knowledge. Significant barriers exist to incorporating complementary and alternative medicine into educational programs, such as differing philosophies about health and lack of research on many complementary and alternative medicine therapies. This study used a mailed questionnaire in which family nurse practitioner program directors described the current status of complementary and alternative medicine teaching in family nurse practitioner programs and identified core competencies for family nurse practitioners. Most programs reported integrating some content on complementary and alternative medicine into advanced practice courses, such as health promotion. Competencies related to interviewing, critical thinking, evidence-based medicine, knowledge of laws, ethics, and spiritual and cultural beliefs were rated the highest. The findings are useful in helping family nurse practitioner faculty incorporate complementary and alternative medicine content into their curricula with the goal of preparing family nurse practitioners for safe practice.     

Novice Nurse Practitioner Faculty and the Online Educator’s Role

Nursing programs continue to transition or establish online education programs in response to the need for nursing faculty to teach in postlicensure to higher educational degree programs. Recruitment efforts target experienced nurse practitioners (NPs) in clinical practice who may be considering an academic role. Before the acceptance of the novice NP faculty role, the components of the role, faculty development resources, extent of orientation, and role expectations must be discussed. Limited preparation to online education environments jeopardizes the recruitment and retention of qualified NP faculty. This article reviews strategies for successfully acclimating novice faculty to online teaching.     

Partners for NP education: the 1999 AANP preceptor and faculty survey

PURPOSE: To increase understanding of national trends in nurse practitioner (NP) clinical education, the Education Committee of the American Academy of Nurse Practitioners (AANP) conducted a survey at the 1999 National AANP Conference in Atlanta. DATA SOURCES: A convenience sample of preceptors (n = 87) and faculty (n = 42) out of the total attendance of 1,744 responded to a written questionnaire. CONCLUSIONS: Preceptor respondents provided data concerning the number of NP students supervised, influence of student supervision on productivity, and availability of incentives for precepting. Faculty reported placement and supervision issues, the extent of precepting in their clinical practice site, and recognition and support for this role. Faculty and preceptors disagreed about the types and number of incentives offered for accepting students as well as the congruence of clinical teaching activities and national teaching guidelines. Precepting did not appear to strongly influence preceptor productivity. External funding did not influence opportunities for clinical education. IMPLICATIONS FOR PRACTICE: In 1998, the graduates of NP programs rose by 15.8% and over half of all nursing students enrolled in graduate nursing programs were seeking a NP education. This increase in students may compromise the ability of schools of nursing to insure quality clinical education of NP students by increasing faculty workload and placing greater demands on expert preceptors in the community. Clinical education is also changing in light of changes in the health care system.     

Invited Paper: Teaching Nursing Diagnosis to Increase Utilization After Graduation

BACKGROUND. The majority of nursing programs identify the nursing process and diagnosis as critical elements in their curricula, yet it is often absent in classroom and clinical discussions. The failure of faculty to integrate the nursing process and diagnoses into learning experiences creates students spending endless hours creating a care plan document that requires little critical thinking, a document that does not improve the student's likelihood of utilizing nursing diagnosis after graduation. PURPOSE. This paper would outline the educational barriers for integration of these concepts into practice. DISCUSSION. Classroom and clinical strategies that guide the student to focused learning on nursing diagnoses and utilize standardized predicted care plans can produce desired curriculum outcomes, and ultimately, practice utilization will be presented.     

Staff development to university faculty: reflections of a nurse educator

TOPIC: Transition of a staff development instructor to faculty in a baccalaureate nursing program. PURPOSE: This article is a reflection of the transition of a staff development educator in a large medical center to that of a faculty member in a small school of nursing. The seriousness of the faculty shortage and the factors that have led to it serve as a background for this discussion as the need for educators in nursing programs is of high priority. To qualify for an academic position, the educator should have teaching experience, educational preparedness, and clinical expertise. SOURCES OF INFORMATION: This paper is based on a review of the literature, newsletters from the American Association of Colleges of Nursing and the National League for Nurses, and personal experience. CONCLUSIONS: The intent of this reflection is to encourage other hospital-based educators and clinicians to consider a career change to academia. Clinically expert faculty can strengthen nursing programs and facilitate the education of nursing students on essential competencies for clinical practice.     

Common content,delivery modes and outcome measures for faculty development programs in nursing and midwifery: A scoping review

BackgroundGlobally, there is a call for urgent investment in nursing and midwifery education as high-quality education leads to quality care provision. This call for investment includes a ‘focus on faculty’, that is, development of those who teach. However, challenges in the preparation and development of faculty have been identified and include lack of recognition of ongoing development, limited pathways for career progression, inadequate provision of, or access to, faculty development opportunities and a lack of research evaluating sustained impact of programs.ObjectivesThe aim of this review was to identify, synthesise and report on common program content, modes of delivery and evaluation processes of faculty development programs in nursing and/or midwifery.MethodsA scoping review was conducted following Joanna Briggs Institute guidance. A comprehensive search strategy was developed and conducted in six health and/or education focussed databases. Peer-reviewed articles, published in English in the last decade and with a primary focus on nursing and/or midwifery faculty were included in the review. References lists of included studies were searched and a search to identify relevant grey literature was conducted. Using systematic review software, titles and abstracts were reviewed by two reviewers with a third reviewer used to resolve discrepancies. Data were extracted and recorded, key characteristics were mapped and content analysis used to synthesise, analyse and report findings.ResultsSeventeen articles were included in the review and identified common content provided in nursing and midwifery faculty development programs. The predominant content was approaches for learning and teaching. Other common content was leadership, research and assessment practices. Modes for program delivery were most often a blend of online and face-to-face. Program evaluation was reliant on participants’ self-reported measures of satisfaction and confidence and did not examine impact over time.Conclusions and recommendationsCommonalities in program content primarily focussed on learning and teaching, but also included content linked to expected professional nursing and midwifery educator competencies such as leadership and research. However, a lack of content on the key faculty activity of curriculum design was noted and should be addressed in future program development. In addition, there was a lack of evaluation on the impact of different modes of delivery. Furthermore, an over-reliance on self-reported evaluation measures and a lack of longitudinal evaluation of impact on education practice and on student experience and outcomes. Future research should include evaluation of modes of delivery and impact on faculty practice over a sustained period.     

The impact of empirical studies of spirituality and culture on nurse education

Aims and objectives. The aim of this paper is to share reflectively how my empirical studies on spirituality and culture have had an impact upon nurse education. Background. Spirituality and cultural dimensions of care are considered to be integral to holistic care. The healing potentials of spiritual and cultural care are well documented. The commitment to the research programme came due to the concern within early literature on nursing that the provision of spiritual care for patients is inadequate. Methods. The research programme used action research comprising largely qualitative approaches. As the holistic and multiperspective nature of spirituality and culture requires a multidisciplinary approach and flexibility of methodology, various research techniques were used. Results. The findings from the research programme led to the development of theories, models and conceptual literature on spiritual and cultural care. In particular, two models evolved from the studies: the ASSET for spiritual cares education and training and the ACCESS for transcultural care practice. The critical incident studies provide insights into nurses’ roles in spiritual care interventions. The phenomenological study highlights that chronically ill patients use spiritual strategies in coping with their illness. Conclusion. Overall, the paper offers a body of evidence that has an impact upon curriculum development in nurse education and nursing practice. Relevance to clinical practice. The ASSET model offers a framework for spiritual care education. The ACCESS model offers a framework for transcultural care practice. The critical incident studies map out nurses’ roles in spiritual and cultural care with scope for development of care intervention models for the future. The coping mechanisms study highlights how patients use spiritual coping strategies such as prayer and other resources to cope with their chronic illnesses.