Nurse educators have always been among the most innovative faculty members in higher education. You only need to read the articles in this issue of Nurse Educator as evidence to support that statement. Nurse educators develop new and innovative approaches to meet students' needs because they want students to learn and be successful and are committed to ensuring that graduates are well prepared for their role. While many disciplines struggle with how to improve teaching in their field, nurse educators seek and embrace new approaches to solve educational problems and prepare students for professional practice. Here are some insights I had from reading the articles in this issue of the journal.
Online education in nursing has led to new technologies for teaching. Nurse educators have been leaders in using technology to promote student engagement and interaction, and create a community of learners in online courses. Foronda1 described the use of VoiceThread to generate verbal transactions among students in an online course, a blog center or chat room for informal conversations, assignments in which students develop infographics and Web sites, and virtual simulations. In this issue, Ballman and colleagues2 describe interactive case studies (ICSs) to promote the development of clinical competencies in their distance-based nurse practitioner course. An ICS is a virtual patient encounter that provides students with the opportunity to interact with a standardized patient for developing competencies in interviewing and collecting patient data.
Competency-based education is not a new concept, but it makes sense for nursing faculty to think about this model for online instruction. With competency-based education, the focus is on learning versus time spent in learning. Students progress through their instruction by demonstrating they have mastered certain knowledge and skills required for the module (or unit of instruction) or course. Online courses provide an opportunity for us to individualize learning for each student if we measure their learning and allow them to progress at their own pace. Competency-based education, though, requires valid and reliable assessments to ensure we are measuring the expected competencies.
Nurse educators need to think more carefully about assessment. We engage in conversations in our schools of nursing about the knowledge and skills to be achieved in courses, but I am not convinced we have enough conversations about assessment. All too often, assessment methods are in courses (online and face-to-face) by tradition ("students always do those assignments in this course"), but they may not be the best methods to use. Educators need to review each method for assessing students' learning in their courses and confirm that it provides data to evaluate if students are developing the expected knowledge and competencies.
Teaching methods should focus on specific competencies that students need to achieve. Time for learning is limited, and the knowledge and skills to be gained in nursing programs are extensive. Teaching methods need to be carefully planned for courses and clinical experiences. This type of planning is demonstrated in the articles in this issue. Many schools have integrated Quality and Safety Education for Nurses (QSEN) competencies in their programs: 3 articles in this issue present teaching methods carefully planned and implemented for students to meet QSEN competencies. Students need to be committed to providing quality and safe care and be prepared to act in clinical situations in which care may be compromised. They need skills to "speak up" and advocate for patients. Doherty and colleagues3 developed a communication competency educational program that includes parts of the TeamSTEPPS communication and collaboration curriculum, video presentations, and group discussions to help students in their associate degree in nursing (ADN) program improve their communication and patient advocacy skills.
Effective teamwork is essential for patient safety. Horsley et al4 described how a nursing and medical school collaborated to systematically integrate interprofessional education (IPE) simulations into the curricula so that every graduate from both schools received TeamSTEPPS education and had a standardized IPE simulation experience. In another nursing program, students do a root cause analysis of an actual medical error. The cases for analysis are selected by the students based on their area of interest.5 These are 3 good examples of teaching methods carefully planned to guide students' achievement of specific competencies, in this case related to quality and safety. Plan your teaching methods to "match" the competencies you want students to develop.
We need to know if our teaching innovations make a difference long term. Students' knowledge will likely increase after a teaching innovation or new approach you develop for your course, but what about long-term effects? I want to know if an IPE simulation, for example, has an impact on students' communication skills and teamwork in later nursing courses and as a graduate. We still have too many studies in nursing education in which a teaching innovation or new approach is compared with no teaching, or competencies are measured before and immediately after the educational intervention. If you teach students using a new technology or method, they will learn. The question instead is will they retain that learning beyond the course, and will it make a difference in their later practice as a student and nurse?
As we develop educational innovations in nursing, let us not forget the affective domain. The affective domain relates to the development of values, attitudes, and beliefs that are consistent with standards of professional nursing practice. One of the reasons Doherty et al3 developed their communication competency educational intervention was to prepare students in their ADN program as patient advocates, with skills to speak up for patients. Students need to feel empowered to address issues in the clinical setting and be willing to act. Those behaviors are in the affective domain. Opportunities for students' interaction with clinical situations and scenarios that require them to think about their own beliefs and values and to take action are critical to development of affective competencies. This is a domain of learning that requires carefully planned teaching strategies. In this issue, Coleman and Dick6 described methods they developed to promote students' awareness of ethical situations and willingness to act when faced with them.
It is time to take program evaluation data seriously. We all evaluate our courses and programs, but many schools of nursing only engage in program evaluation because it is required for accreditation. We need to use those data to make informed decisions about what we do as faculty. I thought about this need when I read the study on the supports, barriers, and strategies to successful student progression in a doctor of nursing practice (DNP) program.7 This was a survey of DNP students and graduates (N = 172). Major barriers were competing demands of work, family, and school. Some of the barriers to progression in the program could be addressed by the school of nursing. For example, 1 barrier identified by students was not receiving information and support from their advisors and having difficulty contacting advisors. We could address that barrier by changing how advising is done with DNP students to improve communication with them and better preparing faculty for their role as advisors.
These are a few of my thoughts in reading the articles in this issue of Nurse Educator. I hope the articles stimulate discussions in your nursing program or give you some new perspectives about your teaching in nursing.
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