In this time of rapidly evolving healthcare systems and changing dynamics in nursing education, the CGEAN Board and many members are concerned with supporting MSN administration programs to thrive and meet the need for well-prepared nurses to take leadership roles in the profession. Over the past several years, members have reported that such programs were closing in response to decreased enrollments or other factors. Given these circumstances, the CGEAN Board decided to query key leaders in the service sector to determine content and curricular elements that are essential for strong, effective MSN in nursing administration programs.
The Circle of Advisors1 (Circle) approach was deemed as ideal to identify strategies to promote MSN administration programs and to outline recommendations about the most current knowledge, skills, and competencies required for the master's degree-prepared nursing leader of the future. This Circle approach is a strategy designed to address innovation, which is what the CGEAN Board was seeking to reinvigorate MSN administration programs. In such cases, the literature is scant. Attempts at determining best practices are difficult or impossible. Thus, advisors are asked to participate in generative thinking. The term, Circle, refers to the idea that asking 1 or 2 people is insufficient. Rather, pulling in a circle of diverse people allows different thinking.
To create the CGEAN Circle, a group of diverse, national figures in nursing service was identified, and approximately 30 invitations to leaders in acute care, ambulatory care, home care, and hospice were issued. Advisors for the Circle received background documents including The Essentials of Master's Education for Advanced Nursing Practice2 and American Organization of Nurse Executives' Nurse Manager Competencies3 and Nurse Executive Competencies4 to provide a foundation for the work. Advisors also received questions that served as the framework for discussions. For example, 1 question was about the critical content areas for leaders at the service line and unit level, and another was about the ideal set of clinical experiences.
Thirteen of the invited advisors came together in a face-to-face meeting at the 2016 International Nursing Administration Research Conference in Orlando, Florida. A deliberative process was constructed to capture the Circle's advice. Each advisor was assigned to a group to address a question followed by other Circle members offering insights. All discussion and ideas were recorded on Post-it notes. Responses to these questions are currently being analyzed. To balance the future with the here-and-now, an open question about pressing workforce issues was asked of the entire Circle with responses recorded in a similar manner as above (Table 1).
The advisors were clear about the importance of staff education. In addition to achieving goals for bachelor's degree-prepared nurses, they discussed ongoing, lifelong learning; the expectations of Magnet(R) designation; and professional certification. These trajectories for ongoing education posed opportunities for MSN administration programs, including nurses interested in formal leadership careers, to link personal and professional development to career enhancement.
Challenging work environments were a major theme. Dealing with chaos and complexity is viewed as a daily event. As if the lack of civility were not challenging by itself, it is intensified by the wide span of control many nurse managers face. Because this issue seems to be global, administrative faculty need to consider content to help nurse leaders be effective at changing work environments, intervening in cases of workplace incivility, and engaging in deliberative conversations about improving the workplace.
The perennial issue of recruitment and retention of staff is complicated by the increasing retirement rates among the boomer generation and shifting paradigms in care delivery, the 4th theme. The final 2 current challenges-nurse leader succession planning and the changing workforce-are well documented in the literature but can be studied from new perspectives to find new answers for a stable workforce able to effect greater outcomes.
One message clearly articulated by the Circle was to stop calling what learners in administrative graduate programs do "clinical." Clinical suggests that a preceptor is needed and that the experience must be within a healthcare setting. Opportunities such as observing high-level discussions or participating in strategic planning can provide more insight into effective leadership than many hours working with a director. So, what did the advisors suggest? The experiential component of the curriculum should be called a "leadership practicum," making clear that experiences to develop advanced leadership skills are very different from clinical experiences.
One final message was clear. These programs are needed! Maintaining MSN in nursing administration/leadership programs and continuing to promote this educational pathway to prepare strong, effective leaders in nursing and healthcare were the consistent message from the Circle, regardless of the service sector represented.
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