Two independent assessments of nursing education have called for a revamping of the system. In the first, published in the January issue of The Joint Commission Journal on Quality and Patient Safety, Kovner and colleagues evaluated a sample of newly licensed RNs to determine what they had learned about quality improvement (QI) in their educational programs.
The data came from a sample of 436 associate's- and bachelor's-degree graduates who were asked about their education in QI (defined as the use of "data to monitor outcomes of care processes" and of "methods to design and test changes to improve quality and safety"). Although nursing educators may think they're preparing students in QI, results showed that 38.6% thought education in this area was poor, very poor, or even nonexistent (they had never heard of QI in school). QI needs to be a high priority, according to the authors, who recommended that "nurse educators and hospitals . . . partner to implement QI education."
On a larger scale, the Carnegie Foundation for the Advancement of Teaching performed a two-phase study that included onsite visits to nine geographically diverse U.S. schools (phase one) and a national survey of faculty and students conducted in collaboration with the American Association of Critical-Care Nurses, the National League for Nursing, and the National Student Nurses Association (phase two). The study authors' recommendations on nursing education, released online by the Carnegie Foundation in mid-January (http://bit.ly/8BxscM), are essentially highlights from the authors' December 2009 book, Educating Nurses: A Call for Radical Transformation. Among many salient points, Benner and colleagues emphasize that nursing educators need to teach students to use science and nursing knowledge in specific clinical circumstances and to foster their ability to reason as the clinical picture changes, taking into account the context and concerns of the patient and the patient's family. This requires a shift from the current sharp separation between the classroom and clinical teaching toward an integration of the two, and toward the use of multiple ways of thinking rather than critical-thinking skills alone.
The authors also weigh in on raising the academic level required for entry into professional practice to a bachelor of science in nursing, an idea that has been batted around for decades. The authors write that nursing lacks "the political will" to implement this entry path, which they believe would lead to better patient outcomes, and they point to the serious holes in faculty preparation and development "across all types of nursing programs." They believe that the profession must "transform the current diverse pathways [into RN practice] into a unified whole."
Gail M. Pfeifer, MA, RN