Nursing Practice News and Information for Nurses in Washington State

ABOUT THE BOOK
Excerpts from a book titled, “Educating Nurses: A Call for Radical Transformation” by Patricia Benner, Molly Sutphen, Victoria Leonard and Lisa Day.  This book was published in December of 2009 by Jossey-Bass.  For additional information about the study design, findings, and recommendations, go to:  http://www.carnegiefoundation.org/elibrary/educating-nurses-highlights#summary.

Educating Nurses: A Call for Radical Transformation is part of a multiyear comparative study of professional education in the United States called the Preparation for the Professions Program (PPP) at The Carnegie Foundation for the Advancement of Teaching. The project was funded by Carnegie and The Atlantic Philanthropies.  This book  identifies the most effective practices for teaching nursing and persuasively argues that nursing education must be remade. The authors call for radical advances in the pathways to nursing licensure and a radical new understanding of the curriculum.

The Carnegie National Nursing Education Study examined three dimensions of nursing education and formation: 1) the learning of theory and scientific methods; 2) the mastery of skillful practice; and 3) the formation of professional identity and agency.  

KEY OBSERVATIONS OR FINDINGS
A major finding from the study is that today’s nurses are undereducated for the demands of practice. Previous researchers worried about the education-¬practice gap; that is, the ability of practice settings to adopt and reflect what was being taught in academic institutions. Now, according to the authors, the tables are turned: nurse administrators worry about the practice¬-education gap, as it becomes harder for nursing education to keep pace with the rapid changes driven by research and new technologies.

Three other key findings informed the authors’ recommendations. These include:
1.  U.S. nursing programs are very effective in forming professional identity and ethical comportment.
2.  Clinical practice assignments provide powerful learning experiences, especially in programs where educators integrate clinical and classroom teaching.
3.  U.S. nursing programs are not effective in teaching nursing science, natural sciences, social sciences, technology and the humanities.

RECOMMENDATIONS FOR PROGRAMS
The authors suggest that nursing educators make four shifts in their thinking about teaching and in their approaches to fostering student learning.  These shifts in thinking are:

1.  From a focus on covering decontextualized knowledge to an emphasis on teaching for a sense of salience, situated cognition and action in particular situations.
2.  From a sharp separation of clinical and classroom teaching to an integration of the two.
3.  From an emphasis on critical thinking to an emphasis on clinical reasoning and multiple ways of thinking.
4.  From an emphasis on socialization and role-taking to an emphasis on formation.

RECOMMENDATIONS FOR POLICY CHANGE
Resulting from the study are a set of specific policy recommendations. These will require that the entire nursing profession work together to transform nursing education.  These recommendations include those around entry to practice, student population and student experience, faculty development, and national oversight of performance assessments for licensure.