Technology: Key to Transforming Nursing Education
By Roy L. Simpson, RN, C, FAAN, DPNAP, Vice President, Nursing, Cerner Corporation
Technology erases the traditional boundaries of space and time, which allows nurses to access innovations in care, proven best practices and insights from academic research on the fly at the patient’s bedside—whether the patient is in a hospital, an outpatient facility, a rehabilitation center or even a private home.
Preparing nurses to lead in this technology-enabled health care system requires sweeping reform in nurse education, utilization and advancement.
The Institute of Medicine’s (IOM’s) landmark study, “The Future of Nursing: Leading Change, Advancing Care,” recommends the nursing profession move immediately to:
- Institute residency training for nurses,
- Increase the percentage of nurses who attain a bachelor’s degree to 80 percent by 2020, and
- Double the number of nurses pursuing doctorates.
To complement this trio of action items, the report also points to the need to remove regulatory and institutional obstacles, such as current limits on nurses’ scope of practice, to allow patients to reap the full benefit of nurses’ education, skills and knowledge.
Technology can accelerate the success of each of the above-named initiatives. For example, replacing traditional residency, which is based on the “see one, do one” medical model, with learning in virtual environments substantially expands the number of nurses who gain new competencies and the depth of their skills. In a virtual environment, nurses can repeat skills-based lessons as often as they need with absolutely no impact on actual patients. Additionally, the “always on” component of virtual learning lends itself nicely to the model of employed nurses working during off hours to advance their education.
In addition to the need for nurses to be educated in new ways, America also needs more educated nurses at all levels of the profession. Experts predict another significant nursing shortage—this one as soon as 2020. While we can only prognosticate on the care requirements of a graying Boomer generation, there is widespread agreement that the coming shortage will embody a more significant demand for sophisticated care than we’ve seen before.
To be able to meet this increased demand for care, we need a new approach to nursing education. Today’s nursing schools center on pedagogy, a model in which the teacher, a recognized expert in the field, disseminates knowledge to students whose job it is to absorb what is being taught. In this environment, only minimal interaction between the teacher and the students occurs, and students’ previous professional experiences have little bearing on what is taught. While children respond well to this approach, most adult students do not.
Learning based in andragogy, on the other hand, allows students to actively engage in what is being taught with the instructor acting more as a facilitator than an expert. In this model, the teacher, who may very well be an expert in a field of study, works to bring out each student’s relevant knowledge. This form of knowledge transfer, which is known as “Adult Learning Theory,” seems better fitted to educating the advancing nurse professional than a pedagogy-only approach. Technology, especially online learning, stands ready to become the delivery platform we need to transform professional education for nurses at all levels.
Finally, the success of this new educational model depends on academia partnering with the commercial HIT (health information technology) world in a synergistic, mutually beneficial way. Technology providers are no more willing to make their technologies available to academics at no charge than universities are to providing free education. Finding ways to integrate technology into this new educational model requires that both sides gain from the association. For example, leading HIT companies that make their systems available to academic institutions will want to gain, and deserve to have, market advantages accrue to them. It will be up to both sides to maintain the delicate balance of mutual benefit without complicating either side’s legal or ethical position.
To conclude, I agree wholeheartedly with the IOM’s overarching recommendation: that nurses must take a leadership role and be fully engaged with other health professionals in redesigning patient care in the United States. To do that, I believe our profession needs to move decisively to leverage online technology as an educational delivery platform, combine pedagogy with andragogy to facilitate adult learning, and build mutually beneficial partnerships between the commercial HIT sector and academe. It will take all of us working together to forge this much needed new educational model.