Nurse Educators FAQ
This resource provides faculty with answers to Frequently Asked Questions (FAQ) regarding issues and trends in nursing education. The FAQ are divided into 3 areas:
• Curricular Trends
• Learning Strategies and Activities
• Evaluation Methods
(Click on a question to view/hide its answer.)
Curricular Trends
Q. What are 1+1 programs and are they common?
A. There is a growing trend to offer seamless nursing programs to help students with career mobility options in all types of colleges and universities. The 1+1 system is one way to achieve this outcome. The most common model is found in two-year nursing programs: The first year is the PN level and the second year is the RN level. Other schools view the entire two years as an RN program with a PN exit option after the first year.
Less common are articulation agreements between community colleges and BSN-granting colleges and universities to offer "two plus two" programs. The most common model allows the student to take two years of pre-requisite arts and sciences in a community college and then transfer to a school that offers the required upper division courses to obtain a BSN. The student usually receives an associate degree from the community college as well. A less common model allows the student to receive an AD in nursing from a community college before transferring to an RN-to-BSN program in an upper division school.
Less common are articulation agreements between community colleges and BSN-granting colleges and universities to offer "two plus two" programs. The most common model allows the student to take two years of pre-requisite arts and sciences in a community college and then transfer to a school that offers the required upper division courses to obtain a BSN. The student usually receives an associate degree from the community college as well. A less common model allows the student to receive an AD in nursing from a community college before transferring to an RN-to-BSN program in an upper division school.
Q. Why are some states developing and mandating standardized curricula, especially for AD and PN programs?
A. The main impetus behind this movement is to prevent students from having to repeat courses if they transfer from one program to another. Examples of states that have some kind of standardization include Arizona, Colorado, Alabama, Texas, North Carolina, and Wisconsin. Information about specific plans can be found on the Internet.
Some states are very prescriptive in their required curricula and others provide flexible guidelines. The National League for Nursing Accrediting Commission (NLNAC) and Commission on Collegiate Nursing Education (CCNE) require that faculty in each accredited program develop their own curriculum, which may be an argument in favor of flexible state program guidelines rather than a more rigid prescriptive approach.
Some states are very prescriptive in their required curricula and others provide flexible guidelines. The National League for Nursing Accrediting Commission (NLNAC) and Commission on Collegiate Nursing Education (CCNE) require that faculty in each accredited program develop their own curriculum, which may be an argument in favor of flexible state program guidelines rather than a more rigid prescriptive approach.
Q. What are the IOM/QSEN competencies and how do they affect our curriculum?
A. In 2003, an interdisciplinary Institute of Medicine (IOM) task force published a study with recommendations about health professions education programs. The group found that all health professions need to improve their academic programs to better prepare their graduates for a dynamic and complex health care system. The IOM recommended that all graduates be prepared to meet five major competencies.
The Quality and Safety Education for Nurses (QSEN) project, funded by Robert Wood Johnson, reviewed these competencies for use in the nursing profession. The project group validated the use of the IOM competencies in nursing and added a sixth one.
Nursing programs should incorporate these competencies into their curricula so that students can achieve them. The QSEN web site provides numerous teaching/learning strategies that can be used in the classroom, clinical simulation lab, and clinical practicum. Some programs have also used the competencies as a way to help organize their curricula. The emphasis of the program is then on nursing care and less on diseases.
The Quality and Safety Education for Nurses (QSEN) project, funded by Robert Wood Johnson, reviewed these competencies for use in the nursing profession. The project group validated the use of the IOM competencies in nursing and added a sixth one.
Nursing programs should incorporate these competencies into their curricula so that students can achieve them. The QSEN web site provides numerous teaching/learning strategies that can be used in the classroom, clinical simulation lab, and clinical practicum. Some programs have also used the competencies as a way to help organize their curricula. The emphasis of the program is then on nursing care and less on diseases.
Q. What is a concept-based curriculum? Should nursing programs be using that model?
A. Many pre-licensure nursing programs of all types have become very disease-oriented and content-saturated. The purpose of using a conceptual approach to teaching nursing is to focus more on nursing and less on diseases. Students learn to make connections between the concepts and major health problems, and not spend a lot of time on disorders they will seldom see in practice. Selected concepts are usually physiologic and psychosocial/spiritual, pathophysiologic, or a combination of both. For each identified concept in the first nursing foundations/fundamentals course, one or more health problems can be used as exemplars to illustrate the concept and emphasize the related nursing/interdisciplinary care in later courses.
For more information on how to use a conceptual approach with the IOM/QSEN competencies in your curriculum, contact Donna to conduct a workshop or consultation.
For more information on how to use a conceptual approach with the IOM/QSEN competencies in your curriculum, contact Donna to conduct a workshop or consultation.
Learning Strategies and Activities
Q. How can we make sure that students read before class?
A. Some students read in preparation for class and others do not. Teachers often become frustrated with this lack of motivation and tend to lecture in class to give the students the information needed. But, students have learned that they don't have to read before class because their instructors usually tell them what they need to know.
Today's nursing students suffer from information overload. They are assigned massive numbers of pages to read, receive large PowerPoint® presentations before class, and are given multi-page study guides for each class session or unit of study. Much of that information is not "need-to-know." Rather the text and other resources are saturated with insignificant details that do not help students become safe, beginning nurse generalists.
If only the essential reading is required, then the students are more likely to take the time before class to prepare. Students are also more likely to read when they know that the instructor will not repeat what's in the book. Instead, the role of the educator is to:
By using these tools, the instructor does not repeat all the information, but rather helps the students process it. Like all educational settings, the focus of the class should be on nursing; i.e., helping the students learn how to think like nurses.
Today's nursing students suffer from information overload. They are assigned massive numbers of pages to read, receive large PowerPoint® presentations before class, and are given multi-page study guides for each class session or unit of study. Much of that information is not "need-to-know." Rather the text and other resources are saturated with insignificant details that do not help students become safe, beginning nurse generalists.
If only the essential reading is required, then the students are more likely to take the time before class to prepare. Students are also more likely to read when they know that the instructor will not repeat what's in the book. Instead, the role of the educator is to:
- Clarify
- Highlight
- Summarize
- Update
By using these tools, the instructor does not repeat all the information, but rather helps the students process it. Like all educational settings, the focus of the class should be on nursing; i.e., helping the students learn how to think like nurses.
Q. How can we engage students in learning when there's a large class? Isn't lecture the best option for a large group?
A. Lecture is only one method of teaching/learning. A small amount of information sharing by the educator is appropriate at times. But lecture implies one-way communication rather than a discussion and interaction with learners. Educational research indicates that students learn best in cooperative learning environments. Even students who do not like group work find that dyad learning activities (in pairs) are very helpful in processing the content and how it's used in nursing. Remember the old adage, "It's better to be a guide on the side than a sage on the stage!"
Q. When some of us try new ideas (like learning activities in pairs), we get bad student evaluations. How should instructors introduce these more innovative strategies?
A. Despite what some faculty claim, most students do not want to be "spoon-fed." However, they are used to this method of teaching from high school and their prerequisite college courses. When new teaching/learning strategies are introduced, it's best to explain their purpose and try one at a time. Each class is comprised of various kinds of learners. What might work in one class doesn't always work in another.
Instructors need to explain that the activities are to help the students learn how to think like nurses—what we've often called "critical thinking." The fact is that nurses have to make timely and appropriate clinical decisions about patient care. We need to start having them practice making decisions in the classroom, clinical setting, and simulation lab.
Instructors need to explain that the activities are to help the students learn how to think like nurses—what we've often called "critical thinking." The fact is that nurses have to make timely and appropriate clinical decisions about patient care. We need to start having them practice making decisions in the classroom, clinical setting, and simulation lab.
Evaluation Methods
Q. How can we make sure that our test questions are like the NCLEX®? It's really difficult sometimes to make the items at an application and analysis level.
A. Writing NCLEX®-style test items is probably the hardest part of a nursing educator's job. Most of the questions on the actual RN and PN licensure exams are at the application and analysis cognitive levels. It is nearly impossible to construct a 4-choice multiple-choice item that is at the synthesis or evaluation level. Knowledge and comprehension questions are the easiest to write.
Students should be introduced to application questions early in their program. Each item should contain a nurse and a patient interaction in a brief clinical scenario. The student should then be asked to make a decision about the care provided by the nurse.
Be sure that your tests simulate the NCLEX® test plan, which is found on the National Council of State Boards of Nursing (NCSBN) web site. Developing a test plan, also known as a test blueprint, will assure that the faculty-made test follows the licensure exam format to establish evidence of content validity. Don't be afraid to use test banks as long as they contain questions that simulate the NCLEX® and have been secured.
For more information on test-writing and statistical analysis, contact Donna to conduct a workshop for your faculty or area programs.
Students should be introduced to application questions early in their program. Each item should contain a nurse and a patient interaction in a brief clinical scenario. The student should then be asked to make a decision about the care provided by the nurse.
Be sure that your tests simulate the NCLEX® test plan, which is found on the National Council of State Boards of Nursing (NCSBN) web site. Developing a test plan, also known as a test blueprint, will assure that the faculty-made test follows the licensure exam format to establish evidence of content validity. Don't be afraid to use test banks as long as they contain questions that simulate the NCLEX® and have been secured.
For more information on test-writing and statistical analysis, contact Donna to conduct a workshop for your faculty or area programs.
Q. How long should a unit exam be and how much time should be allowed to take it?
A. There is no set length for any unit exam. However, if the test is too short, the reliability of the tool will be negatively affected. Most faculty give a 40- to 50-item test, with perhaps a longer comprehensive exam to help students get used to a longer testing time. A minute and a half should be allowed for each item due to increased time for application-style items, alternate item formats, and increasing numbers of ESL students.
Q. We don't like our clinical evaluation tool (CET) because it's too subjective. What are other schools using?
A. By definition, evaluation is a process in which data from measurement tools are analyzed to make a judgment about a situation, program, or individual. In the case of clinical evaluation, the CET is typically used. The trend is to give a pass/fail grade rather than a letter grade for students in the clinical portions of their programs. The CET should be developed as a criterion-referenced tool to identify the competencies that students must master to pass and progress.
The CET should be used at midterm and for the final determination of the student's performance. It is not a weekly measure of the student's progress because the criteria have to be met by the end of the clinical course. Weekly documentation of the student's ongoing progress, strengths, and areas for improvement are described, along with any action plans, if necessary. The documentation should be done for every student regardless of performance ability.
For more information on how to develop a valid and reliable CET, contact Donna to conduct a workshop for your faculty or area programs.
The CET should be used at midterm and for the final determination of the student's performance. It is not a weekly measure of the student's progress because the criteria have to be met by the end of the clinical course. Weekly documentation of the student's ongoing progress, strengths, and areas for improvement are described, along with any action plans, if necessary. The documentation should be done for every student regardless of performance ability.
For more information on how to develop a valid and reliable CET, contact Donna to conduct a workshop for your faculty or area programs.