New Mexico Statewide Nursing Faculty Conference June 3-4, 2009 Jean Giddens, PhD RN, Professor Interim Senior Associate Dean for Academic Affairs College of Nursing, University of New Mexico

o Faculty shortages o Increased workload o Increased student enrollment o Diversity of learners o Content saturation o Information management o New technologies o Rapid changes in health care o Increased complexity of health care o Diverse populations CHANGE ! o  supply of nurses o  supply of nurse educators o Multiple educational paths o Maintain high retention o Graduate Success (NCLEX/Certification exams)

o Content saturation o Information management o New technologies o Rapid changes in health care o Increased complexity of health care o Diverse populations o  supply of nurses o  supply of nurse educators o Multiple educational paths o Maintain high retention o Graduate Success (NCLEX/Certification exams) o Faculty shortages o Increased workload o Increased student enrollment o Diversity of learners CHANGE !

o  supply of nurses o  supply of nurse educators o Multiple educational paths o Maintain high retention o Graduate Success (NCLEX/Certification exams ) o Faculty shortages o Increased workload o Increased student enrollment o Diversity of learners o Content saturation o Information management o New technologies o Rapid changes in health care o Increased complexity of health care o Diverse populations CHANGE !

Giddens - ODU, 2008 o  supply of nurses o  supply of nurse educators o Multiple educational paths o Maintain high retention o Graduate Success (NCLEX/Certification exams) o Faculty shortages o Increased workload o Increased student enrollment o Diversity of learners o Limitations in clinical sites o Content saturation o Information management o New technologies o Rapid changes in health care o Increased complexity of health care o Diverse populations CHANGE !

 Content Saturation  Information Management  Learning Environments

Health sciences education is experiencing content saturation; there is more content than can possibly be taught in any given curriculum.

Curriculum Obesity Content Saturation Content Overload Additive Curriculum

 Late 1980s, the NLN led a curriculum revolution effort to transform the design of nursing programs. ◦ Rejection of long-standing content-loaded, behaviorist model of nursing education. ◦ New focus on selection of content ◦ New interest in facilitation of student learning with new pedagogies

 Bevis (1988) “…..reform efforts in nursing rarely change the substance of the curriculum itself but merely ‘switch, swap, and slide content around’."

Burton (2000) students… “are expected to learn a large volume of material in a short period of time. As a consequence, students tend to rely on rote memorization to pass exams.” Diekelmann (2002) “….textbooks are thicker and course content more complex. Students complain of ‘too much content’ as they appear to have reached their limits with memorization.”

IOM (2003) specifically cites “overly crowded curricula” as one of many challenges in health education reform (p. 38). NLN (2003) …. “many nurse educators continue to teach as they were taught and for a health care system that no longer exists…”

Ironside (2004) “The dilemma nurse educators are increasingly facing is not what to include in a course, but what to leave out.” AACN (2006) “Generalist education at the baccalaureate level is foundational to specialty practice”

 Belleck (2008) “Most of our teaching ‘innovations’ offer incremental ideas for tinkering at the edges, rather than true transformation in the way we conduct nursing education……By and large, nursing education is still ‘teaching heavy’ and ‘learning light.’

INFORMATION AGE The National Library of Medicine’s Medline archives 31,000 new citations per month.

Shift in focus from inpatient/acute care to community focused care. Problem not in change in focus, but the failure of nursing education to eliminate content.

Most nurse educators learned in a content-focused, highly structured curricula. Ongoing belief that all nursing content is learned in a nursing curriculum and the teacher is responsible to ensure all content is delivered.

 Desire for graduates who are prepared to enter specialized settings.  Exposure to specialty content versus becoming a specialist  Emergence of “core competencies” by specialty groups – recommendations for nursing education.

Information management Evidenced-based practice Bioterrorism Public Policy Environment Mass Casualty Response Genetics Gerontology Oncology Critical Care Critical Thinking Vulnerable Populations Cultural Competence End of Life Care Competencies In an examination of the National Council Licensure Examination Test Plan, Belleck (2006) claims to have identified >1000 discrete competencies required of new graduates!

 Information age has lead to exponential changes in the generation of information and diffusion of knowledge.  youtube shift happens:

 Old Paradigm: How Much You Know  New Paradigm: Locating, Analyzing, Interpreting, Applying Information “Nursing faculty are gatekeepers of specialized knowledge….. The nursing instructor has control of the class!” (Belleck, 2008)

Two minute breakout: Higher education emerged from 18 th century Europe. At that time, what did students look like? What were the primary teaching methods?

Generational Gender Diversity Racial/Cultural Socioeconomic Educational ……but teaching strategies have not!

 The “culture” of nursing is predominantly from a homogenous perspective of the “WWW”  O'Lynn (2009) “…we need to move beyond describing differences among diverse students. We need to realize that simply removing barriers only facilitates student retention, thus making students vulnerable to being forcibly molded.” Youtube -

Multiple Perspectives Diverse Experiences Diverse Learning Needs

Low Context High Context Focus on Words Reading Writing Lectures Focus on Relationships Social Learning Case Study Reflective Writing Theory of Context Diversity – R. Ibarra Goal: Transformation of Nursing Programs into Learning Environments

 What is another term for a student with low context strengths?  Answer: Honor Student  What is another term for a student with high context strengths?  Answer: At Risk Student

Critical thinkers Clinical judgment Life-long learners Play well with others Reflective Thinkers Consider alternative points of view

Design nursing curricula that reflect contemporary nursing practice. Provide essential content (knowledge) without an overburdened curriculum. Offer multicontexual learning approaches by promoting student-centered learning. Transform into learning communities that are inviting and in which all learners can thrive.

Educational Reform Curriculum redesign Education programs Changes in course delivery Innovative teaching Diversity Collaboration