Masters in Nursing for Clinical Teaching the

¶ … Masters in Nursing for Clinical Teaching The objective of this study is to examine the importance of a Masters in Nursing for the Nurse in Clinical Teaching endeavors.

The work of Orton (2007) entitled "Nurses As Clinical Teachers" Variables Affecting Teaching Comfort and Self-Efficacy" reports a descriptive correlations study that examined whether there was a "common understanding of a good clinical teacher among nursing students and faculty." (p.ix) Stated as a secondary purpose was the validation of a tool for development of individual prescriptions for improvement of the clinical teaching of nursing instructors.

Common Assumptions A third stated purpose was testing for common assumptions about good teaching: (1) if experience in clinical teaching leads to a better praxis; (2) if educational training (the most common intervention) leads to better teaching; (3) if experience in teaching (other than nursing) leads to better clinical teaching; (4) if the education degree status has an impact on the quality of teaching; and (5) if teaching status (full or part-time) enhances clinical teaching. (Orton, 2007, p.ix) II. Case Study The study involved twenty-five nursing faculty from a junior college and 215 nursing student participants.

It is reported as follows: "Nursing faculty completed identical Q-sorts from two different frames of reference, first for their teacher then followed by their ideal teacher. Students also completed identical Qsorts from two different frames of reference, first for their clinical teacher followed by their ideal teacher. Using the clinical teaching Perception Inventory (CTPIAE) tool, faculty and students ranked 28 one-word behaviors along a 7-point continuum of significance, from least likely to most likely.

Using the Self-Efficacy Toward Teaching Inventory (SETTI), faculty rated their confidence in their ability to perform 48 teaching skills. Faculty also completed a demographic questionnaire." (Orton, 2007, p.ix) The study states conclusions that include that nursing instructors "…agreed with physicians on most descriptors that identified themselves as clinical teachers, and on 90% of the behaviors of the ideal clinical instructor. Nursing instructors and their students agreed on 80% of the behaviors of these same teachers. Nurses and their students agreed on 1/2 of the perceptions of the ideal clinical instructor.

Effective clinical teachers' scores did not correlate with the predictor variables: years teaching nursing, number of educational courses completed, years teaching courses other than nursing, and biological age." (Orton, 2007, p.x) Recommendations made by the study include the following recommendations "A prescription for educating teachers to become more effective clinical instructors includes the implementation of a faculty development program where specific learning needs and faculty readiness are assessed prior to the onset of educating faculty how to teach clinical nursing." (Orton, 2007, p.x) III.

AACN Board of Directors Task Force The AACN Board of Directors established a Task Force on Essential Clinical Resources Fro Nursing's Academic Mission in 1997. The task force was charged with the following: "Develop a comprehensive statement on the essential elements of clinical support for the nursing academic mission. This should include a discussion of the clinical access necessary for preparation of a skilled group of professional nurses for basic and advanced nursing practice.

In addition, the statement should articulate an understanding of the clinical elements necessary for the entire academic mission, including faculty practice and nursing research activities. The statement should also include a description of the facilitators and barriers to clinical access, particularly focusing on the dynamic nature of the health care delivery system." (Orton, 2007, p.1) The AACN additionally reports "…learning to perform as a "nurse" is predicated on engaging in experiential learning with actual patients/clients.

This type of learning opportunity usually is referred to as a "clinical practicum" and represents a field experience. Experiential learning can occur through a number of modalities, including computer and virtual reality simulations, case studies, interactive videos, and hands-on direct patient interactions or experiences. Each of these modalities is an appropriate and useful means of teaching; however, the primary focus of this document is the hands-on direct patient care -- referred to as clinical site-based learning -- experiences necessary for preparing qualified nursing practitioners and researchers.

Experiential learning necessary for baccalaureate educational preparation includes the supervised practice of skilled nursing care in a variety of direct practice sites such as hospitals, extended care institutions, clinics, schools, churches, homes, or other community venues. Students receive a variety of experiences across a health/illness continuum, graduating as novice practitioners for general nursing practice." (Orton, 2007, p.1) IV. Required Clinical Resources Significant clinical resources are required at the master's and doctoral level in order to provide quality in the preparation of practitioners.

Experiential learning opportunities for master's nursing education are reported to "…encompass a similar breadth of venues as that for baccalaureate education. However, master's students preparing for direct patient care roles receive more focused education and clinical experiences on a particular health/illness point (acute/critical care or primary care) or specific population (family or elders), graduating as advanced practice clinicians. Other master's nursing students preparing for non-direct patient care roles (e.g. administration or community health) receive focused education and clinical experiences that reflect their areas of specialization.

Doctoral students must have opportunities not only to practice in their specialty but also must have ample and appropriate research opportunities within their chosen field." (Orton, 2007, p.1) It is reported that in the academic setting the requirements of clinical education are as follows: (1) reconceptualization and redefinition of the faculty role and the educational model that integrates teaching, practice, and research.

This calls for a major change in nursing academic culture, including reward structures; (2) incorporation of faculty practice into the work of the faculty; (3) redefinition of the nature of partnership and collaboration with clinical agencies, including mutual goal setting for achievement of the separate and shared missions; (4) faculty commitment to the partnership and to practice; (5) articulation of faculty contributions to the practice setting and mission (e.g., expert consultation, staff development, direct and indirect provision of nursing services, research collaboration, and mentorship); and (6) specification of the educational, research, and practice agendas inherent in faculty practice.

(Orton, 2007, p.1) IV. Master's Programs for Nursing Educator Preparation According to the work of Lerner and Ruland (2010) entitled "Master's Programs Preparing Nurse Educator: What is the Current State of Affairs?" The nurse educator master's programs "need to be designed to prepare nurses to function as educators in the hospital setting, community colleges, and nontenure track positions in universities.

They should offer a blend of courses that satisfy outcomes of the graduate core suggested by the AACN Essentials document, clinical specialty content, and educational content that will prepare the graduates for the teaching role as well as prepare the graduates for eventual PhD study." (p.1) Lerner and Ruland reports that the Carnegie Foundation recently published the work entitled "Educating Nurses: A Call for Radical Transformation" in which Benner et al. is reported to have "…presented an agenda for transforming nursing education.

One item on this agenda was "Include teacher education courses in master's and doctoral programs." (2010, p.1) Although challenging all nursing master's programs to include teacher education content, the authors advise that an important caveat is that programs must also include clinical practice preparation for future teachers. The curriculum design challenge is to balance total credit hours against the essential elements.

The curricula reviewed in this study revealed several approaches to this challenge." (2010, p.1) When programs were inclusive of all the elements of the graduate core curriculum and additionally require three advanced practice core courses the range of total credits is reported to fall between 31 and 39 without inclusion of education courses or specialty content." (Lerner and Ruland, 2010, p.1) Lerner and Ruland report that only 92 of the programs or 46% made a requirement of some type of advanced clinical specialty courses, which is stated to fall short "of the suggestion by Benner et al.

that all nurse educator preparation programs offer clinical preparation as well as educational preparation." (Lerner and Ruland, 2010, p.1) Findings additionally relate that many of the programs "shared clinical courses with other tracks. This was evident with 12 programs (13%) that share clinical nurse specialist courses and 11 (12%) that share NP courses. Again, this approach requires faculty vigilance in attention to student needs across specialty tracks. The remaining 69 programs (75%) that have clinical specialty courses appear to have developed them specifically for their nurse educator tracks.

These courses vary between 2 and 6 credit hours for theory and may or may not have a clinical component. One creative solution to the clinical practice element seen numerous times was to create a course that focused on learning how to be an effective clinical teacher in a specific area of specialty. This approach supports the recommendation by Benner et al.

that faculty must learn how to coach on practical clinical reasoning for their students to develop sound clinical judgment skills." (Leuner and Ruland, 2010, p.1) Lastly, it is reported that the days that teachers learn to teach 'on the job' are gone. The work of Benner et al. is reported to spell out with clarity precisely what the needs are to "transform nursing education, especially in terms of the need to include education coursework and clinical specialty preparation in the graduate education of nursing faculty.

Now is the time for the nursing education community to work together to develop curricular standards that can be applied to nurse educator programs. Graduate faculty needs such structure to ensure that their curricular decisions are evidence based and in keeping with national trends.

Hopefully, the data in this review will help to inform decisions regarding nurse educator curriculum standards." (Leuner and Ruland, 2010, p.1) The work of the Southern Regional Education Board Council on Collegiate Education for Nursing reports a debate on the "appropriate educational preparation for a nurse educator for many years. Davis et al. (1992) and Krisman-Scott (1998) noted an.