Category: Nurse Educator Education

Authors of the blog:

Dr. Pilar Fuster-Linares

Dr. Leandra Martin Delgado

Dr. Laia Wennberg Capellades

From Universitat Internacional de Catalunya, Barcelona, Spain

The concept of ethical dilemmas has been broadly explored in nursing because of the prevalence of this dilemmas in daily practice (1,2). As nurses we understand the need and importance of having ethical standards in our profession. In 2021, the ICN reviewed and updated the Code of Ethics for Nurses, a statement of the ethical values, responsibilities and professional accountabilities of nurses that defines and guides ethical nursing practice. This document includes the changes that appear in the working environments and the new challenges and dilemmas that have appeared due to the COVID-19 pandemic (3).

Faced with these new elements and in order to show the essence of the ethics of care in the different professional roles, nursing educators must also be updated, not only in the content of the Code of Ethics, but also in the ways in which it is incorporated into nursing curricula.

Although ethical dilemmas are frequent in day-to-day life of the nursing professional, it is difficult for nursing students to identify situations potentially susceptible to be recognized as ethical dilemmas, due to their lack of knowledge of the professional role, their lack of clinical practice or even their lack of autonomy to make decisions in the clinical environment among others (4). For this reason, it is important to work on ethical dilemmas through methodologies that facilitate and stimulate reflection, but that in turn propose situations that students can understand and analyse even if they have not lived them.

Several studies have shown that education through films helps to improve teaching skills and stimulates learner reflection (5,6). Films could be considered as “the audio-visual version of storytelling (….) The cinema experiences act like emotional memories for developing attitudes and keeping them as reflective reference in the daily activities and events” (Blasco, P. et al Journal for Learning through the Arts, v22, n1,2015).

In our case, we incorporate the methodology of reflection through the cinema precisely to offer nurse educators the possibility of experiencing the possibilities of this methodology. We used the film Wit (2001), in which the leading actress Vivian (Emma Thopmson) shares her experience of illness with the viewer, and makes him a participant in her decisions, her experiences and her thoughts. Through the magic of the cinema, Vivian forces us to feel and be moved by her experience, and leads us to reflect on aspects of the nursing profession in a complex situation that is not always evident to us. But above all it allows us to do it from the perspective of the patient and through our own emotion, adding the value of the “experience” to something that priori, could be totally external to us.

This methodology allows us to empathize with the other from the safety of our home, it also allows us to live and relive those moments that cause us more doubt, more surprise or more indignation. We can analyse, dissect and reflect on what we see, but also on what makes us feel what we see, and that part of emotion, adds value to the learning experience, helping to develop concepts and to strongly record elements, in this case of professional ethics.

REFERENCES

1- Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461.

2- Koskimies, E., Koskinen, S., Leino‐Kilpi, H., & Suhonen, R. (2020). The informational privacy of patients in prehospital emergency care—Integrative literature review. Journal of Clinical Nursing, 29(23-24), 4440-4453.

3- Sperling, D. (2021). Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic. Nursing Ethics, 28(1), 9-22.

4- Albert, J. S., Younas, A., & Sana, S. (2020). Nursing students’ ethical dilemmas regarding patient care: An integrative review. Nurse Education Today, 88, 104389.

5- Blasco, P. G., Moreto, G., Blasco, M. G., Levites, M. R., & Janaudis, M. A. (2015). Education through Movies: Improving teaching skills and fostering reflection among students and teachers. Journal for Learning through the Arts, 11(1), n1.

6- Jerrentrup, A., Mueller, T., Glowalla, U., Herder, M., Henrichs, N., Neubauer, A., & Schaefer, J. R. (2018). Teaching medicine with the help of “Dr. House”. PLoS One, 13(3), e0193972

The authors are: Dana Zrubcová, Andrea Solgajová, Ľuboslava Pavelová

Constantine the Philosopher University in Nitra, Slovakia

Contemporary society places high demands on abilities of individuals to work effectively with new information and information resources. Development of science and technology, fast pace in development of new technologies penetrates all areas and is becoming a part of our everyday life. Based on these dynamic changes in society, the necessity of fundamental change in the education system is crucial. Innovative education of nurses is the fundamental source of development in the field, quality of provided care and the patient’s satisfaction with the care provided. Mutual international cooperation and mobility of not only nurses but also the educators point out to the need of significant change in the education of nurses in Slovakia. Changing the traditional way of education as well as implementing the new and modern concept of teaching, plays the key role in the education of nurses in Slovakia.

One of the innovative methods is mobile learning, which is making learning outside of geographical barriers and time constrains possible. It ensures that students have access to various educational materials, with various context with different cultural and environmental cues that are necessary to understand the content. It also facilitates social interaction between students and teachers through mobile applications such as text messaging or tools for student reactions, assessment, and feedback from students. The necessity of implementing mobile education was also indicated by the pandemic situation, because of which it was necessary to move part of the teaching to the online space.

The advances of information technologies, such as mobile apps, offer attractive possibilities for designing more effective learning materials in multimedia environments that may encourage individualized learning and enable efficiency gains for learning achievement (Strandell-Laine et al., 2018).

The mobile apps provide an interactive and individualized opportunity to practice instructional procedures. The virtual reality, designed as structured learning experiences, can replicate high-risk clinical experiences for nursing students to practice skills repeatedly without putting patients at risk (Nielsen et al., 2020).

We see the implementation of simulation methods in the teaching process as an important teaching strategy for improving the quality of education of nurses. The use of simulation methods in teaching is attractive for students. It creates a space to apply theoretical knowledge and practical skills, develops students’ critical thinking and at the same time gives space for immediate feedback and teacher’s response. The simulation of real clinical cases improves mutual communication and enables practicing cooperation in a multidisciplinary team. Repeated opportunities to practice solving a clinical situation in a safe environment, creates space for learning and increases student confidence.

Another area in nurse education that requires change is the implementation of evidence-based teaching strategies. Most important is to apply this concept to the nurse education properly. To educate nurses, it is crucial to respect the four essential elements using evidence-based nursing: evidence, professional judgment, client values, and resource issues. In the current concept of nursers’ education, the prior focus is on promoting critical thinking and evidence-based teaching.

The main aim is to incorporate critical thinking and the concept of evidence-based teaching into teaching of future nurses how to make clinical decisions based on best and reliable evidence. When starting a work practice it is expected in nurses to provide nursing care as well as to be able to justify the reason for their choices and decisions. When making decisions in real life, nurses need critical thinking skills to generate alternatives and use evidence to select the best alternative to achieve specific client outcomes (Ferguson & Day, 2005).

Teaching research and conducting discussions about the credibility of evidence supported by research, is essential to gain the ability to implement evidence-based nursing in practice. Working with scientific databases represents yet another challenge for students of nursing. The support of the educators is particularly crucial at this point. The educator should play the role of a leader, give support, and encourage students to search evidence and find the best possible procedures in care. Part of the evidence-based nursing and nurse education is the acceptance of clients’ values, i.e., holistic care.

Finally, it is also the role of the nurse educator to guide students to be able to make clinical decisions based on resource allocation. After the introduction of the concept of evidence-based nursing and the need to teach future nurses to provide evidence-based nursing care, the question of the provided conditions and facilities for evidence-based nursing care education was raised. What is the acquired knowledge of the educators regarding the concept of evidence-based practice in education? Are these principles applied when curricula and strategies are created for the education of nurses based on the best possible evidence? Do educators use clinical judgment in adopting or adapting recommended practices according to specific situations, curricula, or students? Are students’ values taken into consideration when developing and implementing curriculum and strategies? Are educators considering the implications of applied evidence in education?

Nurse educators need to be trained to understand the benefits of the strategy and their potential impact on knowledge acquisition, such as critical thinking, decision making, and competencies that are essential for today’s nursing students (Breytenbach, ten Ham-Baloyi & Jordan, 2017). Terms and conditions in Slovakia suggest that it is necessary to retrain our educators in the concept of evidence-based education through workshops and/or compulsory training modules. Currently, there is a tendency to use the traditional way of education.

However, the new generation of students needs an innovative, trendy approach. Among other things, the overall population of students of nursing is becoming more and more diverse regarding cultural, social or value differences. It is also necessary to consider the generation gap between students and educators as a factor influencing the educational process. Promoting interaction between educators and students is essential and makes the process more effective and better. Nurse educators need to be urged to pay more attention to the process of assessment and the results in their education.

At the same time, the world is rapidly changing, including advances in science and technology, which points out to increasing demand in the education of future nurses regarding digital skills and competencies. Nursing students’ development is not only the basis for an effective digital transformation in education, but also boosts the graduates’ profile, and the graduate will be able to get involved in society successfully. It is important to incorporate digital learning technologies into education; social media into healthcare as well as simulation and mobile technology; and creation and evaluation of educational material. As an example, interesting models in education of nurses are social media such as blogs, Twitter, Instagram, Facebook, YouTube, Redit, Khan Academy, Pantoon, Canva, Mentimeter, Quizzis, Speaker, Flipgrit or games where they need to provide healthcare and improve their critical reflection, decision making skills, dialogue, and self-efficacy. International collaboration is essential for the digital transformation of nursing education.

At present, Slovakia and other European countries are struggling due to significant lack of nurses. The current situation creates constant pressure to increase the number of nurse graduates therefor the change in the education of nurses is a must. Let’s all support evidence-based nurse education together, so that the myth of ‘evidence-based practice’ becomes a reality under our own terms and conditions.

References

Breytenbach, C., ten Ham-Baloyi, W., & Jordan, P. J. (2017). An Integrative Literature Review of Evidence-Based Teaching Strategies for Nurse Educators. Nursing Education Perspectives, 38(4), 193-197. doi: 10.1097/01.NEP.0000000000000181

Draft Digital Transformation of Education Program in Slovakia and Action Plan for the period 2021-2024 Output from the national project “IT Academy – Education for the 21st Century”, Program_DT_vzdelavania_navrh_20201016-1.pdf

Ferguson, L., & Day, R. A. (2005). Evidence-based nursing education: Myth or reality? Journal of Nursing Education, 44(3), 107-115. doi:https://doi.org/10.3928/01484834-20050301-03

Nielsen, C. A. B., Lönn, L., Konge, L., & Taudorf, M. (2020). Simulation-based virtual-reality patient-specific rehearsal prior to endovascular procedures: A systematic review. Diagnostics, 10(7), 500.

Strandell‐Laine, C., Saarikoski, M., Löyttyniemi, E., Meretoja, R., Salminen, L., & Leino‐Kilpi, H. (2018). Effectiveness of mobile cooperation intervention on students’ clinical learning outcomes: A randomized controlled trial. Journal of advanced nursing, 74(6), 1319-1331.

Dr. Pilar Fuster, lecturer in the Nursing Department-UIC Barcelona

One of my first international experiences as a teacher was on the course Empowering Learning Environments in Nursing Education (EleneIP) which was organised by the University of Turku. This course, aimed at future nursing teachers, was funded twice by the Erasmus Lifelong Learning programme as an Intensive Erasmus course. It was the first initiative to create a common learning space for future nursing teachers from different countries in Europe and focused on using social media as teaching tools as the core theme. The programme was run for the first time in June 2013.

Prior to this experience, as a student, I had undertaken the EANS Summer courses for doctoral studies, so I had some idea of what it meant to be a student and to learn in an international environment. However, the EleneIP course gave me the opportunity to share with other nursing teachers my own knowledge and the tools we had worked on at my university, which could improve the teaching competence of other colleagues. It was a truly satisfying and very inspiring experience, which I not only perceived as a teacher, but was shared by the students on the course. The participants, who came from different countries with very different academic backgrounds, highlighted the acquisition of skills and knowledge of teaching methodologies (social media-simulation-collaborative learning) and of teaching content (ethical aspects-assessment and use of digital materials-cultural and educational aspects and different health systems). In addition, they rated their experiences very positively, highlighting cooperation, teamwork and the opportunity to learn in a multicultural environment.

But it wasn’t just about the teaching methodology and materials. As a personal experience it was fantastic. I shared this course with eight students who came from my university, including classmates and friends. For someone who comes from Spain, who is used to a warm climate, it was quite a challenge to get used to the cold, the long nights and the silence, to share a sauna and swim in icy water! To get to know another culture, different landscapes, a different cuisine! Exchanging stories and understanding how culture shapes our view of the world, what we say, how we perceive things, what things mean to us, to be aware of the differences and how they enrich us, was one of the most important things I took with me. It was without a doubt one of the best experiences for forging closer bonds with colleagues and making new connections!

These types of encounter lead to growth and personal and professional opportunities. In addition to gaining new knowledge, they are a unique opportunity for fostering discussion between those working in an area, in our case, to discuss the education of nursing teachers at a European level. It is also a way to grow as a profession. It helps us to open our minds to different realities from our own, to share concerns and interests and to identify best practices so that we can then share them, discuss them and put them into practice in our own institutions, thereby making improvements through experience-based learning. And not only that, this type of course creates a unique environment of collaboration and cooperation, which encourages the development of new networks, multiplying opportunities for cooperation between participants.

Dr. Pilar Fuster, lecturer in the Nursing Department-UIC Barcelona

References

Salminen, L., Gustafsson, M. L., Vilén, L., Fuster, P., Istomina, N., & Papastavrou, E. (2016). Nurse teacher candidates learned to use social media during the international teacher training course. Nurse Education Today, 36, 354-359.

Papastavrou, E., Hamari, L., Fuster, P., Istomina, N., & Salminen, L. (2016). Using blogs for facilitating and connecting nurse educator candidates. Nurse education today, 45, 35-41.