The Historical Perspective
The “Triple Aim”: Connecting Interprofessional Collaborative Practice and Patient Outcomes
National Standards for Interprofessional Education and Collaborative Practice
Faculty Development for Interprofessional Education
Implementing IPE and CP Initiatives into the Curriculum
Summary
12: Service Learning: Developing Values, Cultural Competence, Social Responsibility, and Global Awareness
Service Learning
Theoretical Foundations of Service Learning
Outcomes of Service Learning
Integrating Service Learning into the Curriculum
Implementing Service Learning in the Nursing Curriculum
Summary
Unit III: Teaching and Learning
13: Theoretical Foundations of Teaching and Learning
Learning Theories
Summary
14: Managing Student Incivility and Misconduct in the Learning
Environment
Incivility in the Higher Education Environment
A Continuum of Misconduct
Proactive Response Strategies
Campus Resources
Implications for Practice
The Faculty–Student Learning Relationship
Summary
15: Strategies to Promote Student Engagement and Active Learning
Student Engagement
Teaching Strategies
Summary
16: Multicultural Education in Nursing
Multicultural Education
The Inclusive Learning Environment
Gender and Linguistic Bias
Developing Inclusive Excellence in Academic Institutions, Programs, Curricula and Courses
Summary: I Hope You Dance
17: Teaching in the Clinical Setting
Practice Learning Environments
Clinical Practicum Experiences across the Curriculum
Effective Clinical Teaching
Effective Clinical Teaching Behaviors and Attitudes
Preparing Faculty for Clinical Teaching
Preparing Students for Patient Care
Clinical Conferences
Complementary Clinical Experiences
Models for Clinical Education
Summary
Unit IV: Technology Empowered Learning
18: Teaching and Learning Using Simulations
Simulations
Planning to Use Simulations
Designing Simulations
Implementing Simulations
Evaluation Considerations when Using Simulations
Summary
19: The Connected Classroom: Using Digital Technology to Promote Learning
Evolution of the Connected Classroom
The Connected Classroom
Digital Technology to Promote Learning in the Connected Classroom
The Connected Clinical Experience
Putting It All Together
20: Teaching and Learning at a Distance
Synchronous Technologies
Asynchronous Technologies
Technologies for Distance Education Clinical and Telehealth
Emerging Trends in Distance Education
Adapting Teaching for Distance Education
Course Enhancements and Resources
Evaluation
Summary
21: Teaching and Learning in Online Learning Communities
Online Learning Communities
Institutional Planning for Online Learning
Faculty Role in Online Learning
Designing Courses and Learning Activities
Content Ownership
Creating Community
Clinical Teaching
Evaluating and Grading Learning Outcomes
Effectiveness and Continuous Quality Improvement
Summary
Unit V: Evaluation
22: Introduction to the Evaluation Process
Evaluation Defined
Philosophical Approaches to Evaluation
The Evaluation Process
Summary
23: Strategies for Evaluating Learning Outcomes
Assessment and Evaluation
Selecting Strategies
Matching the Evaluation Strategy to the Domain of Learning
Communicating Grading Expectations
Strategies for Evaluating Learning Outcomes
Summary
24: Developing and Using Classroom Tests: Multiple-Choice and Alternative Format Test Items
Planning the Test
Writing Test Items
Analyzing Test Results
Revising Test Items
Assigning Grades
Summary
25: Clinical Performance Evaluation
General Issues in Evaluating Clinical Performance
Clinical Evaluation Methods and Tools
Clinical Evaluation Process
Summary
26: Systematic Program Evaluation
Purposes and Benefits of Program Evaluation
Relationship of Program Evaluation to Accreditation
Historical Perspective
Program Evaluation Models
The Program Evaluation Plan
Internal Program Evaluation
Comprehensive Program Evaluation
Summary
27: The Accreditation Process
Overview of the Accreditation Process
Dedication
To all nurse educators who, through their teaching, influence the future of the nursing profession
Contributors
Bimbola Akintade, PhD, MBA, MHA, ACNP-BC, CCRN Assistant Professor and Specialty Director, Adult Gerontology Acute Care Nurse, Practitioner/Clinical Nurse Specialist DNP Specialty, University of Maryland, Baltimore, Baltimore Maryland, Chapter 18
G. Rumay Alexander, EdD, MSN, BSN, FAAN Clinical Professor and Director, Office of Multicultural Affairs, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, Chapter 16
Halina Barber, PhD, MS, RN Assistant Professor, University of Portland, Portland, Oregon, Chapter 5
Diane M. Billings, EdD, RN, FAAN, ANEF Chancellor’s Professor EmeritusIndiana University School of Nursing, Indianapolis, Indiana, Chapter 24
Wanda Bonnel, PhD, RN, APRN, ANEF Associate ProfessorUniversity of Kansas School of Nursing, Kansas City, Kansas, Chapter 25
Mary P. Bourke, PhD, MSN, RN Assistant Dean, Associate Professor, Indiana University, Kokomo, Indiana, Chapter 22
Lori Candela, EdD, RN, APRN, FNP-BC, CNE Associate Professor, School of Nursing University of Nevada, Las Vegas, Las Vegas, Nevada, Chapter 13
Linda S. Christensen, EdD, JD, MSN, RN, CNE Chief Administration Officer, National League for Nursing, Washington,
DC, Chapter 3
Jeanne R. Conner, MN, APRN, FNP-C Nursing Instructor/Course Coordinator, Montana State University-Bozeman, Billings, Montana, Chapter 14
Diann A. DeWitt, PhD, RN, CNE Professor/Director RN-BSN Option, Colorado Christian University, Lakewood, Colorado, Chapter 23
Peggy Ellis, PhD, RN, FNP-BC Dean, School of Nursing and Allied a Health Sciences, Lindenwood University, St. Charles, Missouri, Chapter 26
Mary L. Fisher, PhD, MSN, RN Professor Emeritus, Indiana University, Clinical Professor, University of Florida, Sun City Center, Florida, Chapter 1
Betsy Frank, PhD, RN, ANEF Professor Emerita, School of Nursing, Indiana State University, Terre Haute, Indiana, Chapter 4
Joan L. Frey, EdD, MSN, RN Interim Vice President for Academic Affairs, Dean—Louisville Campus, Interim Dean—Cincinnati Campus, Galen College of Nursing, Louisville, Kentucky, Chapter 2
Barbara Manz Friesth, PhD, RN Clinical Associate Professor/Assistant Dean of Learning Resources, Co-Director of the ELITE Center Encouraging Learning, Innovation and Technology, Excellence, Indiana University School of Nursing, Indianapolis, Indiana, Chapter 20
Karen Grigsby, PhD, RN Associate Professor, Interim Director MSN Program, College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, Chapter 9
Paula Gubrud, EdD, RN, FAAN Senior Associate Dean for Education, Oregon Health & Science University, School of Nursing,
Portland, Oregon, Chapter 17
Susan M. Hendricks, EdD, RN, CNE Associate Professor, Associate Dean for Undergraduate Programs, Indiana University School of Nursing, Indianapolis, Indiana, Chapter 8
Betty J. Horton, PhD, CRNA, FAAN Manager for the International Federation of Nurse Anaesthetists’, Anaesthesia Program Approval Process, (IFNA–APAP)Tower Hill, Illinois, Chapter 27
Barbara A. Ihrke, PhD, RN Vice President of Academic Affairs, School of Nursing, Indiana Wesleyan University, Marion, Indiana, Chapter 22
Pamela R. Jeffries, PhD, MSN, RN, FAAN, ANEF Dean and Professor of Nursing, George Washington University, Washington, DC, Chapter 18
Jane M. Kirkpatrick, PhD, RNC-OB, ANEF Head, School of Nursing, Associate Dean, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, Chapter 23
Michael J. Kremer, PhD, CRNA, FNAP, FAAN Professor & Director, Nurse Anesthesia Program, Rush University College of Nursing & Co-Director, Rush Center for Clinical Skills and Simulation, Chapter 27
Susan Luparell, PhD, APRN, ACNS-BC, CNE, ANEF Associate Professor/Faculty, Montana State University, Bozeman, Montana, Chapter 14
Julie McAfooes, MS, RN-BC, CNE, ANEF Web Development Manager, Chamberlain College of Nursing, Downers Grove, Illinois, Chapter 21
Carla Mueller, PhD, RN Professor, Department of Nursing, University of Saint Francis, Fort Wayne, Indiana, Chapter 12
Janet M. Phillips, PhD, RN, ANEF Director RN to BSN Degree Completion Program, Clinical Assistant Professor, Indiana University School of Nursing, Governor-at-large, National League for Nursing, Indianapolis, Indiana, Chapter 15
Ann M. Popkess, PhD, RN, CNE Assistant Professor, Southern Illinois University Edwardsville, Edwardsville, Illinois, Chapter 2
Martha Scheckel, PhD, RN Professor and Chairperson, Winona State University Department of Nursing, Winona, Minnesota, Chapter 10
Elizabeth Speakman, EdD, RN, ANEF, FNAP Co-Director, Jefferson Center for Interprofessional Education, Associate Professor of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania, Chapter 11
Dori Taylor Sullivan, PhD, RN, NE-BC, CPHQ, FAAN Principal Consultant, Leadership/Education/Quality Consulting, Stuart, Florida, Chapter 6
Sandra M. Swoboda, RN, MS, FCCM Research Program Coordinator/Simulation Educator, Simulation Team Coordinator, Johns Hopkins University Schools of Medicine and Nursing, Baltimore, Maryland, Chapter 18
Theresa M. “Terry” Valiga, EdD, RN, CNE, ANEF, FAAN Professor and Director, Institute for Educational Excellence, Duke University School of Nursing, Durham, North Carolina, Chapter 7
Brent W. Thompson, PhD, RN Associate Professor, Department of Nursing, West Chester University of Pennsylvania, West Chester, Pennsylvania, Chapter 19
Linda M. Veltri, PHD, RN Clinical Assistant Professor, Oregon Health and Science University, Ashland, Oregon, Chapter 5
Reviewers
Amanda Alonzo, PhD, RN Faculty, School of NursingOhio University Athens, Ohio
Mary Barrow, PhD, RN Interim Coordinator Delgado Community College Charity School of Nursing New Orleans, Louisiana
Suzanne M. Clark, RN, MS Trauma Critical Care Clinical Nurse Specialist Commander, Nurse Corps, U.S. Navy (Retired)Adjunct Professor California Baptist University Riverside, California
Tina Covington, RN, MN, CCRN, CNE Professor, Nursing Faculty Delgado Community College Charity School of Nursing New Orleans, Louisiana
Lisa Davis, PhD, RN, NC-BC Professor West Texas A&M University Canyon, Texas
Michelle De Lima, DNP, APRN, CNOR, CNE Assistant Professor Delgado Community College Charity School of Nursing New Orleans, Louisiana
Michelle Dellaria Doas, EdD, MSN, RN Associate Professor Chatham University Pittsburgh, Pennsylvania
Kristina Thomas Dreifuerst, PhD, RN, CNE, ANEF Assistant Professor Indiana University Indianapolis, Indiana
Michelle L. Edmonds, PhD, FNP-BC, CNE Professor of Nursing Jacksonville University Jacksonville, Florida
Ruth Fiedler, EdD, PMH-CNS, CNE Assistant Professor Rush
University College of Nursing Chicago, Illinois
Cris Finn, PhD, FNP, RN Associate Professor Regis University Denver, Colorado
Sandy Forrest, PhD, MSN, MEd, LPC Professor and Master of Science in Nursing Program Director Colorado Mesa University Grand Junction, Colorado
Wendy Garretson, MN, RN, CCRN, CNE Associate Professor Delgado Community College Charity School of Nursing New Orleans, Louisiana
Suzanne Kim Genovese, PhD, MSN, MSA, RN-BC, CNE Associate Professor, Coordinator of International Students, MHA and HCL Program Valparaiso University Valparaiso, Indiana
Lynn George, PhD, RN, CNE Inaugural Dean Carlow University’s College of Health and Wellness Pittsburgh, Pennsylvania
Linda Gibson-Young, PhD, ARNP, FNP-BC, CNE Assistant Professor University of Central Florida Orlando, Florida
Joannie S. Hebert, PhD, RN, CNE Instructor, Southeastern University School of Nursing, Baton Rouge Campus Southeastern Louisiana University Hammond, Louisiana
Sarah Jackson, RDH, MS Associate Professor of Dental Hygiene Eastern Washington University Spokane, Washington
Maria Lauer-Pfrommer, PhD, RN, APN-C, CNE Doctor of Nursing Practice (DNP) Learner Duke University Durham, North Carolina
Frances D. Monahan, PhD, RN, ANEF
Consultant Faculty Excelsior College Albany, New York
Adjunct Faculty University of Arkansas at Little RockLittle Rock, Arkansas
Bridget K. Parsh, RN, CNS, EdD Associate Professor Sacramento State University Sacramento, California
Patricia M. Price, EdD, MSN, RN Assistant Professor Rowan University Rowan University Glassboro, New Jersey
Margaret Reneau, PhD, MSN, RN Online Nursing Faculty Saint Xavier University School of Nursing Chicago, Illinois
Rachel Spector, RN, PhD, CTN-A, FAAN Associate Professor, Capstone Program Boston College Chestnut Hill, Massachusetts
Jason T. Spratt, PhD Dean of Students Indiana University–Purdue University Indianapolis Indianapolis, Indiana
Anita M. Stineman, PhD, RN Associate Clinical ProfessorCollege of Nursing, University of IowaIowa City, Iowa
Kimberly Kilpatrick Uddo, RN, DNP, CNE, CCRN Professor Delgado Community College Charity School of Nursing New Orleans, Louisiana
Ethel Ulrich, DNP, APRN, ANP-BC Assistant Professor, Division of Nursing Molloy College Rockville Centre, New York
Francene Weatherby, RN, PhD, ANEF Professor University of Oklahoma, College of Nursing Oklahoma City, Oklahoma
Peggy A. Weissinger, EdD, MBA Associate Dean of Evaluation and Educational Scholarship Georgetown University School of Medicine Washington DC, Maryland
Diane M. Wink, EdD, FNP-BC, FAANP Family Nurse Practitioner Professor, College of Nursing University of Central Florida Orlando, Florida
Preface
As we reflect on the nearly 20 years that this book has been serving as a teaching guide for faculty, we are amazed at how much has changed in nursing education and practice, and marvel about how nurse educators continue to strive to develop the science of nursing education and improve their teaching practice. We note nursing education’s earlier reliance on theories and practices from higher education and educational psychology, and remark on how the evidence for best practice in nursing education is now increasingly derived from our own science. We note, too, how changes in health care with the emphasis on patient-centered care, shifts from acute care to community-based settings, and the emerging era of connected health are changing the role of the nurse, thus requiring nurse educators to carefully consider the educational experiences they design for learners, so future graduates are prepared for practice in a changing health care system. The nurse of the future must be able to access, evaluate, and synthesize vast amounts of information, use clinical decision support tools, communicate effectively with patients as a member of an interdisciplinary health care team, and make clinical decisions for safe patient care. Preparing this nurse requires educators to guide students to higher-order learning, the deep and applied learning that prepares students for the complex health care settings in which they will be employed. The role of the nurse educator is changing as well, as we promote active learning in a “connected classroom,” develop learning activities for interprofessional education, modify strategies for the increasingly culturally and linguistically diverse student body, and design curricula to facilitate academic progression across nursing programs. The variety of educational programs, designed to prepare graduates for system changes in health care, require savvy leaders who can
guide curriculum development and program evaluation, collaborate with our colleagues in practice and from multiple disciplines, and advocate on behalf of nursing education to funding and policymaking agencies.
We have developed this edition of Teaching in Nursing to prepare nurse educators to address these changes in both academic and practice settings. For example:
• The scope and standards of the advanced practice role of the nurse educator have been more clearly defined and supported with the development of evidence-based core competencies. Certification as a nurse educator is now a credential that is possible to achieve. The chapter on faculty role reflects this recent emphasis on evidencebased faculty competencies and how the faculty role is evolving. As the educational environment continues to transform in response to multiple influences, novice and experienced faculty alike share a need for continuing development in the role throughout their career.
• Educators must be prepared to teach in classrooms that are “flipped,” “connected,” and global. Our classrooms are composed of students of diverse ages, generations, genders, ethnic backgrounds, races, religions, languages, and learning styles. Faculty must be able to respond to a variety of student needs, engage in inclusive teaching, choose learning strategies to appeal to a variety of groups and individuals, integrate technology into their teaching, and manage classes with larger numbers of students. To prepare faculty for these classrooms, we have substantively updated chapters on meeting the diverse needs of students, proactively managing the classroom learning environment, and engaging in multicultural education, and we have added a new chapter on connected learning.
• Students will be practicing in a changed health care environment and in settings in which interprofessional practice and collaborative practice will be the norm. New clinical models, such as the dedicated educational unit and residency programs, are used with the goal of more closely aligning nursing education with the
realities of the practice setting. At the same time there is a dramatic increase in the use of preceptors and adjunct and part-time faculty to support clinical teaching, all of whom must be oriented and welcomed as they transition to faculty roles. The shortage of clinical placements and clinical faculty and the shift of clinical placements from acute care to the community will challenge faculty to develop new and focused clinical models that ensure connecting classroom learning to clinical practice. Strategies such as simulation and unfolding case studies will complement clinical experiences. Chapters related to clinical learning experiences and simulation have been dramatically revised, and we have added a new chapter on interprofessional education.
• As nurse educators respond to the need for new types of academic programs, most notably the proliferation of doctorate in nursing practice (DNP) degrees, chapters on curriculum development and program evaluation assume new importance. Faculty must be able to establish dynamic and fluid curriculum structures and processes that can rapidly address changes in health care delivery. Developing academic progression models that foster seamless transition between program curricula will continue to be an area of curriculum development on which faculty must focus their attention. The complexities of developing prelicensure and graduate curricula have become more marked, and to this end we have included updated and expanded information on curriculum design and development in two distinct chapters, as well as an updated chapter overview on curriculum development. Recognizing the importance of continuous quality improvement and meeting standards for quality established by state boards and national accrediting agencies, we also have updated the chapter on program accreditation.
• As nurse educators respond to national calls for increasing the number of graduates with baccalaureate and doctoral degrees and to become lifelong learners, there will be increasing numbers of nursing programs and continuing education courses offered at a distance. Students and faculty are seeking educational experiences
that are accessible, engaging, and interactive, and educators now find themselves in high-tech campus classrooms with multimedia projection capabilities, using electronic response systems and integrating smart phone and other social media applications into the lesson plan. Educators will find themselves equally teaching online and hybrid courses and using webinars and video conferencing to reach learners worldwide. We have extensively updated the chapters on teaching in the connected classroom and in distance education and online learning environments. All faculty must be prepared to promote active learning through the effective use of the now pervasive information technologies that make education accessible and convenient.
This edition of Teaching in Nursing has been written for nurses who are preparing to teach, for nurses who have recently become faculty members or staff educators and who are searching for answers to the daily challenges presented in their role as educators, as well as for experienced faculty members who are transforming teaching practices for the future. This book is also written for nurses who are combining clinical practice and teaching as preceptors or part-time or adjunct faculty and for graduate students or teaching assistants who aspire to assume a full-time teaching role. Given the current shortage of nurse educators, it is crucial that we continue to prepare and mentor future nursing faculty now. It is our hope that this book can help influence that preparation by providing guidance on the competencies essential to the effective implementation of the educator role.
This edition continues to draw on foundational work while integrating findings from recent research in nursing, education, and related fields. We have attempted to provide a balance of the practical and the theoretical, and urge readers to not only seek new evidence, but also test its application in their classrooms.
We continue to consider this book to be a guide, bringing under one cover an overview of models and approaches for assuming the faculty role; interacting with students; developing curricula; designing learning experiences; using technology and learning resources; and evaluating students, faculty, courses, and programs. Although the
book is organized in five units, teaching in nursing is an integrative process and we encourage readers to select chapters as appropriate for their needs and teaching practice.
We suggest that readers use the book as a guide and resource but recognize that implementation must be adapted to the values and missions of the institutional settings and the personal style and philosophy of the faculty. We intend for this book to stimulate faculty to engage in the scholarship of teaching and learning by reflecting on their own teaching practices, implementing and evaluating new approaches to creating an interactive and inclusive learning community, and conducting their own educational research in classroom and clinical settings.
When we wrote the first edition of this book almost 20 years ago, we did so because we believed that the role of the nurse educator was an exciting and rewarding role, one that required nurturing and development over time. It was our goal to provide a comprehensive resource for faculty that would help guide them as they developed their practice as nurse educators. We still believe this is an exciting time to embrace a career in nursing education and teach nursing a time that is filled with many challenges, opportunities, and rewards for those who step forward to accept the responsibility. It is our hope that this book provides those who engage in the rewarding activity of teaching the future of our profession our students with a resource that will lead to greater fulfillment of the teaching role.
Diane
M. Billings
Judith A. Halstead
October, 2015
