[Music]
[Music]
Hello I'd love to welcome everyone to our new episode of the National League for Nursing's podcast and I have the privilege of having two simulation and faculty colleagues of mine joining me for this podcast. My name is Kellie Bryant. I am the director of the Center for Innovation in Education Excellence at the National League of Nursing. I'm here accompanied by one of my simulation colleagues, Dr. Elizabeth Wells-Beede, who is the senior associate dean at the University
of North Texas Health Science Center. I also have the pleasure of being here with Jasline Moreno who is from Montgomery College and is the faculty lead for the Maryland Clinical Simulation Resource Consortium hosted at Montgomery College, that is a mouthful. So I want to thank you both for being here today to have this very important discussion. Elizabeth, you wrote this amazing scoping review along with some of your colleagues on, "A Scoping Review of Nurse Educator Competencies:
Mind the Gap." That's what we're here today to talk about and I just wanted to start with you know just a little bit of background and letting our audience know a little bit about us and how we got into nursing education. So I'll start with Jasline and if you could just let us know how did you get into nursing education and how well did you feel prepared for that transition? Thank you so much Kellie for hosting this podcast and asking that excellent question.
So I actually got into nursing education by accident. I remember working a shift in the ped's ER at Children's National Medical Center and I think there was an agency nurse working next to me that day and she was like, hey, why don't you try clinical instructor over at the school? I was like, really? And I was young and motivated trying all kinds of different things and I said, sure, sounds cool. So within a week I got hired to be a clinical instructor for a peds unit at
a local community hospital. Mind you, I had only been at Children's in the peds wing for about six months so not an expert in that area as well my orientation to the clinical unit consisted about an hour talking with a nurse who was on the unit and I started my first clinical instructor day at 7 o'clock and had a group of eight students.
Fortunately I had a passion for it but I definitely had a lot of blunders I reflect on it now and I'm like, oh my goodness and that led me to kind of really start thinking about education. I went on and got my
master's at University of Maryland. They had a track that was focused on education so I did have some formal education where I was prepped on how to present PowerPoints and delivery and things of that nature and then transition to a full-time faculty position at a small private institution in Maryland that did not have a formalized training for novice educators, did not have any type of orientation program, it just couldn't support it I think and really
found it to be challenging and I think I got through it because I had some good colleagues who were experienced and who kind of informally answered questions and just you it helped me along
the way and I had a passion for it. I really found my niche later on I moved to a larger community college, Montgomery College, and they had a formalized program and I learned things three years after being a full-time faculty that I had never learned - item analysis, exam reviews as a team and then I had an opportunity and really was supported through professional development. Recently I did the NLN
Sim Lead. I've done lots of professional development on my own and that has really helped my career and really helped me sustain as a faculty member. So that's my long journey like two minutes. And you know what, your journey sounds like a lot of other nurse educators journeys. I think a lot of us went straight from clinical practice whether it was working as a nurse or a
nurse practitioner. Similar journey - I was a nurse practitioner and I got a call that they were in need of clinical instructors and that was my segue into nursing education and I did that for one semester and the next thing you know there was a full-time nursing assistant
professor position and I went for it. So it was like semester of being a clinical faculty and then next thing you know was full-time professor and like you, said being a nurse practitioner does not prepare you for being a nurse educator. I'll never forget writing my first test. I thought it was brilliant. Luckily, I had a mentor and I wrote it and I gave it to my mentor and it came back with so many red marks all over it and the first time I tried to put a syllabus together.
I mean, these are things that we're not taught as nurse practitioners and those skills that are necessary to be in effective educator that like you said, you were lucky you had class, you had a great mentor to show you the way, but I think about all the other faculty who really don't have that orientation or that mentorship going from clinical practice to academia. So Elizabeth, tell us about your journey. How did you get into nursing education?
I think as you mentioned most of ours are very similar and really kind of how we got there. I was fortunate though that I had been on a floor for at least three years years before being asked to be a preceptor but it wasn't that it wasn't a lot longer and while I was precepting on the floor and became one of the primary educators on our unit with really teaching newborn resuscitation and ACLS and BLS I really kind of started finding my passion and
spark for for educating and education. I also had some amazing faculty when I was in nursing school. One in particular that always comes to mind for me and that she was really an amazing mentor and great role model even from the profession and then moving into the education
standpoint. So I embarked on an MSN in education as well and then kind of ended up in a little bit of a reverse of my roles because my husband is retired military and so we traveled a lot with his job because he was in the military for 29 years and so we were actually stationed overseas and I hadn't had the opportunity to be using my
degree. I graduated with my degree when I was over there, kept teaching BLS and ACLS and they kind of came to me and said hey, we have this job that came open and it was actually in simulation so I was actually a simulation coordinator and director before I was in academia as a faculty so I kind of ended up a little bit of the reverse but still needing to use those same things that you're needing to do within a clinical setting and we
were with a medical group that really trained med techs, nurses, physicians, everybody - all health care professions and then when we moved back to the states I had the opportunity of becoming an adjunct faculty for a really short period of time. and then I became full-time faculty but as you had
mentioned, Jasline, it's really interesting. You prepare in your education even as an MSN in Ed not even just so much as an advanced practice registered nurse, you still don't get the experience of really operationalizing everything really well and so same thing as you had mentioned I thought I created some amazing exams and then when half my class failed I was like oh that probably wasn't the best exam at all and really try to backtrack to say okay - this was my mess up.
Let's figure out how to get you guys back on track and then just really navigating and managing a classroom because what I thought was an amazing idea and really had to struggle with a lot is that I'm a very and I think that's probably what geared me towards simulation a lot I'm an experiential learner myself and so I always liked those hands-on activities and like the things that really kind of helped you do things and some students in an ADN program really didn't
appreciate that. Those first couple of years were really difficult and then I embarked on my my PhD and I chose education as my PhD so my I continued that focus to be able to align with pedagogical research and looking at education and that lens because I think it's important as you mentioned Kellie to to really understand how did you become an educator from those other areas and those other experiences that you had and I think unfortunately there
are moments in time that I think our profession especially when you do look at researchers in academia nursing educational research really isn't the big bucket item like that's not where you know you don't typically get funded really well, you're not like the lime light because it's always it's just education. But to me it's always been extremely important to make sure that we're educating our our profession appropriately.
Yes, and it is important so you wrote a wonderful article with for the Nurse Educator with some of your colleagues as I mentioned called, "A Scoping Review of Nurse
Mind the Gap." Do you mind telling us a little bit about your recent article? What was the reasoning for deciding to do this scoping review? Absolutely, thank you. So this particular article that I wrote with Dr. Sharpnack, Darla Gruben, Dr. Klenke-Borgmann, Dr. Goliat and Dr. Yeager kind of really came about the first
conference back face-to-face with NLN. So went to the conference in DC and there was a lot of conversation I believe that was the same year that Dr. Leighton was the speaker and started hearing the buzz of the new article that had come out from Cavanaugh on Dr. Sharpnack and how significantly it went down from that 23% to this 9% and then even again to 7% and so I kind of was sitting there during that time and started thinking, you know, what is
really going on in our culture of education and for students in specific. I'm very, I try to be reflective on my practice as a nurse educator and like I mentioned the first test that I wrote my almost over half my class failed so when I looked at that in my mind the failure wasn't on their part. The failure was on my part and so as I started thinking about this article and hearing everything that was going on and all the conversations that were occurring.
A light bulb kind of went off in my mind and I said, you know, I think actually Dr. Klenke- Borgmann was sitting next to me and I said, "when is it going to be on us?" because in my mind this is similar to that when you do that item analysis on a test and half your class
has failed - it's not on the student anymore. And so to me the light bulb was like, okay, wait a second, we have progressively gone down in our students preparation for residency and I'm very specific about for residency because that makes it even more I think a little bit a bigger red flag to me is that it's not that they're ready for practice. That article is saying that they were 7% ready for residency and so that's not on them anymore. That's
us. What are we doing to really help prepare them for practice and what are we doing to be able to help us be able to be better educators? When you look at historically and you know always coming off of a conference you always hear newer things and different things that you're doing, but historically we've never really been great with the number of faculty that we have for nursing. We know that there's a shortage of
nurses and faculty is even worse. So we've done I think our education practice a disservice because we did reach out and say, oh, well, you're an amazing practitioner. Your patients love you. You have everything all organized, like you're probably one of the best people I've seen do this this and this you communicate with your patients. Well, why don't you come and teach? It's a completely
different world. It's not even ... somebody that's amazing in practice is getting thrown right back into that novice role and they don't understand if they haven't, I mean, even with both Jasline and I we both said we took master's courses in education but yet neither one of us was really shown how do you write test items? How do you analyze the test? What does your syllabus look like? How are you writing outcomes?
I mean you do it, but it's in that same context of our students that you're just so in the moment of trying to do things that you don't really get to contextualize it really great and so that was really kind of where this whole article where that guided. Dr. Sharpnack happened to be at the same conference and so her being one of those primary authors on the actual article I reached out to her and I said would you consider joining us? And she
said absolutely. She said this is so important, this is such important work and so we did the scoping review and as with any scoping review it takes a lot of iterations because you have to read a lot, you have to go back, you have to really, really get into the into the meat of what it is saying and it was it was really interesting and it was amazing it was an amazing team to be able to really pull it together and look at what what
we came out with and that's where the minding the gap is. Elizabeth thank you for sharing that. I was at that conference as well and I can echo the response that we felt as educators, you know, it was a call to action for all of us and I love that you were able to do this work and response to it because I personally I've struggled and you know I've tried different initiatives - where do we
go with this? And as you were speaking I was just thinking about the parallels that we see as new nurses enter the profession, the challenges they have very similar to new educators who enter the faculty role and you know we have a lot of data saying that it's only 7% who's ready for residency. I'd be curious to know how many educators are truly ready as they enter and what does that look like and what type of action do we need to take in response
to that? So I mean some of the things that you said really resonated with me. Thank you for sharing that. I think we wanted to know what did you find most surprising from your research in writing this article?
I mean, I think interestingly enough because the we had some pretty in-depth conversations while we were looking through the literature and really kind of looking at the background and what we were trying to to look at one of the bigger things I think for us that was surprising is the number of times we really
had to go back and look again. We used Covidence and so we went through the whole process of narrowing things down but we also didn't come up with many very articles that really spoke to the purpose and that focus of competency in nurse educators and that was one of the other things and and Jasline you kind of sparked my thought process again when I was talking about
when all this was happening. This also happened to be the same time that AACN had decided to come out with the new Essentials speaking to really where they were looking at with those level ones and level twos and it it was a difficult conference because there was a lot of rumbling to where there was no longer that support for the MSN in education and so if you're saying from a larger accrediting body that that may not be the route any... but they have since retracted on that
thought process and that feeling, but our voices were heard as what I'm hoping as to why that was retracted but it really was interesting that you have this significant very significant number and you think that just changing the competencies for students is going to make that difference yet we're still not looking at how are they being educated and that's I mean I think that's really that missing link. I think that's a huge problem so I don't think we really that was probably the
biggest thing. and we had intended well,maybe we could do a systematic because there's more rigor to a systematic and there's more in depth looking at a systematic and looking at those metrics. We didn't even have enough when we pulled it through the questions that we had. We didn't have enough articles to
even consider a systematic review. There was no way that we would have gotten any analysis or any of the rigor within it so we actually had to shift after a couple of conversations to a scoping because we were really trying to inform because I think that's the hope to and as you mentioned, what is that percentage of competency for educators is that something that needs to
be researched and looked at. I think the thought process now with this scoping review is really hoping to spark people's interest in - we really need to look at this like. There is a correlation and where is that correlation in not truly preparing the students appropriately well? Are we not preparing because one we're educating with some antiquated models of education because we do what we do best as to what we know because we're going
to fall into our comfort zone right. I don't know how many times it's like, oh yeah, I'm going to do this amazing flipped classroom and I'm do all this stuff and you do it and the students are like that
was awful, why did you do that. You get all the push back from them so you kind of hesitantly revert back to, okay, fine I'll just do a PowerPoint because I guess you're just gonna open up your brain and I'm going to dump this knowledge into your brain and you're going to know it by the time you go out, but I mean that's that biggest part of
competency, right? Just because somebody knows it doesn't mean they can do it and that's I think that's the same thing with nurse educators so I don't think there was really a whole lot that was a huge surprise to us except really the number of literature because there's still a significant gap and we really need to be addressing that.
Yeah, I have to say that was most surprising too that during your scope review I think it was 11 articles use and so I love the fact that we bring up we're always so focused on the students and what the students need to do to meet these competencies and now it's like well, we need to look at ourselves and take a look
in the mirror. There's so many of us who are not getting our EdDs or or not getting master's in nursing education or like me I had my DNP is a nursing education, which is kind of rare to find. So for all of these new faculty that are that are coming from clinical practice, what can we recommend because we need them but the expectation is we don't expect everybody to go back to school to get a full degree in nursing
education. So what can we do to kind of close that gap and so that we have nurse education who are prepared to meet those nurse educator competencies what can be done and I'll both of you also?
Yeah, I think it's interesting because it's such a huge ... nursing education isn't just oh you're going to do this one thing and it's going to be amazing it's going to be perfect and it's going to be I feel like it's almost that you even have pockets of specialization within academia and I think we've done a really good job of saying that it's this umbrella thing but it truly isn't because in my mind when I look at like myself
for instance - I'm an amazing simulationist. I mean yes, I'm gonna brag on myself because I love simulation. Maybe my students may not think I'm an amazing simulations, but I think I am and so that was where my interest became really
truly focused on right. So I knew I was going to know those standards of best practice inside and out and how am I going to apply them and I'm going to do all the professional development to make me right so I have advanced designation because I was very intentional in growing my specialty in simulation. I'm a horrible test writer
and I'll say it admittingly. I mean, I don't like and I don't even know if it's just that I'm a horrible test writer or I just don't like it because I don't always feel that it's the great measurement of assessment. It's not an authentic assessment in my mind because test questions are usually very knowledge-focused and when you try to pull out the application into a test question it just becomes cumbersome and then the students complain and say you don't know what
you're doing as a test writer. Then they start blaming you for not knowing what you're doing with your job so I think we need to look at there's also those focus areas within the specialty itself but I think supporting our colleagues and our peers is one of the biggest things we it's really sometimes in my mind a little shameful that we still hear that really horrible statement about eating our young I've done a really I hope I've done a very a decent
job within my own practice that I try really hard to make sure that I'm supporting and trying to help mentor those that are really coming in behind because you're only going to make a better person if you're supporting them and lifting them up pull pushing people down and knocking them down isn't going to help support them they're not going to stay in academia they're going to have we're gonna have the same statistics that we have in practice
right now with with a brand new educator leaving within a year or two years of even being an educator so how can we support to really grow our educators and really model behaviors that we would hope that they can model right so I think nursing programs in themselves and this is this is a big ask because we do have a huge nursing shortage a faculty nursing shortage but I think having appropriate mentorship models and structures that can help with onboarding newer faculty
especially if they're novice faculty because a brand new faculty, I mean, there's a gap in the literature that we're not talking about competency but we've been talking about it long enough that we're not supporting each other well enough.
So if you you have somebody that's an amazing practitioner and you've recruited them and said hey, you got to come work with us as an adjunct then it's I think some of the onuses on that who's bringing them in and who's hiring them to say okay well, what's this structure going to look like for me to help mentor you, what does it look like when building your your courses, what does it look like when you're creating tests, how should they align
with your curriculum and how are they blueprinted back to the objectives and outcomes of your course because I don't think people understand that either how is everything within the curriculum structured and aligned to be able to meet those outcomes and the objectives and I think a lot of times it becomes that content focus of, oh well, they get into practice that's the hard part is that translation of that article ended up being that students don't know how to start IVs when
they get to the hospital. No that's not, that's the misinterpretation of what we mean by them not being able to do things a bachelor's prepared nurse or an ADN nurse. That's not, it's not task oriented. It's what's behind what's the outcome.
What are you truly needing them to do to understand because they could start an IV but if they don't understand that they could have blown the vein or that they could have eviscerated it or that they could have done some damage or if they didn't test do an Allen's test that they could have created some kind of circulatory dysfunction like there's other things that we need to pull out and I think that's where it starts we need to truly be supporting our new educators and what
that looks like is is professional development and mentorship models and it's not going to come from just one location. I mean, NLN is our primary location for education as nurses and they can help with some of the lift but that's
a huge burden to bear by themselves. I mean, they can't mentor every single faculty coming in, they can't offer professional development for every single person or nursing coming in so I think even just pockets regionally to help with some of those things with our experts and looking for people that can mentor because I think that helps with that sense of belonging as well.
We have seemed to go over our time allocation for this podcast so join me in part two as we continue our conversation with Dr. Jasline Moreno and Dr. Elizabeth Wells-Beede to discuss more about educator competencies on part two. [Music]