Nursing Education and Advance Discipline and Liberal Values
Advancing the Discipline of Nursing
The continued development of nursing as a unique discipline requires an intentional approach. Jairath et. al (2018) stated that any further development of the discipline should have the capacity to directly transform the patient's health experience. A new related social order may be necessary in which scientists, theorists, and practitioners work together to address questions to the interplay of big data and nursing theory.
Nursing graduates, particularly at the advanced nursing practice level, must be well-prepared to think ethically, conceptually, and theoretically to better inform nursing care. Students must not only be introduced to the knowledge and values of the discipline, but they must be guided to practice from a disciplinary perspective by seeing patients through the lens of wholeness and inter connectedness with family and community; appreciating how the social, political, and economic environment influences health; attending to what is most important to well being: developing a caring healing relationship; and honoring personal dignity, choice, and meaning. Smith and McCarthy (2010) spoke to the need to provide a foundation for practitioners in the knowledge of the discipline.
Without this knowledge, the persistent challenge of differentiating nursing and the professional levels of practice will continue.Knowledge of the discipline grows in graduate education, as students apply and generate nursing knowledge in their advanced nursing roles or develop and test theories as researchers.
Nursing practice should be guided by a nursing perspective while functioning within an interdisciplinary arena. To appropriately educate the next generation of nurses, disciplinary knowledge must be leveled to reflect the competencies or roles expected at each level.
The Value of a Liberal Education In Nursing
In higher education, every academic discipline is grounded in a unique body of knowledge that distinguishes that discipline. Through the study of the humanities, social sciences, and natural sciences, students develop the capacity to engage in socially valued work and civic leadership in society.
Liberal education exposes students to a broad worldview, multiple disciplines, and ways of knowing through specific coursework; However, the richness of perspective and knowledge is woven throughout the nursing curriculum as these are integral to the full scope of nursing practice (Hermann, 2004).
Successful integration of liberal and nursing education provides graduates with knowledge of human cultures, including spiritual beliefs, as well as the physical and natural worlds supporting an approach to practice.
The study of history, critical race theories, critical theories of nursing, critical digital studies, planetary health and climate science, politics, public policies, policy formation, fine arts, literature, languages, and the behavioral, biological, and natural sciences are key to the understanding of one's self and others, civil readiness, and engagement and forms the basis for clinical reasoning and subsequent clinical judgments.
A liberal education creates the foundation for intellectual and practical abilities within the context of nursing practice as well as for engagement with the larger community, locally and globally.
A hallmark of liberal education is the development of a personal value-system that includes the ability to act ethically regardless of the situation and where students are encouraged to define meaningful personal and professional goals with a commitment to integrity, equity, and social justice.
Liberally educated graduates are well prepared to integrate knowledge, skills, and values from the arts, sciences, and humanities to provide safe, quality care; advocate for patients, families, communities, and populations; and promote health equity and social justice. Equally important, nursing education needs to ensure an understanding of the intersection of bias, structural racism, and social determinants with healthcare inequities and promote a call to action.
Competency Based Education In Nursing
Competency-based education is a process whereby students are held accountable to the mastery of competencies deemed critical for an area of study. Competency based education is inherently anchored to the outputs of an educational experience versus the inputs of the educational environment and system.
Students are the center of the learning experience, and performance expectations are clearly delineated along all pathways of education and practice. Across the health professions, curriculum, course work, and practice experiences are designed to promote responsible learning and ensure the development of competencies that are reliably demonstrated and transferable across settings.
By consistently assessing their own performance, students develop the ability to reflect on their own progress towards the achievement of learning goals and the ongoing attainment of competencies required for practice.
Advances in learning approaches and technologies, understanding of evolving student learning styles and preferences, and the move to outcome-driven education and assessment all point to a transition to competency-based education. This learning approach is linked to explicitly defined performance expectations, based on observable behavior, and requires frequent assessment using diverse methodologies and formats.
Designed in this fashion, competencebased education produces learning and behavior that hardens, since it encourages conscious connections between knowledge and action. Learners who put knowledge into action grasp the interrelatedness of their learning with both theoretical perspectives and the world of their professional work. Achieving a specific competence gives meaning to the theoretical and assists in understanding and taking on a professional identity.
Further, today's students are increasingly taking responsibility for their own learning and, varied as they are in age and experience, respond to active learning strategies. Active learning involves making an action out of knowledge using knowledge to reflect, analyze, judge, resolve, discover, interact, and create. Active learning requires clear information regarding what is to be learned, including guided practice in using that information to achieve a competency.
It also requires regular assessment of progress towards mastery of the competence and frequent feedback on successes and areas needing development. Additionally, students must learn how to assess their own performances to develop the skill of continuous self reflection in their own practice.
Stakeholders (employers, students, and the public) expect all nursing graduates to exit their education programs with defined and observable skills and knowledge. Employers desire assurance that graduates have expected competencies-the ability “to know” and also “to do” based on current knowledge.
Moving to a competency based model fosters intentionality of learning by defining domains, associated competencies, and performance indicators for those competencies. Currently, there is wide variability in graduate capabilities. Therefore, there is a need for consistency enabled by a competency-based approach to nursing education.
A standard set of definitions frame competency based education in the health professions and was adopted for these Essentials. Adoption of common definitions allows multiple stakeholders involved in health education and practice to share much of the same language. These definitions are included in the glossary (p. 59).
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