Cleveland Clinic Nursing Event Focuses on Preparing Nurses for Future Practice

Hundreds of nursing professionals from throughout Ohio recently gathered in downtown Cleveland for a Cleveland Clinic event that highlighted the importance of nursing practice and academia partnerships in securing a more prepared nursing workforce.

“Collaboration between academia and practice undeniably and directly improves the quality of healthcare and impacts the future of the nursing profession,” says Joan Kavanagh, associate chief nursing officer of nursing education and professional development, Cleveland Clinic. “From the practice partners viewpoint, our profession’s wonderful schools of nursing not only provide us with the nurses we need to deliver high-quality care to our patients, but they stand beside us as partners in addressing issues surrounding the preparation and ongoing education of nurses.”

Attendees consisted of nursing professionals from both nursing academia and practice realms, representing numerous Ohio colleges, universities, hospitals and health systems. The event was co-hosted by the Cleveland Clinic Nursing Institute and Ursuline College, located in Pepper Pike, Ohio, and supported by the Ohio League for Nursing and the Ohio Action Coalition, an organization committed to implementing the recommendations of the Institute of Medicine.

It boasted the theme: “Five Years Later: The Call for Radical Transformation in Nursing Education.” And it recognized two timely and relevant nursing practice/education anniversaries.

The first was the tenth anniversary of the award-winning Northeast Ohio Dean’s Roundtable, which is a unique partnership between Cleveland Clinic and 14 Ohio schools of nursing.

When developed, the group’s goal was to create a regional strategy designed to address both the nursing and nursing faculty shortages. This resulted in the Dean’s Roundtable Faculty Initiative, which provides an Internet platform for schools with open nursing instructor positions to search a database of currently practicing nurses who would like to assume the additional role of nursing instructor.

The event also marked the fifth anniversary of the work of nursing education visionary Patricia E. Benner, PhD, RN, FAAN, with the Preparation for the Professions series from the Carnegie Foundation for the Advancement of Teaching.

Dr. Benner’s 2010 work with the Carnegie Foundation called for a more highly educated nursing workforce. It linked patient safety and lower mortality rates to having better prepared nurses at baccalaureate and graduate levels, emphasizing the critical role education plays in a nurse’s ability to practice safely and achieve optimal outcomes.

Dr. Benner, who also authored the best-seller “Educating Nurses: A Call for Radical Transformation,” served as the event’s keynote speaker, setting the stage for the day when she said: “The future of nursing is really jointly held by nursing practice and nursing service.”

Uniting practice and academia for continued improvement

Stressing that nursing practice and academia need to continue to work closely together to achieve a more prepared workforce, guest speakers noted that the advancements of the past five years have transformed the way nursing students are learning as well as the way nursing educators are teaching.

“Today, nursing students are learning how to better translate the knowledge they learn in nursing school to the nursing unit,” Kavanagh says. “Nursing educators are ensuring students experience hands-on skills training through the use of simulation and more.”

Students are also exposed to learning strategies such as Dr. Benner’s ‘Thinking in Action,’ which emphasizes clinical reasoning by way of multiple methods of thinking as opposed to focusing solely on critical thinking.

“We learned a lot from the Carnegie study,” Dr. Benner says. “We thought, as all good nurse educators, that what we needed to improve was clinical education, but what we found is that there was a radical separation of classroom and clinical.”

This idea of a separation between classroom and clinical was the premise for Dr. Benner’s keynote discussion. She, along with close colleague, Patricia Hooper Kyriakidis, PhD, RN, shared a number of thoughts and ideas for attendees to consider, focusing primarily on the following:

• Understanding situated thinking, or ‘Thinking In Action.’ Knowing that the learner’s experience is changed by practice and that context is extremely important to acquiring the necessary knowledge, including medical, scientific and nursing knowledge. Combining ‘knowing about’ with ‘knowing how.’
• Breaking the ‘complex’ to ‘simple’ so the learner can consider the bigger picture. For example, a nursing student may know how to take and chart a blood pressure, but what is truly important is his or her level of productive or contextual thinking. Does the student understand the blood pressure? How do they read it?
• Realizing that ‘ethical comportment’ is just as important as ethics teaching. Learning to embody or enact good practice in specific situations, where the skill of engagement is key. Finding the ideal combination of engagement, attentiveness, compassion and empathy in every nursing student.

Dr. Benner referenced these key points related to knowledge, clinical reasoning and ethical comportment, as the ‘Three Professional Apprenticeships,’ explaining that to garner knowledge in a way in which it can be applied in the clinical setting, requires learning beyond the textbook.

“It’s no small thing to learn to act and think like a nurse,” she says.

Tactical and situational examples in both the nursing practice and academic settings were noted, such as how to improve unprompted clinical reasoning and clinical forethought through situated coaching or developing a sense of salience or clinical imagination by using unfolded clinical cases as opposed to restating facts.

Dr. Benner and Dr. Hooper also shared with attendees the latest in the digital-first, situated learning solution, NovExTM. NovEx is a model and application for learning designed to help educators move beyond a focus on developing students’ critical thinking abilities to helping prepare students who can clinically reason and problem-solve. With it, students are able to apply knowledge as they acquire it. The methodology of NovEx is based on the work of Dr. Benner, Dr. Kyriakidis, and Tom Ahrens, PhD, RN.

Practice and academia jointly hold the future of nursing

Looking forward, nursing practice and academia partnerships like those of the Dean’s Round Table and initiatives such as the Ohio Action Coalition will continue to prominently guide and shape the nursing profession so that nurses are prepared to care for patients in the 21st Century.

“The ongoing collaboration between service providers and educators is paramount to ensuring our nursing students are well-prepared to meet the demands placed on today’s nurse,” Kavanagh adds.

In her closing remarks, Dr. Benner told attendees, “In truth, wherever we are serving, we have to jointly hold the practice in our different settings.”

Jane Mahowald, executive director of the Ohio League for Nursing and co-lead for the Ohio Action Coalition, echoed these comments by quoting Florence Nightingale, who said, “Unless we are making progress in our nursing every year, every month, every week, take my word for it, we are going backwards.”