Creating and Sustaining Excellence in Nursing Education

Advice for nurse educators to help new graduates succeed

In September, the National League for Nursing (NLN) will celebrate 125 years of leadership in nursing education at its annual NLN Education Summit. Building on the work of NLN’s founders, nurse educators everywhere will gather at the 2018 Summit to learn how they can continue to lead and shape nursing education for the future.

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In this Q&A, Joan Kavanagh, MSN, RN, NEA-BC, Associate Chief Nursing Officer for the Office of Nursing Education and Professional Development at Cleveland Clinic, discusses her thoughts on strategies nurse educators can implement to advance excellence in nursing education to best help new graduate registered nurses succeed.

Q: Generally speaking, what does advancing excellence in nursing education look like?

A: In my opinion, the NLN paints a great picture of what is necessary, foundationally, for nurse educators to advance nursing excellence. Per its Excellence in Nursing Education Model, the NLN suggests that to achieve and sustain excellence in educational programs, organizations require eight core elements:

  1. Clear program standards and hallmarks that raise expectations.
  2. Well-prepared faculty.
  3. Qualified students.
  4. Well-prepared administrators.
  5. Evidence-based programs and teaching/evaluation methods.
  6. Quality and adequate resources.
  7. Recognition of expertise.
  8. Student-centered, interactive and innovative programs and curricula.

Within these core elements are various highly important drivers of excellence, such as research and environment – all of which are also reflected in the NLN’s suggested Hallmarks of Excellence in Nursing Education.

While all these elements are critical, providing a student, a learner-centric program stands out as essential. Today, higher education finds itself – much like the health care industry – navigating a sea change. With an unparalleled level of scrutiny on value, outcomes, accountability, access and affordability, the need to produce graduates capable of succeeding in the “real world” has never been greater. Organizations that demonstrate successful commitment to pursing and sustaining the hallmarks of excellence may earn designation into the NLN’s Centers of Excellence program. Cleveland Clinic was proudly named an NLN Center of Excellence just last year, joining a proud cadre of hospitals/health systems with this prestigious recognition.

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Q: Are there other challenges nurse educators face in today’s demanding healthcare world?

A: Absolutely. We are living in a dramatically changing healthcare landscape with accelerated knowledge creation, increased patient acuity and decreased length of stay. In the 1950s it was estimated that the doubling time of medical knowledge was roughly 50 years. Today, a study by Dr. Peter Densen indicates that by 2020, it will be just 73 days. It’s truly overwhelming.

Supporting new nurse graduates certainly isn’t easy, but it’s essential. New graduate registered nurses are expected to know a tremendous amount of information before stepping into their first clinical role, and we want to do everything we can to facilitate and promote their success. I will be presenting at the upcoming NLN Education Summit, along with my colleagues, on quantifying and mitigating the preparation-to-practice gap and will be discussing a selection of ways nurse educators can work to overcome these challenges and help our new nurses succeed.

Q: Given the explosion of information you referenced, how can students optimize their learning while in nursing school?

The amount of data produced now exceeds our ability to assimilate it. This explosion of knowledge intensifies the need for graduates to succeed as thinkers and knowledge workers. I encourage students to read Linda Caputi’s (2018) handbook, Think Like a Nurse. Caputi emphasizes the need to move away from memorizing information to learning how to think. That might sound easy, but it’s complex. Learning how to think is just as important as learning technical psychomotor skills and nursing content. Caputi explains that critical thinking refers to problem solving that we use in everyday life, but clinical reasoning or clinical judgment are used when applying critical thinking to nursing practice to make the best possible decisions.

Q: What strategies do you recommend nurse educators implement to advance excellence?

A:  First and foremost, I recommend healthcare leaders in academia and service work together to best support future nurses for success. As partners, we can accomplish so much more for our future nursing generations than we can as individual entities.

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Additionally, given that each summer Cleveland Clinic welcomes a large number of new graduates preparing to take the National Council of State Boards of Nursing Licensure Examination (NCLEX-RN) and start their first professional nurse positions, I can’t stress enough how important it is to focus practice readiness equally on knowledge acquisition, situated knowledge use, and clinical reasoning. Deliberate practice with contextual thinking is critical. As educators we have to engage our learners in deliberate and reflective practice, connecting pieces of information to discover what is salient in order to apply critical thinking and solve problems. To truly advance excellence in nursing education, educators must use experiential teaching through facilitated, situated cognition with reflection.

Q: What advice do you have for new graduate registered nurses to help transition from academia to professional practice?

A:  Two key pieces of advice I have are:

  1. Look for extern positions between your junior and senior years of nursing school. Cleveland Clinic’s Nurse Associate Extern program is a paid, highly sought-after 10-week educational program that builds student nurse confidence and competence.
  2. Seek positions in healthcare systems that have nurse residency programs. Cleveland Clinic’s nurse residency offers a unique roadmap in aiding new nurses in the transition from academia to professional practice. The residency has two overarching goals: improve practice readiness of new nurses and ensure a competent workforce by providing the enhanced training, skills and knowledge needed to deliver safe, high-quality patient care.