Running head: STRATEGIES FOR NURSE EDUCATORS
Multigenerational Diversity and Technology Changes: Strategies for Nurse Educators
Karen Collins
Ferris State University
1
STRATEGIES FOR NURSE EDUCATORS
2
Abstract
Nursing schools face challenges with educating students from all age groups and generations.
The nursing workforce currently has five generations of nurses. Up to four generations of
students may be present in a classroom at any one time. Each of these generations has their own
value system and work ethic, creating a challenging situation for nurse educators. Rapidly
changing technology is also a challenge for nurse educators. This paper discusses these
challenges, as well as offers strategies for nurse educators to practice effectively.
STRATEGIES FOR NURSE EDUCATORS
3
Multigenerational Diversity and Technology Changes: Strategies for Nurse Educators
In order for nurse educators to practice effectively in today’s health care environment,
they must be up-to-date with technology in the classroom and at the bedside, as well as having a
strong focus on producing a well-educated and professional nursing workforce. By the year
2020, the Institute of Medicine (IOM) recommends that baccalaureate level nurses be close to 80
percent of the nursing workforce (Institute of Medicine (IOM), 2010). In order to achieve this
goal, more nurses need to return to school to obtain their Bachelor of Science in Nursing (BSN)
degree.
The manner in which nurses were educated in the past will not be adequate for the 21st
century due to technology and more complex patient health care needs (IOM, 2010). Nursing
schools are challenged with educating students from all age groups and generations. Additional
challenges include the rapidly changing field of technology in the classrooms and at the bedside.
The purpose of this paper is to discuss two challenges faced by nursing educators and offer
strategies to support how educators can enhance their teaching techniques.
Changes in Technology
Nursing education must embrace technology, as technology is everywhere; in the
classroom with multimedia computers, simulation labs, and computer-based learning tutorials,
and at the bedside with electronic medical records (EMR). It is a challenge for many nurse
educators to become competent in technology such as wikis and blogs, on-line learning systems,
podcasts, webcams, on-line portfolios, and simulations. Technology enhances the nursing
students’ learning outcomes, affects decision-making skills, and is instrumental in developing
specific skills (Talcott, O'Donnell, & Burns, 2013). Advances in educational technology require
STRATEGIES FOR NURSE EDUCATORS
4
nursing faculty to become computer and technology savvy and address the gap that exists
between nursing educators and students (Talcott, O'Donnell, & Burns, 2013).
In the Classroom
Many nurse educators in the classroom setting are challenged by the use of technology
(Axley, 2008). As the average nursing faculty age increases, many are reluctant to adopt and use
the new equipment and technology, and will opt for retirement (Talcott, O'Donnell, & Burns,
2013). This is detrimental to the nursing faculty shortage, the nursing student population, and
thus, the nursing workforce. Younger nursing students have been raised in an era that embraces
technology (Shellenbarger & Robb, 2013). These students, born in 1992 and after, have “never
known a time without computers or cell phones” (Bell, 2013, p. 205).
Use of technology in the classroom setting has significantly changed teaching strategies
(Axley, 2008). Educators are challenged with creating innovative teaching-learning activities to
facilitate learning (Shellenbarger & Robb, 2013). High fidelity and low fidelity simulations
facilitate working within a team, practicing complex skills, and allow students to learn in a safe
environment where no harm will come to a real patient (Gore, Hunt, Parker, & Raines, 2011).
Learning to use technology in the classroom requires dedication on the part of the nurse
educator. Critz and Knight (2013) report using a “flipped classroom” where students watch
lectures online, read evidence-based articles posted by the instructor, and complete text readings
prior to class. This type of “classroom required considerable preparation on the part of the
faculty” (Critz & Knight, 2013, p. 211).
Strategy. A strategy to help nursing faculty members embrace technology is for
administrators/management to offer formal education to develop their skills. The American
Association of Colleges of Nursing (AACN) offers a web-based program aimed to advance
teaching skills, professional scholarship, and instructional improvement (American Association
STRATEGIES FOR NURSE EDUCATORS
5
of Colleges of Nursing (AACN), 2013). Information technology (IT) support was essential in
the study by Critz and Knight (2013). Mentoring or a faculty development program is another
option for success on the part of the faulty members.
In a study done by Talcott, O'Donnell, and Burns (2013), objectives for their program
included: a) develop a program to enhance the knowledge, skills, and abilities of nursing facility
in the application of emerging heathcare technologies; b) assist nursing faculty with initiating
and integrating technology strategies into nursing education programs; and c) measure changes
in nursing faculty knowledge, skills, abilities, and confidence in integrating technology into their
nursing curricula (p. 128). This program was successful and the authors found that “nursing
faculty find value in and understand the potential impact of emerging technologies on nursing
education (Talcott, O'Donnell, & Burns, 2013, p. 130). Technology can enhance learning.
Traditional instructor led lecture and student note taking have been replaced by
PowerPoint presentations, interactive activities, case presentations, and video vignettes (Gallo,
2011). These activities have been shown to enhance the learning experience (Gallo, 2011).
Offering online discussion boards, self-directed learning modules, case presentations, and role
playing were considered to be the best method of education across the generations in a study
compiled by Gallo (2011). Nurse educators will want to add these tools to their teaching
methods, if they have not already done so.
At the Bedside
Advancing technology and thus, the EMR, is a part of the 2010 Health Care Reform
(Brooks & Erickson, 2012). The EMR supports “coordination of care by making patient
information available across providers and settings, promotes the delivery of evidence-based care
. . . and reduce[s] duplication of services. . .” (McCarthy, 2011, p. 212). Medical stakeholders
STRATEGIES FOR NURSE EDUCATORS
6
(e.g. American Nurses Association and the Institute of Medicine) support the use of the EMR to
improve a culture of safe care delivered to the patient (Brooks & Erickson, 2012). Information
in the EMR is legible, accessible, and retrieved easily (Baillie, Chadwick, Mann, & BrookeRead, 2013). Brooks and Erickson (2012) add enhanced confidentiality, decreased errors, and
improved communication as benefits of the EMR. Prior to the creation of the EMR, nursing
students have been able to write on the patient’s paper chart with a mentor’s supervision (Baillie,
Chadwick, Mann, & Brooke-Read, 2013).
Nurse educators are charged with the responsibility of preparing their students to
document appropriately during their clinical rotations. For many clinical educators and their
students, charting in the EMR is not possible due to their exclusion from the hospital’s EMR
training programs. This training is time consuming and costly to the institution due to having to
pay the class instructor. In addition, the nursing students’ clinical time is limited (Bowers, et al.,
2011). K. Searing (personal communication, October 25, 2013) reports that her students spend
an eight-hour day in a hospital computer lab learning how to document appropriately in the
hospital’s EMR. Even then, charting practices for students in different departments in the same
hospital vary (K. Searing, personal communication, October 25, 2013). (Nursing students do
still need a co-signature on their charting in the EMR.)
Strategy. One strategy to enhance the students’ opportunities for navigating the EMR is
to incorporate an EMR into their simulation situations, whether in a simulation lab or a written
scenario. Having an EMR system at the nursing school level will allow students to gain
proficiency prior to employment (Brooks & Erickson, 2012). One of the Quality and Safety
Education for Nurses (QESN) informatics competency skill is to “use high quality electronic
sources of healthcare information” (QESN, 2013). Nursing curriculum must be aligned with the
STRATEGIES FOR NURSE EDUCATORS
7
nursing practice environment (Brooks & Erickson, 2012). Student nurses must develop
confidence in their charting and documentation skills. Integrating technology into nursing
simulation education will allow the students to practice in a safe learning environment while
becoming familiar with this technology. With proficiency, students may then focus on direct
patient care, rather than focusing on the technology (Brooks & Erickson, 2012).
Generational Diversity
Nurse educators are challenged by the diverse needs and skills of their students
(Wellman, 2009). Educators may have four different generations of students in their classrooms
at any given time, each with different learning styles and life experiences (Bell, 2013). The
silent generation, while still in the workforce, probably will not be present in the academic
setting as they are close to retiring. Each generation has their own set of values, beliefs,
attitudes, and work habits (Kramer, 2010). The challenge for nurse educators is to engage this
diversity in the classroom.
Silent Generation
The Silent Generation, also called the Veterans, is cautious, conservative, and
hardworking (Kramer, 2010). Almost 10% of the nursing workforce is comprised of this
generation, many having postponed retirement or have re-entered the workforce (Bell, 2013).
These nurses most likely will not be in the traditional classroom.
Baby Boomers
This generation comprises 55% of the nursing workforce (Bell, 2013). These nurses
prefer open communication, value life-long learning as a means to improve performance, and
value respect (Gibson, 2009). Many baby boomers are working on advancing their career
choices.
STRATEGIES FOR NURSE EDUCATORS
8
Gen X
The Gen X generation is “shaped by a culture of instant results” (Gibson, 2009, p. 37).
This generation is great with multitasking and look to education as a means to an end (Gibson,
2009). Technology is a component of the Gen Xer’s lives.
Gen Y or Millennials
The Gen Y population has the smallest population of nurses (Kramer, 2010). This
generation wants structure, extensive orientation, and formal mentoring programs. This
generation’s approach to learning is by executing, collaborating with teammates, and utilizing
simulations (Kramer, 2010).
iGeneration or Gen Z
This generation of students, born in 1992 and after, has never been without computers,
iPads, or cell phones (Bell, 2013). As a generation, they are open to change. They like the
individualized activities made possible by technology (Bell, 2013). They expect technology to
be incorporated into their daily lives (Gibson, 2009).
Nurse educators are faced with “understanding each generation’s communication
preferences and frame of reference” (Bell, 2013, p. 205). Nurse educators may have students for
whom the computer is a new concept and students who are technologically competent. How
then to create a learning environment where all students can learn and feel safe?
Strategy. Primarily, nurse educators need to consider each generation’s style of learning,
being careful not to stereotype individuals or groups. Kramer (2010) lists several strategies for
the nurse educator:

Seek to understand each generational cohort and accommodate generational
differences in attitudes, values, and behaviors
STRATEGIES FOR NURSE EDUCATORS

9
Develop generationally sensitive styles to effectively coach and motivate all
members of the healthcare team

Develop the ability to flex a communication style to accommodate generational
differences

Promote the resolution of generational conflict so as to build effective teams

Capitalize on generational differences, using these differences to enhance the
work of the entire team (p. 128)
Additionally, nurse educators should focus on the creation of classrooms where the
strengths of each generation of students are enhanced. In the creation of group work, nurse
educators may purposely place students in groups of varying generations. This intentional
placing encourages students to work out and appreciate their differences, as well as work
together as a team, just as in the workplace. The expertise of each generational group will bring
different solutions to the problem. Learning from each other is just as valuable as learning from
the educators. This “rich diversity of generational perspectives” (LeDuc & Kotzer, 2009) will
result in a creative learning environment.
Comparing one generation to another is not new, report LeDuc and Kotzer (2009), but by
recognizing shared values in the classroom and workplace, a commitment to the profession of
nursing is enhanced. The American Nurses Association (ANA) has a Code of Ethics in place.
This code was created as a guide for nurses to act and interact professionally in a manner
consistent with quality nursing care (American Nurses Association (ANA), 2011). By
appreciating the generational diversity in the nursing student population, nursing educators and
students are true partners of the profession (LeDuc & Kotzer, 2009). The conscious effort to
STRATEGIES FOR NURSE EDUCATORS
10
understand each generation of nursing students allows educators to maximize the power of each
generation.
Revelant Theory and Speciality Practice
Bandura’s Social Learning theory (1977) is a relevant theory for educators to model good
behavior. Steps involved in this modeling theory include attention, retention, reproduction, and
motivation (McLeod, 2011). Students will pay attention if the process is colorful and dramatic,
that is engaging and not boring. In the traditional classroom, this means keeping the lecture to
20 minutes or less, and then engaging in bidirectional interaction (Gallo, 2011). Retention and
reproduction, the second and third steps in Bandura’s theory, can be related to students watching
a demonstration and being able to copy or reproduce it when needed. An example of this is
showing students how to gown and glove in a sterile technique and having them demonstrate the
process.
Motivation is the final step in Bandura’s Social Learning theory. Motivation for many,
but not all, students is achieving a good letter grade. However, grades are important for faculty
as it dictates whether or not a student passes the course. Nurse educators, by understanding what
motivates each unique generational group, can impact the learning of each generation.
The National League for Nursing (NLN) has created 10 evidenced-based competencies
for nurse educators (Halstead, 2007). Many of these competencies are incorporated into this
essay. Competency One is Facilitate Learning and is enhanced by “uses information
technologies skillfully to support the teaching-learning process” (Halstead, 2007, p. 18). This is
supported by the use of the EMR and other healthcare technologies. Competency Two is
Facilitate Learner Development and Socialization and is upheld by addressing the unique
learning needs of each of the different generations present in the classrooms. Competency
STRATEGIES FOR NURSE EDUCATORS
11
Three, Uses Assessment and Evaluation, is upheld by nurse educators by using simualtions in
their practice. This technology “provides timely, constuctive, and thoughtful feedback to
learners” (Halstead, 2007, p. 80). These three examples show that the nurse educators
competencies are upheld.
Conclusion
Nurse educators are faced with challenges as they encounter up to four different types of
generations in the classroom. Although there are different generations, each with their own style
of learning, nurse educators ability to use technology in the educational process will enahnce
learning and bridge the generational gap. Revelant theory and realted nurse educator
competencies have been discussed.
STRATEGIES FOR NURSE EDUCATORS
12
References
American Association of Colleges of Nursing (AACN). (2013). Education Scholar: Retrieved
from: http://www.aacn.nche.edu/career-link/education-scholar
American Nurses Association (ANA). (2011). Code of Ethics: Retrieved from
http://www.nursingworld.org/Mobile/Code-of-Ethics
Axley, L. (2008). The integration of technology into nursing curricula: Supporting faculty via the
technology fellowship program. The Online Journal of Issues in Nursing, 13(3),
doi:10.3912/OJIN.Vol13No03PPT01
Baillie, L., Chadwick, S., Mann, R., & Brooke-Read, M. (2013). A survey of student nurses' and
midwives' experiences of learning to use electronic health record systems in practice.
Nurse Education in Practice, 13(5), 437-441. doi:10.1016/j.nepr.2012.10.003
Bell, J. A. (2013). Five generations in the nursing workforce. Journal for Nurses in Professional
Development, 29(4), 205-210. doi:10.1097/NND.0b013e31829aedd4
Bowers, A. M., Kavanaugh, J., Gregorich, T., Shumway, J., Campbell, Y., & Stafford, S. (2011).
Student nurses and the electronic medical record. CIN: Computers, Informatics, Nursing,
29(12), 692-697. doi:10.1097/NCN.0b013e31822b8a8f
Brooks, C. L., & Erickson, L. K. (2012). What is the solution for clinical nurse educators and the
electronic medical record? Teaching and Learning in Nursing, 7(4), 129-132.
doi:10.1016/j.teln.2012.06.003
Critz, C. M., & Knight, D. (2013). Using the flipped classroom in graduate nursing education.
Nurse Educator, 38(5), 201-213. doi:10.1097/NNE.0b013e3182a0e56a
STRATEGIES FOR NURSE EDUCATORS
13
Gallo, A.-M. (2011). Beyond the classroom: Using technology to meet the educational needs of
multigenerational perinatal nurses. The Journal of Perinatal and Neonatal Nursing,
20(2), 195-199. doi:10.1097/JPN.0b013e3182163993
Gibson, S. E. (2009). Enhancing intergenerational communication in the classroom:
Recommendations for successful teacher-student relationships. Nursing Education
Perspectives, 30(1), 37-39.
Gore, T., Hunt, C. W., Parker, F., & Raines, K. H. (2011). The effects of simulated clinical
experiences on anxiety: Nursing students' perspectives. Clinical Simulation in Nursing,
7(5), e175-e180.
Halstead, J. A. (2007). Nurse educator competencies: Creating an evidence-based practice for
nurse educators. New York, New York: National League for Nursing.
Institute of Medicine (IOM). (2010, October). The Future of Nursing: Retrieved from:
http://www.iom.edu
Kramer, L. W. (2010). Generational diversity. Dimensions of Critical Care Nursing, 29(3), 125128. doi:10.1097/DCC.0b013e3181d24ba9
LeDuc, K., & Kotzer, A. M. (2009). Bridging the gap: A comparison of the professional nursing
values of students, new graduates, and seasoned professionals. Nursing Education
Perspectives, 30(5), 279-284.
McCarthy, D. (2011). Integrative models and performance. In A. R. Kovener, & J. R. Knickman
Eds.), Jonas and Kovner's Health care delivery in the United States (10th ed.) (pp. 205231). New York: Springer Publishing Company.
McLeod, S. A. (2011). Albert Bandura/Social Learning Theory. Retrieved from Simple
Pyschology: http://www.simplepsychology.org/bandura.html
STRATEGIES FOR NURSE EDUCATORS
14
Quality and Safety Education for Nurses (QSEN). (2013). Informatics:Retrieved from
http://www.qsen.org/competencies/pre-licensure-ksas/
Shellenbarger, T., & Robb, M. (2013). Pinstructive ideas: Using a social networking bulletin
board for nursing education. Nurse Educator, 38(5), 206-209.
doi:10.1097/NNE.0b013e3182a0e5e7
Talcott, K., O'Donnell, J. M., & Burns, H. K. (2013). Technology and the nurse educator: Are
you ELITE? Nurse Educator, 38(3), 126-131. doi:10.1097/NNE.0b013e31828dc2a8
Wellman, D. S. (2009). The diverse learning needs of students. In D. M. Billings, & J. A.
Halstead (Eds.), Teaching in nursing: A guide for faculty (3rd ed., pp. 18-32). St. Louis,
MO: Saunders/Elsevier.