California Institute for Nursing &
Healthcare
Nursing Education Redesign
for California:
New Opportunities
for Nurse Educators
Jan Boller, RN, PhD
Project Director,
White Paper on Nursing Education Redesign for California
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Goals For This Session
1. Examine a recent statewide approach to build
consensus around priorities for nursing
education redesign in California.
2. Analyze and respond to seven recommended
priorities for nursing education redesign in
California based on this consensus process.
3. Explore new opportunities for California’s
nurse educators generated by these
recommendations.
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Project Overview
White Paper: Nursing Education
Redesign for California
Funded by a grant from
the Gordon and Betty Moore Foundation
Project Objectives:
•
•
•
•
Examine the need to reshape nursing education,
Make recommendations on elements for redesign,
Define the action steps, and
Provide plans for building consensus to accomplish
redesign
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Driving Forces Influencing the Need
to Reshape Nursing Education
1.
Changing demands from patient care delivery systems
requiring new skills and competencies;
2.
The impact of clinical simulation on nursing education
offering new avenues for learning;
3.
The nursing shortage requiring new ways to educate
nurses; and
4.
Renewed interest in collaboration and articulation
between associate and baccalaureate degree nursing
education programs.
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Nursing Education Redesign for
California Cosponsors
• Association of California Nurse Leaders (ACNL)
• California Organization of Associate Degree Nursing
Program Directors, North and South (COADN)
• California Association of Colleges of Nursing (CACN)
• American Nurses Association California (ANA\C)
• California Board of Registered Nursing (BRN)
• California Institute for Nursing & Health Care (CINHC)
(Grant Administrator)
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Nursing Education Redesign
Thought Leaders
• ADN Directors and Faculty, Students
• BSN/Higher Education Chairs, Deans, Faculty, Students
• Clinical Service Executives, Educators, Advanced
Practice Specialists, New Graduates
• Health Care Professional Organization Leaders
• BRN Executives and Supervisors
• Policy Specialists
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Nursing Education Redesign
Expert Consultants
• Statewide Collaborative Education Models:
Christine Tanner, Paula Gubrud-Howe, Louise Shores, Oregon
Consortium for Nursing Education
• Educating Nurses for Complex Care:
Patricia Benner & Molly Sutphen, Co-Investigators, Carnegie Study
for the Preparation of the Professions: Nursing Education Study
• Evidence-Based Nursing Education:
Nancy Spector, National Council of State Boards of Nursing
• Professional Role Competence & Development:
Maria O’Rourke
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Evidence-Based Approaches for
Leading Change & Building Consensus
• World Café, Collaboration (Brown & Isaacs; Himmelman)
• Appreciative Inquiry (Cooperrider & Whitney)
• Nominal Group Process, Delphi (Delbecq, VandeVen, &
Gustafson)
• Interactive Audience Response Voting Technology
• IHI Model for Improvement (IHI; Langley, Nolan, Nolan,
Norman, & Provost)
• Building Communities of Practice/Participatory
Reflection & Action Science/Managing Polarities
(Lave & Wenger; Wenger, McDermott, & Snyder; Scott & Cleary)
• Theory “U”: Creating an Emerging Future (Scharmer)
• Learning Organizations/Teams (Senge, et al.)
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Interactive Audience Response:
Using Technology to Build Consensus
We must change the way we
teach and prepare nurses if we
intend to respond to the
current and future health care
needs of Californians.
Strongly Agree
Agree
Disagree
Strongly Disagree
14%
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Nursing Ed Redesign Summary
gr
ee
ag
re
e
0%
Di
s
ly
St
ro
ng
A
is
a
D
ly
St
ro
ng
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gr
ee
0%
Ag
re
e
a.
b.
c.
d.
86%
9
Using All of Our Intelligences
•
•
•
•
•
Mind
Body
Heart
Spirit
Creative
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Findings
+ Strong commitment among
nurse leaders to collaborate
and deliver high quality
education;
+ Best practices in California
reveal many points of
excellence;
+/▲ Diverse resources exist for
education, but limited
availability and high demand
challenge access;
+/▲ Substantial efforts to increase
articulation between ADN &
BSN programs, yet only 26%
of California’s ADN graduates
obtain BSN or higher degrees
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▲
Faculty salary disparities thwart
recruitment of teachers;
▲
Variations in educational
practices and outcomes across
the state. Need for statewide
collaboration;
▲
Gaps in RN new graduate role
performance consistent with
national findings: critical thinking,
clinical judgment, inter-professional
collaboration, evidence-based
practice, and working in complex
systems;
▲
Persistent disconnect remains
between academia and service,
compromising student clinical
experiences
Nursing Ed Redesign Summary
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Nursing Education Redesign for California
Strategic Action Priorities
• Form a Strong Statewide Academic/Clinical Service
Coalition that Sets Standards and Shares Resources:
– Professional and clinical role formation and development based
on a novice-to-expert continuum
– Integrate Simulation, Technology, & Informatics into Education
– New Graduate Residencies & Transition Programs
• Create a Collaborative Model: California Nursing
Education Highway System
– Seamless advancement from ADN & BSN to graduate levels,
with multiple “on & off ramps” providing adequate supplies of
diverse, well-prepared clinicians & faculty
– Faculty development
• Eliminate Academic Salary Disparities
• Create a Center for Knowledge Development
– Foster innovation and evaluation of education effectiveness
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Nursing Education Redesign
for California: Recommendations
21st CENTURY RN
WORKFORCE
CENTER FOR KNOWLEDGE
SIMULATION & TECHNOLOGY
NEW GRADUATE RESIDENCIES
FACULTY DEVELOPMENT/RECRUITMENT
COLLABORATIVE EDUCATION MODEL:
EDUCATION HIGHWAY
NOVICE-TO-EXPERT DEVELOPMENT FRAMEWORK
ACADEMIC/SERVICE PARTNERSHIPS & STANDARDS
ST CENTURY
VISION: ©2006
WELL-PREPARED
NURSES
FOR
THE
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Nursing Ed Redesign Summary
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1. Academic/Service Partnerships
Forge a strong and stable coalition of academic,
service, policy, and industry partners to shape
nursing education in California.
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2. Professional and Clinical Role
Establish core competencies and guide
professional and clinical role formation
based on a novice-to-expert continuum.
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(Artwork used with permission: E. Loyd, Nursing Student)
3. Collaborative Education Model
Provide a coordinated statewide system
(California Nursing Education Highway) for
increased access and seamless advancement
in nursing education.
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4. Faculty Development &
Recruitment
Recruit, develop, and retain well-prepared and
diversified faculty.
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5. Simulation, Technology, &
Informatics
Integrate simulation, technology, &
informatics into the nursing education
curriculum.
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6. Residencies
Assure safe and effective transition from prelicensure graduate to entry-level practice
through evidence-based residencies.
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7. California Center for Nursing
Knowledge
Create a resource center and data repository
to inform excellence in nursing education and
practice.
Show me the
Science!
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Next Action Steps
1. Disseminate
recommendations
2. Build coalition
3. Engage key stakeholders
4. Acquire funding
5. Establish California
Center for Nursing
Knowledge
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Questions
•
•
•
•
•
•
What clarifying questions do you have about
these recommendations?
Merits?
Concerns?
What’s Missing?
What new opportunities for nurse educators do
you see in these recommendations?
How can nurse educators be involved moving
these recommendations forward?
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Thank You!
Celebrating Nurse Educators
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Contact Information
• Jan Boller
Project Director, Nursing Education Redesign
jan@cinhc.org
• Deloras Jones
Executive Director, California Institute for Nursing &
Health Care
deloras@cinhc.org
• Information about the White Paper on Nursing Education
Redesign for California can be accessed at:
www.cinhc.org
Located in the CINHC@Work
Section
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References
• Access www.cinhc.org/atWork for references on:
– Academic/Service Partnerships
– Professional and Role Competence & Novice-toExpert Development
– Collaborative Education Models
– Faculty Development & Recruitment
– New Graduate Residencies
– Simulation and Technology
– Building Knowledge for Evidence-Based
Education & Curriculum Reform
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References: Building Consensus for
Change, Improvement, and Innovation
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•
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Brown, J. Isaacs., D., World Cafe Community (2005). The world cafe:
Shaping futures through conversations that matter. San Francisco: Berrett
Koehler.
Cooperrider, D. L. & Whitney, D. (2005). Appreciative Inquiry: A Positive
Revolution in Change. San Francisco: Berrett-Koehler Publishers, Inc.
Delbecq, A., Van de Ven, A., & Gustafson. (1975). Group techniques for
program planning: A guide to nominal group and Delphi processes.
Glenview, IL: Scott, Foresman and Co.
Himmelman, A. T. (1994). Communities working collaboratively for a
change. Resolving conflict: Strategies for local government. M. Herrman.
Washington, D.C., International City/County Management Association: 2747.
Himmelman, A. T. (2004). Collaboration for a change: Definitions, decisionmaking models, roles, and collaboration process guide. Himmelman
Consulting: 1-26.
Institute for Healthcare Improvement. www.ihi.org
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References: Building Consensus for
Change, Improvement, and Innovation
(continued)
•
•
•
•
•
•
Langley, G. J., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P.
(1996). The improvement guide: A practical approach to enhancing
organizational performance. San Francisco, Jossey-Bass.
Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral
participation. New York, Cambridge University Press.
Scharmer, C. O. (2007). Theory U: Leading from the future as it emerges.
Cambridge, MA, Society for Organizational Learning.
Scott, E. S., & Cleary, B. L. (2007). Professional polarities in nursing.
Nursing Outlook, 55(6), September/October, 250-256.
Senge, P. M. (2006). The fifth discipline: The art and practice of the learning
organization. (2nd. Ed). New York: Currency Doubleday.
Senge, Cambron-McCabe, N., Lucas, T., Smith, B., Dutton, & Kleiner, A.
(2000). Schools that learn: A fifth discipline fieldbook for educators, parents,
and everyone who cares about education. New York: Currency Doubleday.
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References: Building Consensus for
Change, Improvement, and Innovation
(continued)
•
•
•
•
•
Senge, P. M. Kleiner, A., Roberts, C., Ross, R. B., & Smith, B. J. (1994).
The fifth discipline fieldbook: Strategies and tools for building a learning
organization. New York, Currency Doubleday.
Senge, P. M. Kleiner, A., Roberts, C., Ross, R.B., Roth, G., & Smith, B.J.
(1999). The dance of change: A fifth discipline fieldbook for mastering the
challenges of learning organizations. New York, Currency Doubleday.
Senge, P. Scharmer., C. O., Jaworski, J., & Flowers, B. S. (2005).
Presence: An exploration of profound change in people, organizations, and
society. New York,:Currency Doubleday.
Wenger, E., McDermott, Richard, Snyder, William M. (2002). Cultivating
communities of practice. Boston, Harvard Business School Press.
Whitney, D., Trosten-Bloom, Amanda (2003). The power of appreciative
inquiry: A practical guide to positive change. San Francisco, Berrett-Koehler
Publishers, Inc.
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