Challenges in Nursing Education Research

Abstract

Examining Clinical Learning Experiences OVER THE YEARS, the NLN has spearheaded many revolutions in nursing education and supported attempts by faculty and schools to explore fresh approaches to the enrichment to student learning. The community-based efforts of the 1990s were characteristic of efforts to encourage systematic modification of how students and faculty conceptualize the role of the nurse and the dimensions of the patient's experience, whether that of an individual, family, or community. As successful as many of these initiatives have been, recent experiences have brought home how unsuccessful the nursing education community has been in changing the lundamental nature of clinical learning experiences. For most of our history, we have approached clinical experiences at the undergraduate level in the same way. With few exceptions, all entry-level programs plan for students to provide clinical services to patients under the supervision of the faculty of the school. (This worker relevant term continues to be applied to these learning experiences despite its inappropriateness in the educational context.) These experiences presumably enable our students to apply what they have learned in the classroom setting to the real clinical environment with real people. The word presumably is used with much intention. To date, there has been little evidence that substantiates the dependence within nursing education on clinical learning experiences as they are currently offered. We all presume that learning occurs. Employers articulate the need for more clinical experiences in nursing education programs to foster a smoother transition for new graduates. The basis for their request is their presumption that such learning will provide the basis for a stronger new clinician. Thirty years ago I focused my doctoral dissertation on describing clinical learning experiences in a baccalaureate nursing program. In a recent meeting with over 50 educators, I presented that study, without initially revealing when it had been undertaken. My motive was to dramatize the failure on the part of nurse educators to institute change in clinical learning experiences. A lively discussion ensued about some of the common events of the clinical experience, such as pitfalls in patient assignment, lack of contiguous lab days, dis-connects between the staff of the nursing unit and the faculty, and the impact of the student group on the learning of individuals within the group. When I asked my colleagues how old they thought my research was, responses ranged from one to live years. …