Educating nurses: A call for radical transformation

Abstract

Benner, P., Sutphen, M., Leonard, V. & Day, L. ( 2010 ). Stanford, CA: Jossey-Bass . 260 pp. ISBN 978-0-470-45796-2 . Price $US40.00 (hard cover ) This book is part of Carnegie's larger research program examining and comparing education and preparation for the professions, such as law, medicine, clergy, engineering, and nursing. The primary author of this book, Patricia Benner, is famous for her earlier work, “From Novice to Expert” (Benner, 1984), and her skill acquisition model still is cited often in nursing practise and education. However, the ways to acquire the skills and knowledge to be a nurse and how instructors can facilitate such learning are not discussed in her initial writing or in the literature following her early work. Twenty-five years later, the book “Educating nurses: A call for radical transformation” offers some paradigm cases and exemplars to delineate how nursing students form their professional identity and how instructors can facilitate nursing students' eventual growth from novice to expert. The book is composed of five chapters. Chapter one describes the background and challenges confronting nursing education in today's clinical and teaching environment. Chapters two-to-four are delineations of paradigm cases that represent a new approach to nursing education. In Chapter five, the authors present some recommendations to transform nursing education. Some of the issues that are addressed in Chapter one might be specific to situations in the USA. Yet, I see similar trends in Japanese nursing education and share similar concerns and I suspect that many nurse educators in other countries also would share in these views. In Chapter five, the authors propose a new approach to nursing education that is based on the findings of exemplary teaching in current nursing education. Their recommendations are not prescriptive; therefore, they are applicable to education outside of the USA, as well. What the authors propose is a paradigm shift in nursing education – shifting from catalogued knowledge to situated and live knowledge in dynamic clinical situations, shifting from a separation to an integration of classroom and clinical teaching, and shifting from critical thinking to clinical reasoning – as well as a new direction in terms of the formation of a professional identity as a nurse. In order to make these shifts happen, nurse educators and institutes of education have to be creative and reflect on their education at both the micro and macro levels. We need to look into individual teacher–student interactions, as well as curricula and programs in order to find the pitfalls and strengths in current teaching. The paradigm cases that are presented in chapters two-to-four are the strengths that the authors found in current nursing education. As a nurse educator, it was very exciting to read vivid delineations of how other instructors teach (chapters two-to-four). Faculty members in a college of nursing are frequently busy and often work in isolation. Seldom do they have an opportunity to see or know how other instructors teach. Three paradigm cases and some exemplars that are presented in this book are inspiring and challenged me to rethink the organization of my own teaching. In the college of nursing where I currently work, the faculty members who read this book developed a forum in order to have open conversations to learn from each other and to discuss how to integrate the ideas into the curriculum and to make the shifts described earlier happen in our school. During the last few years, nursing professionals have been gaining momentum in being recognized in society and taking a more central role in providing quality health care in the USA. A recent report by Institute of Medicine (2011) (another must-read reference for nursing leaders) is a great example highlighting the increasing attention on, and expectations about, nurses in society. In order to respond to these expectations, nurse educators need to foster strong and competent nurses who can make changes in health care. Educating nurses is a fundamental step in creating a bright and strong future for nursing and a healthier society. This book is a wake-up call for nurse educators to reflect on what we currently do well, what is not working or what has room for improvement, and how to make the radical transformation happen that is necessary for a better future in nursing and society.