As nurse educators, we are consumed with deliberations about how to best prepare tomorrow's nurses, especially given the complexity of the health care environments in which they will work. We want our graduates to be safe, competent practitioners, well prepared to care for individuals and families with complex health care needs. And we want them to practice to the full extent of their educational preparation and scope of practice.
As we continue to question our pedagogy, we remind ourselves that we want the most skilled and knowledgeable nurses caring for ourselves and for our families when we require care - the expert nurse, not the novice described in Benner's (1984) theory. Yet, we know from the recent research published by Kavanagh and Szweda (2017) that most new graduates are not expert nurses. Based on five years of data, evaluating more than 5,000 newly graduated nurses from more than 140 nursing programs, the researchers found that fewer than one-fourth scored in the safe or acceptable range (p. 58).
We know that knowledge is only part of the requirement for safe practice. We recognize that we must prepare individuals whose professional understandings are grounded in a philosophical perspective of persons and their environments and the nurse's role in helping individuals move toward health and wellness.
For us as educators, our problem is also not a shortage of knowledge. We have a rich history, with a renewed focus on nursing education research. We can cite past research on clinical judgment, including research on problem solving, decision-making, and critical thinking, terms that are often used synonymously with clinical judgment. Tanner's classic literature reviews on the topic of clinical judgment remind us of the plethora of studies (Tanner, 1998, 2006). In her 2006 review, Tanner identified nearly 200 studies on this topic.
Much of our knowledge about how to prepare nurses who can practice safely and competently leads us to develop greater integration between academic and service sites. Academic-practice partnerships are considered paramount to success in preparing safe practitioners for the future. Kavanagh and Szweda (2017) have a number of recommendations that should be considered by all academic institutions, including curricular revisions, academic-practice partnerships, and guided learning opportunities to develop clinical reasoning skills and critical thinking.
Much of our knowledge about how to prepare nurses who can practice safely and competently leads us to develop greater integration between academic and service sites. Academic-practice partnerships are considered paramount to success in preparing safe practitioners for the future.
We have dedicated a special issue of Nursing Education Perspectives, the 2017 Summit issue (Vol. 38, No. 5), to highlighting academic-service partnerships that address the Institute of Medicine's (2011)Future of Nursing recommendations. We also are calling for papers for a 2020 issue of Nursing Education Perspectives focused on Institute of Medicine recommendations and changes in nursing education 10 years after the report was first released. Our chance for changing the future is now, but we must embrace the current reality that requires leading change and advancing health.
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