Hiring and retaining qualified nursing faculty remain a significant challenge; the current faculty shortage only intensifies the situation. To meet the demand for quality nurse educators, many nursing education programs are hiring actively working staff nurses to assist in the clinical education of nursing students. These part-time clinical instructors have become an integral part of the nursing education team.1 This collaborative relationship allows these nurses to continue to work at the bedside while providing them opportunities to hone their skills as nurse educators.2
One of the challenges many part-time clinical instructors face is a lack of formal education in the principles and practices of adult education. Rather, they are hired and may be mentored by more seasoned educators. This approach, however, may lead to many issues: frustration, varying levels of program commitment with a part-time role, inconsistent application of program policies, and difficulty evaluating student performance.3,4
Evolution of the Nurse Educator Institute
To address issues of nursing faculty shortages, the North Carolina Board of Nursing (NCBON) revised faculty qualifications in 2008. In North Carolina, all faculty who teach must meet the same criteria. Included in this revised criteria was the requirement that, within the first 3 years of employment, faculty must have preparation in teaching and learning, principles of adult education, and curriculum development, implementation, and evaluation. This is documented by completion of 45 contact hours of continuing education courses, completion of a certificate program in nursing education, 9 semester hours of education course work, national certification in nursing education, or documentation of successful completion of structured individualized development activities of at least 45 contact hours approved by the Board.5
The Northwest Area Health Education Center (NWAHEC) of Wake Forest School of Medicine, in conjunction with nursing program directors, collaborated to develop a program to address the faculty shortage. The NWAHEC strives to enhance the health of the public in its 17-county region in northwest North Carolina by improving the supply, distribution, and quality of health and human service personnel.6 The NWAHEC is a component of the North Carolina statewide AHEC system whose mission is to support regional health care and provide professional continuing education.
Course Development
Five experienced nurse educators, including 3 program directors, a nurse educator and director with NWAHEC, and a nurse faculty member, convened to develop this program. To ensure compliance with the NCBON Education Rules, an education consultant from the NCBON provided feedback.
The authors reviewed information from many sources including the National Academy of Medicine (formerly the Institute of Medicine), National League for Nursing (NLN), Southern Regional Education Board, National Council of State Boards of Nursing, and Quality and Safety Education for Nurses competencies. After this review, it was apparent that there were 4 broad areas to be included in the Nurse Educator Institute (NEI): socialization to the role of nurse educator, adult learning theory, curriculum and development, and testing/evaluation. The recommended references for the Certified Nurse Educator Examination from the NLN and classic nursing and adult education texts were used in course development.
These 4 broad concept areas evolved into 4 modules. In module I, "Socialization," the following concepts are presented: development of role identity, educator role, scholar role, collaborator role, and ethical-legal teaching framework along with nursing education leadership. Module II, "Teaching/Learning Methodologies," includes history of education and nursing education, learning styles, generational diversity related to the adult learner, clinical versus didactic learning, reflective practice, and information technology. Module III, "Curriculum Design," discusses concepts such as philosophy, mission, outcomes/objectives, taxonomies of learning and learning styles, and measuring learning. In module IV, "Improving Performance," the participant learns how to integrate concepts of testing and evaluation with the National Council Licensure Examination (NCLEX) test plan.
As the NEI was being developed, 1 common concept that continued to surface was the importance for the participant to have opportunities to engage in activities that reinforced the content in each module. Therefore, the authors developed a workbook that provides multiple options for participants to practice skills they learn during the program. Interactive activities and feedback, including reflection and research, are included in the workbook. It also includes a glossary of terms specific to nursing education and an extensive reference list.
Once enrolled in the program, the learner receives a flash drive with all the information contained in the modules and the 142-page NEI workbook. On completion, the participant takes a posttest. Once the posttest is submitted with a passing grade of 70%, a certificate of completion is issued. Participants who complete the entire program including the posttest are awarded 60 contact hours through Northwest AHEC, which is an approved provider of continuing nursing education by the North Carolina Nurses Association (NCNA), an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.
Although the initial purpose of the NEI was to meet new education rules for nurse educators, the program can also serve as a mechanism to recruit staff nurses to the role of nurse educator. Many of these staff nurses enjoy teaching students during their clinical time and actively seek out learning opportunities for students. Some of them may serve as preceptors for nursing students during their capstone clinical experience. The NEI provides a flexible and nonthreatening option to introduce them to nursing education and roles and responsibilities of the educator.
This online course, maintained by NWAHEC, is reviewed and revised every 2 years by the original course faculty along with a nurse educator with Northwest AHEC to meet the evolving needs of nurse educators and prospective nurse educators. The NEI is renewed for continuing education contact hours by the NWAHEC nurse educators every 2 years. The course is listed on the Northwest AHEC Web site and is open for enrollment to all nurse educators.
Evaluation
To date, 293 nurse educators have completed the NEI offered through Northwest AHEC. The overwhelming majority of the learners have been from North Carolina. Geographically, 48 of the 100 counties in the state have participants who have enrolled. In addition, nurse educators from 11 other states have participated.
Most of the nurse educators (94%) who completed the program either strongly agreed or agreed that the activities reinforced and improved current skills, content provided new information they expected to use, reinforced best practices to improve delivery of nursing education, incorporated a broad repertoire of instructional strategies, and used evaluative information to improve the instructional process. In addition, 92% agreed that the online format was conducive to learning. All program completers indicated that the program was presented in a fair and unbiased manner and satisfied requirements in North Carolina for teaching in nursing programs, as set forth by the NCBON. The course content, teaching methods, handouts, and audiovisuals were rated as appropriate, useful, and consistent with the course objectives.
Participants indicated that they made the following changes in practice or professional development as a result of the NEI: applied systematic program evaluation more effectively, used the information in the clinical setting, ensured that learning outcomes were measurable, and incorporated a greater variety of teaching methods other than lecture, based on concepts learned from the modules. The cost of the NEI is $650; educators within the 17-county NWAHEC region are offered a discounted rate of $325. In addition, each school involved in the original development of the program was awarded 2 scholarships per calendar year.
Summary
The NEI, launched in 2008, has assisted educators with building a foundation in teaching learning theories and methodologies, curriculum development, evaluation of outcomes, and performance improvement. The NEI has been used by nurse educators across the country and continues to be available to prepare nurse educators.
Acknowledgments
The authors acknowledge the original NEI authors: Sheryl Cornelius, Cynthia Geouge Davis, Larry Freeman, Phyllis Horton, Bonnie G. Pope, and Camille N. Reese.
References