Authors

  1. Oermann, Marilyn H. PhD, RN, ANEF, FAAN

Article Content

We need good evidence in nursing education to make decisions about teaching practices in the classroom, online courses, simulation, and clinical settings. Many of the educational practices that faculty use in the classroom are evidence based (eg, active learning methods, flipped classes, scenarios for students to apply their knowledge, open-ended questions to encourage higher level thinking, and other teaching approaches). We know characteristics of online courses that lead to improved learning outcomes and can design courses based on that evidence. Study after study in nursing is building strong evidence on simulation, and sufficient research has been done to conduct systematic reviews and meta-analyses of simulation, generating best practices for simulation teaching. In most nursing programs, clinical practice remains an important component, as it should. But where is the evidence to guide our clinical teaching practices?

 

Evidence-based teaching is using research findings and other knowledge to guide our educational decisions.1 The knowledge we gain from this research about how students learn best helps us make decisions about instructional approaches. Consistent with evidence-based nursing, our decisions also should take into account theories and concepts about learning, practice, and skill development, among other areas; the teacher's expertise and experience as a nurse educator; and the student's learning needs and own goals.1 Sometimes, we do not have evidence, but we "know" from our experience what would work best to help students learn. Nurse educators support evidence-based teaching and recognize its importance.2 Although this support is critical, the fact remains that we need rigorous research to generate evidence we can use.

 

I don't see enough work being done to guide how we teach in clinical settings. How much and what types of practice facilitate transfer to clinical settings? What is the best way of integrating simulation with practice in clinical settings: what type of practice should come first, or doesn't it matter? Think about all of the competencies for students to develop in your program. What approaches to clinical practice work best to guide student development of those competencies? There are some activities that new graduates should be able to perform safely and effectively when they complete our prelicensure (or nurse practitioner) programs. These are activities that we ensure new graduates can perform independently: what are they? What types of clinical practice do students need to become skilled in those activities? And how should we assess students' abilities to perform care at the end of the program? Many of our writing assignments in clinical courses are not based on evidence but are there by tradition. With a growing focus on population health (read the articles in this issue), what types of clinical experiences should students have? Many studies have been done on interprofessional education, but the question remains on how to guide learning about interprofessional care. We know how to engage students from different health care professions in simulations and case analyses, but how should we structure clinical opportunities where students can learn to work together as a team in providing patient care? And the list goes on[horizontal ellipsis].

 

Although many health care educators have called for multisite studies, some of the research to generate evidence for clinical teaching is difficult to do across schools. There are too many variables (student backgrounds, types of previous experiences, clinical environments in which students care for patients, and teacher characteristics, among others) that cannot be controlled and would influence outcomes. The call for multisite studies in nursing education should not hinder faculty from conducting rigorous studies in their own courses that we can use as evidence for clinical teaching. Good studies with sound methodology can be reviewed, appraised, and synthesized (we do that for evidence-based practice).

 

Clinical teachers need evidence to "make the most" of students' limited experiences in clinical settings and to focus the learning activities on what works best to improve learning outcomes and competencies. Let's shift some of our research efforts to produce evidence for clinical teaching-we need it now.

 

References

 

1. Oermann MH, Conklin JL. Evidence-based teaching in nursing. In: Oermann ML, De Gagne JC, Phillips BC, eds. Teaching in Nursing and Role of the Educator: The Complete Guide to Best Practice in Teaching, Evaluation, and Curriculum Development. 2nd ed. New York, NY: Springer;363-377. [Context Link]

 

2. Kalb KA, O'Conner-Von SK, Brockway C, Rierson CL, Sendelbach S. Evidence-based teaching practice in nursing education: faculty perspectives and practices. Nurs Educ Perspect. 2015;36(4):212-219. [Context Link]