Technology changes in the proverbial blink of an eye. Working and teaching during the COVID-19 pandemic has proven how much it will be used in the field in both practice as well as nursing education.
Julie Stegman, Vice President, Nursing Segment of Health Learning, Research & Practice at Wolters Kluwer, took time to answer our questions about their survey, Future of Technology in Nursing Education.
Why did you decide to conduct this survey? What did you hope to learn from it?
As technology advances, and more and more people have access to computers and smartphones, tech is augmenting almost every workforce. Nursing is no exception. We originated our first survey around technology usage and adoption in Nursing Education five years ago to understand how rapidly nursing programs were implementing technology as part of the education process. Technology helps nursing educators prepare students for practice so they can deliver the best care to patients everywhere, and today’s students have an expectation for a dynamic and multi-modal learning experience.
We decided to refresh our survey this year to understand the shifts in education related to the COVID-19 global pandemic and beyond. We surveyed nursing deans, program directors, and faculty to identify their plans for technology usage, adoption, and investment during the next five years and explore the barriers and opportunities related to those plans.
What are the most important results of the survey? What does this say about the future of nursing education?
Some of the results of the survey were predictable: over the last year and a half, there’s been a massive transition from in-person learning to virtual learning, with some 73% of institutions going fully online at the start of the pandemic, and another 22% adopting a hybrid model.
Though the adoption of virtual simulation and other technologies were already in play in nursing education before COVID, the pandemic greatly accelerated it out of necessity. Some 48% of respondents say they plan to invest more in virtual simulation during the next 2 years, with virtual simulation reaching full adoption by 2025.
Overall findings of the survey point to a “classroom of the future” that is hybrid, geared for digital learners with emerging and existing technologies.
How did the study work?
For our Future of Technology in Nursing Education survey, Wolters Kluwer carried out six in-depth interviews with qualified nursing respondents in August 2020, followed by a quantitative online survey sent out in December 2020. The purpose of the study was to understand technology trends. The online survey, done in collaboration with the National League for Nursing, was sent to a list of nursing administrators, faculty, and Deans provided by the National League for Nursing, yielding 450 responses.
The opinions of these respondents were critical to capture because they represent real nursing education leaders making a difference in the world of nursing education today. No one can better speak to both the day-to-day circumstances and the long-term technological trends than these respondents, and we are very pleased with our sampling.
What survey results surprised you the most?
As we showed with our previous survey, nursing education continues to be an area of early adoption of technology. This has been particularly evident in simulation learning, including research into the value and effectiveness of this learning modality. Our survey continued to reinforce this shift, with nurse educators looking ahead to fuller scale adoption of technologies as well as a continued interest in emerging technologies.
I was most surprised that the incredible shift to online learning we experienced during COVID-19 is anticipated to continue with three in ten (31%) educators saying their programs will offer the same number of online courses, and 39% indicating their program will offer more online courses.
What are the three key barriers that the survey showed are barriers to the adoption of technology? Any ideas how the nursing field can overcome them?
Various factors are hindering tech adoption in nursing education, including a lack of funding and lack of technology infrastructure. Another difficulty nursing education is facing as a side effect of increased tech adoption is faculty who may be resistant or slow to change their approach to teaching, with many faculty members opting to retire and leave the workforce. This has the potential to exacerbate an existing shortage in nursing faculty. We need to remedy this shortage to ensure that all qualified applicants can enter nursing school and become practice-ready nurses to mitigate and meet the anticipated patient demand.
COVID-19 has shown us that learning technologies need to be in place to continue to provide the best possible nursing education in the face of unpredictable learning environments, as well as address many pre-existing challenges educators faced with clinical learning. We anticipate that the pandemic and the associated shifts in learning and teaching approaches will also force a shift in funding which will help address previous hurdles as many of these solutions move from “nice to have” technologies to those that are necessary within nursing schools.
To address the gap in nursing education as a result of recent waves of retirements, we need to ensure educating future nurses is seen as critical to the nursing profession and address the challenges that create this faculty shortage. This includes compensation differences in clinical roles vs. education and ensuring that masters and doctoral programs can also increase acceptance of applicants. In addition, it’s critical to ensure that future educators are familiar with and embrace the benefits that educational technologies can bring to the learning process.
Ultimately, the #1 goal for nurses is to provide the best care to patients, everywhere and in any care setting. This begins with education and it’s essential that nursing faculty and students have the tools available to empower them to be ready to enter the workforce. The Dean’s Survey helps us understand which technologies are likely to drive this momentum, and where we can continue developing solutions to help prepare practice-ready nurses.
It’s not an exaggeration to say that technology has become the driving force behind every industry and health care is no exception. Clinical informatics is a thriving field for all types of clinical professionals who have expertise in information technology. For nurses, it presents the opportunity to improve patient care by participating in the evolution of health care on a systematic level.
Most nurse informaticists have nursing experience and an advanced degree, either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), with a focus on clinical informatics. Most nursing schools offer these types of degrees today.
The Role of Nurse Informaticist
More rigorous experience and education requirements are warranted for nurse informaticists because often they fill leadership and consultant roles. For example, a nurse informaticist may be part of nursing administration within a hospital, serving as a liaison between staff nursing and the executive team. In this instance, the nurse informaticist serves as a resource for both: educating nurses on effective and efficient use of electronic health records (EHR) and other relevant technology, and translating any issues or insight into a pertinent context for leadership, some of whom may be non-clinical.
Some nurse informaticists find themselves working in the business and technology sectors, completely removed from the clinical setting. In such cases, nurse informaticists are often considered consultants, whereby they serve as clinical experts advising and overseeing the development of new technology relevant to nursing. For instance, companies that develop EHRs hire nurse informaticists to analyze if the implementation and evolution of their technology are feasible in the real world of nursing. Because health care technology is in a state of constant progression, these nurse informaticists often find themselves with permanent positions within these sectors.
Indirect patient care
One consideration for every nurse interested in informatics to consider is the cessation of direct patient care. Although nurse informaticists in clinical settings may interact with patients, there are few if any informatics positions that include typical nursing tasks. Instead, the nurse informaticist’s prior experience as a nurse serves as a boon to implementing positive changes in care that benefit nurses and patients alike. In this way, the nurse informaticist can be considered a provider of indirect patient care, as they are empowered to improve patient care on a greater scale than they otherwise could as bedside nurses, especially as technology has an increased role.
Most of us have heard the term “digital divide,” and many of us are familiar with the move towards electronic health records (EHRs) in the workplace. However, very few hospitals or medical offices are discussing the real-life implications of those two facts merging in hospitals and medical offices across the country where nurses who have limited computer experience are suddenly being asked to do electronic charting.
According to the US Census Bureau, only 56.9% of black and 58.3% of Hispanic households had internet access in their home, compared to 76.2% of all non-Hispanic white households, in 2011. This means minority households are currently falling on the wrong side of the digital divide. That being said, 26.8% of the nursing students in baccalaureate programs from 2010-2011 were minorities, according to the American Association of Colleges of Nursing, which means we have a significant percentage of nurses who will be entering the workplace with the potential of having limited computer experience. In the past, that wouldn’t have been a problem, considering most medical offices used paper charts and filing systems. However, with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, medical offices and hospitals are being strongly encouraged to adopt EHRs as quickly as possible.
According to the HITECH Act, medical offices that do not use an EHR in a “meaningful way” by 2015 will start to incur penalties, beginning with a cut of 1% to Medicare funding in 2015 and increasing to 3% in 2017. After that point, medical offices may also be subject to additional financial penalties.
What does that mean for today’s nurses? Based on government reports, 72% of office-based physicians used electronic medical records (EMRs) or EHRs in 2012. In Massachusetts, that number goes as high as 89.2%. In order to qualify for funding and avoid penalties, offices must have met “meaningful use” objectives in 2012, including electronically tracking all orders, vital signs, medication allergies, medications taken, patient demographics, and smoking status.
Any of those items sound familiar? The same things nurses have been entering on paper charts for decades are now being entered electronically. In short, this means if you haven’t already begun using an EHR or EMR on the job, you will probably see one soon. And if you’re just starting out, the chance of finding a nursing position without needing to use one on a daily basis is dwindling incredibly fast. For some, that could mean using a piece of hardware or technology for the first time. But the transition doesn’t need to be scary. So, how exactly can you prepare for the change?
First of all, it’s important to understand that the EHR/EMR industry comes with support—and lots of it. If you’re currently at a job that’s implementing an EHR system like Cerner, Epic, or Allscripts, and you haven’t already done so, ask for training. Almost all EHR companies offer comprehensive training during the implementation process, and it’s expected that staff will attend those sessions. If for any reason you cannot attend a session the first time around, don’t hesitate to ask for additional training or inquire about what tutorials and materials might be available for you to review. There are entire support and training departments within each of the large EHR companies. Those departments are available to make your transition easier, so don’t be afraid to use the resources made available to you.
For the thousands of nursing students who will be entering a largely electronic workplace, what other preparations can be made? Many nursing instructors have decided to face the issue head on. By providing nursing students with access to an academic EHR in the classroom, instructors can help make the transition easier for students when entering the workforce. After all, nurses have enough to worry about during their first week in the field.
Computer programs like EHR Tutor, based in Parma, Ohio, can be purchased by nursing schools and used as a daily teaching tool in the classroom. For example, when discussing vitals or medications, students can look at charts done for electronic patients and analyze that data. Students can also chart information themselves, just as they would on paper, which can then be submitted to the instructor for grading. Schools with access to iPads or laptops are also allowing students to use programs like EHR Tutor during clinical rotations to chart real information under fake patient names. That way, by the time students are on their own, using EHRs will be just as comfortable as pen and paper.
EHRs and EMRs are here to stay. For some nurses, that may present a tremendous challenge. However, there are many tools available to nurses who may be feeling a bit overwhelmed. By using those resources (like using academic EHRs in the classroom and asking for additional training in your workplace), we can ensure that our nurses and future nurses make the transition to EHRs as painlessly as possible. That way, our nurses can spend more time focusing on the important things—the patients.
Nikki Yeager is a freelance writer and software trainer based in New York City.
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