Giving Back: Teaching the Nurses of the Future

Giving Back: Teaching the Nurses of the Future

Have you ever thought about changing career paths and teaching up-and-coming nurses? For those of you who have, we wanted to provide you with some information about what it’s like to teach, including the challenges and the benefits.

Michelle DeCoux Hampton, RN, PhD, MS, Professor and Doctor of Nursing Practice Program Director at Samuel Merritt University School of Nursing in Oakland, California, took time to talk with us about her experiences in teaching.

Following is an edited version of our Q&A:

What does your job entail? Do you specialize in specific topics that you teach? How many courses do you teach each semester?

I started in 2005 as a full-time faculty member teaching psychiatric mental-health nursing, health assessment, and synthesis for students throughout our accelerated bachelor’s program in nursing. Later, I began teaching an online course in research in the Master’s program and then the Doctor of Nursing Practice Program.

In 2013, I became the Director of the Doctor of Nursing Practice Program, and now I teach evidence-based research and several of the DNP Project courses that are geared toward providing mentorship to doctoral students as they complete their scholarly projects.

In my administrative role, 75% of my time is administrative work involving admissions, student advisement and progression, faculty support, as well as curriculum review and improvement, among other responsibilities. In my full-time teaching role, I taught about two courses per semester.

Why did you choose to teach?

My interest in teaching stemmed from my enjoyment of education from the student perspective and my many positive experiences with faculty and mentors.

I first tested myself as the Director of Staff Development in a skilled nursing facility to see how I would like being “on stage” before I ever applied for a teaching position at a university. I was able to learn a lot about adult education and enjoyed the opportunity to connect with the facility staff through our orientation and continuing education programs.

I advised many of our staff nurses about how to go about continuing their formal education and found it was one of the most enjoyable parts of my role in staff development.

What are the biggest challenges of your job?

Compared to being a staff nurse, one of the biggest challenges in teaching is that there is often no one to fill in for you—at least not at a moment’s notice. You often find that you work when you’re ill, on semester breaks to prepare for the next semester, and on your vacations. The flexibility is nice in a lot of ways, but the tradeoff is that you’re never really off the grid.

What are the greatest rewards?

One of my favorite parts of my job is to work with my doctoral students on their DNP Projects—usually an evidence-based practice implementation project. These students evaluate best practices through critical appraisal of the research literature, design practice change programs, implement changes that involve policy and procedure changes of the staff in a variety of health care settings, and evaluate the outcomes. Through each of their projects, they have provided improved health care to individual patients, communities, and within organizations. Seeing these projects develop from an idea to influencing real people’s lives is incredibly rewarding, and it never gets old.

What would you say to someone considering this type of work?

To me, the best teachers that I’ve known and worked with take a service-oriented approach to education—providing what the student needs to progress to the next level, to continue growth. This takes good observation skills, flexibility to change your approach based on where your student is and what his/her needs are, and a willingness to keep learning. The field of education, beyond what we need to know as nurses, continues to evolve and we have to evolve with it.

Is there anything else that is important for nurses to know?

In my early years of teaching, I felt like I needed to know everything—to answer all of my students’ questions on the spot. This expectation of myself produced a lot of anxiety and self-doubt for me.

Over time, I relaxed a bit more and accepted that even if students wanted me to have all the answers, that was not possible 100% of the time. Feeling confident in the knowledge that I had and my ability to research answers that I couldn’t answer right away effectively, enabled me to say that I didn’t know, but would find out or even enlist the support of other students to find the answer. It was a turning point for me. I don’t think I would have been able to sustain a career in education long term with my previous mindset.

An Effective Teaching Method: Double Testing

An Effective Teaching Method: Double Testing

Current literature reminds us that active learning helps promote critical thinking and problem-solving abilities. Active learning requires that students be engaged through more than listening, reading, writing, and discussion. 

Research has significantly proven the opposition amid adult and child learning styles. Established on the research that adults do not learn in the same style as children, it is practical to accept that one cannot teach adults employing methods developed and planned to facilitate the learning experience of children. Malcolm Knowles, a pioneer in the field of adult learning, hypothesized some assumptions to assist teachers with teaching children and adults. These assumptions include:

The Need to Know. Adult learners need to know why they need to learn something before undertaking to learn it.

Learner Self-Concept. Adults need to be responsible for their own decisions and to be treated as capable of self-direction.

The Role of Learners’ Experience. Adult learners have a variety of life experiences that represent the richest resource for learning. These experiences are, however, imbued with bias and presupposition.

Readiness to Learn. Adults are ready to learn those things they need to know in order to cope effectively with life situations.

Orientation to Learning. Adults are motivated to learn to the extent that they perceive that it will help them perform tasks they confront in their life situations.

The reason most adults enter any learning experience is to create change. This could encompass a change in their skills, behavior, knowledge level, or even their attitudes about things. In a 2006 article published in the journal Urologic Nursing, Sally Russell suggested that, compared to school-age children, the major variances in adult learners are in the degree of enthusiasm, the extent of earlier experience, the level of engagement, and how the learning is applied. Double testing allows the adult student to be engaged in the learning process.

Students need support and validation from their peers. In any classroom, evaluation is necessary. In 2012, the National League for Nursing suggested in its fair testing guidelines that tests and other evaluative measures should be used “not only to evaluate students’ achievements, but, as importantly, to support student learning, improve teaching, and guide program improvements.” Double testing is one such teaching method in which evaluation, peer support, and validation can be instituted to support student learning.

Instructors who teach in higher education can no longer rely on lecturing as their main teaching method. In Teaching in Nursing: A Guide for Faculty, scholars Diane Billings and Judith Halstead emphasize that dependence on the use of the lecture is no longer an accepted teaching technique. Instead, faculty must integrate the use of technology so that students will be more actively involved and engaged in the learning process. Also, faculty must focus more on teaching in a learner-centered fashion, as opposed to the teacher-center approach.

Double testing has been proven to be an effective teaching method.  A 2013 study published in Nursing Education Perspectives found that learning, communication, and collaboration were prevalent themes in students’ perceptions and opinions of double testing. According to the researchers, the study found that “a majority of students preferred double testing and indicated that this testing method had more advantages than disadvantages.”

Throughout nursing programs, instructors are responsible for assessing students’ abilities and assuring they are competent to practice nursing. Since one of the nursing instructor’s goals is to prepare students to be safe and competent nurses, I believe that collaborative learning, such as double testing, is an excellent strategy to assist students in being able to successfully care for patients. I have used this teaching method for more than two years with senior two-year nursing students and have found that double testing promotes group interaction, interpersonal skills, and interdependence among the nursing students—qualities needed to work with members of any health care team.

In using the double-testing method, I have also found that students are more engaged and more cooperative; they also exhibit improved critical thinking skills. For example, when double-testing scores were compared over a six-month period, students’ overall grades increased from 69% to 82%. Indeed, a systematic review conducted by The Campbell Collaboration confirms that the benefits of collaborative testing “include—but are not limited to—better critical thinking skills, better collaboration and team work among peers, reduced test anxiety, and improved test taking performance.”

In a 2011 study published in Science, Deslauriers, Schelew, and Wieman  compared the amount of learning students experienced when taught—in three hours over one week—by traditional lecture and by using interactive activities based on research in cognitive psychology and physics education. The researchers found that students in the interactive class were more involved and absorbed more than twice the learning than their colleagues in the traditional class.

Twenty-first century students should be allowed some control over their learning. For many years, teacher-centered instruction has been dominant in higher education. In a traditional classroom, students become passive learners or just receivers of teachers’ information; whereas, with double testing, the students make the decision whether or not to participate. This way, students take charge of their own learning and are openly involved in the learning process.

In “Helping Students Get to Where Ideas Can Find Them,” an article published in 2009 in The New Educator, Eleanor Duckworth asserts that teacher-centered learning actually hinders students’ learning. In contrast, double testing is a learner-centered teaching method, which focuses on how students learn instead of how teachers teach.

I believe that double testing is a worthy teaching method that instructors can use in the classroom to enhance student-student and student-teacher interactions. Most educators understand that learners have different preferences and styles of learning and believe that it is essential to use teaching methods and approaches that will satisfy the variety of learning styles in the learning event.

Annie M. Clavon, ARNP, PhD, MS, CCRC, is an associate nursing professor at Keiser University in Ft. Lauderdale, Florida.


Growing the Numbers of Diverse Nursing Faculty

Growing the Numbers of Diverse Nursing Faculty

A chance encounter with a professor at the University of Colorado Denver changed the trajectory of Anissa Buhring’s career, transforming her dream of teaching into a goal with a deadline.

Buhring Huerta

It was a summer day in 2003 when she decided to learn more about the university’s doctoral programs, recalls Buhring, CNS, RN, a clinical education specialist at East Morgan County Hospital in Brush, Colorado. Buhring, who is Latina, had always wanted to earn her PhD and teach. “[But] those were jobs that people outside of my ethnic background held. Even though that was a dream of mine…there was nobody else like me that I came across,” she notes.

But that summer day, she briefly met Dr. Ruby Martinez and walked away inspired. “She doesn’t realize what a huge influence she had on me that day. At that moment, I realized [my goal] was possible and that there was someone else like me that had done it. She told me that I needed to do it and I could do it. She gave me her card, and I never ran into her until years later as part of the National Association of Hispanic Nurses. And now she’s my mentor,” says Buhring, a 2012 recipient of the Johnson & Johnson/American Association of Colleges of Nursing (AACN) Minority Nurse Faculty Scholars program and a PhD candidate at the University of Colorado Denver.

Buhring’s memorable experience illustrates the power of diverse academic role models, which most nursing schools and programs across the country lack. According to 2011 data from AACN’s annual survey, only 11.8% of full-time nursing school faculty come from minority backgrounds, and only 5.1% are male.

“I believe that when students do not see faculty that look like them, they feel that it may be impossible to attain high-level career goals,” says Carolina G. Huerta, EdD, RN, FAAN, chair of the nursing department at the University of Texas-Pan American (UTPA), where 85% of the faculty is minority. “Students who do not see faculty that look like them may not approach faculty for clarification on academic material for fear that they will not be understood. All of the literature supports the importance of role models that look like and can relate to the students culturally.”

In 1992, when Huerta became chair, she decided the program would grow its own diverse faculty to better serve the majority-Hispanic student enrollment. Today, out of 27 nursing faculty, four are non-Hispanic white; six are Asian; one is mixed Hispanic; and 17 are Hispanic. There is one male, although that may change since 20% to 25% of students in the nursing programs (BSN and MSN) are male.

Located 12 miles from the Texas-Mexico border, “our university is located in an area that is poor and medically underserved, and many do not find it a desirable place to seek employment,” says Huerta. Not many people apply for faculty positions or employment from outside the area. There are few jobs for spouses or significant others, and the proximity to the Mexican border is not a selling point.

Many of the nursing faculty were born and raised in the community or are longtime residents. Many graduated from UTPA. Seventeen of the 27 faculty employed received their MSN through UTPA or through a UTPA cooperative program. Seven faculty members have either finished or are at the dissertation phase of their PhD/DNP. “I believe that the ‘grow your own’ philosophy has been extended by my giving them the time to complete doctoral work. The program coordinators and I have done as much as possible to accommodate their work schedule so that it does not conflict with their doctoral study,” says Huerta, who is “unaware of another program like ours.”

Culturally competent mentoring, more scholarship money, and better faculty salaries will increase diversity in nursing education, says Huerta, who was named by AACN and the Robert Wood Johnson Foundation (RWJF) as the National Advisory Committee chair for RWJF’s New Careers in Nursing (NCIN) program. The program provides scholarships to second-
career college-educated minority or disadvantaged individuals pursuing a career in nursing by enrolling in accelerated BSN and/or MSN programs.

The NCIN program has supported over 125 schools and awarded $35,170,000 in scholarships to 3,517 entry-level nursing students in the United States since it started in 2008.  “I think that a program such as this that focuses specifically on preparing nursing educators could be a success,” says Huerta.

More scholarships would make a difference, especially if  no major strings are attached such as having to work for X number of years in an underserved area, she says. Boosting faculty salaries would also make nursing education a more appealing career.

“We need to infuse money into campaigns that highlight minority and diverse nurses making a difference, especially in nursing education. I know that Johnson and Johnson has done this and they have been successful. We need more of this.”

One of five recipients selected for the Johnson & Johnson/AACN Minority Nurse Faculty Scholars program last year, Buhring agrees more opportunities are needed to develop a pipeline for minority educators. She pitches in as a mentor for middle and high school students as well as first-generation college students. Buhring looks forward to the impact she will have as an educator. “I want to pass that flame to others,” she says. “Whether it’s for nursing or just knowing it’s possible as a Latino to go to college.”