Nursing curricula today focus on the nurse-to-patient relationship, backed with heavy content and a plethora of facts to be memorized. Most nursing students graduate without a basic understanding of the entire healthcare system, team nursing concepts and quality and safety practices within the healthcare realm.
In a predominantly passive learning environment of school, nursing students rotate through various specialties and follow a disease-oriented model of curricula as it pertains to the individual specialty. Since the majority of clinical experiences take place in an acute care setting, students cannot adequately learn care coordination and about non-hospital job opportunities that are available to graduating nurses. With the shift in healthcare policies now making nursing care in non-acute care settings more important, how can future nurses be better prepared to accept these varied roles and function competently within them?
Recommendations from The Future of Nursing Education indicate that to improve nursing education, the nursing curriculum needs to focus more on a competency-based learning style with a broad-base of interprofessional education.
The licensing exam for new nurse graduates is a minimum standard, testing minimum safe competencies, according to Michael Bleich, RN, PhD, Dean of the Oregon Health & Science University School of Nursing. The public is looking for optimal competency. Task-based competencies are easy to measure, but when it comes to care management, which requires a high level of skill and mastery throughout all care settings, the nursing curriculum is not addressing those skill sets.
The nursing curriculum needs to bring a greater degree of focus on several areas such as clinical judgment, critical reasoning, evidence-based practice, team care concept, leadership opportunities, care across the lifespan, and cultural sensitivity.
Collaboration amongst healthcare specialties, where all healthcare students can learn to work together, is the necessary next step in a changed learning environment. As healthcare mandates have changed the focus of healthcare to the team concept, nurses need to be educated about other health professionals.
Effective teamwork improves outcomes for patients. If, for example, a patient is referred to occupational therapy, a nurse might believe the occupational therapist is focused on enabling the patient to return to work, but occupational therapists also work with elderly patients in nursing homes. How will the nurse know what this means and how the skills taught will affect the patient’s daily living? How will the nurse identify when an occupational therapist might be needed?
The Future of Nursing Education recommends that nursing schools incorporate other health professional schools into an interprofessional collaboration with joint classroom and clinical experiences, in order to address the changing healthcare model and effect better patient outcomes. Reimbursement from insurance companies is becoming predicated on positive outcomes, and penalties will be assessed for less than optimal care and bad outcomes. Nursing graduates who have learned the team concept of care will have the necessary skills to produce positive outcomes.