Evidence is accumulating that nurses completing pre-licensure programs are not equipped with the essential knowledge and skills for today’s nursing practice, nor prepared to continue learning for tomorrow’s nursing. Citing the need to improve quality and increase capacity, this paper offers three recommendations for transforming nursing education: (1) Create new nursing education systems which use existing resources in community colleges and universities and which provide for common prerequisites and a shared competency-based nursing curriculum and instructional materials. (2) Convene one or more expert panels to develop model pre-licensure curricula which: (a) can be used as a framework by faculty in community college-university partnerships for development of their local curriculum; (b) are based on emerging health care needs and widely accepted nursing competencies as interpreted for new care delivery models; (c) incorporate best practices in teaching and learning. (3) Invest in a national initiative to develop and evaluate new approaches to pre-licensure clinical education, including a required post-graduate residency under a restricted license. The author notes that these changes will require significant investment in the reforms, as well as in nursing education research and faculty development. The return on investment would be improved educational capacity and a better prepared nursing workforce, responsive to emerging health care needs and rapidly changing health care delivery systems. TRANSFORMING PRE-LICENSURE NURSING EDUCATION: PREPARING THE NEW NURSE TO MEET EMERGING HEALTH CARE NEEDS The Carnegie Foundation for the Advancement of Teaching joins a chorus of calls for transformation of pre-licensure nursing education (Benner et al., 2009b). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as increasing complexity of community based practices, Benner and colleagues concluded that nurses entering the field are not equipped with the essential knowledge and skills for today’s practice nor prepared to continue learning for tomorrow’s nursing (p. 31). They found (1) weak curricula in natural sciences, technology, social sciences and humanities, and in developing cultural competency; (2) weak classroom instruction and limited integration between classroom and clinical experiences; (3) limited strategies in helping The Future of Nursing: Leading Change, Advancing Health Copyright National Academy of Sciences. All rights reserved.

The Future of Nursing: Leading Change, Advancing Health Key Messages and Report Recommendations

Approximately 60% of registered nurses (RNs) still enter practice with an associate’s degree or diploma in nursing (ADN). Due to recommendations to change entry level to practice to the bachelor’s degree in nursing (BSN), there are now more than 700 RN to BSN programs in the United States. The purpose of this qualitative systematic review was to understand more about what occurs when an RN returns to school for a BSN and to develop a model of the transition. The qualitative findings of 19 research reports were included, which translates to approximately 445 RNs’ perspectives on the RN to BSN transition. A visual representation of the RN to BSN transition was also generated. A seamless transition of the RN to a BSN does not exist at this time. The results are useful to nurses, academicians, and health care organizations as they move to meet current recommendations.

The RN to BSN Transition: A Qualitative Systematic Review.

The British Columbia Ministry of Health in Canada approved a new registration category for dental hygienists in 2012. This category included four abilities that registrants were required to demonstrate at a 4th-year baccalaureate degree level.



Objective

To identify the differences, if any, between diploma and bachelor's degree education with regard to the 4 legislated abilities focused on the process of care for clients with complex needs and/or disabling conditions including client safety, referrals and interprofessional collaboration.



Methods

Registrants who had entered practice with a diploma and then gained a baccalaureate degree were invited to participate in an online survey including closed- and open-ended questions. The study was a mixed-method design where the qualitative data were nested concurrently in the open-ended questions; the data were analysed through thematic analysis using grounded theory methods.



Results and discussion

Respondents (n = 123; 51%) indicated their client care had improved with baccalaureate education due to increased knowledge, increased understanding and increased abilities to make judgements with a particular emphasis on evidence-based decisions. These more advanced abilities provided them with increased confidence for taking action particularly in interprofessional contexts and increased the quality of their decision-making thus leading to better care for clients.



Conclusion

Respondents described their dental hygiene services as generally being of a higher standard and specifically in the 4 legislated abilities as a direct result of baccalaureate education.

Differences between diploma and baccalaureate dental hygiene education in British Columbia: a qualitative perspective

The Nursing Profession: Development, Challenges, and Opportunities Edited by Diana J. Mason, Stephen L. Isaacs, and David C. Colby (San Francisco, CA: Jossey Bass, 2011) (403 pages, $75.00 paper)Published in 2011, this text is the fifth book in the Robert Wood Johnson Foundation (RWJF) Health Policy Series. The foreword by Risa Lavizzo-Mourey, president and CEO of the RWJF suggests use of this book as a companion to the 2010 "Future of Nursing" report from the Institute of Medicine (IOM) and RWJF collaborative. Susan Hassmiller, RWJF Special Advisor on Nursing and Director of the Initiative on the Future of Nursing, states in the preface that the IOM committee working on the report was heavily influenced by the best thinkers of those who study and practice nursing, including authors of the articles reprinted in this book. The Nursing Profession: Development, Challenges, and Opportunities provides a comprehensive collection of 24 articles significant to the nursing profession. Readers will instantly recognize contributing authors' names from nursing's historical past such as Florence Nightingale and contemporary nurse scholars Peter Buerhaus and Linda Aiken. In addition, nurse historians Joan Lynaugh and Karen Buhler-Wilkerson are among the authors whose notable works were selected for this text.The text begins with an original article written by Diana Mason who provides a succinct review of the nursing field. She speaks to the rich history of nursing, its current issues and challenges, as well as a vision for nursing's future. Mason sets the stage for the selected articles to follow organized into thematic categories of interest to the nursing profession today: (a) The History of Nursing and the Role of Nurses; (b) Nursing Education and Training; (c) Advanced Practice Nursing; (d) The Nursing Workforce/Nursing Shortages; (e) Quality, Safety, and Cost; and (f) Specialty Practice in Nursing. Each section contains two to five articles, spanning time from 1860 to the present, selected by the editors for high quality content and influence to the field of nursing.Organized with a health policy framework, each article was reprinted as written by the original author. An "Editors' Note" provides a brief introduction to each chapter which serves as a helpful preview for the first time reader and a quick reference for others. The editors highlight salient points of interest and how the content speaks to the development of nursing, its distinct challenges, and its many opportunities.As noted in the opening paragraph, this text is suggested for use as a companion to the RWJF and IOM "Future of Nursing" report which responds to the dramatic health policy changes found in the 2010 Affordable Care Act. This legislature represents the broadest health care overhaul since the 1965 creation of the Medicare and Medicaid programs. Transforming the health care system to provide safe, quality, patient-centered, accessible, and affordable care requires a comprehensive rethinking of the roles of many health care professionals, nurses chief among them. …

The Nursing Profession: Development, Challenges, and Opportunities

The purpose of this survey was to examine the attitudes, influences, and practices of associate degree nursing (ADN) faculty in relation to advising students about nursing education progression. The results indicated that ADN faculty have a sense of moral and personal role responsibility to encourage students to continue their education. Deficits in faculty knowledge of program details and multiple demands on their time are factors that influence advising practices.

Nursing education progression: associate degree nursing faculty perspective.

In a statewide study of nurse educators from nationally accredited ADN programs, 42 of 109 baccalaureate outcomes were reported met in their programs Those outcomes clustered in 3 areas: information management and application of technology, professionalism and professional values, and generalist nursing practice The 67 outcomes that were not met were in the categories of liberal education, organizational and systems leadership, evidence-based practice, healthcare policy, finance and regulatory environments, interprofessional collaboration, and population health This research provides important evidence from which to construct an outcomes-based associate degree to baccalaureate curriculum

Meredith Muenks

Papers

Baccalaureate outcomes met by associate degree nursing programs.