Teaching in Nursing:

1
Teaching in Nursing

• A Guide for Faculty
• by D. M. Billings and J. A. Halstead,
• 1998

2
The Faculty Role --Ch. 1Historical Perspective
of Faculty Role in Higher Education

• Sole reliance on the use of lecture is no longer
  an accepted teaching method.
• Technology has changed the way people teach.
• Nursing is changing to a community based,
  consumer driven system.
• Shift from acute care to primary care.

3
Faculty Rights and Responsibilities in Academia

• Right to self-governance.
• The core responsibility of the faculty is the
  teaching and learning that takes place in the
  institution.
• Evaluation is also a major responsibility role.
• Mentoring faculty and other students.
• Teaching and Scholarship
• Key is being able to juggle all of the required
  roles and expectations.

4
Faculty

• Appointment
• Promotion
• Tenure

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Appointment

• Ranks or tracks
• Tenure established for faculty whose primary
  responsibility is teaching and research
• Clinicalfor faculty whose primary responsibility
  is clinical supervision
• Research Scientistfor faculty whose
  responsibility is generating new knowledge and
  disseminating the findings
• Adjunctprimary employment is not within the
  school of nursing
• Emeritusretired faculty

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Tenure

• Expectation that the faculty member will remain
  competent and productive and maintain high
  standards of teaching, research, service, and
  professional conduct.
• Provides member protection of academic freedom
• Granted after a review by committee

7
Promotion

• Advancement in rank

8
Teaching as a Scholarly Endeavor

• Faculty will need to develop expertise in
  flexible, fluid curricula design and outcome
  assessment.
• Discovery, Integration, Application, and Teaching
• The teacher is no longer the only expert but
  someone who joins with the student in the
  learning process.

9
Teaching Competencies

• Competencies related to Curriculum, Course
  development and evaluating students.
• Competencies related to Professional Practice
• Competencies related to Relationships
• Competencies related to Service/Faculty
  Governance
• Competencies related to Scholarship

10
Orientation Programs and Faculty Development

• Orientation Programs are necessary to assist new
  faculty to acquire teaching competencies,
  facilitate socialization to the teaching role of
  the faculty, and support faculty as they develop.
• Faculty development refers to a planned course of
  action to develop all faculty.

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Evaluation of Teaching Performance

• Performance is constantly reviewed
• Evaluation is a vital component of tenure

12
The Diverse Learning Needs of Students

• Chapter 2

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Profile of Nursing Students in the 90s

• Trends in the 90s have indicated that it is
  likely that nursing students will be increasingly
  older, more culturally diverse, married with
  families, geographically removed and have prior
  educational experiences.
• More men are starting to become nurses, also.

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The Culturally Diverse Student

• The National League of Nursing (93) has called
  for a greater number of culturally diverse
  students in schools of nursing to reflect the
  changing society.
• Students with culturally diverse background can
  face a number of barriers that affect their
  ability to be successful.
• Faculty commitment is another element crucial to
  the success of minority students.
• Financial problems, personal factors and lack of
  support become barriers, also.

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Interventions to Increase the Success of
Culturally Diverse Students

• Role Models-minority role models are needed to
  provide students with opportunities to see
  minority faculty functioning successfully.
• Support Services-Special supports services for
  culturally diverse students can increase their
  chances of academic success.

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Learning Style

• The unique ways in which a person perceives,
  interacts, and responds to the elements in a
  learning situation.
• Learning styles classify individuals according to
  the preferred educational conditions that will
  help ensure that they are learning as much as
  possible.

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Kolbs Learning Style Inventory

• Accommodative-task accomplishment
• Assimilative-reflective observation
• Divergent- concrete and reflective
• Convergent-active experimentation

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Using Learning Styles in the Classroom

• Once and educator knows the students preferred
  learning style, that information can be used in
  tutoring or counseling the student.
• Teach to different learning styles and maximize
  student learning.
• Great way to understand the diverse student in
  the ever changing environment.

19
Critical Thinking Abilities

• Nursing programs are required to demonstrate that
  their students can think critically.
• It is a complex process and can not be measured
  directly.
• It is not a single way of thinking.

20
Critical Thinking Inventories

• Watson-Glaser Critical Thinking
  Appraisal -Composite of attitudes, knowledge, and
  skills.
• Cornell Critical Thinking Test
• -Reasonable reflective thinking focused on
  deciding what to believe or do.
• California Critical Thinking Skills Test
• -Standardized test of multiple choice
• California Critical Thinking Disposition
  Inventory
• -Analysis of 7 disposition scales

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Cognitive Development

• The way in which individuals reason, view
  knowledge, manage diversity of opinion and
  conflicting points of view, and relate to
  authorities or experts.
• Standardized tests are not the only way to test
  cognitive development.
• Pre-assessment activities can be used to
  determine cognitive abilities.
• Ongoing Process
• Must be able to shift concern from content to
  student.

22
The Academic Performance of Students (Legal ad
Ethical Issues)

• Chapter 3

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Student Faculty Interactions

• The National League for Nursing (93) says The
  nature of the student-faculty relationships
  should be egalitarian and collaborative.
• Ongoing, open dialogue with students that results
  in a clear communication of mutual expectations
  and responsibilities is an essential component of
  the relationship.

24
Legal Issues Related to Academic Performance

• Helms and Weiler recommend that preventive
  activities should be designed to avoid
  litigation.
• With schools of nursing implementing clear
  policies about academic progression of students
  and periodically reviewing faculty practices
  related to these policies.

25
Legal Issues Related to Academic Performance

• As long as the student has been afforded due
  process in the decision-making process, the
  courts will support the right of the faculty to
  fail a student because of unsatisfactory academic
  performance.
• Due process means that the students have the
  right to know what behaviors and competencies are
  expected of them to successfully pass a course,
  the right to timely feedback about their
  performance, and the opportunity to correct
  behavior that is considered unsatisfactory.

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Due Process for Academic Issues

• Clearly Communicate student and faculty rights in
  student and faculty handbooks.
• Systematically review catalogs, handbooks, and so
  on to determine whether they are up-to-date with
  current policies and procedures.

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Due Process for Academic Issues Continued

• Course requirements and expectations should be
  clearly established at the beginning of the
  course
• Maintain all tests and written work in files
  until the student has successfully fulfilled
  program and course requirements
• Students should have the opportunity to view all
  evaluation data that are placed in their student
  file
• When potential for course failure or dismissal
  exists, students should receive notification of
  their academic deficiencies.

28
Grievances and the Student Appeal Process

• Even if the student has been treated with the due
  process, it is possible that the student may seek
  legal recourse.
• Student is then responsible for demonstrating the
  that the faculty is at fault.

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The Student Appeal Process

• A student must exhaust all school appeal
  processes before seeking legal action.
• Both student and faculty member are heard in
  front of a neutral party.
• Two outcomes Grade is upheld, or corrective
  action is taken, either in a grade change, or
  further evaluation.

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Faculty Role in Student Appeals

• Examine the charge if legitimate, consider
  alternative to grievance procedure.
• Consider long-term effects of any action.
• If all proper procedures and standards have been
  applied, allow grievance to go forward.

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Academic Performance in the Clinical and
Classroom Setting

• Faculty are responsible for guiding students in
  the development of their professional nursing
  skills.
• All states have Nurse Practice Acts to regulate
  nursing practice and education.
• Students are responsible for providing the same
  standard of care as registered nurses.

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Academic Failure in the Clinical Setting

• Faculty are responsible for care given by
  students under their supervision.
• Faculty must judge students ability to apply
  classroom knowledge to clinical setting.
• Courts have upheld faculty rights to dismiss
  students who have failed to meet clinical
  criteria.

33
Academic Failure in the Clinical Setting,
Continued

• Clear communication and clear expectations/objecti
  ves are key to preventing unsafe situations for
  students, faculty, and institution.
• Objective written records should be kept on each
  student.
• Provide constructive student feedback.

34
Assisting the Failing Student in the Clinical
Setting

• Protect students right to due process.
• Instances of positive and negative student
  performance should be recorded.
• Develop a learning contract with the student.

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Assisting the Failing Student in the Clinical
Setting (cont.)

• Hold feedback sessions with the student.
• Student understanding that evaluations include
  increased observations by faculty.
• A second instructors evaluation can help
  increase objectivity.

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Academic Failure in the Classroom Setting

• Students may be overwhelmed by coursework.
• Students have too many obligations outside
  school.
• Students are unable to draw on many necessary
  levels of cognitive ability.

37
Assisting the Failing Student in the Classroom
Setting

• Creative program development can help students
  overcome academic obstacles.
• Support services can assist students in
  adjusting.
• Nursing organizations are a source of
  encouragement.

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Academic Dishonesty

• Faculty factors can influence student dishonesty.
• Remind students they are being observed during
  tests.
• Maintain copies of past student papers to avoid
  plagiarism.

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Academic Dishonesty (cont.)

• Include consequences of cheating on the syllabus.
• Once evidence of cheating is found, the student
  must be confronted.
• Due process should be carried out.

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Student-Faculty Relationships

• Unethical teaching behavior results from lack of
  respect for students.
• Seek help on developing effective student-faculty
  relationships.
• See the relationship as a partnership.

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Students with Special NeedsChapter 4

• Includes students with physical or mental
  impairment, chronic illness, learning disability,
  or chemical dependency.
• Very little data has been collected on the
  subject of students with special needs in nursing
  programs.

42
Legal Issues Two Most Important Laws

• Rehabilitation act of 1973
• Americans with Disabilities act of 1990

43
Rehabilitation act of 1973

• States that individuals cannot be denied access
  to, or participation in, any program or activity
  that receives federal funding.
• Includes all higher education and post secondary
  education institutions that receive federal
  funding.

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Americans with Disabilities Act of 1990

• Protects the rights of disabled individuals in
  the arenas of education, employment, and
  environmental accessibility.
• Failure of an institution to provide
  accommodations for students with disabilities can
  result in legal action.

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Implications for Nursing Education

• Students must inform institution of disability.
• Institutions must determine what accommodations
  are reasonable.
• Educators must determine what is essential vs.
  what is traditional.

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The Nursing Student with a Learning Disability.

• The most common form of student disability.
• A learning disability can easily go undetected
  until the college years.
• May be able to demonstrate knowledge through
  practice, but unable to show through written or
  timed tests.

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Characteristics of Learning Disabilities

• Disability can easily be limited to a specific
  area, such as memory, language, or math.
• Disabilities are individualized
• Learning Disability students have average or
  above average intelligence
• Most or all have developed strengths to offset
  disability

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Accommodating Learning Disabilities

• Refer a student to an expert in learning
  disabilities.
• Focus on students strength, not disability.
• Facilitate an environment where the student can
  overcome disability, rather than be hindered by
  it.

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Campus Support Services

• Most campuses have support services built in for
  Learning Disabled Students.
• Use of services is voluntary

50
Accommodations for NCLEX Licensure

• All nurse educators need to be familiar with
  accommodations provided for disabled students
  when taking the nursing licensure examination.

51
The Impaired Nursing Student

• Nursing Students are at risk for developing
  chemical dependency problems during there
  education.
• Reasons
• Easy access to drugs
• Stress may influence alcohol and drug use
• College environment provides easy access

52
Characteristics of the Impaired Student

• Frequent Mood Swings
• Unprovoked irritability or hostility
• Preference for working alone
• Overly apologetic behavior
• Increased tardiness and absenteeism
• Decreased Productivity
• Intricate excuses for behavior

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Characteristics of the Impaired Student Cont.

• Inappropriate personal appearance
• Personal relationship difficulties
• Inability to meet deadlines and keep schedules
• Social and Emotional withdrawal
• Odor of alcohol or mints detected on breath

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Characteristics of the Impaired Student

• Other potential indicators
• Unsteady gait
• Affected speech
• Bloodshot sclera and alteration in pupil size
• Tremors
• Difficulty following directions or performing
  calculations
• Diaphoresis
• Nausea and vomiting

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Faculty Responsibilities Related to the Impaired
Student

• Clearly understand the policies and procedures
  for assisting students
• Adher to those policies and procedures
• Do not try to council students, send them to
  treatment.
• Some schools have developed there own programs,
  key aspects include
• Ensuring the confidentiality of students
• Clarifying the responsibilities of the students
• Orienting the student population to the purpose,
  activities and responsibilities of the program.

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Nursing Students with Mental Health Problems

• Nursing students may be at risk for mental health
  problems because of high levels of stress.
• Some students may also already have mental health
  problems before entering into the program, which
  may lead them to be attracted to the helping
  profession.
• Indicators of mental health programs
• Frequent absenteeism
• Disruption of logical thought
• Decrease in the quality of work

57
Faculty Responsibilities Related to Students with
Mental Health Problems

• ADA prohibits discrimination against individuals
  who are mentally impaired
• Actions should be within the institutions
  policies and producers.

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Curriculum DevelopmentChapter 5

• Issues faculty must consider
• Financial resources
• Is the curriculum meeting the students needs and
  the needs of the community?
• Is the curriculum design one that will be
  appropriate for future classes
• Does the university provide programs that are
  higher quality, more accessible, and more
  economically sound than those competitors?

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Curriculum Development

• Faculty need to address the following questions
• Are the students prepared for the world?
• Will the curriculum help students prepare for the
  workforce?
• Is the curriculum outdated?
• Is the curriculum meeting the needs of women and
  minorities relating to the global economy.

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Definition of Curriculum

• Definitions of curriculum include
• Preselected goals/outcomes to be achieved
• Selected content in a program of study
• Process and experiences to facilitate learning
• Resources used in classroom
• The responsibility of the teacher and learner for
  learning
• How and where learning takes place

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Definitions of Curriculum Cont.

• Interpretations of the curriculum
• Organized knowledge presented in a set of
  subjects/courses
• Modes of thought
• Cognitive/affective content and process
• A set of instructional end or objectives
• Activities that go on in a school
• Learners experiences as a result of schooling.

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Curriculum Development in Nursing

• Debated issues about the conceptualization of
  curriculum
• The nature and scope of content
• The amount of planning involved in selecting and
  achieving outcomes
• The extent of teacher/student involvement
• The focus of interaction be between the teacher
  and students
• What is learned and how learning is taking place

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Types of Curricula

• Official Curriculum consists of a framework with
  a philosophy or mission.
• Operational curriculum consists of what is
  actually being taught.
• Hidden Curriculum consists of the teaching of
  values and beliefs
• Null Curriculum represents values and behaviors
  that are not taught.

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Curriculum Components

• Component used by faculty in the review, and
  development of curriculum include
• Foundations
• Philosophy/Mission
• Design
• Frameworks
• Outcomes/competencies/Objectives
• Educational Activities
• Evaluation

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Foundation

• Set the external boundaries of a subject, whereas
  historical perspectives provide a view of the
  evolving content and roots of the discipline.

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Philosophy/Mission

• Philosophy provides the framework for curriculum
  choices that are made.
• Missions must address the knowledge and
  technology explosion, critical think, problem
  solving, multiculturalism, and communication in
  response to the changes in everyday life.

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Types of Philosophies

• Perennialism based on knowledge.
• Essentialism based on idealism and realism.
• Progressivism based on pragmatism, focuses on the
  educational needs of the individual.
• Reconstructionism based on pragmatism,
• Focuses on the educational needs of society.
• Existentialism focuses on individualism and
  self-fulfillment.

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Designs

• Need to incorporate opportunities for students to
  problem solve and think critically.
• Traditional curriculum design are changing
  because of technology design.
• Computerized modules are more cost-effective and
  save time.

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Organizing Frameworks

• Provides students with learning experiences
  necessary to achieve the desired education
  outcomes.
• Assessment of outcomes is an essential component
  of curriculum.
• Assessment should be given to students in a
  timely fashion.

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Outcomes/Competencies/Objectives

• Lenbug and Bevil posed several questions for
  nursing program faculty evaluation
• Who will develop the assessment outcomes?
• Who will develop instruments to measure the
  outcomes?
• Who will maintain the records?
• Who will interpret the assessment findings and
  how these findings will be used?
• What effect will findings have on faculty jobs?
• Is the success of the program supported by
  administration and faculty?
• Are graduates prepared to meet the needs of
  nursing practice?

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Educational Activities

• Learning activities should enhance students
  knowledge and prepare students for the real
  world.
• Incorporate Collaborative learning experiences.
• Involvement of alumni and other professionals.

72
Curriculum Development as a Process

• Curriculum Development is a process not an event.
• Faculty most remain responsive to the needs of
  society and students and design curriculum
  accordingly.
• Faculty engaging in curriculum development should
  examine their environment.

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Barriers to Curriculum Development

• Ritchie 13 reasons why curriculum change was
  resisted by faculty
• Fear of losing control
• Misunderstanding due to lack of information or
  confusion about new vocabulary and jargon
• Perception of lack of skill to progress
• Different views about what needs to be done
• Lack of motivation to study the change
• Lack of the perception of a need to change
• Too man changes and to many demands

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Barriers to Curriculum Development Cont.

• Desire to be vindictive and make the leader look
  bad
• Idea that no one can tell me what to do
• Threat to change current social support systems
• Lack of resources
• View that formal methods used to facilitate
  change are barriers rather then helps
• Lack of rewards.

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Barriers to Curriculum Development

• Faculty observe the manner in which the leader
• Respond to critical incidents and crisis
• Supervises evaluates, praises, handles conflict
  resolution, directs changes and represents the
  organization
• Executes rewards and assigns, promotes, and
  terminates employees.

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Curriculum Development as Planned Change

• Regular review of curriculum is crucial to adapt
  to changes in the field.
• Committee review can be a means for improvement,
  and can foster critical thinking skills in
  students.