South Florida Hospital News
Tuesday November 20, 2018

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November 2010 - Volume 7 - Issue 5




Nursing Education in the 21st Century: Turning Challenges into Opportunities

Nursing education in the 21st century presents a multitude of challenges that may be translated into opportunities. One of the most significant challenges facing nursing today is the decision regarding the basic level of educational preparation of the professional nurse. In 2004, the American Association of Colleges of Nursing (AACN) reaffirmed its position that baccalaureate education is the minimum level required for entry into professional nursing practice. Over the years, there has been significant resistance to the concept of differentiated levels of nursing practice based on levels of educational preparation. The concept of differentiated levels of practice entails that nurses prepared in associate degree, baccalaureate degree and masters degree programs should have differing roles within the practice setting and possibly varying levels of licensure. The AACN identifies differentiated practice as one of the “hallmarks of the professional nursing practice environment.” Agreement on basic preparation of the professional nurse may be the most important action that the profession as a whole can undertake.

Similar to nursing practice, where the expectation is to measure patient outcomes and adopt evidence-based practice, nursing education will be challenged to develop student outcomes and adopt evidence-based education. Passive learning utilizing the traditional format of lectures will be replaced by critical thinking exercises addressing simple to complex situations, independent decision making, and creative problem solving. In addition, faculty will be required to document evidence-based teaching and learning as part of the accreditation process.
Access to nursing programs for traditional and nontraditional students will become an even greater concern. Presently, qualified nursing applicants are being turned away from nursing schools because of a shortage of nursing faculty. Relatively few younger nurses are entering the field of nursing education and open faculty positions remain unfilled. The faculty shortage translates into a student shortage which will heighten the nursing shortage. Through collaborative efforts between academia and practice settings as well as private and public funding sources, a solution to this dilemma can be addressed. 
Nursing courses that are delivered by distance learning technologies will continue to increase in numbers. Accelerated programs, flexible course scheduling and remote site options will become a standard for the delivery of nursing courses. The virtual patient world could present various clinical case scenarios which would enable students and nurses to learn new skills and update previously learned ones. Faculty will be involved in the progression of the scenario for the purpose of assessing learners’ abilities to respond to changes in patients’ conditions. In addition, faculty will be able to adjust the simulated experience to the learners’ level of expected clinical performance. While the use of simulation is fairly new in nursing education, the technology is advancing and the trend is expected to continue. A challenge for nursing students which is unique to the use of the virtual environment is the process of encountering patient avatars in the virtual environment and interacting with patients who are not physically present. Visibility of patient avatars through a medium may be very different from the live sight, touch and interaction with a patient. The concept of a virtual patient world challenges nurses to utilize technology to enhance nursing practice but not to undermine the importance of authentic presence on the part of the nurse in the context of the nurse patient relationship.
The challenges of nursing education in the 21st century will require the attention of the entire nursing profession to work together to develop and insure a desired future vision for nursing.
Suzanne J. Crouch, Professor of Nursing, Palm Beach Atlantic University, and Nursing Research Consultant, Martin Memorial Health Systems, can be reached at
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