Name: Jeanne Maricor O.

Bandayan

MAN Batch 16 (Davao)

Date of Submission: Dec. 14, 2010

MODULE 1 LESSON 1

ACTIVITY #2

What does curriculum mean to you as a nurse practitioner? Explain the relevance of
curriculum to nursing practice.

As a nurse practitioner, curriculum is the most important influence in my nursing

practice because it shapes the way I view my work. Curriculum is more than content,
courses, and texts. Curriculum is a noteworthy event, one that plays a significant part in
shaping my identity through the boundaries setting out its purpose. It guides my practice
and allows me to express my values and beliefs in the way I deliver care in any given
situation. In addition, it helps me to distinguish my professional discipline from other
health care workers, so I have clarity about my unique contribution. Most importantly,
curriculum provides a knowledge base about my chosen profession that opens a path
for growth and development to keep up with the evolving times and to go forth into the
future with a strong foundation.

Curriculum is foundational to the development of nursing as a discipline and a

profession.
Nursing curriculum development has gone through its share of change, influenced by
the different worldviews that have taken hold at various times of nursing history.
Curriculum is indeed significant to the nursing practice because it establishes the
relationship among the school subjects, as well as issues within individual school
subjects, and the relationships between the curriculum and the world. Overall, it
establishes the relationship among all the courses and the contexts within which nursing
takes place.
ACTIVITY # 3

Why is it important that the curriculum should reflect the urgent needs, issues and
problems facing the country today? Why do you think revision of our present curriculum
is continuously changing?

The nursing profession is facing a number of challenges in the ever-changing world of

health care and education. In response to these changes, the nursing curriculum needs
to reflect the current trends and issues in the Filipino society in order to articulate our
contribution to the health care system and client care.

Revisions are constantly being imposed to the current nursing curriculum because new
issues concerning the nursing profession arise. The educational process is a social
process therefore, it is dynamic. Thus, in order to address the need to seek solutions
and improvements in these issues, nursing curriculum is redefined. Certainly, the issues
confronting health care are relevant to nursing.

ADDITIONAL REQUIREMENT: SUBMIT 2 ARTICLES WITH COMMENTS/ANALYSIS

ON THE CURRENT TRENDS/ISSUES

ARTICLE #1:

INNOVATIVE NURSING EDUCATIONAL CURRICULUM FOR THE 21ST CENTURY

AUTHORS:
MARY ELLEN SMITH GLASGOW, LYNNE M. DUNPHY, and ROSALIE O. MAINOUS

Mary Ellen Smith Glasgow, PhD, RN, ACNS-BC, is associate professor and associate dean for
undergraduate programs, MSN programs and Continuing Nursing Education, Drexel University
College of Nursing & Health Professions, Philadelphia, Pennsylvania.

Lynne M. Dunphy, PhD, APRN, BC, is professor and Routhier Endowed Chair for Practice at
the University of Rhode Island, Kingston.

Rosalie Mainous, PhD, ARNP, NNP-BC, is associate dean for graduate programs and research,
University of Louisville, Louisville, Kentucky.
Background

Innovation in academic settings, specifically colleges of nursing, is often hindered by the

pressure to meet educational and regulatory requirements established by national organizations,
accrediting agencies, and the state boards of nursing that govern and set standards for nursing
practice at both the baccalaureate and graduate levels (Melnyk & Davidson, 2009). These
regulations should not be barriers to innovation. Time-honored traditions in nursing education,
such as the current undergraduate clinical instruction model, a disease and illness-oriented
curriculum, and the need for extensive clinical practice before matriculating in doctoral
programs, should be reexamined. There is a need to embrace technology-infused education,
trans-disciplinary approaches to care, and translational research. Students need to learn how to
effectively assess and manage some of the most significant health problems currently
confronting our society (e.g., mental health disorders, obesity, patient safety) and how to
innovate changes in our health care system (Melnyk & Davidson). Furthermore, a very
uncomfortable, difficult question needs to be asked: “What should be the most appropriate
degree for entry into nursing practice?”

Given the complexity and wide range of knowledge and competencies that will be required of
nurses in the 21st century, it is strongly recommended that nurses be prepared at the
baccalaureate level for entry into practice. Moreover, the entry into practice debate needs to be
resolved in the 21st century (Benner, Sutphen, Leonard, & Day, 2010).

Innovations: Technology-Infused Education, Transdisciplinary Approaches to Care, and

Translational Research

Simulation is one very effective tool that exposes students to the complexity of clinical settings
without the hazards of real life (Ironside, Jeffries, & Martin, 2009). Future nursing curricula need
to develop interdisciplinary simulation scenarios focusing on collaboration and crucial
conversations so that students can learn how to deal with ineffective professional relationships
and unsafe practice in a controlled environment (American Association of Critical-Care Nurses,
2005). Transdisciplinary or interprofessional models of simulation and debriefing can be used to
examine and dissect failed communication in health professions education and result in a series
of recommendations to improve health care environments and patient outcomes. The curriculum
for the 21st century needs to provide an opportunity for future health care providers to participate
in collaborative education to obtain the necessary advocacy skills to promote a safe, healthy
environment for the patients they serve. Additionally, with the rapid expansion of knowledge, the
development of information appraisal and navigation skills are essential for future nurses
(Melnyk & Davidson, 2009).

Transdisciplinary or interprofessional models of education are at the core of a new type of

dedicated education unit, one that educates nurses, physicians, pharmacists, and other
professionals depending on the type of patient needs addressed. Dedicated Education Units have
previously implemented best practices utilizing the staff nurse as educator (Moscato, Miller,
Logsdon, Weinberg, & Chorpenning, 2007). This new model of education is broader, more
inclusive, and seeks to find commonalities in the cultures of both service and academe and may
provide an ideal site for faculty practice as well. As a starting point, a hospital environment is
chosen as an exemplar to demonstrate the feasibility of the model. Chief nursing officers would
dedicate select units and develop methods to choose seasoned nurses to work as change agents in
the new environments. Clinical educators in nursing and other disciplines would establish daily
rounds with input from all students at varying levels based on Benner's Novice to Expert model
(Benner, 1984). More experienced students would mentor the novice. A model of leveled
reflective learning has been described in Sweden utilizing different hospitals for different levels
of learning within the context of the dedicated education unit (Lindahl, Dagborn, & Nilsson,
2009).

Nurses, hospitalists, and other health professionals are educated in teaching pedagogy and
contribute to the education and evaluation of the students. This innovative model also facilitates
a better understanding of what each discipline contributes to the overall plan of health
improvement. Students are exposed to multiple faculty members who share responsibility for
students and students become members of the team (Budgen & Gamroth, 2007). Trans-
disciplinary team meetings will periodically assess the adequacy of the model, the experience of
the student, and the areas for growth.

Building the Science

It has been well documented that the nursing profession faces a serious shortage of nursing
faculty, as well as a severe dearth of underrepresented minority faculty (Potempa, Redman, &
Anderson, 2008; Sullivan Commission, 2004), that has dramatic implications for, and is a threat
to, the future of nursing. In order for nursing to be a truly resonating force for health in the 21st
century, it is essential that we grow the science of nursing and demonstrate its effectiveness in
fostering health. The case can be made that the production of master's and doctorally prepared
nurses is more critical than a focus on preparation of registered nurses. Difficult decisions must
be made. Which educational setting best supports the preparation of different levels of practice?
Advanced practice nurses across the board are needed; nurse faculty, nurse leaders, and nurse
scientists are all in high demand. Master's entry into professional nursing programs has brought a
needed cadre of adult learners with broad-based backgrounds into nursing that enhance the
discipline. The emergence of the professional doctorate (DNP) is integral to supporting
disciplinary growth. We promote a view of the practice doctorate as one not divorced from
research but rather additive to the development and use of science. But this will not be enough. A
solid background in science, scientific inquiry, and the scientific basis of health is essential to
develop health care innovation.

Recommendations

The authors propose strategies to shape the future of health care by creating models of nursing
education focused not only on curriculum changes, but also on transforming the student
population, integrating the science and research in the curriculum, and influencing health care
policy.

CURRICULUM AND TECHNOLOGY

 • Create truly unique transdisciplinary simulation centers across the country, where
students from the health disciplines, nursing, health professions, and medicine, will be
exposed to the complexities of teamwork within the clinical setting.
• Develop curricula well grounded in disease prevention, health promotion and screening,
and public health. Include greater emphasis on the aging, older adult, ethics, genetics,
public speaking, and writing skills (Sauder et al., 2006).
• Develop sufficient technology skills to better support increased knowledge management,
including point-of-care technology.
• Include a nurse educator role in all master's and doctoral programs.
• Increase the emphasis on global health and knowledge development at all educational
levels.
• Teach students to deal with the ambiguities of the health care environment.

TRANSFORMING THE STUDENT POPULATION

• Increase the number of BSN accelerated and master's entry in nursing programs designed
for second-degree students.
• Increase doctoral student enrollment, especially for underrepresented minorities (Kim et
al., 2009). Partnership models between research-intensive institutions and schools with
less research are essential. Models that support early professional movement to the
doctorate are essential.

INTEGRATING SCIENCE AND RESEARCH

• Focus on interpreting clinical data and managing improvement.

• Cultivate disciplinary knowledge across all levels of curricula based on an understanding
of the science of the discipline and the scientific process (Potempa & Tilden, 2004).
• Develop the role of the nurse scientist.
• Develop scientifically aware nurse clinicians who will collaborate with nurse scientists to
move research to the bedside. Focus on evidence-creating nursing, the direct
collaboration between nurse clinicians and nurse scientists.
• Reengineer the DNP to include the conduct of research in the form of a practice
dissertation.

HEALTH CARE POLICY

• Increase support for BSN education as a minimum requirement for practice.

• Increase support for the development of advance practice nurses to meet the growing
need for primary care providers identified in health care reform measures.
• Institute transdisciplinary dedicated education units across the country.
• Promote a better understanding of the business and financial dimensions in nursing and
health care.
• Advance Medicare or other federal support to create a Graduate Nursing Education Fund
(similar to Graduate Medical Education).
• Institute a national nursing licensure program.
SUMMARY

Nursing science can raise clinical standards, influence health policy, inform citizens, improve the
health and well-being of the public, and possibly transform care (Tilden & Potempa, 2003). With
health reform cresting, nurses have an enormous opportunity to influence a new, evolving health
care system that truly improves the health of our nation. The time for innovation is now.

COMMENTS/ANALYSIS:

The changing landscape of health care in the society requires that clinicians be skilled
in responding to varying patient expectations and values; provide ongoing patient
management; deliver and coordinate care across teams, settings, and time frames; and
support patients' endeavors to change behavior and lifestyle — education that is in short
supply in today's academic and clinical settings. Nursing education needs to innovate at
the micro and macro system levels for the 21st century. It cannot be business as usual.
In order to truly transform care, practice and education will need to partner on
curriculum development and the professional socialization of the new nurse.

Source: http://www.nlnjournal.org/doi/full/10.1043/1536-5026-31.6.355

ARTICLE #2

Title: The Future of Nursing Education: Ten Trends to Watch

Barbara R. Heller, Marla T. Oros, and Jane Durney-Crowley

The millennium has become the metaphor for the extraordinary challenges and opportunities
available to the nursing profession and to those academic institutions responsible for preparing
the next generation of nurses. Signal change is all around us, defining not only what we teach,
but also how we teach our students.

Transformations taking place in nursing and nursing education have been driven by major
socioeconomic factors, as well as by developments in health care delivery and professional
issues unique to nursing. Here are 10 trends to watch, described in terms of their impact on
nursing education.

1. Changing Demographics and Increasing Diversity

2. The Technological Explosion
3. Globalization of the World's Economy and Society
4. The Era of the Educated Consumer, Alternative Therapies and Genomics, and Palliative Care.
5. Shift to Population-Based Care and the Increasing Complexity of Patient Care
6. The Cost of Health Care and the Challenge of Managed Care
7. Impact of Health Policy and Regulation
8. The Growing Need for Interdisciplinary Education for Collaborative Practice
9. The Current Nursing Shortage/Opportunities for Lifelong Learning and Workforce
Development
10. Significant Advances in Nursing Science and Research

1. Changing Demographics and Increasing Diversity

Population shifts in the United States have affected health care priorities as well as the practice
of nursing. Due to advances in public health and clinical care, the average life span is increasing
rapidly. By 2020, more than 20 percent of the population will be 65 and older, with those over 85
constituting the fastest growing age group.

Greater life expectancy of individuals with chronic and acute conditions will challenge the health
care system's ability to provide efficient and effective continuing care. Significant increases in
the diversity of the population affect the nature and the prevalence of illness and disease,
requiring changes in practice that reflect and respect diverse values and beliefs. Disparities in
morbidity, mortality, and access to care among population sectors have increased, even as
socioeconomic and other factors have led to increased violence and substance abuse. Nursing
practice, education, and research must embrace and respond to these changing demographics,
and nurses must focus on spiritual health, as well as the physical and psychosocial health of the
population.

Student demographics are also changing. Ethnic and racial diversity of nursing schools has
increased dramatically, creating a rich cultural environment for learning. Students are entering
schools of nursing at an older age and are bringing varying college and work experiences, as well
as more sophisticated expectations for their education. They are typically employed in full-time
careers, and many are raising families, which places constraints on their educational experiences
and necessitates greater flexibility in scheduling.

Schools of nursing must be prepared to confront the challenges associated with today's more
mature student body, and educational methods and policies, curriculum and case materials,
clinical practice settings, and research priorities need to value and reflect the diversity of the
student body, as well as the population in general. At the same time, schools must focus
recruitment efforts on the more traditional, younger student.

2. The Technological Explosion

The rapid growth in information technology has already had a radical impact on health care
delivery and the education of nurses. Advances in processing capacity and speed, the
development of interactive user interfaces, developments in image storage and transfer
technology, changes in telecommunications technology, and the increased affordability of
personal computers have contributed to the explosion of information technology applications.
Advances in digital technology have increased the applications of telehealth and telemedicine,
bringing together patient and provider without physical proximity. Nanotechnology will
introduce new forms of clinical diagnosis and treatment by means of inexpensive handheld
biosensors capable of detecting a wide range of diseases from miniscule body specimens.

Dramatic improvements in the accessibility of clinical data across settings and time have
improved both outcomes and care management. The electronic medical record will replace
traditional documentation systems. Through the Internet, consumers will be increasingly armed
with information previously available only to clinicians. Electronic commerce will become
routine for transacting health care services and products.

Nurses of the 21st century need to be skilled in the use of computer technology. Already,
distance learning modalities link students and faculty from different locales and expand the
potential for accessible continuing professional education. Technically sophisticated preclinical
simulation laboratories will stimulate critical thinking and skill acquisition in a safe and user-
friendly environment. Faster and more flexible access to data and new means of observation and
communication are having an impact on how nursing research is conducted.

3. Globalization of the World's Economy and Society

Globalization has been brought about by many factors, including advances in information
technology and communications, international travel and commerce, the growth of multinational
corporations, the fall of communism in Eastern Europe and the Soviet Union, and major political
changes in Africa and Asia. With the "death of distance" in the spread of disease and the delivery
of health care, there are both extraordinary risks and extraordinary benefits. Along with the
potential for rapid disease transmission, there is potential for dramatic improvements in health
due to knowledge transfer between cultures and health care systems.

Nursing science needs to address health care issues, such as emerging and reemerging infections,
that result from globalization. Nursing education and research must become more internationally
focused to disseminate information and benefit from the multicultural experience.

4. The Era of the Educated Consumer, Alternative Therapies and Genomics, and Palliative
Care.

The Educated Consumer Despite some information gaps, today's patient is a well-informed
consumer who expects to participate in decisions affecting personal and family health care. With
advances in information technology and quality measurement, previously unavailable
information is now public information, and consumers are asked to play a more active role in
health care decision making and management. The media and the Internet have facilitated this
trend.
Technological advances in the treatment of disease have led to the need for ethical, informed
decision making by patients and families. Consumers are thus becoming more interested and
knowledgeable about health promotion as well as disease prevention, and there is increased
acceptance and demand for alternative and complementary health options. The increased power
of the consumer in the patient-provider relationship creates a heightened demand for more
sophisticated health education techniques and greater levels of participation by patients in
clinical decisions. Nurses must be prepared to understand this changed relationship and be
skilled in helping patients and families maximize opportunities to manage their health.

Alternative Therapies and Genomics Amazing growth is taking place at opposing ends of the
technological spectrum. The impact of the Human Genome Project and related genetic and
cloning research is unparalleled. Gene mapping will drive rapid advances in the development of
new drugs and the treatment and prevention of disease. Technological sophistication of the
highest order is required for this research, which has the potential to lead to unparalleled ethical
questions and conflicts while bringing about critical diagnostic and therapeutic developments.

At the low-tech end of the spectrum, the voracious demand by consumers for "alternative" or
"complementary" therapies to enhance health and healing has begun to influence mainstream
health care delivery. Several academic medical centers now have offices of alternative medicine,
and the National Institutes of Health recently funded new initiatives dedicated to this field.
Increasingly, major health systems are seeking ways to provide both traditional, Western
medicine while offering the best of the alternative therapies to their patients.

As is true for many trends, alternative medicine holds both promise and peril. While it is thought
that it may unlock behavioral and spiritual components of health and healing heretofore resistant
to most conventional medicine, risks of consumer fraud, therapeutic conflict, and patient
noncompliance are real. Nursing research has the potential to enhance knowledge regarding what
constitutes a "healing" therapy. Nursing education and practice must expand to include the
implications of the emerging therapies from both genetic research and alternative medicine,
while managing ethical conflicts and questions. The inclusion of nontraditional health care
providers may augment the health care team.

Palliative and End-of-Life Care Technological advancements in the treatment of illness and
disease have created new modalities that extend life while challenging traditional ethical and
societal values regarding death and dying. Greater recognition of the need to ensure comfort and
promote dignity is reflected in the now nearly universal promotion of advanced directives, organ
donation, and palliative care for the terminally ill. New settings for care, such as inpatient and
home-based hospice, and new forms of care, including pain management, spiritual practices, and
support groups and bereavement counseling, are now likely to be part of well-developed health
care systems. A significant gap in the body of scientific knowledge and clinical education with
regard to palliative and end-of-life care remains, and nursing education must prepare graduates
for a significant role in these areas.

5. Shift to Population-Based Care and the Increasing Complexity of Patient Care

Rising costs and an aging population have led to new settings and systems of care across the
health care continuum. Managed care and risk-based contracting mechanisms have forced a shift
from episodic care with an acute orientation to care management with a focus on population-
based outcomes.

The marriage of care with cost requires nursing professionals to have an understanding of
practice methods that improve quality, respond to clinical complexity, and lower costs. Patients
in inpatient settings are increasingly more acutely ill; the standard ratio of critical care/specialty
beds to general use beds in hospitals today is close to 1:1, up substantially from a decade ago.
Furthermore, expanded life expectancy has led to increases in the number, severity, and duration
of chronic conditions, thereby increasing the complexity of the care provided and managed by
clinicians. The community has largely become the setting for chronic disease management and
prevention.

Providing services for defined groups "covered" by managed care will demand skills and
knowledge in clinical epidemiology, biostatistics, behavioral science, and their application to
specific populations. Nurses must demonstrate management skills at both the organizational and
patient care levels. These concepts must be incorporated into the nursing curriculum.

6. The Cost of Health Care and the Challenge of Managed Care

Cost of Health Care A concern of businesses and governments for at least 30 years, the cost of
health care in the United States has approached 15 percent of the total gross national product.
Thus, individuals have joined the debate about health care costs. Despite the fact that more than
40 million Americans lack health care insurance coverage, and certain health indices lag by a
wide margin behind those of other societies, total health care spending in this country
significantly outstrips that of other developed countries. Many reasons have been suggested,
including the advanced technology available to virtually all residents through academic medical
centers, the scientific and technologic infrastructure that has led to most of the diagnostic and
therapeutic breakthroughs in medicine, cultural norms regarding aging and end-of-life, the cost
of violence and drug addiction, and the growing economic and health disparity between
segments of the population.

Concerns about cost have led to the popularity of managed care options, first by corporations for
their employees and now by governments, through the Medicare and Medicaid programs.
Despite recent federal budget surpluses and proposals to expand funding and benefits in
Medicare, there is serious concern among economists, legislators, and bureaucrats about the
long-term solvency of both publicly funded programs.

Concerns about cost are present in every form of nursing practice; they affect how work is
organized, treatment plans for patients, and patients' perceptions of and participation in care. For
example, even individuals with health insurance are wary of increased out-of-pocket expenses
and noncovered services. And there is heightened concern about pharmaceutical costs, fueled, in
part, by the development of sophisticated new drugs.
Managed Care and Reimbursement Challenges Within both the public and private sectors,
managed care is quickly becoming the dominant reimbursement mechanism for health care
providers, bringing both opportunities and problems. Despite the promise for flexible financing
that managed care risk was thought to offer, provider contracts are still based on fees for service,
reducing the incentives to truly manage care, prevent illness, and promote health. Nursing
professionals, who have historically taken the lead in health education and health promotion, are
disappointed by the lack of financing and reimbursement available through managed care
organizations for these vital services. However, advanced practice nurses - nurse practitioners
and case managers in particular - have benefited greatly by the managed care movement.
Demand for these lower cost providers has dramatically increased, and their competence and
quality in the primary care field have been acknowledged.

APNs still confront barriers to direct reimbursement from managed care organizations that lack
the knowledge and political will to challenge the traditional medical model. Across the country,
nurse practitioners are deterred from being credentialed on provider panels. More research is
needed to demonstrate the value to the health care delivery system, as well as the cost
effectiveness, of health education, health promotion, and advanced nursing practice. Nursing
education programs must prepare students at all levels for roles in case management and
employment in the managed care environment.

7. Impact of Health Policy and Regulation

The impact of federal and state health policy and regulation on the practice of nursing cannot be
ignored. Issues surrounding health care are often complex, involving the fields of medicine and
economics, and affecting individuals' rights as well as access to health care. Consumers are
concerned about quality, and corporations and individual providers are concerned about
economic survival.

Two major trends will have a significant impact on health care delivery. First, there will be an
increase in state and federal regulation as costs rise and managed care continues to expand.
Along with regulation, there will be attempts to shift to less expensive settings and apply market
forces to restrain costs.

Second, shared responsibility for the Medicaid program and the shift to managed care has
resulted in an increased oversight role for the states. States must define, measure, and assess
quality, and serve as contractors for corporate entities while enforcing accountability of managed
care organizations. Both new regulation and devolution have serious implications for health care
delivery and the practice of nursing. Historically, nursing's influence on policy and regulation
has been disproportionately low relative to the breadth of nursing practice and its importance
within the health care delivery system. Nursing schools, scholars, executives, and professional
nursing organizations must more actively contribute to the development of health policy and
regulation. Ethical issues involved in working in an integrated system constrained by economic
incentives are being defined more and more by government policy makers, not health care
professionals. Nursing leaders should contribute to the dialogue that defines these issues;
students must be prepared for a meaningful role in the political arena.
8. The Growing Need for Interdisciplinary Education for Collaborative Practice

A wide range of knowledge and skills is required to effectively and efficiently manage the
comprehensive needs of patients and populations. The health care delivery system of the future
will rely on teams of nurses, nurse practitioners, physicians, dentists, social workers,
pharmacists, and other providers to work together. While interdisciplinary and collaborative
practice is still not the norm, there has been a heightened awareness of the need for coordinated
care and a significant increase in the use of midlevel providers, such as APNs, as part of the
primary care team.

With care management a critical component in health care delivery, nurses must demonstrate
leadership and competence in interdisciplinary and collaborative practice for continuous quality
improvement. Team-based, interdisciplinary approaches have been shown to be highly effective
for improving clinical outcomes and reducing cost. Teaching methods that incorporate
opportunities for interdisciplinary education and collaborative practice are required to prepare
nurses for their unique professional role and to understand the role of other disciplines in the care
of patients.

9. The Current Nursing Shortage/Opportunities for Lifelong Learning and Workforce

Development

Nursing shortages have a negative impact on patient care and are costly to the health care
industry. A significant nursing shortage exists today, particularly in acute and long-term care
settings. It results from many factors. For example, nurses of the "baby boom" generation are
beginning to retire; women today have numerous career opportunities; and there is a lingering
perception of nursing as a "trade," versus a "profession," which contributes to the lack of new
individuals entering the field. As the age of entering students rises, the number of years of
practice decreases, also affecting supply. While the number of male and minority students has
been steadily rising, their ranks are still underrepresented.

The current shortage is judged to be deeper than past shortages and probably more resistant to
short-term economic strategies that have worked before. However, as in the past, the current
shortage will almost certainly raise salaries and increase flexibility for nurses. Other recent
advances in the profession and the health care industry are likely to have a positive impact on
recruitment. These include the opportunity to practice in a variety of clinical settings; the
dramatic increase in opportunities for APNs; new careers in care management and case
management; and the interest of biotechnology, information technology, and pharmaceutical
companies in hiring skilled nursing professionals. Nursing education must partner with the health
care industry to develop innovative short- and long-term solutions that address the nursing
shortage, including aggressive student recruitment and the initiation of an intense
media/marketing campaign. The public image of the nursing role must be revitalized to change
outdated perceptions.

The need for more sophisticated nursing management and leadership to respond to the clinical,
organizational, and fiscal challenges faced by the health care industry has not gone
unrecognized. Nurse managers and executives require clinical experience and strong
communication skills, as well as business acumen and knowledge of financial and personnel
management, organizational theory, and negotiation. With the nursing labor budget constituting a
significant proportion of total spending, and cost overruns, in acute care hospitals, long-term care
facilities, and home care agencies, nursing management is too often found to be lacking in
fundamental decision science and fiscal knowledge. A great need exists for educational support
for experienced nurses to be developed into nurse executives, prepared to work competently
alongside their business colleagues. Nursing schools are called on to expand their core and
continuing education programs to address these needs.

Schools of nursing have many of the core resources needed to deliver continuing professional
education and can provide appropriate courses efficiently and effectively. Affiliation with
schools by nurses in active practice may lead to an increase in enrollment for advanced degrees.
Health care and health-related organizations may serve as institutional partners in sponsoring
such program offerings, which would contribute to their relevance, increase participation, and
lower costs.

10. Significant Advances in Nursing Science and Research

Nursing research is an integral part of the scientific enterprise of improving the nation's health.
The growing body of nursing research provides a scientific basis for patient care and should be
regularly used by the nation's 2.5 million nurses. Most studies concern health behaviors,
symptom management, and the improvement of patients' and families' experiences with illness,
treatment, and disease prevention. Research is conducted to improve patient outcomes and
promote the health and well-being of communities, especially of the most vulnerable
populations.

Nursing research and scholarship has received significant funding by public and private agencies
in the last decade and is increasingly recognized as an independent body of knowledge.
However, the challenges associated with advancing the research agenda in nursing are complex
and varied. Schools of nursing are not sufficiently focused on the scholarship and science of
nursing as top priorities, and, although graduate degrees in nursing have become more common,
doctorally prepared nursing professionals are not being produced in large enough numbers to
meet the growing need. In addition, there is a need for enhanced mentorship for new researchers
to strengthen skills and capacity to conduct meaningful nursing research. Significant
opportunities exist for schools of nursing, especially those affiliated with academic health
centers, to address these challenges and enhance the research contributions of nursing scholars.

About the Authors Barbara R. Heller, EdD, RN, FAAN, is dean and professor at the School of
Nursing, University of Maryland, Baltimore. She is serving her second term as a member of the
National League for Nursing Board of Governors. Marla T. Oros, MS, RN, is assistant dean for
clinical practices and services, School of Nursing, University of Maryland. Jane Durney-
Crowley, MHA, RN,.a member of the Board of Visitors, School of Nursing, University of
Maryland, is Executive Vice President, Operations and Culture, Catholic Healthcare Partners,
Cincinnati, Ohio.

Source: http://www.nln.org/nlnjournal/infotrends.htm

COMMENTS/ANALYSIS:

At the dawn of the 21st century and the long-awaited new millennium, nurse educators
face a rapidly changing health care landscape, shifting student and patient
demographics, an explosion of technology, and the globalization of health care, in
addition to a myriad of everyday challenges. As we position ourselves to meet today's
challenges and tomorrow's, we must understand the drivers affecting nursing. To quote
Peter Drucker in Managing for the Future, "It is not necessary to be clairvoyant to know
the future; it is only necessary to clearly interpret what has already happened and then
project forward the likely consequences of those happenings" (Truman Talley Books,
1992). Rapidly evolving technology, increasing clinical complexity in many patient care
settings, advances in treatment, and the emergence of new diseases are all factors
contributing to the increased need for a strong emphasis on critical thinking and lifelong
learning among professional nurses. Further, new clinical roles, the need for managerial
and executive talent, the imperative to retain nurses in active practice over longer
careers, and the desire by practicing nurses to move up the economic ladder lead to the
demand for continuing education and career mobility and development.