Nursing Education Domain

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Bold Idea:

To promote excellence in nursing ethics education, in order to build a strong and diverse health care workforce to advance the ethical delivery of health care.

The group’s initial focus was on the education of students in pre-licensure, graduate and doctoral education.  Similar work is needed to support the continuing education of practicing nurses.

This idea relates to the following foundational concepts:

  • Clinical competence is a first-order requirement for ethical practice
  • All nurses, regardless of the settings in which they ultimately practice, will encounter ethical challenges and must be prepared to meet them
  • Ethics education builds on the student’s underlying values and is formative, necessary, must begin early, and must continue throughout a nurse’s career
  • Ethics education must be informed by the American Nurses Association (ANA) and the National Student Nurses Association (NSNA) codes of ethics and other relevant guidelines

In order to achieve stronger ethics components of educational programs, specific systemic shifts are needed:

Action Plan Steps

Short-term actions

Many of the actionable steps discussed by the work group could be accomplished within a relatively short timeframe. Several build on the activities planned in other summit domains (clinical practice, research, policy) and could have synergies with other existing initiatives.

  1. Define and specify the content and assumptions underlying the bold idea and describe the desired future state
  2. Create an infrastructure for continuing follow-up by the education work group, including identification of necessary resources
  3. Conduct a survey of the current status of ethics education in all levels nursing education programs (what is being taught and by whom). The survey would include questions about the educational preparation of faculty to teach ethics, the ethics content of textbooks and student handbooks used, and faculty perceptions of the kinds of resources they lack.
  4. Reinforce ethics requirements in national nursing education standards.
  5. Develop recommendations for alternative ways to prepare faculty to teach ethics effectively (for example, an ethics “bootcamp” continuing education program for faculty without formal training in ethics)

Longer-term Actions

Using an adaptation of the social-ecological framework, a number of longer-term goals for ethics education can be described:

  • Related to the individual nursing student
    • Strengthen expectations for students’ ethical behavior and civility within the educational setting
    • Reinforce and strengthen ethics requirements in national nursing education standards
    • Address students’ moral distress in clinical and academic settings
  • Related to relationships with others (patients, family, other students, inter-professional teams)
    • Use contemporary teaching techniques for inter-professional teams to practice addressing ethical issues
    • Inter-professional focus and involvement in these effects
  • Related to licensure and credentialing
    • Strengthen questions regarding ethics on nursing licensure and certification examinations
  • Related to educational institution factors
    • Establish analysis of nurse educators’ practices in ethics education, as a basis for revising exams such as the National League for Nursing’s (NLN) Certified Nurse Educator examination
    • Provide ethics education and tools for all levels of students and nurses, including continuing education for nurses in practice, at all levels of expertise
    • Facilitate transitions between learning and practice by connecting “ethical” education (by the student) to “ethical” practice (of the new nurse)
    • Develop and engage nurses in direct care practice (and possibly patients, families, and caregivers) in developing ethics education content

We welcome your responses and ideas regarding improving nursing ethics education. Feel free to contribute to the discussion here.

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