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Considering a clinical faculty role? Strategies for success By Kathleen Tornow Chai, PhD, MSN, RN, CNE

YOU LOVE NURSING and like your job, but do you sometimes feel that you’d like to do something more? Does the little voice in your head murmur, “I could do that!” when you watch clinical instructors teaching students on your unit? Now might be the right time to explore the option of joining them as a clinical faculty member. This article describes the experience of 80 nurses who made the transition from clinical nurse to clinical instructor by participating in a program designed to facilitate the process. For this article, clinical instructor is defined as a nursing faculty member who teaches the clinical aspects of the courses for prelicensure students. Some clinical instructors also teach theory. Why is now the time? Nursing is a discipline that requires not only great theoretical knowledge, but also excellent clinical skills. Finding nurses with both the education and the clinical expertise required to be capable clinical instructors is a significant challenge. In 2013, over 78,000 applicants were turned away from nursing schools due to a shortage of nursing faculty.1,2 Many states have strict requirements for ensuring current clinical competence for instructors and prescribing the ratio of clinical instructors to students.3 (For more information about a particular state’s requirements, the National Council of State Boards of Nursing has links to all state boards of nursing at http://www.ncsbn.org.)

To bridge the gap between theory and practice, various options have been tested. In one study, faculty members from the university were paired with experienced staff members at the hospital; they worked together to precept students in clinical areas. They found this method enhanced the students’ clinical experience.4 To expand their workforce, other schools of nursing have hired nurses with bachelor’s of science in nursing (BSN) degrees to teach clinical courses while they’re overseen by a master’s or higher degree-prepared nursing faculty member.5 Another approach is to expose experienced clinical nurses to different aspects of teaching and mentor them as they step into these roles for short periods. An example of this type of clinical faculty program is reviewed here, including participants’ responses to both the program and aspects of role transition. Program overview The clinical faculty program was developed to meet the requirements for nurses who wanted to be instructors but didn’t have at least 1 year of teaching experience or coursework in teaching, as required in California. It took place at a university with large, primarily online postlicensure RN-to-BSN and MSN nursing programs. The course was a three-unit master’s level course, so attendees were required to have a BSN degree. This hybrid course included four full-day sessions on campus once a month. Between those sessions, communication took place online using the university’s

Web-based learning management system. Participants also spent at least 48 hours with a current clinical faculty member while they were doing clinicals. Participants were matched to clinical faculty based on geographic location and area of clinical expertise. The course was taught by a team of three faculty members: an experienced classroom and clinical instructor, a new professor who’d been teaching full time in classroom and clinical settings for 1 year, and an experienced online professor. The course was taught via situated learning. (See Terms of learning.) This approach increases participation and boosts individual and group learning.6 Role-playing scenarios based on actual experiences, reflections, and dialogue benefitted participants because they could begin thinking through these challenges even before their own clinical preceptorships began. Eighty nurses with experience ranging from 4 years to over 30 years in nursing took a semesterlong course. Two years later, 70% are teaching either clinical courses or clinical and theory courses in schools of nursing. In articles and through discussion, they shared expected and unexpected challenges they experienced in the teaching role. The information they shared provides the basis for the strategies outlined. Learning to teach Many of the participants had originally attended nursing programs based on a traditional learning style, such as in diploma, associate’s May l Nursing2015 l 23

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degree, or BSN programs. Switching to a situated learning style was an obstacle the new clinical instructors had to overcome. Another challenge was that while most participants were familiar with adult learning theory, using it as the basis to teach didn’t always come naturally. At the beginning of the course, terms such as pedagogy, andragogy, and Bloom’s taxonomy were new to these clinical nurses. This was an eye-opener for most participants, who realized they hadn’t considered various aspects of teaching methodology. Socratic questioning was also new to most participants. They were amazed at the variety of ways an instructor can assess and meet learning needs. Need to know it all? While the participants had expertise in their own clinical area, one of their concerns was that they might not know enough. During the program, many realized that they couldn’t know everything, but the feeling that this lack would hamper their ability to educate nurses persisted. Many participants who’d served as preceptors for new employees found the faculty situation to be a challenge. As preceptors, they felt free to find the answers together with the new staff. However, as faculty members,

they thought they needed to know more, but as they began to work with experienced clinical educators, they found that knowing all the answers was not necessarily helpful to nursing students. In fact, providing the students with the skills needed to find the answers proved to be very beneficial in the long run. As the participants gained experience, they became more confident about their own expertise as well as the role of a “guide on the side” who helps students find their own answers. Role transition Evolving from expert clinical nurse to novice nursing faculty evoked a range of emotions. Participants hadn’t realized that as instructors, they were back at Benner’s novice role.7 Those who initially wanted to teach in their own place of employment began to understand that this new role might change how their colleagues perceive them. They worried about how coworkers would see them and if help would be available if they had questions. They wondered if physicians and other colleagues would continue to rely on them for patient information while they were in the instructor role. Faculty education frequently takes place on the job. According

Terms of learning • Andragogy is the art and science of helping adults learn. • Bloom’s taxonomy is a framework for organizing the cognitive behaviors expected from the student learner in the educational process.14 • Pedagogy is the art, science, or profession of teaching primarily children. • Situated learning style means that objectives, tasks, and concepts are connected to students’ past experiences.15 • Socratic questioning is an educational method of asking questions to encourage the learner to develop critical thinking about the topic.16 • Traditional learning style consists of lectures and demonstrations; teachers evaluate students’ performance in clinical experiences.17

to Phillips and Vinten, the apprenticeship model for clinical nursing educators has been in place for a long time.8 When this model is used, role transition can be difficult. Challenges with role transition and role identity push the instructor to return to the role of clinical expert rather than teacher.9 Two previous studies identified five stressors on new faculty.10,11 (See Five challenges of transitioning to the clinical faculty role.) Returning to the role of novice isn’t comfortable. The transition can be unsettling, even though most new faculty think it will be temporary.12 Learning to teach is challenging, and mentorship isn’t always adequate. Knowing about role transition before taking on the new role helped participants prepare for the experience. They oriented the nursing staff and manager to their new role in the unit in which they’d be teaching and outlined what responsibilities they expected and which ones weren’t within their scope. They also oriented the students to the role of the instructor versus the clinical nurse and the manager. Time management The challenge of clinical placement surfaced during the program. Many participants didn’t realize the difficulties involved in placing prelicensure students. Hospitals in southern California are saturated with these requests. To accommodate students, many schools offer various shifts and days of the week, including weekends, and place students in multiple areas so the number isn’t overwhelming to staff. One-to-one observation and oversight becomes challenging under these circumstances. In addition, clinical instructors keep current documentation on

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each student. Before starting the clinical faculty program, participants hadn’t considered the high level of organization and time constraints associated with teaching. As they progressed with both theory and clinical portions of the course, they learned efficient ways to take notes daily, prioritizing responsibilities for those who needed direct oversight, communicating with students by using cell phones (when appropriate), and addressing challenges sooner rather than later. Patience needed Expert nurses tend to act quickly and decisively when an emergency or unexpected situation arises. Realizing that an immediate response might not always be beneficial in a teaching situation made some participants question their natural responses. One said, “I’m afraid to allow the student to problem solve and serve as a guide.” This participant further clarified that she didn’t know if she’d be patient enough to wait for a response. Reverting to the role of clinical expert is the fallback position that new faculty often take. Finding the balance between teaching and taking action is a novice teaching skill. Lessons learned The strategies presented here address many challenges identified by new nursing faculty. Recognizing the potential speed bumps early in the program let the participants begin developing coping strategies early in their role transition. Faculty teaching this program shared examples from their own practice to illustrate the challenges and solutions. This initial information brought up concerns that participants may not have considered

Five challenges of transitioning to the clinical faculty role10,11 1. Little time for transition to the new position 2. Difficulty establishing credibility 3. Inadequate time management skills 4. Spotty mentorship 5. Change in status from expert nurse to novice faculty.

before starting the class. A related goal was to equip them with tools to deal with such challenges so that they’d be able to begin to cope adequately as soon as they began their clinical preceptorship. In the clinical setting, they were encouraged to practice some of the skills discussed, trying different ones as they progressed. For most, this was a very positive experience. The fact that almost 2 years after completing the program most participants were still teaching lends credibility to the approach taken. Incentives are needed. Initially, the clinical faculty program was funded by a grant, and free tuition was provided for those who were accepted. Since that time, the program has become self-supporting, meaning that nurses now have to pay for it and enough nurses have to take the class to support it. Consequently, enrollment has waned. For at least five participants, the program hasn’t yet led to clinical faculty positions, but it’s motivated them to advance their education. They’re currently in master’s or doctoral programs. Identifying opportunities to enhance current professional abilities and foster new nurse educators needs to be marketed in a positive way. The number of faculty won’t increase substantially any time soon, but with the recent changes in healthcare, the need for nurses will expand in the not-too-distant future. According to the Bureau of

Labor Statistics’ employment projections for 2012 to 2022, the RN workforce is expected to grow by 500,000 jobs by 2022.13 At the same time, another 500,000 nurses will be needed to replace those who will retire. Small projects such as this demonstrate just one way to help increase the number of faculty needed. Implications for the future Recent political decisions mandate a stronger drive to increase nursing faculty. The question is “How can experienced nurses be incentivized to join the ranks of educators?” One solution to consider is approaching current expert nurses and providing an educational experience that demonstrates the benefits associated with teaching. Educational programs should address the five challenges described when undertaking educational preparation for clinical roles. Service organizations, such as hospitals and clinics, might wish to work with staff to develop a basic tool chest of teaching strategies so that staff may consider clinical instruction as a potential option. Identifying various tools to address different learning situations and then testing for their effectiveness could enhance the delivery of clinical education and minimize the anxiety new faculty experience when entering the field. Ready, set, teach? If you’ve been inspired to transition to the role of clinical instructor, take May l Nursing2015 l 25

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the first step by researching programs available in your area or online. You can make a difference. ■

6. Mann KV. Theoretical perspectives in medical education: past experience and future possibilities. Med Educ. 2011;45(1):60-68.

openings due to growth and replacement needs, 2012 and projected 2022. 2013. http://www.bls. gov/news.release/ecopro.t08.htm.

7. Benner P. From novice to expert. Am J Nurs. 1982; 82(3):402-407.

REFERENCES

8. Phillips JM, Vinten SA. Why clinical nurse educators adopt innovative teaching strategies: a pilot study. Nurs Educ Perspect. 2010;31(4):226-229.

14. Seaman M. Bloom’s taxonomy: its evolution, revision, and use in the field of education. Curriculum and Teaching Dialogue. 2010-2011;13 (1-2):29-43.

1. American Association of Colleges of Nursing. Nursing faculty shortage. 2014. http://www.aacn. nche.edu/media-relations/fact-sheets/nursingfaculty-shortage.

9. Boyd P, Lawley L. Becoming a lecturer in nurse education: the work-place learning of clinical experts as newcomers. Learning in Health and Social Care. 2009;8(4):292-300.

2. Fang D, Li Y. Special survey on vacant faculty positions for academic year 2011-2012. 2011. American Association of Colleges of Nursing. http://www.aacn.nche.edu/leading-initiatives/ research-data/vacancy11.pdf.

10. Gormley DK, Kennerly S. Predictors of turnover intention in nurse faculty. J Nurs Educ. 2011;50(4):190-196.

3. Hewitt P, Lewallen LP. Ready, set, teach! How to transform the clinical nurse expert into the parttime clinical nurse instructor. J Contin Educ Nurs. 2010;41(9):403-407.

11. Cash PA, Doyle RM, von Tettenborn L, Daines D, Faria V. Working with nurse educators’ collective wisdom: implications for recruitment and retention. Nurs Econ. 2011;29(5):257-264.

4. Lovecchio CP, DiMattio MJ, Hudacek S. Clinical liaison nurse model in a community hospital: a unique academic-practice partnership that strengthens clinical nursing education. J Nurs Educ. 2012;51(11):609-615.

12. Cangelosi PR, Crocker S, Sorrell JM. Expert to novice: clinicians learning new roles as clinical nurse educators. Nurs Educ Perspect. 2009;30(6): 367-371.

5. Roehrs CI. Getting started: needs and preferences of Colorado faculty for graduate education in nursing. Nurs Educ Perspect. 2011;32(2):84-88.

13. U.S. Department of Labor. Bureau of Labor Statistics. Economic news release. Table 8. Occupations with the largest projected number of job

15. Henderson G, Nash SS. Excellence in College Teaching and Learning: Classroom and Online Instruction. Springfield, IL: Charles C. Thomas; 2007. 16. Schneider J. Remembrance of things past: a history of the Socratic method in the United States. Curriculum Inquiry. 2013;43(5):613-640. 17. McNett S. Teaching nursing psychomotor skills in a fundamentals laboratory: a literature review. Nurs Educ Perspect. 2012;33(5):328-333. Kathleen Tornow Chai is the acting director of the School of Nursing at California State University, Dominguez Hills, in Carson, Calif.

The author has disclosed that she has no financial relationships related to this article.

DOI-10.1097/01.NURSE.0000463668.14218.5b

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Considering a clinical faculty role? Strategies for success.

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