Creating an Inclusive Science for Nursing Education
NO ONE WOULD ARGUE that research-based nursing practice is not needed or that there should not be a science of nursing. That would be an anathema. Yet, how are students best prepared for practice in ways that reflect the research base of our discipline? There is a nascent and increasingly sophisticated emerging science for nursing education that makes research-based teaching and practice possible. However, the challenges to creating a science of nursing education are substantial. With no funding available from the National Institute for Nursing Research and the need to go outside the discipline for funding, grants are often small, resulting in studies that are rarely generalizable or replicable.
There was a time, in the not so distant past, when the same could be said about nursing research addressing clinical problems. Cadres of nurse scholars once pushed for funding, controlled by the profession, to ensure that both current and future nursing practice would be research based. These efforts were substantial. They occurred while scholars and scientists pooled their resources and struggled to work together in grass-roots research that began to define the phenomena of concern and to demonstrate the potential for clinical nursing research to influence future patient care. Perhaps efforts to create an inclusive science of nursing education reflect the discipline’s ongoing commitment to research that informs our practice. We are responding now as we did then.
The need for substantive funding to support nurse researchers who struggle to sustain educational research programs is imperative. Without funding for educational research, assistant professors, many with recent PhDs, must develop clinical research programs in order to get funding, establish a research trajectory, and secure tenure. Senior nurse researchers are being called to develop sustained educational studies using the methodological sophistication of their clinical research programs.
Without tenured faculty studying nursing educational issues over time, the discipline loses the collective wisdom and expertise of senior faculty members and research into preparing future generations of nurses becomes haphazard and of limited utility. The lack of a sustained funding stream in nursing education further precludes examining educational issues over time, from multiple perspectives and using multiple methods. An inclusive science of nursing education demands this level of research expertise to provide an evidence-based nursing education.
The discipline also must begin to more actively challenge the belief that research in nursing education is not nursing research but educational research (best conducted within the discipline of education). This belief is based on the assumption, for example, that teaching merely involves taking a learning theory from higher education and applying it to a nursing course with nursing students. Furthermore, while in higher education there are a handful of learning theories, even in the discipline of education the practice of teaching remains largely undertheorized, and a research base for the discipline is likewise depauperate.
Calls for an inclusive science of nursing education are becoming more frequent (1,2) as the discipline faces substantive challenges in both academic and practice settings. The call for a science of nursing education resonates and provides an opportunity to study teaching and learning as a disciplinary practice. That is, it allows for the exploration of theories from higher education to shape and inform nursing education as well as to discover and develop pedagogies for nursing education that shape and are shaped by nursing practice.
One such pedagogy, Narrative Pedagogy, was developed from studying how nursing teachers, students, and clinicians actually teach and learn nursing (3). Continuing to investigate the practices of schooling, learning, and teaching will further increase our disciplinary understanding of the nature of teaching and learning in nursing and offers a view of research in nursing education that is consistent with the definition of nursing research.
What is the nature of an inclusive science of nursing education? Perhaps it is timely to reclaim an understanding of science that is inclusive – a definition that would include multimethod, multisite, and multiparadigmatic studies. An inclusive science for nursing education would embrace scientific, critical, feminist, phenomenological, and post-modern studies. In this way, interpretive scholarship is a co-equal contributor to the inclusive science of nursing education. Likewise, an inclusive science for nursing education would be multipedagogical as research in nursing education examines pedagogies that are new to nursing as well as those generated by studying actual nursing situations.
Pedagogies are particular approaches to schooling, learning, and teaching. The most common pedagogy is conventional pedagogy (outcomes or competency-based nursing education). Alternative pedagogies were developed in higher education in the 1970s and 1980s and while new to nursing, offer substantive new possibilities for nursing education. Pedagogies are proliferating but they are too often not researched or evaluated and many of their possibilities lie slumbering. On the other hand, testing strategies that use a particular pedagogy is not to test the pedagogy in its entirety. Critical reviews of extant research in nursing education are central to assuring an inclusive science of nursing education that reflects all the pedagogies, conventional, new, and those as-yet-unthought.
The Curriculum Revolution sponsored by the National League for Nursing in the early 1990s began a substantive critique of outcomes and competency-based nursing education (4,5), and since that time, nursing research has been investigating and developing substantive new pedagogies. In the current literature on the interpretive pedagogies, there is increasing evidence of studies that both critique conventional pedagogies and explore reform through increasing use of those pedagogies new to nursing (3,6-9). It is to be noted that these alternative pedagogies co-occur and often arise out of conventional pedagogies. And research is showing that many teachers are using interpretive pedagogies without being aware of the approaches they are embracing (10). As an inclusive science of nursing education emerges, reform that is research based is further developing new pedagogies to overcome some of the problems not addressed by conventional approaches. In this way, innovation and reform that is research based, often using the alternative pedagogies, are sustained. Perhaps at the heart of reform and using these alternative pedagogies is faculty development and calling faculty back to their own learning.
Conventional pedagogies and outcomes education are necessary but not sufficient to meet the demands of contemporary nursing education. For example, during times of faculty shortage, the most time-consuming pedagogy, outcomes education, continues to be the pedagogy that is predominantly used in schools of nursing. An inclusive science of nursing education might investigate questions such as: How might the pedagogies new to nursing free up faculty and students in ways that create time for thinking and learning together? What is gained and lost when alternative pedagogies are enacted in particular courses or in diverse schools of nursing? What are the markers of what works and what does not work when using alternative pedagogies that decenter cognitive gain? Would using small teams of researchers in a variety of schools, sharing resources and expertise, contribute to longitudinal research so necessary in a research-based nursing education?
Perhaps challenging the taken-for-granted assumptions of conventional pedagogy will identify best practices and contribute to an evidence-based nursing education. In this issue, Pamela Jeffries provides a framework for further research in simulation and Marjorie Schaffer, Pamela Nelson, and Emily Litt develop a strategy to ascertain public health competencies in baccalaureate students. These studies contribute to a research-base in the conventional pedagogies.
Studies are needed to extend and document the interpretive pedagogies as well. Carmella Mikol presents a description of how a critical pedagogy has fostered a lecture-free school of nursing, and Alix McGregor explores the oppressive practices of teachers. Pamela Cangelosi and Karen Whitt explicate a review of literature and draw attention to questions for future research, specifically the evaluation of accelerated degree programs and how these programs are proliferating without research. Pamela Ironside, Jennie Gunn, and I provide a hermeneutical exegesis of the themes embedded in the Diekelmann literature of the Curriculum Revolution and provide interpretive scholarship in the exploration and genesis of new pedagogies. Ironside contributes an interpretive phenomenological study to explicate the meanings and significances of excellence as embedded in the experiences of students and teachers in contemporary nursing education.
In this way, this special issue of Nursing Education Perspectives reflects a gathering of methods, pedagogies, and perspectives toward an inclusive science of nursing education. It presents refereed multimethod, multisite, and multiparadi\gmatic studies toward creating an inclusive science of nursing education that reflects current pedagogical innovation – challenging our assumptions about our day-to-day practices and experiences and proposing and evaluating alternatives. It brings together conventional, critical, feminist, postmodern, and phenomenological perspectives of our teaching practices and the ways of thinking about what teachers and students do and how they do it. In response to the NLN call for creating a science of nursing education, perhaps an inclusive science will develop that is grassroots, multiparadigmatic, multisite, multimethod, and multipedagogical, leading to substantive innovation through research!
References
1. Diekelmann, N. L., & Ironside, P. M. (2002). Developing a science of nursing education: Innovation with research. Journal of Nursing Education, 41, 379-380.
2. National League for Nursing. (2002). Funding for Nursing Education Research. [Position Statement.] New York: Author.
3. Diekelmann, N. L. (2001). Narrative pedagogy: Heideggerian hermeneutical analyses of lived experiences of students, teachers, and clinicians. Advances in Nursing Science, 23(3), 53-71.
4. Diekelmann, N. L., Ironside, P. M., & Gunn, J. (2005). Recalling the revolution: Innovation with research. Nursing Education Perspectives, 26, 70-77.
5. Ironside, P. M. (2005). Working together, creating excellence: The experiences of teachers, students, and clinicians. Nursing Education Perspectives, 26, 78-85
6. Diekelmann, N. L. (2003). Thinking-in-action journals: From self-evaluation to multiperspectival thinking. Journal of Nursing Education, 42, 482-484.
7. Doane, G.A. H. (2002). Beyond behavioral skills to human- involved processes: Relational nursing practice and interpretive pedagogy. Journal of Nursing Education, 41, 400-404.
8. Duchscher, J. E. B. (2003). Critical thinking: Perceptions of newly graduated female baccalaureate nurses. Journal of Nursing Education, 42, 14-27.
9. Swenson, M. M., & Sims, S. L. (2003). Listening to learn: Narrative strategies and practices in clinical education. In N. L. Diekelmann (Ed.), Interpretive studies in healthcare and the human sciences, Vol. 2: Teaching practitioners of care: New pedagogies in the health professions. Madison: University of Wisconsin Press.
10. Diekelmann, N. L. (2003, April 4-5). New pedagogies/new possibilities: Shaping our future in nursing education. Paper presented at Exploring New Pedagogies: Creating a Science for Nursing Education, National League for Nursing, Minneapolis, MN.
NANCY L. DIEKELMANN, PHD, RN, FAAN
Nancy L. Diekelmann, PhD, RN, FAAN, is Helen Denne Schulte Professor Emerita, University of Wisconsin-Madison School of Nursing. Along with Pamela M. Ironside, PhD, RN, she is guest editor for this special issue.
Copyright National League for Nursing, Inc. Mar/Apr 2005