Nursing and Health Policy Perspectives
We must take a critical look at nursing education
Article first published online: 21 AUG 2013
© 2013 International Council of Nurses
International Nursing Review
Volume 60, Issue 3, page 281, September 2013
How to Cite
Adler-Collins, J. K. (2013), We must take a critical look at nursing education. International Nursing Review, 60: 281. doi: 10.1111/inr.12051
- Issue published online: 21 AUG 2013
- Article first published online: 21 AUG 2013
The new members of the International Council of Nurses (ICN), China and Palestine, bring the membership total to 135 national nurses associations. The rich diversity of cultures and heritages that ICN represents under the banner of global nursing presents us with unprecedented opportunities and challenges in terms of what we can share with each other, as individuals or member organisations, to shape nursing and healthcare policies and practices. The newly elected ICN President, Judith Shamain, has called on nurses to have an impact in whatever area of work we can influence.
Nursing quite naturally focuses a great deal of attention on the clinical setting, nursing skills and praxis at the bedside. Such attention has brought about new areas of nursing research grounded in evidence-based practice. Yet for all the advances, one area of nursing remains relatively unexamined and has few accounts of evidence-based practice – the complex issue of nurse education. While it is a cornerstone of any nation, education is at the same time highly problematic and difficult. It requires great skills in the present to project the skills needs and mix, resources and workforce frameworks the nation will require in the future in a rapidly changing world.
It is time for us to take a critical look at nursing education. We can no longer gloss over the cracks and pretend that no problems exist. As an educator and a nurse, I truly worry about where nurse education is headed, and the fact that nearly all nursing curriculums in developing countries are dominated in content and philosophy by Western forms of knowledge.
Heated debates rage across the theory/practise divide as to what constitutes a ‘good’ nursing education, and what elements should or should not be in a ‘good’ curriculum. Each special interest group has its own opinion on the knowledge, knowing and praxis requirements. In addition, the colonization of education curriculums remains one of the most important challenges facing nursing today, with nurse education programmes often failing to reflect cultural knowing and diversity. Many developing countries are struggling to establish their health education systems using higher degrees awarded by universities outside their cultures. The ministries of health in many developing countries face an absence of nurse-trained educators/teachers, particularly indigenous ones.
As a matter of urgency, we have to address the complex issues of professional education and become effective agents of sustainable change. We must speak from our communities of practice and make our voices heard at health trusts, university boards and government policy meetings both at national and international levels. We must do so while remaining grounded in our advocacy for our patients, profession and countries. Working across the disciplines of education, we can nurture the talent and expertise available through the ICN membership, which is not limited by geographical position, access issues or language.
The extent of what we can accomplish is limited only by our desire to act and become involved. If we are to create the impact asked of us by our president, we need to rise above entrenched responses and be creative and innovative in seeking workable solutions step by step.
Nursing needs to recognise not only in words but in action that not all nursing takes place at the patient's bedside, and that different educational beliefs and cultural conditions need to hold equal educational value across any curriculum. No individual form of knowing should be given preference over another. Nurse educators, once suitably qualified as teachers maintaining clinical practice and teaching skill sets, should work as educational teams to seek out and co-create new forms of global nursing knowledge. Then, and only then, will we be in a position, as a profession, to have an impact in the places where our voices are currently silent and excluded.