Journal of Nursing Education

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EDITORIAL 

Are We Asking the Right Questions? JNE's Year in Review

Christine A Tanner, PhD, RN, FAAN

Abstract

I found out just a few months ago that there are nearly 50 journals devoted to pedagogy in higher education; the vast majority of these are disciplinespecific. That means that publishers, editors, editorial boards, peer reviewers, and authors all believe that there is something peculiar about the education of students in their discipline that goes beyond what can be offered by the general literature on higher education. It seems like what's peculiar might fall into two categories: (1) that whatever is a big issue or hot topic in the discipline probably has particular pedagogical implications (e.g., some new scientific discovery might require a different kind of teaching in chemistry), and (2) that teachers ofthat discipline need specialized kinds of knowledge to deal with the problems and issues that surface in their day-to-day practice as teachers. If JNE is really doing its job as a discipline-specific pedagogical journal, we should see reflected on its pages nursing education's response to important issues in health care and nursing practice as well as exploration of the problems that teachers of nursing encounter in their everyday practice. So how are we doing?

The big issues in health care are obvious. Health care reform is on the horizon and there seems to be general agreement that nursing practice will change dramatically. During 1993, we've published little related to our response to health care reform. This is not a surprise, since trying to figure out both what and how to teach for a reformed system is like hitting a moving target. We are attending to the development of clinical practice sites in the community and to the notion that nurses may be important agents of reform as political activists. And look for our May 1994 special issue devoted to nursing education and health care reform. It promises to be both provocative and enlightening.

Other issues in health care have surfaced on these pages. We have investigated ways to improve nursing students' attitudes toward particular vulnerable groups, assuming that improved attitudes enhance the likelihood that our students will choose to work with these groups and that their care will be better. Specifically, we have studied the effectiveness of workshops and/or clinical experiences in improving attitudes toward persons with AIDS, toward disabled individuals, and toward the elderly. It might be useful now to explore other outcomes of our educational interventions, such as the quality of care actually delivered, or even the propensity of our students to seek out employment opportunities where they will be giving care to vulnerable populations.

Increasingly, we are recognizing that rapid changes in health care, the enormous knowledge explosion, demands for increased accountability in higher education coupled with declining resources, and a diverse student population compel us toward the development of new pedagogies. During the past year, we have explored feminist pedagogy and examined the centrality of caring in new paradigms for nursing education. Numerous alternative pedagogies are yet to be explored for their relevance and utility in nursing education. To promote further discussion about alternative educational paradigms, a special issue of JNE will be devoted to narrative pedagogy in May 1995.

Public discussion about ethical issues in health care has become daily fare for most Americans. Moreover, ethical issues are central to the practice of most nurses. Interestingly though, during the past year we've , published virtually nothing in JNE about the moral dimensions of nursing practice - ways in which we explore it with our students, how we help them develop in their own moral agency, or even minimally how we might help our students be prepared for the dilemmas they will surely…

I found out just a few months ago that there are nearly 50 journals devoted to pedagogy in higher education; the vast majority of these are disciplinespecific. That means that publishers, editors, editorial boards, peer reviewers, and authors all believe that there is something peculiar about the education of students in their discipline that goes beyond what can be offered by the general literature on higher education. It seems like what's peculiar might fall into two categories: (1) that whatever is a big issue or hot topic in the discipline probably has particular pedagogical implications (e.g., some new scientific discovery might require a different kind of teaching in chemistry), and (2) that teachers ofthat discipline need specialized kinds of knowledge to deal with the problems and issues that surface in their day-to-day practice as teachers. If JNE is really doing its job as a discipline-specific pedagogical journal, we should see reflected on its pages nursing education's response to important issues in health care and nursing practice as well as exploration of the problems that teachers of nursing encounter in their everyday practice. So how are we doing?

The big issues in health care are obvious. Health care reform is on the horizon and there seems to be general agreement that nursing practice will change dramatically. During 1993, we've published little related to our response to health care reform. This is not a surprise, since trying to figure out both what and how to teach for a reformed system is like hitting a moving target. We are attending to the development of clinical practice sites in the community and to the notion that nurses may be important agents of reform as political activists. And look for our May 1994 special issue devoted to nursing education and health care reform. It promises to be both provocative and enlightening.

Other issues in health care have surfaced on these pages. We have investigated ways to improve nursing students' attitudes toward particular vulnerable groups, assuming that improved attitudes enhance the likelihood that our students will choose to work with these groups and that their care will be better. Specifically, we have studied the effectiveness of workshops and/or clinical experiences in improving attitudes toward persons with AIDS, toward disabled individuals, and toward the elderly. It might be useful now to explore other outcomes of our educational interventions, such as the quality of care actually delivered, or even the propensity of our students to seek out employment opportunities where they will be giving care to vulnerable populations.

Increasingly, we are recognizing that rapid changes in health care, the enormous knowledge explosion, demands for increased accountability in higher education coupled with declining resources, and a diverse student population compel us toward the development of new pedagogies. During the past year, we have explored feminist pedagogy and examined the centrality of caring in new paradigms for nursing education. Numerous alternative pedagogies are yet to be explored for their relevance and utility in nursing education. To promote further discussion about alternative educational paradigms, a special issue of JNE will be devoted to narrative pedagogy in May 1995.

Public discussion about ethical issues in health care has become daily fare for most Americans. Moreover, ethical issues are central to the practice of most nurses. Interestingly though, during the past year we've , published virtually nothing in JNE about the moral dimensions of nursing practice - ways in which we explore it with our students, how we help them develop in their own moral agency, or even minimally how we might help our students be prepared for the dilemmas they will surely encounter in their practice.

Cultural diversity and multiculturalismi are central themes in both health care reform and in debates occurring within higher education. An entire issue of JNE was devoted to multiculturalism in nursing education; in it, we explored ways in which nursing can be prepared to meet health care needs of America's increasing racial diversity; we examined the Eurocentrism of nursing's curriculum and we highlighted particular learning needs of a racially/culturally diverse student population. We have only begun to address these questions. We need continued critical work on the cultural assumptions deeply embedded in nursing curricula; we need to continue to extend our understanding of and response to the experiences of our ethnically diverse student population.

We are still struggling about how to support faculty clinical practice without making their workload totally intolerable. We are equally concerned about students' role strain. We continue to explore the best ways to teach certain skills, as well as how to teach research, research utilization, and writing, and many exciting educational innovations have been offered. What is strikingly absent from the past year's volume of JNE, and, indeed, from previous volumes, is clinical teaching and learning.

While we've explored many alternative sites, we've not had much in JNE about the booming academic nursing centers and their role in modeling what's possible in nursing practice. Moreover, we have had very little to say on these pages about the nature of clinical teaching and learning. Many years ago, Betty Pugh reported that much of the research on clinical teaching was about students' perceptions of effective clinical teachers. In the past few years we've had at least one report of ways to evaluate clinical faculty. We've offered some ways to approach leadership and management experiences. But we've seen very few new ideas about, for example, how clinical experiences might be organized across an entire curriculum, the nature of those clinical experiences, ways in which we might evaluate student performance (always a big issue among nursing faculty), issues in grading clinical performance, and, probably more important than anything, what and how students learn from their experience.

Because clinical experience is central to learning a practice discipline and because there seem to be so many recurring issues that surface in day-to-day clinical teaching, it's time to turn some of our attention here. The November 1994 issue of Journal of Nursing Education will be devoted to clinical teaching and learning. Manuscript submissions are due by April 1, 1994.

So, are we asking the right questions? I think we're at least moving in the right direction; we've some gaps, at least in terms of what's been published in JNE. There's also been subtle but perceptible movement in the ways in which we frame the questions. Behavioral pedagogy that so dominated our literature a decade ago has clearly receded in importance. While empirical studies continue to be important, we are seeing the same diversity in approaches to scholarship that the rest of the profession is enjoying. Phenomenological, feminist, and critical scholarship are becoming more common as appropriate ways to frame and explore pressing questions. Through these pages, I hope that we can continue to provoke, prod, and encourage thoughtful reflection on nursing education; through such scholarship may our practice as teachers advance.

10.3928/0148-4834-19940101-03

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