Journal of Nursing Education

Major Article 

Transitional Experiences: From Clinical Nurse to Nurse Faculty

Danielle M.E. Hoffman, DNP, RN, TNS, EMT-P

Abstract

Background:

A limited pool of nurse faculty has affected enrollment of nursing students and the ability to produce the nursing workforce needed for the evolving health care system. The experiences clinical nurses face as they transition to the faculty role may contribute to the faculty shortage.

Method:

A qualitative descriptive study was conducted to explore the lived experiences of clinical nurses as they entered the nurse faculty role. A purposive sample was recruited from two higher learning institutions in the midwestern United States. Data analysis was performed using Colaizzi's method.

Results:

Four themes emerged: Perpetual Novice, Faculty as a Resource, Teaching Ambiguity, and Student as My Patient. The prominent theme surrounded the idea that the faculty were in a state of constant change as a perpetual novice.

Conclusion:

Implications exist for academic nursing program administration to invest in developing nurse faculty skill level and ease the transition to the role. [J Nurs Educ. 2019;58(5):260–265.]

Abstract

Background:

A limited pool of nurse faculty has affected enrollment of nursing students and the ability to produce the nursing workforce needed for the evolving health care system. The experiences clinical nurses face as they transition to the faculty role may contribute to the faculty shortage.

Method:

A qualitative descriptive study was conducted to explore the lived experiences of clinical nurses as they entered the nurse faculty role. A purposive sample was recruited from two higher learning institutions in the midwestern United States. Data analysis was performed using Colaizzi's method.

Results:

Four themes emerged: Perpetual Novice, Faculty as a Resource, Teaching Ambiguity, and Student as My Patient. The prominent theme surrounded the idea that the faculty were in a state of constant change as a perpetual novice.

Conclusion:

Implications exist for academic nursing program administration to invest in developing nurse faculty skill level and ease the transition to the role. [J Nurs Educ. 2019;58(5):260–265.]

The shortage of nurse faculty in academia is ongoing across the country, which affects the number of prospective nursing students who can be accepted into a nursing program (American Association of Colleges of Nursing, 2017). With an aging population and an increasingly more complex health care system, the need for nurses steadily increases. Lack of nurse faculty hinders the ability to produce the nursing workforce needed for the evolving health care system. The National League for Nursing (n.d.) purports that focusing on health care workforce education can help reform challenges in the current health care system and has recognized that lack of faculty intensifies the problem.

A multitude of reasons may affect the nurse faculty shortage, including the experiences clinical nurses face as they transition to the faculty role. Identifying and influencing factors that affect the transitional process may equate to increased faculty retention and suggest a remedy to the national nursing shortage by indirectly increasing the supply of nurses. The purpose of the study was to explore the lived experiences that affect the transition of clinical nurses as they entered the nurse faculty role and to describe participants' collective transitional experiences. Additionally, the study seeks to investigate any differences or similarities between the transitional experiences of nurse faculty from varying types of higher learning institutions.

Literature Review

Transition from clinical practice to academia has been researched periodically over the past decade. Research has focused on transitional role development, transitional role strain, and faculty retention. When role development practices, such as financial compensation, balance, and supportive collegial atmosphere, were incorporated into the transitional process, a successful transition and enculturation of novice nurse faculty to the teaching role resulted (White, Brannan, & Wilson, 2010).

Contrarily, transitional role strain was a barrier to transition, including financial barriers, demanding workloads, lack of preparation for teaching, and a strained collegial atmosphere (Anderson, 2009; Schriner, 2007; Specht, 2013). Financial constraints, such as low salary, were a common theme found in various studies (Anderson 2009; McDonald, 2010). An unmanageable workload and lack of supportive collegial environment, such as incivility, lead to poor integration into the academic culture (Bittner & O'Connor, 2012). An indiscriminate and unstructured orientation was identified as a barrier to the transitional role development of a novice faculty (Weidman, 2013).

Theoretical Framework

Benner's (1982) novice-to-expert framework lends perspective on how a nurse transitions through stages of skill acquisition from novice to expert knowledge and practice. Benner's framework anchored the design of the study and was the lens with which the participant experiences were viewed. Figure 1 represents a directional model of the transition from novice to expert, depicting how transition can be cyclical in that if a nurse enters a new area of practice, the nurse is once again a novice.

Novice-to-expert directional model.

Figure 1.

Novice-to-expert directional model.

Method

A qualitative descriptive design was used to examine transition from clinical nurse to nurse faculty. The design followed a systematic and logical approach to gather rich data and provide a comprehensive description of the participants' perspectives. A broad question, refined through interview questions, served as the basis for the study and centered around lived experiences of nurse faculty: What are the experiences of clinical nurses who have transitioned into the role of nurse faculty?

Ethical Considerations

Approval from each university's institutional review board was obtained to ensure protection of human subjects. Participants were informed of the intent and process of the study. All participants signed consent forms confirming their understanding and agreement to participate in the study. Confidentiality was maintained by keeping the interview process discrete and deidentifying all data.

Sample

A purposive sample consisted of 15 nurse faculty recruited from two higher learning institutions in the midwestern United States. Participant clinical backgrounds and specialties were varied. Participant demographics may be found in Table 1.

Participant Demographic Data (N = 15)

Table 1:

Participant Demographic Data (N = 15)

Data Collection

Data were collected over a 1-month period in audiorecorded, semistructured, face-to-face interviews that were 30 to 60 minutes in length. The data collection instrument in the study was the researcher, and dialogue was the research tool. Following a brief, self-administered demographic questionnaire, participants were interviewed. Open-ended questions posed during the interview centered on the participants' experience when transitioning into the faculty role; questions are provided in Table 2. Emergent and clarifying questions were used to elicit further meaning. During the interview, the researcher listened, observed participants, took field notes, and conducted random member checking to clarify meaning related to the participants' lived experiences. Saturation was determined when no new information was being gleaned, responses were repetitive, and previously collected data were confirmed. Audio data and field notes were transcribed verbatim for analysis.

Interview Questions

Table 2:

Interview Questions

Data Analysis

Colaizzi's (1978) method for qualitative research studies was the systematic approach used to examine, analyze, and synthesize data. An exhaustive review of data began by reading the demographic descriptions to delineate the background of each participant. Transcripts were compared with the audio records for accuracy. After audio record accuracy was confirmed, multiple readings of the transcripts were conducted. Data were coded, reduced, and organized for further analysis. Significant participant statements, related to the research question, were abstracted from the data. Data were grouped and compared to formulate meanings from the participants' experiences. Data were reviewed by both the researcher and peer reviewer independently and were refined further through consensus discussions. As a final validating step, the researcher verified results with an expert panel.

Methodological Rigor

Numerous strategies were used to ensure rigor, trustworthiness, and that the data were analyzed in a way that ensured participants' experiences were fairly described. Strategies included a continual bracketing process via reflexive journaling, member checking conducted throughout the interview process, an audit trail detailing study decisions, and multiple reviews of audiorecordings and interview notes to ensure stability of the interview process. Rigor was also established by triangulation, where the researcher, peer reviewer, and expert panel confirmed the results.

Results

The data review indicated no relationship between participant demographic variables and experiences encountered during transition to the faculty role. Analysis of the data revealed four emergent themes. Figure 2 provides a model of the four themes stemming from the central concept of transition to the nurse faculty role.

Emergent themes from the experience of transitioning to nurse faculty.

Figure 2.

Emergent themes from the experience of transitioning to nurse faculty.

Perpetual Novice

The most prominent theme identified was the Ideation of the Perpetual Novice. The idea of constantly starting over, not developing, or remaining in a continuous state of newness defined perpetual novice. The transition from a novice to competent, proficient, and even an expert is unattainable. Participants shared feelings and difficulties with starting over. One participant stated:

I think you really don't get a handle on things, I would say [for] about 3 years, really. I hear other people say that too. Takes you about 3 years to…because the other thing is…we're constantly, it seems like, preparing to teach a new course.

Another participant described the difficulty of building on coursework when there was not an opportunity for repetition:

I've had new coursework every semester, not the same classes. This semester, I only had one new course but if you are teaching something for the first time and you don't get to repeat it, then there's no opportunity to build on it.

In addition to being in a state of continual change, participants reported they were still transitioning. Reports of remaining in transition arose from the participants experiences with new situations occurring daily. A participant described this common experience by stating:

I feel like I'm still transitioning. There's not a day that goes by [when] something comes up that you're [thinking], “Oh I haven't faced this before.”

Faculty as a Resource

Participants reflected on their experiences when entering the faculty role and the orientation process. Participants described entering a welcoming and supportive environment; however, orientation to the faculty role was reportedly inconsistent. Faculty experiences varied from no orientation to formalized orientation with an assigned mentor. A commonality was that all participants sought peer faculty as a resource and described positive experiences regarding faculty peers serving in the role of a resource. Faculty as a Resource was the most frequent theme discovered. One participant illustrated this theme with the comment:

But it's nothing for us to walk down the hall and say, “I have this situation,” or “People weren't engaged today in class, what did you experience what should I do?” That kind of thing. My resources are my colleagues.

Multiple participants related their experience with Faculty as a Resource by describing having someone with more experience or expertise to guide them. To the participants, faculty peers served as a sounding board for questions. A participant imparted:

Everybody in the nursing department was very good at being willing to help me so I could go to anyone and ask questions about, “I'd like to do this. What do you think of this?” or, “Is it okay if I do this?” That was nice that I felt free to go to anybody.… I always had someone to be able to bounce things off of.

Faculty described the need to seek experienced faculty as a resource because the academic environment was so different from that of the clinical environment. A participant shared:

I think it's just figuring out your resources and who can be most helpful to you when you run into things you don't know because I was stepping into really a whole new career. I didn't realize it at the time that it was going to be so different, but it was so different.… There were so many people that had more experience than me that had been here [and] were very willing to talk with me.

Teaching Ambiguity

Participants indicated that despite an advanced degree, individuals were uncertain in terms of teaching. Nearly all participants asserted that an understanding of teaching should be predicated by formal preparation in a graduate degree program. Faculty participants described an absence of preparation for teaching or lack of instructional processes in their various graduate education programs. The lack of preparation resulted in feelings of ambiguity related to teaching as illustrated in two participants' comments:

I think that because my specialty was not in teaching or education and that kind of stuff, a lot of times I have a lot of self-doubt, like, “Am I doing this right? I'm not doing this right?”

Coming into being new faculty, even though there is a framework for each class, which is literally a course description and the objectives for the course, you're still figuring out what you're going to teach for content. In a clinical role, you're educated to be a clinician. As a faculty, I had no education about how to do education.

Often, faculty participants shared an understanding of how to teach a patient but were at a loss about how to formally teach students in the academic environment. Without having any experience in the formal academic setting, participants described the need for a learning curve and feelings of having to “figure it out.” One participant recalled:

It's so different than, working outside, figuring out how to write tests and test questions, and dealing with student concerns, and just those things that really…we're not trained for, even within a program where I was taught a lot of education-type stuff, but it was more within a hospital setting. So, there's a lot of the formalities in an education setting that…you kind of learn as you go….

Entering the role of faculty as a beginner, described as being “brand new,” contributed to lack of confidence during the transition period for nurse faculty. Lack of confidence was clearly stated by one participant:

New educator, what do you do? Nobody tells you in school. What happens when they all fail that exam? Nobody tells you about that in school. “I think I'm a horrible teacher.” That's that thing when you're that brand-new educator, you don't have that confidence yet in yourself.

Another participant conveyed:

It is like transitioning into a brand-new role and almost like being a brand-new nurse again because you're bringing in all of this background, but you're coming in and you're essentially a beginner again. I don't even know how many years that it's going to take me until I can say I feel really confident about what I'm doing.

In addition to identifying aptitude in teaching as an under-girding for the nurse faculty role, one participant thought an acumen for the course being taught was also a necessary preparation point. The participant described that clinical knowledge was not enough—rather, a specific knowledge in the course topic was necessary to deliver course content. As the participant explained:

The only thing that felt a little unsettling was if I was teaching a course…. I think one of my very first courses was geriatrics. Of course, I take care of geriatric patients in hospital, but to actually teach the course from that perspective, I had to do a lot of reading myself and preparing. Even though the class was already established, I still had to prepare more myself so that I felt like I was more knowledgeable in teaching [it].

A discrepant point, uncovered during collection and analysis of data, suggested having a sense of teaching or knowledge in teaching led to a more positive transition from clinical nurse to nurse faculty. A single participant had perspectives surrounding a clear preparation in teaching that differed from all other participants. The faculty participant shared:

I had overall a positive experience because my Master's focus was in nursing education. I had theoretical preparation and also clinical experience prior to starting the role as a full-time faculty member. When I transitioned, I already had been aware of many of the things and knew what to expect in terms of how to serve in the faculty role.

Student as My Patient

A unique theme that emerged was Student as My Patient; no other previous studies identified a similar theme. Participants, when describing similarities between the clinical and faculty role, perceived students as their patients. Most participants regarded caring and teaching practices for the student as a parallel to practices that were used with patients. One faculty participant described:

I look at my student as my patient/family. And I'm here to serve them, and the goal of course is for them to be successful and be professional nurses and grow and develop.

Participants indicated that experiences as clinical nurses served as a reference in the faculty role for creating an environment that would meet the needs of students. A participant shared:

What do I need to get done, and how do I make sure that the students are getting what they need, just like we do with clients [in clinical practice].

The analogy of the student as the patient was embedded in nurse faculty reflections of similarities between clinical and faculty roles. In both roles, the participants identified as teachers. Teaching of the student was the same as for the patient. A participant remarked:

I view the work I do as an educator very similar to how I would've delivered care to a patient, going back and reflecting, and [examining] did I provide the best care, or did I present the material the best I could.

A second participant related:

It's just different, we're still teaching. We taught patients all the time. You do patient teaching, patient education, and now we're teaching students.

Discussion

This study contributed the perspectives of nurse faculty who transitioned in differing contexts and at any point in their career to recall experiences of transition and provide insight that was not explored in previous studies. Results of this study revealed remarkable similarities among transitioning faculty, regardless of the participants setting or context. An apparent similarity was faculty experiencing an orientation process of 1 year or less. Moreover, participants described a sense of “things coming together” at the 3-year point after role transition, which is congruent with Benner's (1982) framework. Evidence suggested that experiences surrounding the transition of clinical nurse to the role of nurse faculty were influenced by the ability to advance beyond an introductory level of skill or knowledge, teaching certainty, and utilizing faculty peers as a resource.

Experiences of participants in this study supported findings of previous studies indicating a brief or limited orientation (Schriner, 2007; Weidman, 2013). Consistent with previous research, participants reported common feelings of ambiguity and self-doubt due to limited preparation for the teaching role (Cangelosi, 2014; Schriner, 2007; Specht, 2013). Due to limited understanding, novice faculty commonly sought experienced peer faculty as a resource to discern relevant components of teaching.

Furthermore, this study adds the concept of perpetual novice to the faculty role. Study findings suggested that clinical nurses who transitioned to the role of nurse faculty experienced difficulty surrounding ideals of habitually starting over with new courses, textbooks, and even new curriculum. Routinely starting over contrasts with a natural progression, where knowledge and understanding is gained through transition over time (Benner, 2004). Constantly starting over resulted in the participants feeling as if there is limited ability to build on knowledge, perform, and progress beyond the level of a novice.

An unexpected, yet related finding was in the faculty participants' analogy of the student as the patient. Actions of serving, which were a part of the clinical role for the patient, were translated to practice in the role of nurse faculty for the student. Faculty considered students to be patients, and they likened care and teaching of the student to that of care and teaching of a patient.

Implications for Practice

This study's results have significant implications for nursing program administrators. Results provide clarity on the factors that affect transition and open an opportunity for dialogue between nurse faculty and nursing program administrators. Both nursing program administrators and faculty peers share in the responsibility to facilitate novice nurse faculty in attaining the skills and capabilities necessary for the role.

Nursing program administrators must take an intentional approach to optimizing the transition to academic practice and facilitate novice faculty advancement to a competent level in teaching. First, nursing program administrators should describe the clear expectation that transition to a level of comfort and competence will take beyond a period of 2 years. Reassurance should be offered that both administration and peer faculty will serve as resources during the transition. Second, an expanded and progressive orientation period that aligns faculty resources with transitioning novice faculty should be implemented. The expanded orientation would consist of a gradual and stepwise transition process, developing throughout the course of 2 years, that would include orientation led by an assigned faculty mentor, incorporating team teaching and encouraging use of peer faculty as resources to overcome teaching ambiguity issues that arise, allowing novice faculty to teach the same course (preferably within their clinical expertise) and to use the same course materials during the transition period.

Further, study results can inform and provide important insight for clinical nurses contemplating transition to the role of faculty and for faculty who are in the process of transition. Anderson (2009) posited that becoming a nurse educator is more than adding the role of educator to that of nurse. Highlighting the experiences that arise during the transition period, from the perspectives of faculty who have transitioned, and offering clarity on role expectations will allow transitioning faculty to adapt and progress through transition with less difficulty.

Recommendations for Future Research

To pursue this line of study, additional research is needed to determine whether experiences identified are representative of other faculty roles, such as clinical or adjunct. As this study represented, nurse faculty from one geographic area, future research with a larger geographical area may address this limitation and provide broader representation of the experiences of transition to the faculty role. To gain new information, future research should investigate nurse administrators' perspectives related to transition.

Conclusion

Conclusions drawn from the study provide valuable insight into the transition of a clinical nurse to nurse faculty. Individual meanings elicited from participants experiences were explicitly described lending to an understanding of transition through the lens of the faculty who underwent the experience. Overall, the faculty experiences that surfaced in the study were remarkably similar despite the setting or context in which the experiences took place.

This finding offers a common ground for higher learning institutions and nursing programs to collaborate to find innovative strategies to support clinical nurses as they transition to the role of nurse faculty. Although it may be unrealistic to expect all graduate nursing programs to include teaching courses within their curriculum, it is realistic to incorporate an expanded orientation process for nurses who transition to faculty positions. Strategies to enhance the transition process by expanding the orientation period may lead to ease of transition for novice faculty. A concerted effort and continued attention to meeting the needs of the novice nurse faculty could promote transition and optimize retention. Retaining faculty equates to longevity in the role and ultimately could ameliorate the nurse faculty shortage.

References

  • American Association of Colleges of Nursing. (2017). Nursing shortage fact sheet. Retrieved from https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage
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  • Bittner, N.P. & O'Connor, M. (2012). Focus on retention: Identifying barriers to nurse faculty satisfaction. Nursing Education Perspectives, 33, 251–254. doi:10.5480/1536-5026-33.4.251 [CrossRef]
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Participant Demographic Data (N = 15)

DemographicValueMeanMode
Age, years35 to 6653.647, 57, 62
Clinical experience, years7 to 4323.8638
Faculty experience, years1 to 207.362, 3, 7
Highest degree obtained11 MSN, 2 DNP, 2 PhD
Program type4 ADN, 11 BSN
Gender1 man, 14 women

Interview Questions

Please tell me your rationale for transitioning from a clinical nurse to nurse faculty.

What was it like to transition into the faculty role?

Describe your experiences regarding the orientation process to the faculty role.

Describe any obstacles encountered while transitioning into the faculty role.

Discuss the atmosphere you entered when you transitioned into the faculty role.

Tell me about similarities and differences in skill set between clinical nurse and nurse faculty.

Please describe your level of competency with the nurse faculty skill set as a novice compared to now.

Is there anything else you would like to add that you think I might find helpful?

Authors

Dr. Hoffman is Assistant Professor, Department of Nursing, St. Ambrose University, Davenport, Iowa.

The author has disclosed no potential conflicts of interest, financial or otherwise.

The author thanks the faculty who graciously agreed to participate in the study, as well as Sarah Castro, MPH, for invaluable assistance with peer review.

Address correspondence to Danielle M.E. Hoffman, DNP, RN, TNS, EMT-P via e-mail: hoffmandanielle@sau.edu.

Received: July 16, 2018
Accepted: February 04, 2019

10.3928/01484834-20190422-03

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