Findings of the Review
Eleven themes and four meta-themes emerged from the metasynthesis of the 12 primary qualitative research studies included in this systematic review (Figure 2). The synthesized findings provided insight into clinicians' experience of their transition to academic nurse educator. Expert clinicians described their transition to novice nursing faculty as unprepared (three themes), missing being an expert (three themes), in search of mentoring (three themes), and beginning to thrive (two themes).
Meta-themes and themes.
Unprepared. Feeling unprepared was a consistent experience of the transition from expert clinician to academic nurse educator (Anderson, 2009; Dempsey, 2007; Gardner, 2014). Clinicians often entered academic nursing to give back to the profession by influencing and preparing the next generation of nurses. Having developed positive relationships with students as a preceptor, they saw nursing education as a way to make their mark on the profession (Schoening, 2013). They admitted having an idealized impression of the nurse educator role; they expected teaching in an academic setting would be similar to the teaching they had done as clinicians (Chargualaf et al., 2017; Schoening, 2013). As a result of these unrealistic expectations, novice faculty found themselves feeling unprepared for the faculty role, the cultural differences between practice and the academic, and student encounters.
Faculty role. Very few novice educators received formal preparation for teaching during their graduate programs, which affected their transition. Although experienced as clinicians, participants found that teaching nursing required a different skill set than practicing nursing (Cangelosi et al., 2009). Graduate education had prepared them to practice but not to teach nursing; however, they found themselves in academic settings where they were expected to teach with no formal teacher education or prior teaching experience (Schoening, 2013).
Participants felt unprepared for the workload expected of faculty. They were surprised that teaching a course took so much time to prepare and to manage with grading papers and extra paperwork (Gardner, 2014; McDermid et al., 2013). Having idealized the faculty role, they were surprised by the other demands placed on faculty to publish; to write and receive grants; and to participate in service to the department, the college, the university, the community, and the nursing profession. One participant described her surprise about:
…how hard they [academics] worked, how much was involved, that it never ever ends. On my bad days I was like…I'm going back to nursing because I don't care how hard I work at that bedside for that 12 hours; when I go home it's over.
Cultural differences. New faculty were unprepared for the cultural differences between the clinical and academic settings. One participant commented:
…it's an entirely different culture than anything I've ever been exposed to. There…is a different language and different expectations that you don't encounter in the hospital setting or the business world.
Participants found the emphasis on individual achievement foreign to their experience as clinicians. They were accustomed to working as a team with shared goals to improve patient outcomes rather than as individuals pursuing promotion and tenure. A retired U.S. military officer described this phenomenon:
In the military, we're not about us. We're about the team. We're about the mission.… In academia…you have to do these individual things in order to move up the chain and be recognized.
Accustomed to having their clinical competence assessed by supervisors and colleagues, participants were surprised by the weight given to student evaluations of faculty (Chargualaf et al., 2017). One participant said:
I figured out real quick…that students have…a lot of power with their evaluations. This was distinctly different from the military where the only evaluation that matters is your supervisor's evaluation and your colleagues.
As a result, they found themselves unprepared for managing student encounters.
Student encounters. As clinicians, positive experiences with students motivated many to become faculty so they could influence the next generation of nurses. However, they were not prepared for the negative encounters that occurred when they became teachers (Anderson, 2009; Chargualaf et al., 2017; Schoening, 2013). Being responsible for student evaluations changed the dynamic (Schoening, 2013). A participant told a story about a difficult student encounter:
[O]ne student I had…was quite aggressive towards me and…in front of the whole class…[s]he told me I couldn't fail her because she had “paid for her degree”… and she only failed because of me…I didn't know what to say…I was devastated and felt really responsible.
Expert clinicians entered the academic setting un-prepared for the realities of the faculty role. Surprised by the demands of teaching and changes in their relationships with students, they were not ready for the differences between teaching in an academic setting and nursing practice.
No Longer an Expert. Clinicians as teachers were no longer experts (three themes). Teaching elicited uncomfortable feelings about being a novice again. They missed the ease of the clinical environment and their status as experts, and they were afraid of failing. Many experienced second thoughts about their decision to become an academic nurse educator. “Participants had a secure environment in which they operated as expert clinicians. Transitioning to a new context removed that security and comfort” (Anderson, 2009, p. 205).
Being a novice again. Participants left the security of clinical settings where they understood expectations for advancement and were recognized for their expertise as nurses to become novice nurse educators. They experienced both excitement and fear as they traded the familiar for the unknown. Although some felt excitement for the new challenges posed by the academic environment, many experienced a fear of failure (Cangelosi et al., 2009). They wondered how they would cope with being novices. One participant described her experience:
I look back and I remember being terrified. I got sent the class outline a couple of days before…. I stood in front of this classroom of students thinking “I can't do this; I'm a nurse not a teacher!”… But you know as nurses we tend to just roll with the punches and we just sort of go in and do it…and I did.
These novice nurse educators feared they might fail as a teacher by being unable to answer students' questions. They responded to this fear by spending significant time preparing for student encounters and anticipating student questions, which added to their workload. They wanted students to see them as expert teachers (Cangelosi, 2014; Siler & Kleiner, 2001).
Missing being an expert. Participants missed the safety of feeling confident in their skills as expert nurses where they knew how to handle challenges (Anderson, 2009). They missed being recognized for their expertise. One participant said, “I had a lot of respect and authority where I worked, and I had no juice here and felt very incompetent and unprepared” (Gardner, 2014, p. 108). Another aspect of missing being an expert focused on teaching assignments that did not use their areas of expertise. Many thought they had been hired because of their strong clinical skills and expected to use those in teaching. However, they often were assigned to teach unfamiliar material or new classes, which added to their workload (Hoffman, 2019; McDermid et al., 2013).
Questioning my decision. Questioning their decision to enter teaching was a common experience during their first year as new faculty. They often wondered how they would meet all that was expected of them and questioned whether academic teaching was what they wanted to do (Siler & Kleiner, 2001). One participant explained:
There was a time where both of us...were really overloaded with all these new preps and...having all these complaints from these students where we were really thinking, do we really want to do this?
Many saw the assumptions about workload as excessive and unrealistic. Expectations in clinical practice seemed more realistic and less intrusive into family life, causing participants to question their decision to enter teaching. A return to the more realistic responsibilities of the clinical setting was tempting (McDermid et al., 2013).
In Search of Mentoring. Mentoring was the essential component in easing the transition from expert clinician to novice faculty (three themes). Participants benefitted from formal mentoring programs and informal mentoring by supportive faculty colleagues. Unfortunately, participants reported being left on their own to figure out their new role.
Benefits of formal mentoring. Formal mentoring facilitated the transition into the faculty role; participants across studies consistently identified the importance of an experienced faculty mentor to guide them as they learned to teach. White et al. (2010) described how new faculty experienced a formal mentoring program:
The informants felt they gained skills and knowledge in the “how to” of teaching, as well as being able to go to their mentor for practical help. Participation in the mentorship program seemed to help them overcome some of the frustrations as they learned useful strategies to become better teachers.
An assigned mentor can facilitate the transition from clinician to nursing faculty (McDermid et al., 2016). One participant described the role her mentor played in her transition:
I really didn't know what I was supposed to be doing…. I had no confidence in my new role…. Thank God for her (my mentor). She always has the time for me whenever I was not sure of something…. She has clarified so much about the job…it did help my confidence.
The desire for a formal mentor was a common finding, but when a formal mentor was not available, participants identified the importance of supportive faculty colleagues (Dempsey, 2007; Gardner, 2014).
Supportive faculty colleagues. Supportive faculty colleagues aided the transition into the academic setting. Participants felt supported when faculty colleagues were available to answer questions and offer feedback. These colleagues often helped them to develop coping strategies and to understand the institutional environment of the university (Dempsey, 2007; McDermid et al., 2016). One participant described this support:
The one thing that really helped was all my colleagues around me. They came up to me and made me understand that they were there, and I could just go and ask them for help.… The support of the people around you is really essential.
Participants reported actively seeking out support from more experienced colleagues for help when teaching new content. One participant said:
…my mentor didn't teach it. I had to find someone who did…. I went right to her…. I learnt to go to different people for different things. Between them all, I managed to get what I needed.
Not all participants had the advantage of effective formal mentoring or supportive colleagues. They described being left to navigate the transition on their own.
Left alone to navigate faculty role. Mentoring clearly facilitated the transition from expert clinician to novice nurse educator. However, participants reported inadequate mentoring and the lack of a structured orientation as their common experience (Anderson, 2009; Cangelosi, 2014; Chargualaf et al., 2017). Novice faculty expected that their colleagues would help them learn how to fulfill the responsibilities of the faculty role (Cangelosi, 2014; Chargualaf et al., 2017; Dempsey, 2007; Schoening, 2013). However, they often were assigned to develop courses with no institutional or collegial guidance. Even if they had an assigned mentor, the mentor often seemed a poor fit or too overloaded with their own teaching responsibilities to be helpful (Chargualaf et al., 2017). A participant said:
I just wish I had someone to bounce things off…. On the units I have worked, we always consulted each other, but here it is hard to find someone who can take the time
Another participant who had been in the military described her attempts to get questions answered as “…reconnaissance work—you have to pull teeth to get the information” (Chargualaf et al., 2017, p. 6). Despite feeling on their own to figure out the faculty role, participants began to thrive rather than just survive.
Beginning to Thrive. A healthy transition was characterized by beginning to thrive as a teacher (two themes). Characteristics of thriving included increased comfort in establishing boundaries with students and managing expectations of themselves as faculty (Schoening, 2013). Participants learned to manage negative student feedback as well as the inherent ambiguity of the academic setting (Hoffman, 2019; McDermid et al., 2016). As they developed an identity as nurse educators, they became more comfortable and confident in their new roles (Schoening, 2013).
Managing student feedback. Learning to manage student evaluations and feedback was crucial to a successful transition. Participants learned to see both positive and negative student responses as opportunities to think about their teaching (McDermid et al., 2016). One participant said, “My first SFTs (student evaluations) weren't that great… but I look at the comments and…I learn from them…now I can improve and change what I need to change” (McDermid et al., 2016, p. 33). Faculty who established boundaries with students learned to thrive in their new role (Schoening, 2013). A participant described how she made this transition:
The first year I was really green and timid.... I wanted to work with the students, but it was almost like a friendship.... Now…I'm the teacher…. We are going to play by the rules. I'm flexible, but not as flexible as when I first started.
Learning to manage student feedback facilitated participants' confidence as teachers.
Gaining confidence as a teacher. Over time, new faculty grew more confident in their ability to teach; they began to think creatively about teaching and their teaching style (Gardner, 2014). One participant stated, “I've crossed…from surviving to thriving.... I feel the space to be creative. During that first year you are so busy surviving…and now it feels fun” (Anderson, 2009, p. 206). As novice faculty gained confidence in their teaching, they were able to expand their goals for student learning. A participant explained, “I finally realized that it isn't the facts I give them, but it's...getting them to make the connection and to see the bigger picture” (Schoening, 2013, p. 171). As they learned to manage student feedback and gained confidence in their ability to teach, novice educators began to enjoy their new role as faculty.