SHAPING THE FUTURE OF
NURSING EDUCATION &
PRACTICE
Dr. S. A. Tabish
FRCP, FAMS, MD HA(AIIMS), FACP,
Postdoc Fellowship (England) Doctorate in Educational Leadership (USA)
Professor & Head cum Chief of Hospital
Sher-i-Kashmir Institute of Medical Sciences, Srinagar [India]

A NOBLE PROFESSION
• Nursing is a noble profession, filled with wonderful
people, and with the support of each other, can go
on providing great care to vulnerable patients all
over the world.
• Nursing is a truly inspiring and thoroughly
rewarding career like no other, however, for all of
the amazing things you experience on a daily basis,
there are also tough parts to deal with, like stress,
long hours and struggling to make time for family
• Yet, despite these struggles, nursing is full of
exceptional people that do amazing life changing
things.

NURSING: AN ART…A SCIENCE
•By using scientific knowledge
in a humane way, nursing
combines rational, scientific
methods with caring behavior.
•Nursing focuses not on the
illness but the client’s
response to illness.

EVERY DAY IS DIFFERENT
• As a nurse, every day is different. You never know what is
going to happen, and if you ever think you do, something
will come along to surprise you.
• A Nurse must be able to use her knowledge, expertise,
and experience to make swift judgement calls. There is
no substitute for experience, but knowledge is the key to
being able to make good decisions. Read and learn
constantly, especially if there are areas for improvement.
• Not only do you have to constantly keep learning as a
nurse, but you also have to be naturally hard-working.

NURSING IN THE CHANGING WORLD
•In the 21st century the whole foundations
of health care are being shaken.
Technology is taking service to new
heights of portability: less invasive, short-
term, and with greater impact on both the
length and quality of life
•Technology has made it possible to change
the character and content of the work
altering forever what the nurse does and
the places where she does it

NURSING IN THE CHANGING WORLD-II
• The innovations we are accommodating
today are the science fiction we were all
reading 20 years ago
• Most nurses never anticipated that they
would live through the chip-based
technologic innovations that are now
commonplace in today's health service
environment.
• The challenge is providing quality and safe
care to people

NURSING IN THE CHANGING WORLD-
III
• Globally, academia and service alike, play a vital role
in the future of nursing
• Together they are responsible to provide aspiring
nurses with the tools necessary to not only meet
today’s, but tomorrow’s complexities of health care
and to demand the knowledge, skills and attitudes
that are consistent with professional practice
• Academia and service areas must work together to
improve the educational preparation of nursing
students today.

NURSING IN THE NEW
MILLENNIUM
Neighbourhood will employ nurses who will work in 24
hour nurse managed clinics.
Nurse Practitioners will cross medical threshold to
provide services usually provided by physicians.
Nurse therapists will provide numerous services to
the clients and their families.
Hospital stays will be exceedingly short and early
discharge will become more important.
Nurses will be strong and autonomous practitioners
whose practice and care delivery focuses much more
on health than illness

TEACHING APPROACHES
• Lecture
• Problem-based learning
• Competency-based
learning
• Concept mapping
• Portfolio
• Self-learning packets

TEACHING APPROACHES - II
• Clinical intensives promote in-depth specialty
knowledge and skills relevant to specific
populations by building on concepts addressed in
previous courses.
• A critical feature of the clinical intensive is
student choice; students choose the clinical
experiences they wish to take based on their
perceived needs or interest

TEACHING APPROACHES-III
•The use of preceptors in undergraduate
nursing education is a common practice
well documented in the nursing literature
•Precepted experiences involve pairing a
learner with a nurse clinician and are
designed to provide clinical experiences
to students on a one-on-one basis

Learning Style
 Lecture
 Reading
 Audio-visual
 Demonstration
 Discussion group
 Practice by doing
 Teaching others
 Immediate application in
real situation
Knowledge Retention
- 10%
- 20%
- 30%
- 50%
- 75%
- 85%
- 90%
- 90%
(National Training Laboratory
Institute, Alexandria, VA, 2006)

WHAT DO WE WANT TO “STICK”
 Disease processes
 Assessment data
 Critical thinking
 Nursing diagnoses
 Interventions
 Emergent care
 Desired outcomes
 Customer service

INTERACTIVE LEARNING
METHODOLOGIES
•Action methods
•Literature
•Art
•Memory aides

ACTION METHODS
 Drama
 Case scenarios
 Simulation
 Soap operas/television
segments

SMALL GROUP LEARNING ACTIVITY
 Break into small groups
 Choose a topic (disease process,
assessment data, nursing
interventions, emergent care, desired
outcome, etc.)
 Choose an interactive learning
process
 Create your tool to “Make It Stick”!

FUTURE TRENDS IN NURSING
EDUCATION
Increased collaboration between
nursing practice and nursing
education
Increased emphasis on
collaboration between healthcare
disciplines
Increased development of
educational products for faculty and
students

FUTURE TRENDS -II
Increased student and nurse mobility
(including increased licensure mobility)
Increased distance (online) learning
Schools of nursing providing ongoing
professional development for competence
requirements
Increased teaching of evidence-based practice

SERVICE [PRACTICE] EDUCATION
• Innovations in health care, expanding health care systems
and practice settings, & the increasing needs of clients
have been a stimulus for new nursing roles are specific
employment positions or paths
• Because of increasing educational opportunities for
nurses, the growth of nursing as a profession, and a
greater concern for job enrichment
It includes three broader areas:
• Practice (nursing care)
• Research
• Administration

MOBILE NURSING
Mobile nursing is a service agency that provides home
teaching and care for patients with varied needs and health
problems.
BENEFICIARIES:
 Patients discharged early from hospitals
 Patients suffering from chronic and acute medical problems
 Surgical patients. o Patients requiring I.V. therapy
 The elderly Respiratory patients. o The seriously ill Patients
in need of medication management o Hospice concept o
Ventilator dependent o Assistance with bathing, dressing,
meals, transportation, light housekeeping

SPACE NURSING
Functions:
• Evaluate emergency plans
• Use of medications in space
• Telemedicine opportunities.
• Performing surgery in space
• Developing a condition database to
evaluate the risk of certain accidents
or illness during a flight.

FORENSIC NURSING
• Specialized training in forensic evidence
collection, criminal procedures, legal
testimony expertise.
• Liaison between the medical profession
and that of the criminal justice system
•Came about in 1992

HOSPICE NURSING
•Observing, assessing, and
recording symptoms for
terminally ill patients
•Patient’s social worker, home-
care aide and physical,
occupational, or speech therapist.

RESEARCH IN FUTURE
•The development of scientific knowledge base that
enables nurses to implement on evidence based
practice
• Evidence Based Practice incorporates critical thinking and
research utilization competencies
Objectives:
 To create a research culture
 Provide high quality educational programme to prepare a
workforce of nurse scientist
 Develop a sound research infrastructure
 Obtain sufficient funding for essential research

EVIDENCE BASED PRACTICE
•Goal is to achieve cost-effective, high quality
patient care based on scientific inquiry
•The primary focus of health care institutions
today is on the provision of quality care within
a cost effective framework. This emphasis on
outcomes has led to a movement requiring
evidence based care.
•The movement toward evidence based practice
requires that educators & practitioners engage
in collaborative research

CHALLENGES FOR THE NURSE
EDUCATOR IN
21ST CENTURY
 The need to establish an independent
evidence base in nursing education
 Innovative studies that are conducted often
consist of small samples & narrow
settings, & often are not replicated. As a result
of there is
little development of the science of
nursing education
 To engage in research aimed at determining
the effectiveness of nursing education

FUTURE OF NURSING CAREER
•Many nursing functions will be automated
•Result of nursing shortages, healthcare
facilities will be forced to use their nurses
judiciously
•Changes in technology will possibly attract
more men and minorities into the profession
•The number of outpatient care will increase, as
will the need for home health care nurses
community health care focus more on
preventing the illnesses rather than treatment

CHANGING ROLE

INNOVATIONS IN NURSING
EDUCATION
When it comes to innovation in nursing education, the time is
now…and tomorrow
Some important innovations include:
• Online education
• Interprofessional education
• New degree programs
• New models of academic progression
• Simulation and virtual simulation
• For evaluating and encouraging the new generation for the
Nursing Education, teamwork is critical

TECHNOLOGY AND TEACHING INNOVATIONS
•By working collaboratively, there is better
alignment of nursing academics and nursing
practice
•New models with increasing capacity for
nursing students in the midst of a shortage
of clinical sites will maximize scarce
resources
•Increasing the ability for practicing nurses
in health care settings to assist with
educating nursing students may improve
clinical learning outcomes

NEW STRATEGIES
•New strategies must be used in nursing
education: Simulation and personal digital
assistants (PDAs) are some of the new strategies.
•Simulation is a teaching strategy that involves
replicating reality
•Increased efficacy in teachers has been linked to
higher student achievement, positive work
environments and job satisfaction, persistence,
and the tendency to try innovative strategies.
•The simulations and PDAs must be integrated in
nursing education.

COMPETENCIES FOR NURSING
PROGRAMS
Six competencies for nursing programs to meet
include:
• Patient-Centered Care
• Teamwork, Collaboration
• Evidence-Based Practice
• Quality Improvement
• Safety and Informatics
Nurses not only need to have practical skill, but they
need to possess the appropriate knowledge, skills,
and attitude to move the profession into the 21st
century
Nursing practice is a shared responsibility

CONCEPT-BASED CURRICULA
• What is needed now is dramatic reform and
innovation in nursing education to create and
shape the future of nursing practice
• There is a need to design evidence-based
curricula that are flexible, responsive to
students' needs, collaborative, and integrate
current technology.
• New pedagogies are required that are
research-based, responsive to the rapidly-
changing health care system, and reflective of
new partnerships between and among
students, teachers and clinicians

Nursing is an art: and if it is to be
made an art, it requires an exclusive
devotion as hard a preparation as any
painter's or sculptor's work; for what
is the having to do with dead canvas
or dead marble, compared with
having to do with the living body, the
temple of God's spirit? It is one of the
Fine Arts: I had almost said, the
finest of Fine Arts
— Florence Nightingale