Teaching Nursing Students to Think Clinically with Realistic Instructional Tools

Tim Bristol

By Tim Bristol, director of strategic planning, NurseThink, Wolters Kluwer Health.

The ever-worsening nursing shortage is taking the United States by storm, with nearly 800,000 nurses planning to leave their roles or retire by 2027. Unfortunately, nursing education is not immune to this crisis.

The American Association of Colleges of Nursing (AACN) reports that 8.8% of faculty positions are vacant at U.S. nursing schools and additional positions would need to be created to meet student demand. Without enough faculty, this has a serious impact on the capacity and effectiveness of nursing education programs as nursing schools are already being forced to turn away qualified applicants. Fortunately, while faculty shortages won’t be solved overnight, advancements in instructional technology can help fill the gap.

One key challenge facing nursing education is that the curriculum is not set up to teach students in a way that mirrors real-world practice. While new nurses today will often face greater challenges – and often higher caseloads – than ever before, nursing students are not being adequately trained to face this reality. In many ways, today’s nursing classrooms look no different than the classrooms students may have encountered in 1993. But a lecture hall looks very different than the chaotic hospital setting new nurses will actually experience. To help ensure students build skills and engage in clinical judgement, even if faculty numbers are limited, incorporating electronic health records and virtual simulation into their daily education can make a major difference.

Electronic health records are not optional

While electronic health record (EHR) systems are a highly discussed technology across the healthcare landscape, they have been shown to reduce errors and lower medical costs. Needless to say, EHRs are here to stay across healthcare and something that care teams need to use, every day. However, they can only positively impact healthcare as a whole if nurses are trained to use them effectively and efficiently before they encounter them in clinical practice.

It’s important for faculty to understand how easy it is to implement EHRs into the daily classroom experience. Students could simply login to a basic, blank EHR and enter data based on a case study or challenge given by their instructor. For example, students could be tasked with entering a blood pressure reading that would indicate that they should hold (not give) a patient medication to lower their blood pressure. When faculty allow students to experience this type of activity, they are learning in the same way in which they will be using EHRs in practice. This is something that could easily be incorporated into nursing classrooms, even in a lecture hall of 100+ students.

The virtual world makes simulation accessible

Virtual simulations are increasingly demonstrating value for nursing education, helping students feel engaged and better retain what they’ve learned. By incorporating simulation on a weekly or daily basis into the curriculum, this lets learners dive deep into patient scenarios, allowing them to truly learn about nursing in a way not easily replicated with most other learning strategies. Up until recently, one major challenge was that many simulation tools are inaccessible to aspiring nurses, due to the cost and complexities involved.

The virtual simulation (vSim) world is now comprised of technology that is easily understood and usable by faculty in all environments. Computer requirements for vSim tools that resemble realistic patient scenarios are such that nursing students can easily use these programs on even the most basic of computers. While the technologies available and their complexities differ, these vSim programs are very realistic and allow students to practice high-level decision making in scenarios they wouldn’t likely encounter as part of their clinicals.

Within the virtual world, the realism of simulation is now accessible to all students. The next step is to make sure nursing faculty realize how critical these tools are. While an instructor might struggle to fit vSim into class time, the reality is that students can often learn more in 30 minutes of simulation than they could in a 2-hour lecture.

Bringing the nursing classroom into the future

The future of the nursing profession and healthcare really is in the hands of all nursing programs. Overall, what’s paramount here is that nursing students learn in the same way in which they will use that information at the bedside. This requires getting them comfortable with entering information into EHRs and practicing with realistic patient simulations on a weekly if not daily basis. Thanks to technological advancements in recent years, these tools are increasingly accessible, and we must prioritize training educators on how these tools can be easily adopted in their classrooms to ensure the next generation of nurses are practice ready.

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