NurreEducotron Todq (1991) 11, 100-103 Q Longman Group UK Ltd 1991
Nurse Education Tomorrow Conference 1990
Preparing nurse teachers for their future role
Peter D Birchenall
For over a decade general education has been aware of the advantages of linking initial teacher training with in-service provision for qualified teachers. This relationship brings together student teachers and qualified experienced teachers in a way that is mutually beneficial to both parties. It provides opportunities for the student to observe and reflect on the teaching style and approaches of established professionals who in turn will gain much from working closely with trainers and students from colleges of education. This paper develops a series of issues relating to IT-INSET including educational accountability, reflective practice, and the provision of quality education.
The preparation required to bring about the transition from experienced and well qualified Registered Nurse, to that of qualified and competent teacher is a lengthy and complex business. Both roles have the similarity of being primarily practice based, each has a body of knowledge derived from a variety of sources; each has a secret garden ofactivities and practice which is not to be found in any official curricu- lum, yet is substantial in the way that it informs the practitioner. Skilled teaching is an ability to enjoin the knowledge and skill encompassed within both roles in such a way that a teacher is able to claim credibility in her subject area, thus moving towards specialism and away from gen- eralism. In support of this, it is proposed that initigl teacher preparation (IT) should be linked
Peter D Bitchenall MA RNMH RGN DN (London) RNT Senior Lecturer in Nursing, Institute of Nursing Studies, University of Hull, Cottingham Road, Hull, North Humberside HU6 7RX (Requests for offprints to PB) Manuscript accepted 29 October 1990
with in-service education of teachers (IN-SET) as a means of maintaining a high quality edu- cational service involving colleges of nursing and midwifery in partnership with teacher training colleges.
IT-INSET-THE WAY FORWARD?
IT-INSET relies heavily on the cooperation of schools to provide good learning environments and suitable role models who can work with the student teacher on a shared basis with the teacher training establishment. The theory which governs this approach to teaching is founded on the principle that a classroom is anywhere that planned teaching occurs. It is where a relationship can be fostered between the initial preparation of student teachers, and the in-service training requirements of those who are practising teachers.
In the case of nursing education and the subsequent preparation of teachers of nurses this arrangement would involve service and teaching staff working in an educational part- nership with the student teacher and her super-
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visor. The learning environment could equally be a formal classroom or any approved training area for student nurses. An arrangement such as this relies heavily on the use of learning contracts which place a greater responsibility on everyone concerned. Learning contracts not only benefit the student but also empower the role model to become an even better teacher through a recog- nition of those areas of her practice which would benefit from in-service education. This recogni- tion comes from reflective analysis, and in a sense the qualified teacher will use the student as a mirror in identifying personal strengths and deficiencies. Conversely the student will learn about teaching through intelligent observation and questioning, leading to informed practice.
The English National Board for Nursing, Midwifery and Health Visiting (1989) has adopted this approach as being the way forward for nurse teacher preparation. In its paper entitled Preparation of Teachers, Practitioners/ Teachers, Mentors and Supervisors in the Con-
text of Project 2000 the English National Board say that initial teacher training can no longer be regarded as a once and for all preparation. Neither can it occur in isolation from the prepar- ation required by service staff, especially as they will be expected to make a new and significant contribution to the education of a different type of student nurse. By giving emphasis to the relationship between theory and practice the English National Board throw into sharp focus a requirement for nurse educationists to give more thought to the way that knowledge is actually gleaned through experiential means. To encourage progression through initial prepar- ation into the wider dimensions of professional development will provide a teaching force that is responsive to change, and properly equipped to meet the educational demands of student nurses who are adult by virtue of age and expectancy. It is generally accepted that nursing skills are acquired through reflective, informed practice, (Clarke 1986; Powell 1989) therefore it follows that the style of teacher preparation is an essen- tial component in promoting such practice. At a recent conference Birchenall(l990) spoke of the need for teacher training to be more closely allied with the learning environment within
which student nurses are prepared for their professional role. The emphasis for nurse teacher preparation should always be directed towards the skilful provision of good learning experiences firmly rooted in the process of nursing, and patient care. This once again rein- forces the value of effective preparation for role modelling and mentoring. To view nurse teacher training as a separate issue from the preparation required by role models and men- tors would serve only to work against the edu- cational philosophy of Project 2000 which places the student nurse and the patient/client equally at the centre of a curriculum which is not only about professional development but also the delivery of appropriate care. It follows that the student teacher of nurses should become skilled in facilitating both these important facets of basic and post-basic education.
ACCOUNTABILITY AND NURSE EDUCATION
The notion of accountability has now become an integral part of nursing. Therefore it is essential for teachers to develop skills which are directed towards enabling student nurses to become analytical, questioning and informed decision makers. From the outset of their course, student nurses have the right to expect tutorial guidance towards achieving this goal. However, the Strategy for Nursing (DoH 1989) questions whether students professional education always encourages them to develop and exercise these skills. There is a perceived need for the graduate and non-graduate nurse to come closer together in terms of educational opportunities. The teaching of Project 2000 at diploma level should play a large part in reducing this gap. It becomes important for the change in academic require- ments to be reflected in nurse teacher prepar- ation especially as diploma level teaching is new to basic nurse education.
Educational accountability does not end with the nurse teacher but extends into the domain of the service manager who will be in partnership with the education staff when defining the audit arrangements for the practice areas. These
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arrangements should be aimed at providing positive learning opportunities which can be
effectively exploited by teachers and students alike. Indeed, the English National Board has expressed a wish for trainee teachers to retain and develop clinical competence which can only be realised through working with student nurses and clinical colleagues in a dynamic care environment. For this to be effective, prepar- ation for teaching must once again take account of the theories and practice of nursing. Teacher training courses should display a flexibility aimed at enabling student teachers to pursue professional nursing studies alongside edu- cational studies.
TEACHER PREPARATION AND REFLECTIVE PRACTICE
In recent times attention has been paid to the idea of intelligent reflection and its place in the educational process (Schon 1987). Nurse teachers have shown a willingness to adopt the basic theories of reflective practice especially as Project 2000 requires student nurses to gain their initial insight into care through informed observation. Thereafter they gradually become skilled at demonstrating nursing actions which are the product of reflective and creative thought. Creative thought is an activity which can be developed through practice, (Tomlinson 1981) and students of nursing should, from the outset of their course, be encouraged by their teachers to think intuitively about their practice.
The success or otherwise of this approach will depend largely on the design of the curriculum. An essential part of nurse teacher preparation is curriculum studies, which as Birchenall (1985) points out, engages the student teacher in becoming familiar with an ever increasing sphere of activity, and maximising the effects of relevant innovation. The concept of reflective practitioner falls into this category and requires nurse teachers of the future to be wholly familiar with the process of interactive and intuitive teaching. Modern nursing calls for curricula that promotes reflective thought as a precursor to nursing action. This places an important respon-
sibility on those who prepare the nurse teachers of tomorrow to fashion programmes of study which give credence to the importance of teaching from a framework of creative and reflective analysis. This will serve to strengthen the relationship between theory and practice. Clarke (1986) supports this view when writing of Shotters theory of personal action (1974, 1975). Reference is made to deliberately thought out actions which have a goal in sight and form a basis for the development of nursing theory in the mind of the practitioner. This has the effect of highlighting the unification of theory and practice as the principal element of skilled nurs- ing care, and consequently it is one of the most important aims in nursing education.
THE NURSE TEACHER AS A PROVIDER OF QUALITY EDUCATION
In these days where the concept of consumer and provider is part of the language of the health service we see recent literature pointing towards the importance of quality control/assurance in nursing education (Nicklin & Lankshear 1990). These authors make reference to the student and the service manager as the consumers of nurse education. Davis (1990) proposes that the product of nurse teaching should be wholly research based and as such infers that students as consumers are entitled to a quality education which is derived from authentic and appropriate research.
Tomorrows knowledge will be founded in todays research, therefore tomorrows teacher will not only be skilled in using research derived from relevant sources, but also be adept at planning and carrying out personal empirical study. Similar thinking is at the centre of current debate in the University sector. In its publication Maintaining and Monitoring Academic Standards (1988) the Committee of Vice Chancellors and Principals of the United King- dom address pertinent issues regarding the evaluation of quality in teaching. Amongst these issues the committee pronounced positively on
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the relevance of research to the maintenance of the curriculum.
Academics argue that teaching and research are closely allied and each benefits the other. Questions are asked in academic circles about the extent to which the quality of teaching can be enhanced through a commitment to research. This commitment can either be individual or institutional and similar questions need to be asked about nurse education. These questions raise a number of issues regarding the quality of teaching and the dangers of adopting a too narrow approach to teacher education. Clark (1987) writes of the large areas of practice in the health professions which are continued in the absence of supportive evidence. This conven- tional wisdom is well established, and according to Clark there is a need for practitioners to develop their own prescriptions or models for practical action. He takes the view that:
The good practitioner is not a robot pro- grammed to respond in a stereotyped way to a predefined problem but a creative intellect prepared where necessary to seek a unique solution to each problem.
This powerful argument serves to remind us that as we relentlessly pursue quality teaching through a researched knowledge base there is an equal place for individuality and flair. Un- doubtedly the need to address quality in teaching and its relationship to the intelligent use of scientifically determined evidence is essential, but teacher education should also pro-
tion is taken in the future preparation of nurse teachers there will be strong links to Prqject 2000 and a requirement to display quality teaching at an advanced academic level. How this can be achieved is not yet established and the debate will continue for some time yet. This paper contains a number of arguments and suggestions relating to the initial training and in-service preparation of teachers which collectively may make a useful contribution to this debate.
Birchenall P D 1985 Applying aspects of curriculum studies to the practice of nurse teaching. Nurse Education Today 5: 147-150
Birchenall P D 1990 Developing a Reflective Framework for Practice. Proceedings of the International Conference on Psychiatric Nursing, Newcastle upon Tyne, 27 April 1990
Clark C 1987 The university contribution to professional education. Nurse Education Today 7: 17-20
Clarke M 1986 Action and Reflection: practice and theory in nursing. Journal of Advanced Nursing 11, 1: 3-11
Committee of Vice Chancellors and Principals of the United Kingdom 1988 Maintaining and Monitoring Academic Standards
Davis B 1990 Research-based teaching. Nursing Standard 4,48: 38-40
Department of Health 1989 A Strategy for Nursing. A Report of the Steering Committee, p 24
English National Board for Nursing, Midwifery and Health Visiting 1989 Preparation of Teachers, Practitioner/Teachers, Mentors and Supervisors in the Context of Project 2000.
Nicklin P, Lankshear A 1990 Quality Control. Nursing Times 86.36: 61-62
vide the profession with people who can moti- Powell J H 1989 The Reflective Practitioner in Nursing.
vate and inspire. A balance between the two Journal of Advanced Nursing 14, 10: 824-832
should be at the root of teacher preparation Schon D A 1987 Educating the Reflective Practitioner:
Towards a New Design for Teaching and Learning in because unless students are motivated and the Professions. Joss&-Bass, San Fr&cisco _
inspired, quality will suffer in a way that may be Tomlinson P 198 1 Understanding Teaching. McGraw
difficult or impossible to measure. Hill, Lon...