Students are overwhelmed by the burden and amount of information they are expected to retain in nursing education.
When I asked graduate nurses at an NCLEX® review class I was teaching what they would recommend to improve nursing education, many of their responses centered around the burden of content overload:
- “Slim down the information.”
- “Need to simplify the information.”
- “We get so much information and thousands of pages to read. It is not possible to know it all.”
- “I wish they would make it known what is most important to focus on.”
- “Information overload! Too many details without clear instruction on the critical data. Unrealistic reading expectations.”
- “Too much info given to us. You should make it basic and teach what you really need to know. We will learn the rest in practice.”
- “Too much information thrown at us and no idea where to focus. I felt I learned bits and pieces about subjects all over the place instead of really understanding anything!”
- “We were rushed covering the huge content in a small amount of time.”
Infobesity
There is a consequence to information overload and “infobesity” that students experience in nursing education.
Graduate nursing students may know enough content to pass the NCLEX®, but do not know and understand the content well enough to USE and APPLY it to the bedside and as a result, are NOT adequately prepared for clinical practice.
According to the recent journal article, “A Crisis in Competency: The Strategic and Ethical Imperative to Assessing New Graduate Nurses’ Clinical Reasoning” infobesity was identified as one of the contributing factors to the lack of practice readiness of nursing graduates who passed the NCLEX®, but only 23% demonstrated entry-level competence in their ability to think like a nurse using the skill of clinical reasoning.
Unintended Consequences of Information Age
We live in an unprecedented era of access to information and knowledge.
In nursing content alone, knowledge is doubling every six years (Huston, 2013)!
Ten years ago, Christine Tanner (2007) recognized the challenge of information overload that was already present in nursing education and that in order to be comprehensive and cover the content, textbooks and curricula have grown unchecked.
Dr. Patricia Benner (2011) also sees nursing textbooks as unwieldy encyclopedic compendiums of information that focus primarily on knowledge acquisition but overlook knowledge usage and application.
As a result of drowning in a sea of information, novice student nurses are unable to use knowledge and apply it to practice.
Critical Thinking Defined
When the essence of critical thinking is defined and understood the implication and unintended consequences of infobesity become clear.
This definition of critical thinking by Potter and Perry (2012) makes this connection clear.
Critical thinking is a commitment to think:
- Clearly
- Precisely
- Accurately
- ACT on what you KNOW about a situation
Did you catch that?
A graduate nurse or any nurse in practice will not recognize the need to ACT unless they KNOW.
This is why info obesity is enemy #1 in nursing education and responsible nurse educators must do whatever is needed to slim it down at all costs!
What Educators Need to do Differently
Nothing will change until something changes.
in order to change to strengthen nursing education and better prepare students for clinical practice, the following principles can guide educators to slim down the content in your program.
1. Determine what content is NEED to know vs. NICE to know.
Use your lens of clinical practice to determine what content is relevant and most important.
The goal of nursing education is to prepare students for what they will most likely experience in their first year of practice, not for every obscure illness or problem that is included in Med/Surg textbooks.
How do you decide what content is need and nice to know?
- NEED to know content. Answers the question, “What does a nurse need to know (about today’s content) in order to safely provide care for a patient with…?”
- NICE to know content. Includes aspects of care that are important, but not essential. This content is also readily available in textbooks so students can read and review on their own.
Classroom NEED to Know Content
In order to structure a concise and meaningful 20 to 25 minute classroom presentation (not the entire hour!) that captures the essence of NEED to know information so students can translate this to practice, consider the following content areas as essential highlights to help students transfer learning from the classroom to the clinical setting:
- Pathophysiology review
- Relevant/most important labs
- Relevant/most important medications
- Emphasize mechanism of action!
- Medical management of topic
- Most important nursing priorities/plan of care
- Body system to focus/essential assessments
- Review worst possible/most likely complication(s)
- Assessments needed for EARLY identification of problem
- How to manage problem if presents
2. CONTEXTUALIZE content to the bedside
Once the most important content has been identified and presented, now this content must have the hook of being contextualized to the bedside of patient care so novice nursing students can readily see why it is relevant.
This was an essential shift of integration from the Carnegie Foundation research presented in Educating Nurses (Benner, Sutphen, Leonard, & Day, 2010). This is not only common sense for a practice-based profession, it is also educational best practice!
Action Step…Change the way you THINK!
As I travel across the country and share my clinical reasoning tools and strategies, I am surprised how few nurse educators have read the educational research contained in Educating Nurses.
If you have not yet read or reviewed this resource you must do so!
Change and transformation in nursing education will not come by merely teaching new ways and strategies of doing things differently. You need to change the way you think and WHY transformational change is needed and must be embraced.
Make it a priority to click the image link below and obtain a copy of Educating Nurses, read it and be challenged and encouraged to do things differently before a new school year begins.
My new book coming for nurse educators TEACH Students to THINK Like a Nurse coming later this summer will build on the findings of Educating Nurses and will help you recognize the importance of doing things differently.
In Closing
Infobesity not only impacts the ability of students to learn, it also influences their ability to use and apply knowledge and critically think in the clinical setting.
Emphasize NEED to know content and make DEEP learning of what is MOST important your primary objective as an educator.
Do not hesitate to be ruthless and put your classroom presentations as well as curriculum on a needed diet and then contextualize this need to know content to the bedside!
Do this and you are well on your way to being a needed transformer of nursing education that will result in your students not only being well prepared for the NCLEX®, but more importantly professional practice!
What do you think?
What have you done in your classroom to decrease content saturation and emphasize what is most important?
Comment below and let the conversation begin!
RELEVANT Past Blogs to Check Out
Learn more! The following past blogs provide additional background on todays topic!
- Why TML (Too Much Lecture) in Your Classroom Can Be Deadly
- What Transformational Nurse Educators Have in Common with Gray Whales
- Don’t Just Flip Your Classroom…TRANSFORM it!
References
- Benner, P. (2011). Proceedings from NovEx introduction workshop: Educational philosophy and pedagogical goals of NovEx situated learning program. Pepperdike, Ohio.
- Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass.
- Huston, C. (2013). The impact of emerging technology on nursing care: Warp speed ahead. Online Journal of Issues in Nursing, 18(2), 1. doi 10.3912/OJIN.Vol18No02Man01
- Kavanagh, J. & Szweda, C. (2017). A crisis in competency: The strategic and ethical imperative to assessing new graduate nurses’ clinical reasoning. Nursing Education Perspectives, 38(2), 57-61.
- Potter, P. A. & Perry, A. G. (2012). Fundamentals of nursing. (8th ed.). St. Louis, MO: Mosby–Elsevier.
- Tanner, C. (2007). Keynote address. Ohio League for Nursing Spring Education Conference, Dublin, Ohio.
Keith Rischer – Ph.D., RN, CCRN, CEN
As a nurse with over 35 years of experience who remained in practice as an educator, I’ve witnessed the gap between how nursing is taught and how it is practiced, and I decided to do something about it! Read more…
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