Philosophy of Education for Nursing Practice

Philosophy of nursing education guides daily activities in nursing schools and helps future nurses sharpen their goals and make decisions. Philosophical statements assist nursing schools in designing and implementing curriculum and in evaluating its effectiveness. Bruce, Rietze, and Lim (2014) view philosophy as a way of framing questions related to what is known, believed, and perceived. It is a way of thinking, examining, and contemplating about what is regarded as a worthwhile pursuit. In nursing education, philosophy describes the value system that shapes the curriculum. In designing an educational curriculum, faculty must consider and incorporate its values and beliefs. According to Billings and Halstead (2016), philosophy of nursing education addresses the values and beliefs about learning, teaching, the role of students and faculty, the purposes of the curriculum, and other concepts that are critical in nursing practice, such as environment, society, and human beings. The relationship between educators and nursing students influences their beliefs and values. It also influences the faculty’s expectations regarding learners. Nursing education philosophy varies depending on the level of the program.

Philosophy of Education for Undergraduate Nursing Students

Undergraduate nursing education prepares students for entry into practice, and thus the curriculum philosophy includes reference to the four nursing metaparadigm: persons, environment, nursing, and health. Undergraduate students are taught about the goals of nursing, the roles of nurses in health care systems, and the role of the environment in health. These beliefs form an essential part of the undergraduate nursing curriculum philosophy. They help undergraduate students develop an understanding of how the environment and its systems affect health and well-being of the individuals from diverse backgrounds. Thus, nursing metaparadigm adequately prepares students for providing a holistic care that respects psychological, physiological, cultural, and spiritual dimensions (Keating, 2015). Nursing emphasizes the caring philosophy and the delivery of the patient-centered care with the aim to ensure safety, health, and the well-being of the individuals, families, and communities.

Learning theories and educational framework are used as part of the philosophical basis for undergraduate nursing curriculum. One of these theories is the cognitive apprenticeship, a teaching-learning approach where students learn expert knowledge and acquire nursing skills in a community through practice. Teaching strategies such as coaching and modeling, and learning strategies such as exploration, reflection, and articulation, are used to help students articulate and examine their practice, reflect on their practice, and identify key aspects. Epistemological philosophy is also used to enhance learning by emphasizing the relationship between knowledge and persons. Apart from informal education, the gaining of experiences and learning also occur through informal experiences (Aliakbari, Parvin, Heidari, & Haghani, 2015). Undergraduate students shape learning through intellect, intuition, experience, and practice.

In this era of unprecedented change in healthcare, education for the undergraduate students must respond to the emerging challenges. A well-conceived curriculum for the undergraduate program is critical for the preparation of nurses (Bruce, Rietze, & Lim, 2014). Nursing faculty uses professional standards that offer critical guidance in order to design curriculum for the undergraduate program. According to Billings and Halstead (2016), faculty should consider other factors relevant to the students’ needs and community. Apart from content related to nursing, the curriculum for undergraduate students incorporates liberal education to prepare nurses who are clinically competent, ethically motivated, and compassionate. Education in liberal sciences and arts exposes students to the content that becomes a part of critical thinking and prepares them for adapting to changing circumstances. Healthcare is undergoing rapid change, and thus nurses should be competent in new skills and knowledge.

Faculty preparing curriculum for undergraduate nursing programs considers the current and future trends in healthcare because they are likely to affect practice. Although predicting the future health care needs and issues is difficult, without such vision, nursing schools will not be able to prepare the graduates adequately. Over the last two decades, various reforms have been suggested to ensure that entry-level nurses have a set of competencies needed to provide quality care in a dynamic and increasingly complex healthcare environment (LeFlore & Thomas, 2016). Today, the priority for undergraduate students’ education lies on what the graduates can do with their learning rather than what they learn. Nursing education for the undergraduate students has shifted from a narrow focus on mastery of learning and emphasis on a specific set of skills to broader learning competencies and more integrative learning experiences. Additionally, there is a radical transformation in nursing schools that seeks to prepare students better by revising the curriculum to ensure that they are not saturated with content. Keating (2015) points out that content-laden curriculum creates a barrier to the integration of knowledge into practice. Faculties designing undergraduate education are focusing on what students need to learn to become competent instead of continuing to add more content to the already overloaded curriculum. Billings and Halstead (2016) suggest that the curriculum for undergraduate nursing students should consider what must be taught and how to deliver the content efficiently and effectively. Undergraduate nursing education should focus on competency needed to ensure that students are adequately prepared to work in a complex healthcare environment.

Philosophy of Advanced Practice Nursing Students’ Education

Nursing education for the advanced practice students has been changing rapidly over the past decade. The initiatives developed in response to the increased focus on patient safety and to the healthcare reform legislation that guides education programs, preparing nurses to practice in advanced practice nursing (APN) role. The faculty that plans curriculum for APN believes in equipping students with skills and knowledge needed to adopt a practice that is innovative and evidence-based. Nursing schools for APN adopt a scholarly approach to educate advanced practice students. According to LeFlore and Thomas (2016), the education program for APN integrates the concepts of healthcare theory, health policy, ethical leadership, and research with principles of evidence-based practice, leadership, and healthcare systems. Advance practice students are taught courses related to this topic to help them develop the set of competencies needed for practice. The curriculum includes courses that teach students how to apply theories and concepts. Such courses help them develop leadership skills needed in healthcare system.

APN education emphasizes the intense practice and integrative practice experiences. Advance practice students adopt a practice application that plays an integral role in the integrative practice experience. The program helps students develop competencies needed to practice in increasingly complex environment and leadership roles. It equips nurses with knowledge of how to improve health outcomes and leadership skills in order to strengthen the healthcare delivery and nursing practice (LeFlore & Thomas, 2016). The approach also prepares APNs for developing and sustaining therapeutic relationships with other professionals and patients with the aim of achieving optimal care and health outcomes.

The curriculum for APN education is changing from content focus to competency focus due to the need to collaborate within and across the programs. The design of the curriculum focuses on the skills, knowledge, and values that encompass nursing practice. All the stakeholders are involved in deciding the expected competencies or outcomes. The change in healthcare system places a new demand on the APN, and thus the curriculum should be adapted to ensure that new competencies are evaluated and taught appropriately (LeFlore & Thomas, 2016). The use of a competency-based model enables the educators to adapt the curriculum to accommodate the rapid changes in healthcare and ensure that the advanced practice students are adequately prepared to provide quality care (Keating, 2015). Moreover, the educators value the emerging technology and its ability to enhance care. As a result, education program for advanced practice students has been expanded to incorporate courses needed to equip the graduates with technical skills to ensure that they deliver high quality and safe healthcare while minimizing cost.

Philosophy for Doctoral Nursing Students’ Education

Education program for doctoral nursing builds upon the skills and knowledge gained during the undergraduate level. It is characterized by the increased breadth and depth necessary for the practice of advanced nursing. Doctoral program focuses on research methodology and scientific content, which require an original research (Billings & Halstead, 2016). It reflects a synthesis of nursing arts and thus is based on clinically and theoretically directed research. One of the critical elements that the educator believes in is that all nurses pursuing doctorate program need to undergo intense practice to ensure their competence. Doctoral program provides skills and knowledge necessary for the students in order for them to have foundation of graduate education and become professional nurses. They are taught scientific underpinning of practice that helps them garner expertise in application of nursing knowledge in their practice. Students are taught to adopt innovative and evidence-based practice by integrating research findings in their practice (Billings & Halstead, 2016). They are prepared to integrate nursing science with the knowledge from different areas such as ethics, organizational, analytical, psychosocial, and biophysical sciences as the basis for advanced nursing role. The ability to analyze and synthesize new knowledge enhances the effective performance of the nurse.

The program prepares nurses to influence healthcare through leadership in various areas, including development of nursing knowledge, nursing theory, research, policy, and education. It prepares nurses to take part in research activities by providing them with knowledge on evidence-based practice and scientific foundations of nursing practice. The doctoral program prepares nurses to engage in inquiries by using inter-professional collaboration, technology, quality improvement methods, and research. They are also taught knowledge application activities, such as translational sciences, evaluation of practice, the participation in collaborative research, and improvement of reliability of nursing practice (Iwasiw, Goldenberg & Iwasiw, 2015). These competencies help nurses to take a leading role in APN.

Curriculum for doctoral program emphasizes the evaluation of new practice approaches based on nursing theories as well as those from other disciplines. The doctoral program is guided by theory and knowledge from nursing science, biological sciences, social sciences, and arts (Billings & Halstead, 2016). Knowledge from these disciplines provides a broad foundation of nursing theories. The integration of knowledge across disciplines helps students discover new phenomena and apply discoveries to address issues in the increasingly complex health environment. Courses that introduce science-based concepts and theories help students describe the actions and advance strategies to enhance healthcare delivery and determine the nature of health (Billings & Halstead, 2016). Doctoral program equips the nurses with research skills necessary for the development of new nursing practice needed to solve the complex health issues.

Conclusion

The curriculum reflects the philosophy of nursing education and varies depending on the level of the program. The outcome of an undergraduate program is to prepare competent nurses of the beginning level, whereas doctoral program prepares nursing students for advanced practice roles in the rapidly changing society and dynamic healthcare system. The philosophy of APN education is practice-oriented whereas values for doctoral program are research-oriented. The curriculums for all levels of education are undergoing changes to respond to the change in professional, scientific, and societal forces. The APN education and doctoral program are changing from content focus to outcome or competency focus. Nursing education for all levels must continue to change in order to meet the needs of healthcare delivery systems.