Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences

Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences

Teaching and Learning in Nursing xxx (2016) xxx–xxx Contents lists available at ScienceDirect Teaching and Learning in Nursing journal homepage: www...

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Teaching and Learning in Nursing xxx (2016) xxx–xxx

Contents lists available at ScienceDirect

Teaching and Learning in Nursing journal homepage: www.jtln.org

Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences1,2 Rhoda A. Owens, PhD, RN ⁎ University of North Dakota, College of Nursing and Professional Disciplines, Grand Forks, ND 58202-9025, USA

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Article history: Accepted 12 October 2016 Available online xxxx Keywords: Part-time nursing faculty Associate degree faculty Pedagogical skills Role transition Transformative learning Professional identity

a b s t r a c t The purpose of this study was to explore and interpret the part-time nursing faculty's perceptions of their need to learn pedagogical skills during their role transition experiences from an expert clinician identity to a clinical instructor identity while teaching at a rural 2-year institution (community college). A qualitative design with Moustaka's phenomenological methods approach was conducted with 3 nurses as they transitioned into their clinical instructor identities. Analysis of the data yielded 5 themes: (a) development of their clinical instructor identity; (b) perception of similar and different learning needs; (c) incentive and motivation to learn; (d) the necessity of prior and current nursing experience; and (e) the importance of other faculty and resources. Study results propose the use of Illeris' Transformative Learning and Identity theory as a framework for associate degree nursing program administrators to use in the development of successful part-time faculty orientation and professional development programs. © 2016 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.

Introduction In the United States, prelicensure nursing programs are experiencing a significant shortage of faculty (Benner, Sutphen, Leonard, & Day, 2010; Davidson & Rourke, 2012; National League for Nursing [NLN], 2016; Schoening, 2013). According to the NLN (2016) Annual Survey of Schools of Nursing Academic Year 2013–2014, 25% of practical nursing/vocational nursing and 28% of associate degree nursing (ADN) programs reported that a lack of faculty was a main obstacle to expanding their program enrollment numbers in an attempt to decrease the United States nursing shortage. As a result, these nursing programs are increasing the use of part-time faculty, both as direct hires and by forming partnerships with health care facilities through which staff nurses serve as part-time clinical instructors to teach students in the laboratory and clinical settings (Hewitt & Lewallen, 2010; McDonald, 2010; Schoening, 2013). Entering academia as a part-time nursing faculty member requires a major transition from the role of a clinician in nursing practice to the role of an educator in higher education (Davidson & Rourke, 2012; McDonald, 2010; Schoening, 2013). According to

Billings and Halstead (2016), the nurse educator role is a recognized role within the discipline of nursing which is distinct from clinical practice. In addition to being competent to practice in the clinical setting, the nurse educator's role requires specialized preparation, skills, and knowledge to prepare nursing students to practice safe quality patient care (Billings & Halstead, 2016). Problem Statement The purpose of this study was to explore part-time nursing faculty's perceptions of their learning needs during their role transition experiences from an expert clinician identity to a clinical instructor identity while teaching at a rural 2-year institution (community college). There is a dearth of research that explores part-time nursing faculty's role transition, especially at 2-year institutions in rural regions. Given the extensive competencies required to educate nursing students and the importance of professional identity development in a successful role transition process, further research is needed. This study analyzed experiences of part-time faculty at 2-year institutions within a rural region with the development of their nurse educator identities. Literature Review

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Acknowledgment of financial support: None. Presentation information: Not previously presented. ⁎ Corresponding author. Tel.: +1 701 720 1588, +1 701 777 4175. E-mail address: [email protected]. 2

The purpose of the literature review was to ascertain what research existed relating to the learning, role transition, and identity development experiences of part-time nursing faculty in ADN

http://dx.doi.org/10.1016/j.teln.2016.10.002 1557-3087/© 2016 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.

Please cite this article as: Owens, R.A., Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences, Teaching and Learning in Nursing (2016), http://dx.doi.org/10.1016/j.teln.2016.10.002

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R.A. Owens / Teaching and Learning in Nursing xxx (2016) xxx–xxx

programs. Most previous research on these topics has focused on full- and part-time faculty at 4-year institutions. A lack of research exists regarding the experiences of part-time faculty in 2-year ADN programs. Several qualitative studies were conducted on the experiences of new faculty's role transitions from expert clinicians at bachelor of science degree in nursing (BSN) programs. The transitioning experience often produces stress and anxiety in new faculty. In addition, they must learn new knowledge, skills, and values to adequately socialize to their new role. A study of full-time nursing faculty at a BSN program completed by Schoening (2013) generated the nurse educator transition model. The model proposes that full-time nursing faculty's role transition experiences include feelings of anticipation, excitement, and role ambiguity; learning teaching skills and roles; and finally identity formation as an educator. Participants were selfdirected in learning necessary skills, roles, and responsibilities related to their educator identity. Anderson (2009) had similar results, however, he found that the learning, role transition, and identity development process differed between full-time faculty because of past clinical and teaching experiences indicating transitioning is an individual process. A study completed by Duphily (2011) identifies several themes suggesting a difficult transitioning for novice full-time nursing faculty at two ADN programs. A lack of education preparation, transitional stress and uncertainty, feelings of isolation, decreased job satisfaction, inconsistent support and lack of socialization, and difficulty establishing proper student–faculty relationships contributed to problems with nurses successfully transitioning to their full-time nursing faculty roles. Research reveals the need for part-time clinical instructors at BSN programs to be oriented to the organization's faculty pay and benefits, resources, and meetings; clinical policies and procedures; curriculum content and objectives; simulation technology; and assessment and evaluation of student learning (Davidson & Rourke, 2012). Implementation of effective orientation and professional development programs can provide support and assist part-time faculty in developing their teaching abilities to promote effective student learning (Davidson & Rourke, 2012). Besides the need for orientation and professional development, many studies support the need for mentorship by experienced faculty of all new part- and full-time nursing faculty for their successful transition to their teaching role (McDonald, 2010; Schoening, 2013; Weidman, 2013). Identifying nursing faculty learning needs is critical for the establishment of such programs. For ADN programs, mentorship and orientation of all faculty, part-, and full-time, is required according to the standard 2.8 set by the Accreditation of Commission for Education in Nursing (2017). The diverse pedagogical skills required by all nurse educators in the academic setting have been defined by several professional nursing organizations and nursing program accrediting agencies. The Scope and Standards of Practice for Academic Nurse Educators (NLN, 2013) define eight core competencies that promote excellence in the nurse educator role that nurse educators must be held accountable to: (a) facilitate learning, (b) facilitate learner development and socialization, (c) use assessment and evaluation strategies, (d) participate in curriculum design and evaluation of program outcomes, (e) function as a change agent and leader, (f) pursue continuous quality improvement in the nurse educator role, (g) engage in scholarship, and (h) function within the educational environment (NLN, 2013). In addition, the increased emphasis in health care on patient safety, quality care, and patient care outcomes led to the development of

the Institute of Medicine's (now known as the Health and Medicine Division) Five Core Competencies for health care professionals (Finkelman & Kenner, 2012). Attainment of these competencies along with the NLN Core Competencies and other pedagogical skills are critical for nurse educators so they can facilitate effective student learning. Nursing program outcomes should focus on production of graduates who can provide safe, high-quality patient care in a variety of health care settings. To teach curriculum focused on the NLN and Health and Medicine Division Core Competencies, all nursing faculty need professional development on curriculum concepts and interactive teaching strategies. Content based on the competencies include extensive updating of curriculum on how to provide patient-centered care, work on interprofessional teams, employ evidence-based practice, apply quality improvement, and utilize informatics in clinical practice and health care systems (Finkelman & Kenner, 2012). Last, the student population and organizational environment of 2year ADN programs are different when compared with 4-year institution nursing programs (Cohen, Brawer, & Kisker, 2014; Levin, Kater, & Wagoner, 2011). Students at 2-year institutions are generally nontraditional and more diverse with multiple life experiences who struggle to fit required course work and activities into schedules constrained by family commitments, child-rearing responsibilities, and part- and full-time jobs (Cohen et al., 2014; Levin et al., 2011). In addition, students are generally less academically prepared to pursue a degree than students at 4-year institutions (Cohen et al., 2014; Levin et al., 2011). Levin et al. (2011) discovered that all part-time faculty at 2-year institutions generally are not offered the same opportunities for orientation and professional development as fulltime faculty. Therefore, it is critical that all ADN program nursing faculty be educationally prepared to modify teaching strategies to facilitate effective learning in these diverse students with multifaceted roles. ADN programs must graduate students prepared to enter nursing practice able to provide safe quality patient care. Theoretical Touchstone Illeris' (2014) Transformative Learning and Identity theory was used as the theoretical touchstone for this study. Illeris (2014) defines transformative learning as learning that involves change in the identity of the learner. Identity is about being a person in the world, who one experiences being, and how one relates to and wants to be experienced by others (Illeris, 2014). Finally, establishment of one's identity involves the three dimensions of learning (content, incentive, and interaction) in society and depends on the learner's characteristics and present and past experiences (Illeris, 2014). This theory provided a touchstone for the study as it provides a context for critical factors relating to nurse educator identity transformation not previously studied in this population. Methodology The design for this study utilized phenomenological qualitative methods. Moustakas (1994) describes the aim of phenomenology as “…to determine what an experience means for the persons who have had the experience and are able to provide a comprehensive description of it. From the individual descriptions, general or universal meanings are derived…essence and structure of the experience” (p. 13). The phenomenon in this study involved exploring the individual nursing faculty experiences as they transitioned from the expert clinician identity to the clinical instructor identity while teaching at a rural 2-year institution. Specifically, participants were asked to share what pedagogical skills and additional learning each faculty perceived was needed in order to be an effective clinical instructor.

Please cite this article as: Owens, R.A., Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences, Teaching and Learning in Nursing (2016), http://dx.doi.org/10.1016/j.teln.2016.10.002

R.A. Owens / Teaching and Learning in Nursing xxx (2016) xxx–xxx

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Participants

Results

After receiving institutional review board approval, part-time nursing faculty teaching at a small distant site of a rural midwest 2year institution were e-mailed a brief description and purpose for the study. Interested faculty were asked to e-mail the researcher. The college is part of a nursing education consortium of four 2-year institutions in a rural region that offer two programs, practical nursing certificate and an associate degree in nursing. Inclusion criteria for participants included those willing to share their experiences, considered to be clinical experts in nursing, and taught students part-time in the laboratory and/or clinical settings less than 2 years. Participants were female whose employment as a clinical instructor ranged from 4 months to 1 ½ years (M = 9 months). Years of nursing practice experience ranged from 5 to 14 years (M = 10 years), and they continue to practice in a variety of clinical settings. Past and present clinical practice experiences included such areas as rehabilitation, medical/surgical, emergency room, pediatrics, obstetrics and gynecology, intensive care unit, and the neonatal intensive care unit. Education levels included two participants with a BSN degree and one participant with a master of science in nursing degree.

Five themes emerged during data analysis as described below with exemplar participant quotes and observation data.

Procedure

Over time, through their role transition process and individual learning experiences of new roles, responsibilities, and teaching skills, the development of their clinical instructor identities occurred. Their comfort levels increased. Learning how to teach was critical to their successful transitions. The perceptions of students and other faculty were also important to their identity formations.

The details of the study were further described personally by the researcher to interested part-time nursing faculty, and informed consent was obtained. Participants were assigned pseudonyms to maintain anonymity. Multiple sources of data were collected and analyzed by the researcher concurrently over a 4-month period using a triangulation approach to provide credibility and trustworthiness (Creswell, 2013; Glesne, 2011; Moustakas, 1994). Data sources included audio recorded semistructured face-to-face individual interviews, a reflective journal, and observations of the participants in the laboratory and clinical settings while teaching their students. Four-hour observations of each participant were completed by the researcher prior to their interviews and focused on their competencies with the use of pedagogical skills. The researcher collected field notes of the teaching observations and completed a reflective journal. Individual interviews lasted 60 to 90 minutes, were audio recorded, and held privately in each participant's office. Participants were asked open-ended interview questions to describe their present and retrospective clinical instructor role transition experiences, instructor identity formations, and perceptions of the pedagogical skills they needed to facilitate effective student learning. The researcher collected the data until the point of saturation. Three participants were included in this study. Data Analysis The participant's verbatim interview transcripts, researcher's field notes, reflective journal, and descriptions of the teaching observations were analyzed continuously using the steps of Moustakas' (1994) data analysis method. Using a content analysis approach, we developed common themes by grouping significant statements, descriptions of observation data, and textural descriptions of the participant's experiences (Moustakas, 1994). Member checking was conducted continuously as interviews were transcribed and analyzed. Participants had the opportunity to review their transcriptions and analysis after each interview, and communicate any inconsistencies and inaccuracies they observed that involved data interpretation and analysis. In addition, a second experienced qualitative researcher reviewed the methodology, data analysis and interpretation to ensure that it was logical and consistent and to provide further credibility and trustworthiness.

Theme 1: Development of Their Clinical Instructor Identity When each participant first began as a clinical instructor, all experienced feelings of role ambiguity, stress, and a lack of teaching experience. Each perceived her identity as that of an expert clinician with specific roles and responsibilities. For example, Sally described her experiences, Well, at first I was a little uncomfortable and confused about my roles and responsibilities. I did not have a clue what I was supposed to do…After all, I am a bedside nurse with expert knowledge and skills. In the past I had nursing students follow me, however, my role as a clinical instructor would be different. I feel much more comfortable now teaching…I have learned how to teach….I see the “lightbulbs” go on now in the students. It has been a learning process. I feel like a clinical instructor now…Students and faculty perceive me as one.

Theme 2: Perceptions of Similar and Different Learning Needs Participants perceived several similarities on their need to learn pedagogical skills such as handling student issues, using technology and effective teaching strategies, facilitating student learning, demonstrating laboratory skills, assessing and evaluating student learning, and developing curriculum. However, they expressed differences such as using a simulator, organizing clinical experiences, and giving effective student feedback. Contributing factors for these perceived differences could be that participants were hired to work in different courses (laboratory and/or clinical) and varied in their past and present teaching, learning, and clinical practice experiences. Observation data analysis further reinforced that the participants had correctly identified personal mastery of pedagogical skills in several areas. Participants used teaching methods such as demonstrating skills, lecturing, performing pre- and post-clinical conferences, and giving constructive feedback to students. Take for example this observation field notes passage describing Kimberly as she is demonstrating assessment of a newborn during a laboratory course, Kimberly continues her lecture and demonstration of the newborn assessments. As she demonstrates the assessment, she describes normal and possible abnormal findings. Presentation is organized and progresses from head to toe. Kimberly allows time for students to ask questions. Several students ask questions and Kimberly proceeds to answer each of their questions. Students were otherwise quiet and appeared attentive while watching her demonstration. Kimberly explained to the students how she will evaluate and assess their performances on the skills. Another example can be seen in this observation field notes passage describing Sally during a preclinical conference with her students, Sally is observed assessing her students to determine whether or not they are prepared to care for their patients today.

Please cite this article as: Owens, R.A., Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences, Teaching and Learning in Nursing (2016), http://dx.doi.org/10.1016/j.teln.2016.10.002

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R.A. Owens / Teaching and Learning in Nursing xxx (2016) xxx–xxx

Each student takes his or her turn discussing their patient's past and present medical history, medications, priorities, and nursing care plan for the day. Sally uses teaching strategies such as lecture and discussion. She asks students what they view as the focus and priority care for each of their patients. Sally appears to give feedback by verbal and nonverbal actions (head nodding, eye contact) so that students know if they are correctly answering questions or describing priority cares. Sally appears comfortable. Students are engaged and fully participate in the preclinical conference. Their perceptions of the need to learn various teaching skills were similar and different among participants indicating that learning is an individual process and reinforces the necessity for their involvement in determining their own needs. They were observed using a variety of learned pedagogical skills while teaching their students. In addition, they appeared comfortable, and students seemed engaged in their learning activities further reinforcing participants' perceptions that they have mastered various pedagogical skills necessary to facilitate student learning. Theme 3: Incentive and Motivation to Learn During their interviews, participants described an incentive and motivation to learn various pedagogical skills, new roles, and responsibilities viewed as important to their instructor identities. In addition, participants discussed various reasons why they chose to pursue a career as a clinical instructor. Some of their reasons included a career change, job satisfaction, more work–life balance, to prepare students to enter nursing practice, and positive past teaching experiences. For example, Kimberly expressed, “I really enjoy working with students. I really enjoy seeing them grow and I enjoy doing the clinical part and teaching part of it.” Betty commented, “I need to be in charge of my education I feel I need to do my job correctly. This is a new job for me and I have much to learn about doing clinicals at the hospital.” Finally, Sally stated, “There is always something new and important to learn that I can use to improve my teaching.” Participants expressed feelings of work satisfaction and the importance of learning how to teach students effectively. In addition, they believed in the importance of life-long learning and professional development on teaching skills and changes in clinical practice. Theme 4: The Necessity of Prior and Current Nursing Practice Experience Their knowledge, skills, and past experiences of working in clinical practice and with nursing students provided participants a foundation to add their new knowledge on use of pedagogical skills to promote student learning. However, they expressed that teaching students as a nurse versus as a clinical instructor was different because they felt more responsible for student learning as instructors. In addition, all participants stressed a necessity to remain competent in clinical practice and that sharing their experiences with students was helpful to facilitate student critical thinking and clinical reasoning. For this reason, all continue to work part time in clinical practice. In the following excerpt, Sally described how she perceives that her experiences in nursing practice help her be a more effective clinical instructor and provides her with past experiences to share with students to stimulate their learning, My years of nursing practice experiences in the rehabilitation and medical/surgical units definitely help me as a clinical instructor…I feel there is a whole lot to learn in nursing practice before you can be an effective teacher…Through the years, I taught many students as a nurse…However, as a clinical instructor, I am more responsible for their learning…You can teach your students what

you have learned in the real world as examples of what they read in their textbooks…I am always stressing patient safety. I continue to build on that practice experience and learn something each day about teaching my students and how to be a better teacher. Similar to Sally's responses, Betty described in the following excerpt that she also feels nursing practice experience is very valuable to her instructor identity, By also working in the clinical setting as a nurse, the clinical instructor can share real life nursing experiences with students to help them learn. The students like to hear about these experiences. I talk about my experiences based on the topic or theory content I need to cover during that lab or clinical time. My clinical practice has provided that needed base to add my new knowledge on how to teach. Students seem to appreciate faculty who work in clinical practice and academia. Past and present experiences in nursing practice and teaching students provided participants a necessary foundation for them to learn new roles, responsibilities, and pedagogical skills required to be a clinical instructor. In addition, they believe in the need to remain competent in clinical practice. Theme 5: The Importance of Other Faculty and Resources Interacting and socializing with other nursing faculty assisted all participants with learning pedagogical skills, roles, and responsibilities. All expressed in the importance of finding a mentor. In addition, they expressed value in utilizing various resources such as journals, books, e-mails, and Web sites to learn additional skills. For example, Kimberly stated, “All the other faculty have been very helpful to me in learning my roles and responsibilities. Talking to them and observing them teach has also helped me learn the needed teaching skills…. I have learned from books and websites.” In addition, Betty commented, “Sarah has been a real mentor to me. She has taught me my responsibilities and how to teach my students. I have learned a lot by watching and talking to her.” Through the use of available resources while interacting with other faculty in the academic setting, participants have learned the necessary roles, responsibilities, and pedagogical skills to develop their instructor identities. Observing experienced faculty teach students also assists the part-time faculty in their learning. Discussion Several themes emerged from this study suggesting similarities and differences in the role transition and instructor identity development experiences for part-time nursing faculty at rural 2-year institutions. Participants in this study described a lack of teaching experience, feelings of role ambiguity, and an incentive to learn pedagogical skills and instructor roles and responsibilities during their role transitions. These results are similar to findings in other studies of faculty at 4-year institutions (Forbes, Hickey, & White, 2010; McDonald, 2010; Schoening, 2013). During their nursing careers, nurses change their professional identities by learning different skills, roles, and responsibilities as they transition between different practice areas and successful identity formation leads to work satisfaction (Johnson, Corwin, Wilson, & Young, 2012). Previous research discovered that faculty at 4-year institutions develop their educator identities by learning teaching skills, roles, and responsibilities (McDonald, 2010; Schoening, 2013). This study had similar findings in that ADN program parttime faculty perceived that their learning experiences facilitated their successful role transition and development of their nurse

Please cite this article as: Owens, R.A., Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences, Teaching and Learning in Nursing (2016), http://dx.doi.org/10.1016/j.teln.2016.10.002

R.A. Owens / Teaching and Learning in Nursing xxx (2016) xxx–xxx

educator identities. Anderson (2009) discovered that part-time faculty at a 4-year institution have both common and uncommon learning experiences as they complete their role transition to their clinical instructor identities. Similar to findings by Anderson (2009), this present study suggests part-time faculty at an ADN program perceived a need to learn similar and different pedagogical skills, roles, and responsibilities, supporting previous research that learning during role transition is an individual experience and contributes to nurse educator identity development. Findings of this study illustrate gaps in existing research of parttime faculty teaching at 2-year institution (ADN) programs. The results propose the use of Illeris' (2014) Transformative Learning and Identity theory to analyze rural 2-year institution part-time nursing faculty's role transition experiences that facilitated the development of their nurse educator professional identity. Participants experienced the three dimensions of learning that are a part of Illeris' (2014) Transformative Learning and Identity theory, such as an incentive to learn pedagogical skills, roles, and responsibilities (content) during their interactions with other faculty in society (academic, clinical, and laboratory settings). Furthermore, faculty in this study stressed that their existing clinical practice skills, knowledge, and experiences provided a foundation for learning new knowledge (roles, responsibilities, and pedagogical skills—content) necessary for development of their instructor identities. Illeris (2014) also concluded that learning is an individual experience dependent on the individual's characteristics, past, and present learning experiences. Limitations Although the number of participants was small for this study, data saturation was accomplished through the data collection and analysis process. One 2-year institution in a rural setting was used, limiting the findings. Indications for Future Research Overall, more research is needed with part-time faculty at 2-year institutions (ADN programs). Future research should involve a larger more diverse sample of part-time nursing faculty at multiple 2-year institutions. In addition, further studies are needed on the use of Illeris' Transformative Learning and Identity as a theoretical framework to analyze part-time faculty role transition and identity development. Conclusion Understanding the experiences of part-time faculty at 2-year institutions (ADN programs) while they complete their role transitions from their expert clinician identities to their nurse educator identities can aid the development of orientation and professional development programs. ADN program leaders must provide equal quality programs to all faculty (part time and full time). The use of Illeris' (2014) Transformative Learning and Identity theory holds promise for use as a framework by prelicensure nursing program administrators in the development and evaluation of such programs. Finally, because findings illustrated that part-time faculty have an incentive to learn, nursing education administrators must strive to involve them in determining their learning needs and planning their professional

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development so they develop nurse educator competencies. The transition from clinician to educator requires the faculty to learn pedagogical skills that will prepare nursing graduates to give compassionate, safe, and high-quality patient care in a variety of health care settings. For example, mentoring programs could be developed for part-time faculty by pairing new faculty in rural regions with other experienced faculty at rural institutions via the Internet. New faculty assuming an educational role also require flexible and easy access to resources such as e-books, webinars, journals, and other online resources. The faculty shortages and the critical need to transition expert clinicians to nursing educators with diverse pedagogical skills require institutions to address faculty role transition and identity requirements.

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Please cite this article as: Owens, R.A., Part-Time Nursing Faculty Perceptions of Their Learning Needs During Their Role Transition Experiences, Teaching and Learning in Nursing (2016), http://dx.doi.org/10.1016/j.teln.2016.10.002