Looking back – what advice would you give your first year self… hear are some of the things I would have liked to have known more about!
Practice-informed nursing: The future of transformative nursing education and research in a technological context
Three significant factors will impact on the future of nursing education and research in Australia
- Entrenchment of a culture of patient safety among practice-ready graduates while offering transformative educational experiences to nursing students and building resilient communities. Rural and regional communities, Indigenous people, and international inclusiveness and connectivity will be particularly important.
- Entrepreneurial nursing academics will be pivotal in developing innovative ways to fund practice and research projects; deliver quality-learning programs; and produce a strategic mix of research outputs. This is critical because of cuts to funding across the higher education sector and increasing competition for research grants.
- Capitalising on E Health – using the term broadly to cover not only storing, retrieving, maintaining and sharing patient records safely and effectively, but also electronic health service delivery assisted by communications technologies, such as web-conferencing, internet-based interventions, and the use of apps and social media. And there’s also E Health in academia – the way that the technologies are revolutionising the teaching, learning and research environment for nursing. Nursing academics’ expertise in E Health technologies will undoubtedly need to expand in the future.
transformative practice informed patient safety
The health industry expects universities to produce nursing graduates who are practice-ready and proficient in delivering quality health care where patients are safe, health risk is reduced, and deterioration is detected and responded to quickly. The graduates must be prepared for the high acuity of workplaces in the health sector, and must possess the indispensable attribute of resilience. Industry also expects graduates to be skilled in collaborative teamwork and capable of leadership and supervision early in their careers (Australian Commission on Safety and Quality in Health Care, 2010; Australian Institute of Health and Welfare, 2014; NSW Health, 2013).
A new era in the nursing discipline is dawning where transformative models of service and care are prioritised. The transformative process surpasses the traditions of ‘evidence-based practice’ and ‘life-long learning’, which frequently uses ‘time-spent’ as a metric to determine learning outcome.
Instead, future nursing needs contemporary continuous transformative learning, and practice-informed research using continuous models that are more flexible and nimble, in order to enhance capacity to adapt to rapid changes. Preparing students to be practice-ready has become increasingly challenging within the traditional three-year degree program, where specialty themes compete for inclusion. There is a need for innovative and entrepreneurial practice-informed teaching and learning to invigorate future curriculums, in conjunction with a balanced approach to practice-informed research agendas.
Postgraduate courseware will need to align with, and adapt to, market forces. In Australia, this includes addressing the changes announced by government to create Primary Health Networks and Health Care Homes, and ensuring the supply of qualified nurses to fill posts in these national centres (for example, Credentialed Mental Health Nurses). Advocating for appropriate reimbursement of specialist nurses will be a critical driver of postgraduate education (Australian College of Mental Health Nurses, 2013).
nurse entrepreneurialism in higher education
Funding for the higher education sector has been dwindling in recent years leading to major budgetary challenges, particularly for regional universities. Popular, high-enrolment courses like Bachelor of Nursing will continue to be important and strategic contributors to the overall university budgets.
International university ranking analysts suggest that “strongly motivated academics can offset to some degree limited funding” (Williams, Leahy, de Rassenfosse, & Jensen, 2016). Actively seeking collaborations will be vital to ensuring research funding success at the highest level, and so will serious attention to grantsmanship.
Nursing curriculum, with its expensive practicums, will undergo closer fiscal scrutiny in the future. So will other teaching related expenditure, with imperatives to maintain industry accreditation, to provide quality educational experiences for students, to have genuine consumer participation in curriculum design, and to incorporate digital and simulated pedagogies while managing cost effectiveness.
A particular challenge for nursing is to improve the impact of nursing research generally. Co-investigative nurse membership of collaborative interdisciplinary research teams has been important. A newer challenge is to move towards a position of excellence in nurse-led health research. New opportunity exists to do this, with the Australian Research Council looking to widen the definition of measurable impact to include category 2 and 3 grants, and with impact metrics increasingly linked to Google open access outputs, and international linkages including co-authorship (Williams et al., 2016).
Nurse researchers will need to be grant-ready and this includes building track record in grant success, and generating publications from their research. Concurrently, nursing scholars will need to develop industry and research linkages (including international higher degree research student intakes), together with the technological skills to generate outputs in digital domains.
safe and effective e health innovations
State and Federal governments are turning their service delivery focus and funding streams toward E Health services to meet growing expectations across the Australian consumer population (Australian Bureau of Statistics, 2013; Australian Commission on Safety and Quality in Health Care, 2015). For example: digital gateways for triaging and accessing health care service provision (Department of Health, 2015), managing patient health records, and delivering, monitoring and evaluating health interventions (Christenson & Petrie, 2013; Department of Health, 2016; Department of Health, 2015; E Mental health strategy for Australia, 2012; Keast, 2016).
E Health skills will need to be recognised as a core competence in future nursing curriculums (Australian Commission on Safety and Quality in Health Care, 2015). The rise of E Health presents opportunities for nursing with improved digital pedagogy learning design systems to produce nursing graduates who are practice-ready for the new and evolving practice domain of safe E Health. This has particular relevance for including and servicing rural and regional communities.
The nursing academy in Australia is trending against the odds. Nationally, enrolments are high, outputs and impact are strengthening despite dwindling higher education budgets for the discipline. Nursing academics will continue to drive the Australian nursing discipline into the future as they transform their focus towards practice-informed teaching and learning, practice-informed research integrated with international connectivity, and stronger collaborative relationships with the health sector and wider society.
- Australian Bureau of Statistics. (2013). Internet Activity, Australia, December 2012. (8153.0). Canberra: Australian Bureau of Statistics. Retrieved from http://www.abs.gov.au/
- Australian College of Mental Health Nurses. (2013). A Survey of Credentialed Mental Health Nurses working in the Mental Health Nursing Incentive Program.
- Australian Commission on Safety and Quality in Health Care. (2015). Australian Commission on Safety and Quality in Health Care Annual Report 2014/15. Retrieved from http://www.safetyandquality.gov.au/
- Australian Commission on Safety and Quality in Health Care. (2010). National Consensus Statement: Essential Elements for Recognising and Responding to Clinical Deterioration. (pp. 1-24). Sydney: Australian Commission on Safety and Quality in Health Care (ACSQHC).
- Australian Commission on Safety and Quality in Healthcare. (2016). Safety in E Health. Retrieved from http://www.safetyandquality.gov.au/
- Australian Institute of Health and Welfare. (2016). Primary Health Network (PHN) data. Retrieved from http://www.aihw.gov.au/
- Australian Institute of Health and Welfare. (2014). Australia’s Hospitals 2013-14. Retrieved from Australian Institute of Health and Welfare:http://www.aihw.gov.au/
- Australian Research Council. (2016). 2015-2016 State of Australian University Research ERA National Report. Retrieved from: http://www.arc.gov.au/
- Best, O. (2015). The cultural safety journey: An Australian nursing context. In O. Best & B. Fredericks (Eds.), Yardjuligin: Aboriginal and Torres Strait Islander Nursing and Midwifery Care (pp. 51-73). Port Melbourne: Cambridge University Press.
- Christenson, H., & Petrie, K. (2013). Information technology as the key to accelerating advances in mental health care. Australian and New Zealand Journal of Psychiatry, 47(2), 114-116.
- Department of Health. (2015). Australian Government Response to Contributing Lives, Thriving Communities – Review of Mental Health Programmes and Services. Canberra: Australian Government Retrieved from http://www.health.gov.au/
- Department of Health. (2016). Health Budget 2016–17. Retrieved from http://www.health.gov.au/
- Department of Health. (2015). e-Health. Retrieved from http://www.ehealth.gov.au/
- E-mental health strategy for Australia. (2012). Canberra: Commonwealth of Australia Retrieved from http://www.health.gov.au/
- Godbold, N., & McCaffery, K. (2015). Improving care by listening: care communication and shared decsion-making Communicating quality and safety in health care (pp. 164-175). Port Melbourne: Cambridge University Press.
- Keast, K. (2016). How technology will advance nursing practice. Retrieved from http://healthtimes.com.au/
- Little, F., O’Brien, A., Gray, M., Wilson R. L., & Finn, A. (2015). Scoping novel rural mental health clinical placements for undergraduate nursing and social work students in Northern NSW. Final Report: 20th November 2015. Retrieved from Hunter & Central Coast Interdisciplinary Clinical Training Network:
- NSW Health. (2013). Policy Directive: Recognition and Management of Patients who are Clinically Deteriorating. (PD2013_049). Sydney: NSW Ministry of Health.
- Usher, K., Woods, C., Casella, E., Glass, N., Wilson R. L., Mayner, L., . . . P., I. (2014). Australian health professions student use of social media. Collegian, 21(2), 95-101. doi:10.1016/j.colegn.2014.02.004
- Williams, R., Leahy, A., de Rassenfosse, G., & Jensen, P. (2016). U21 Ranking of National Higher Education Systems 2016. Retrieved from http://www.universitas21.com/
- Wilson, R. L., Ranse, J., Cashin, A., & McNamara, P. (2013). Nurses and Twitter: The good, the bad, and the reluctant. Collegian(0). doi:http://dx.doi.org/10.1016/j.colegn.2013.09.003