There are many national reports indicating the need for change in health care and in the education of health-care professionals in particular. In its report entitled
crossing the Quality Chasm: A New Health System for the 21
st Century, the Institute of Medicine (IOM, 2001) acknowledges that the education of health professionals in need of major change and asserts that the clinical education of health professionals is outdated and not responsive to the present or future needs in health care. As its guiding vision, the IOM (2003) makes the recommendation that health professionals should be educated to deliver patient-centered care within an interdisciplinary team that emphasizes evidence-based practice, quality improvement approaches, and informatics. The backdrop of needed change will serve as the starting point for discussions regarding essential attributes needed in nursing education. Emphasis on student learning, promotion of evidence-based practice and development of authentic student-teacher relationships are those attributes that are foundational to effective teaching.


Over the past decade, education has shifted from a teacher-centered to a student centered approach. Understanding and facilitating student learning must be a priority for the nurse educator of the 21st century.

In nurse education research, there always has been a greater focus on the outcomes of learning, rather than on understanding the processes involved in learning. Research aimed at understanding how students learn result in the development of best practices in teaching. For example, there is some empirical support for the use of concept mapping as a strategy that promotes critical thinking. In order to facilitate learning, nurse educators must be cognizant (aware) of a variety of factors that students bring to the learning setting. For example, a typical classroom may consist of second-degree students or second career students (Boomers), returning or transfer students who may be in their mid 20s and 30s (Geneses) or students who attend college immediately after graduating from high school (Millennials).

Skillful assessment of student learning outcomes is also needed in order to evaluate how students learn and the degree to which teaching strategies encourage meaningful learning. A recent survey of nursing students suggests that the content demands of the nursing curricula are so great that little time is left for students to assimilate that content into useful clinical knowledge. Novice nurses are less aware of their thinking and learning processes when compared with experiences nurses.


The primary focus of health care institutions today is on the provision of quality care within a cost effective framework. This emphasis on outcomes has led to a national movement requiring evidence based care. A survey to determine the readiness of U.S. nurses for evidence-based practice and found that respondents reported a lack of value for research in practice.

The movement toward evidence based practice requires that educators and practitioners engage in collaborative research. The nurse educator of the future must form collaborative relationships not only with practicing nurses but also with other members of the health care team.

With patient-centered care as its focus, nursing and medicine, for example, need to collaborate in clinical studies in order to improve outcomes of care. Most importantly, nurse educators must role model this behavior for students so that students learn that practice and research coexist and cannot be seen as separate entities. Research becomes meaningfully grounded in practice rather than a theoretical topic unrelated to the practice setting.

Evidence-based practice is here to stay and discussions centering on nursing education and nursing practice must be strongly grounded in nursing research.


There is mounting evidence to suggest that a thoughtful student-teacher relationship is essential for students to develop and grow. The traditional behaviorist model viewed students as empty vesicles who were eager to receive knowledge transmitted from the teacher. The humanistic approach recognizes that students have their own experiences that enrich learning while also viewing the student as a participant in learning.

Since that time, others have carefully examined the centrality of the student-teacher connection in promoting learning. The current research suggests that learning and student development are promoted through strategies aimed at getting to know students and connecting to students through more thoughtful, concerted means.

When investigating student perceptions of effective and ineffective clinical instructors, it was found that students perceived that the most effective clinical instructors were those having strong interpersonal relationships with students. The nurse educator of the future will need to establish authentic relationships with students grounded in mutual trust and respect so that students gain the self-confidence to achieve their potential.


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