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Is a student demonstrating a skill in the lab enough to consider that student competent? Can the student then demonstrate proficiency in that skill in a clinical setting without the aid of faculty? How much reinforcement is needed to help a student obtain competency? These are just some of the typical questions that float around the Department of Nursing at Trinity Christian College when the curriculum is being discussed. We’ve now realized that the answers to these questions don’t have to come from nursing alone.

Part of the mission of our department is to prepare academically and clinically excellent professional nurses for a lifetime of Christ-like service to others. There is a specific dedication to mentoring professional nurses in the practice of clinical reasoning and preparing graduates who are committed to the pursuit of lifelong personal and professional development. To be clinically excellent, students must demonstrate the knowledge, skills, and attitude necessary to provide safe care. So how does the project described in the previous two essays in this series help the Department fulfill this mission while benefiting students, faculty, and beyond?

Benefits to students

A common approach to nursing education is that students are taught a skill in a theory course and the lab, then are expected to practice the skill, and eventually demonstrate the skill to a faculty member to be considered competent to perform in the clinical setting. A common misconception can be that demonstration of the skill equals proficiency, though true proficiency requires much more. While still working in the scope of practice of a student nurse, many skills require direct observation of faculty, but for students to truly demonstrate proficiency they also need to be able to perform the skill independently. The simulation lab can serve as a valuable resource in this scenario, as it is a realistic client care setting while also being a safe learning environment. Students can make mistakes without harming real people, and through their mistakes, students can learn how to prevent those same errors from occurring in the healthcare setting and work towards skill proficiency.

During this research study, students had to demonstrate a skill related to antibiotic stewardship that faculty had reported students found to be challenging. The education faculty designed a training intervention intended to support student proficiency while the nursing faculty designed the simulation experience to serve as the setting. For the first time in the curriculum, students provided client care in the simulation lab independently across multiple sessions. As nursing faculty, we wondered if students would leave the simulations realizing they had made mistakes and needed more knowledge or to practice on their own to be prepared for the next attempt. The results of the study showed that faculty application of Behavior Skills Training was key to improving students’ safe demonstration of the skill. When the nursing faculty shared with the research team that we weren’t sure that the Behavior Skills Training procedure would make a difference over pure repetition, our education colleagues laughed and said, “We were!”

This study reinforces that faculty must help students in understanding that professional nursing is a continual learning process. Skills have to be continually practiced to maintain proficiency rather than a “one and done” approach. It was rewarding as faculty to see the student growth, but it was also rewarding for students to get to see their own growth plotted and receive feedback from faculty outside of the department who were impressed by the knowledge required to provide optimal care.

Faculty and Student Benefits

This study provided the opportunity for us as nursing faculty to role model professional practice for students, giving them a real example of how faculty can collaborate with other professionals to participate in research, demonstrate innovation, and improve student outcomes that directly translate into clinical practice. After participation, students heard the history of how the project came to life starting with a student’s idea. And perhaps this project could be the ignition to light another student’s idea that can lead to even more opportunities to share God’s gifts and learn more about God’s interconnected world.

Faculty, Department, and College Benefits

Nursing faculty shortages are a significant reality in higher education right now. Many barriers to participating in scholarly projects exist, such as lack of mentorship due to faculty shortages or high rates of turnover, and nursing professors having educational backgrounds focused more on direct clinical practice than research. In addition, many nursing faculty are still mentally and physically depleted from the hardships of COVID, while also having to consider how to make curriculum modifications to competency-based education if adopting the new AACN Essentials. It is understandable that the thought of adding a research project might leave professors feeling, well, overwhelmed.

However, this project shows that interdisciplinary research is not only an exchange of gifts but enables the formation of new gifts. As nursing faculty, we experienced how competency-based education ideas and solutions to curriculum needs can be supported by an interdisciplinary team. We gained wisdom and support from those around us including colleagues in education and the natural sciences. With thanks to 1 Corinthians 12, although we are members of different parts of the college, we are all one body. The gifts given to one, are gifts for the whole.

Tina Decker

Tina Decker is Professor and Chair of Department of Nursing at Trinity Christian College.

Sarah Gouwens

Sarah Gouwens is Associate Professor of Nursing at Trinity Christian College.