Emerging Trends and Challenges in 21st Century Nursing Education

Emerging Trends and Challenges in 21st Century Nursing Education
Executive Summary
Technology has become more popular as a medium for teaching and is imperative to today’s learning environment. As nursing education shifts to incorporate different modes of learning and teaching, different technologies must be used to promote student-centered learning. This educational technology can be beneficial to nursing students by ensuring user-friendly access to course content, interprofessional collaboration through sharing information and discussions, and access to information from any setting using a reliable internet connection. “The Role of the BSN Nurse in Promoting Community Health” course is among the areas in the nursing education curriculum that requires the integration of emerging technology. The purpose of this proposal was to identify a nursing curriculum technology that would promote learning and student outcomes for the identified course.

A curriculum needs assessment was done to identify the current gaps in achieving desired learning outcomes. Data was collected from the existing and past learning activities which demonstrated gaps in areas of students’ engagement, effective utilization of the online environment, and poor evaluation mechanisms for students. Different stakeholders including students, nurse educators, and the nursing administration were consulted and actively involved during the gap analysis process.

The findings indicated that the establishment of a curriculum technology change would benefit the learner and enrich a complete foundation of nursing education in the institution. The Canvass Learning Management System (LMS) was identified as the solution to fill the gaps identified. The platform will be crucial in importing, building, and managing courses while promoting communication between instructors and students.

Curriculum Technology Proposal

Literature Review

Credible Sources

Please refer to Appendix A, Table 1: Literature review summary table

In recent times, the use of e-learning platforms has increased due to the massive developments in technology. These platforms are crucial to student learning because they provide easy access to learning materials and facilitate student-centered learning. Nursing education is among the sectors that have come along way to incorporate and apply technology in student learning. Today, many students utilize online learning platforms especially for distant learners and this is made possible through education technology. Technology in nursing education has benefits and setbacks that should be addressed by educators to facilitate student-centered learning.

Summary of Sources

Impact of Technology on Education

Numerous research conducted on the use of technology in education indicates several benefits to the learner. Information communication technology has enhanced and promoted active learning (Raja & Nagasubramani, 2018). Students and teachers are able to interact through various platforms and this has increased student engagement. Secondly, studies demonstrate that the use of technology has promoted collaborative and cooperative learning among teachers and students regardless of their distances (Huddle, 2019). Additionally, aspects of creative learning, integrative learning, and evaluative learning mechanisms have been increased. Today, students can access materials online, and give feedback to their instructors easily.

Negative Impact of Technology on Learning

Advances in information technology (IT) have impacted the healthcare landscape globally. Nursing students sometimes find it difficult to cope with clinical situations due to over-reliance on technology. For instance, creativity and quick decision making has been affected in situations where technology is not available. Studies also demonstrate that concentration in online platforms has decreased concentration and diverted the focus of students (Singh & Masango, 2020). Lastly, technology use is a major hindrance to accuracy and self-reliance among students. Students are no longer able to work independently without consulting other sources. In class, there is an increase in cheating using smartphones, computers, and other technologies (Huddle, 2019). Perhaps, the traditional textbook learning method helped shape independent and focused nurses.

Gaps in Technology use

Technology erases the traditional boundaries of space and time, which allows nurses to access innovations in care (Serdyukov, 2017). The student learning environments provide the most basic platforms for the use of technology today. Nursing students now have access to online education and can utilize live web-based simulations and electronic textbooks in learning. However, nursing educators face challenges in incorporating technology into the nursing curriculum. Most commonly observed is the use of e-books and flipped-classrooms to engage students in learning. There is a need for the incorporation of other technologies like the Lippincott solutions platform, Canvass learning systems, and other learning management systems to improve education in nursing (Foronda et al., 2017). To successfully achieve desired outcomes, my proposed emerging technology for the community health nursing course is the canvass platform. This platform will benefit the learner and enrich the complete foundation of nursing education in the institution.

Needs Assessment

The needs assessment is a process of assessing gaps between the current condition of an organization and the desired outcomes. To effectively identify the existing gap for curriculum technology use, information from the students was collected on areas that might require change. Secondly, a review of the identified gap was done to help set desired outcomes upon implementation of education technology for the course. The last part involved the identification of processes to bridge the gap and a plan to administer the identified technology after involving other stakeholders.

Need-Gap Analysis

The introduction of new technology into the nursing field requires analysis of the technology need and available resources to support the change. The first step that was used to conduct the assessment included a survey for the current and previous learning activities. It was necessary to refer to these activities to avoid the implementation of a technology that would less benefit students or that would provide duplicate outcomes for the learners. Secondly, a review of the student surveys and feedback was done to identify areas of improvement and to ascertain f the new technology would improve learning outcomes. The involvement of stakeholders during the process was necessary to ensure the selection, implementation, and sustainability of the technology was possible.

Stakeholders

The Administration. Implementation of a new change in organizations requires the input of administrators because they have power and influence over change management. In the implementation of the new technology, the administration will direct the change process, provide support to the educators, and provide financial aid to purchase the new technology. Additionally, their role is crucial towards the acceptance of the new technology by other stakeholders due to their power and influence.

Nurse Educators. Nurse educators are involved in curriculum development and evaluation to ensure the learner benefits from the content and the learning materials. The Canvass platform will be a technology to facilitate student online learning and it is crucial to involve the nurse educators in its implementation. This team will assess the needs of the learners and decide whether the new change will be appropriate to meet the desired outcomes of the community health nursing course.

Students/Learners. Students are important partners in nursing education including the implementation of change processes in the institution. This team is able to assess the need for new ways of learning including relevance to the curriculum and the nursing course. The student’s input will be required to ensure every individual can access the technology and also gain insight into the cultural and individual factors that might hinder the adoption of the technology. A face to face meeting with the students will be necessary during the gap analysis process.

Methods of Collaboration

Exceptional healthcare is facilitated by a collaborative approach that takes into consideration the views of every team. During stakeholder involvement, collaborative practice will be demonstrated through meetings and continuous communication using social platforms. Meetings will be organized for the administrators and the nurse educators to discuss the new technology. Additionally, emails and over the phone communications will ensure the teams are aware of the action steps towards the adoption of the new change. For the students, a face-to-face meeting will be held to discuss the process of implementation while collecting their views on the new technology.

Current Technologies

Table 2: Curriculum Technology Need-Gap Analysis

Current Curriculum Technology

Desired Curriculum Technology

Need-Gap

Action Steps to Meet the Need-Gap

E-textbooks and Journal articles

Canvass Learning Management System (LMS). A platform that will enable evidence-based learning via flipped classrooms, virtual simulations, communicating with students and presenting grades for students.

In recent years, the use of textbooks and journals has received attention in practice and research. E-textbooks are available to guide students but factors like missing standards and barriers in utilizing the materials limits their use. There is a need for a platform that allows for the availability of the learning resources including other features for interaction and access of personal student information.

1. Inform the learners and faculty about the availability of the new technology.

2. Acquire the technology and demonstrate how it will improve and promote student-centered learning for the course.

3. Liaise with the administration and the IT team to install the platform.

4. Train the learners, nurse educators, and other stakeholders on how to use the platform.

5. Fully implement learning using the platform after successful teaching and training.

6. Evaluate the new change, and make necessary adjustments to meet learning outcomes.

Comparison of Technologies

E-textbooks and journal articles are widely used in learning today. Continuous advancements in technology have provided an opportunity for publishers to offer digital textbooks to students. These materials have helped save costs for shipping and maintaining books for students. Secondly, these materials promote interaction and collaboration resources that cannot be availed in printed material (Robb, 2019). For example, the e-book resources have hyperlinks and media content that can help students understand more. These technologies also have disadvantages to the user including limited new content and mismatch with preferences. For example, most e-books rely on content from previously published books and some journals do not even present real content that can help students grow.

The Canvass LMS platform is an emerging technology for students and educators used for managing courses. Unlike digital textbooks and journals, this platform allows for access to other services at any time. The platform is advantageous because learning becomes mobile, it is fast and steady, it is customizable and it has high-security measures for the protection of privacy (Fernandez et al., 2017). The platform can also provide learners with access to evidence-based courses thus improving their critical thinking skills and creativity. However, the platform is disadvantageous because it relies on an internet connection which can be costly to students and the frequent maintenance protocols may make accessibility difficult sometimes.

Technology Challenges

Community health nursing today has advanced to involve the delivery of care to more informed patients. The increasing burden of chronic diseases and the emergency of new diseases requires a well-prepared community health nurse to make appropriate decisions at the community level. The current technology does not allow for students to have exercises like simulations that introduce the student to the community. It limits the preparation of students to deal with the ever-changing needs of the population. Secondly, the technology does not fully focus on student-centered learning because of the limited interaction with the instructors and other students. Another challenge is that it only allows for the evaluation of the student’s progress based on a few assignments and examinations. Aspects such as online student interaction are not promoted.

Overcoming Challenges

To overcome the identified challenges, the introduction of the Canvass platform will ensure students get an opportunity to engage in outside class activities. Unlike the current technology, the Canvass platform will allow for more online learning through simulations. Secondly, the learners will have easy access to numerous resources that can be printed and discussed in class using the flipped classroom method. Because every student will have their own page, it will be easy for the instructor to evaluate student engagement and discussions using online forums.

Summary of Findings

There is a gap for technology use to effectively meet the course outcomes for the BSN community health nursing course. The current technology available only utilizes e-books and journals that do not provide students with enough experience to deal with the evolving needs of the community. The current technology also makes it difficult for instructors to present learning materials to students and it only allows evaluation of understanding and engagement through examinations. This gap can be filled by introducing a new technology that incorporates all aspects of online learning including monitoring of the student’s progress. The Canvass LMS platform is the best choice for achieving the learning outcomes in the course “The Role of the BSN Nurse in Promoting Community Health”. The Canvas Platform offers students evidence-based learning activities that stimulate critical thinking, encourage learners, and enhance competency through standardized and efficient curriculum according to national nursing guidelines.

Collaboration with Stakeholders

The first approach involved meeting with the administration to present the proposal for adopting new technology for the course. The discussion which utilized several meetings proved that the students needed a new technology for online learning to facilitate engagement. Secondly, the nurse educators were consulted for opinions on the new technology where the majority accepted the introduction of the Canvass platform for learning. Students were also able to provide feedback on their need for a more engaging platform that could break the paperwork system of learning. However, the majority of the students proposed the use of the Lippincott solutions platform but the administration and other stakeholders did not find it suitable for the organization. No other technology was proposed as an alternative to the Canvass platform and this led to the mutual agreement to use it for the course.

Force Field Analysis Assessment

Table 3. Organizational Readiness for Curriculum Proposal

Forces FOR Curriculum Proposal	Curriculum Proposal	Forces AGAINST Curriculum Proposal
Evidence-based student learning platform	Implementation of the Canvass LMS – e-learning platform	Technological uncertainty
Secure and reliable platform for learning		Training period for students and instructors
Flexibility and ability to customize features.		Initial installation and maintenance costs
Reliability and value for money
Support for instructors and students

Organizational Factors
Internal factors that might hinder the adoption of the new technology include lack of insufficient funds and lack of enough support for the new change. Canvass LMS is a technology that relies on the availability of strong support systems. The administration might be reluctant to release funds for the technology due to uncertainties. Secondly, the lack of enough support from the administration and other key stakeholders might affect the adoption of the new platform.

External factors that might affect the adoption of the Canvass LMS technology include licensing by regulatory bodies and cybersecurity issues. The institution will have to provide proof that the new technology will enhance student learning and align with the nursing curriculum. Obtaining licensure and approval might be a problem if sufficient documentation and support for the technology are unavailable. Secondly, the increased incidences of cybersecurity and breach of data might require more time for the establishment of a secure network to support the technology.

Forces for Integration

Canvas LMS is a cloud-based e-learning platform that has been chosen because it is open-source, flexible, and able to customize features. This flexibility allows for easy use by students and instructors. The system also provides an extensive API making it easy for third parties to pull and push in data. Secondly, the platform allows for evidence-based student learning by promoting discussions, sharing of information, simulation and case study learning, and evaluation of the course. Lastly, the platform is built in a secure and reliable platform that ensures information is not shared without permission. The platform is always under regular internal audits and contacted security specialists to publish a public security audit.

Challenges for Integration

The adoption of the Canvass LMS, just like any other technology, is subject to uncertainties about the probability to achieve expected outcomes. Evidence from other institutions suggests that students might demonstrate dormancy but instructors have an important role in shaping this outcome. Secondly, training for this technology might take a long given the busy schedules of instructors and students. Lastly, organizational support due to the initial installation and maintenance of the platform might hinder its adoption. Lack of finances might also affect the training of users which can promote rejection or dormancy towards the technology use.

Change Theory

To fully implement the Canvass LMS technology, I will use Kurt Lewin’s change management theory.

Justification of Theory

Kurt Lewin’s change management theory consists of three stages including the unfreezing, change/movement, and the refreezing stage. The unfreezing stage involves creating the need for change by marketing the new strategy and communicating the change using a long-term vision. The second stage represents the implementation of the new change. Information flow and leadership are crucial at this stage. The refreezing stage involves helping individuals to recognize the change as the new status-quo (Wojciechowski et al., 2016). Training and support are used to drive the refreezing stage. Lewin’s Three-Stage Model of Change provides an intuitive and fundamental understanding of how changes occur, in the context of the social behaviors observed at an individual and collective level within a group. The reason for using this model is that it is simple and the change manager can easily monitor processes during the change process.

Potential Resistance and Barriers

The potential resistance during the new change implementation is expected from the nurse educators and students. Nurse educators might feel that the new change will not lead to the realization of expected outcomes because of its complexity. Students might also show some reluctance towards the new change because they had earlier proposed the use of the Lippincott solutions platform. Potential barriers for change include lack of enough finances to fund the technology, limited time for training and practice, and lack of strong support from essential stakeholders such as nurse educators and the administration.

Plan to Implement

The implementation plan of the Canvass technology for learning will follow Lewin’s theory. During the unfreezing stage, an analysis of the existing insufficiencies on the curriculum will be done and communication of the need for change will follow. Meetings for scheduling of the new change will be held and all stakeholders will discuss the way forward with the change. Upon agreement by all teams, the administration will liaise with the IT team to purchase the new technology. The movement stage will involve training of the students, nurse educators, and other relevant parties on how the technology works. Communication will be done using organized meetings to ensure all teams are aware of the change. The refreezing stage will come after the technology has demonstrated results in improving student performance and achieving other course outcomes. Continuous training yearly will be appropriate to ensure the sustainability of the change.

Conclusion

Rationale and Purpose of Proposal

The purpose of the proposal is to identify a nursing curriculum technology that will promote the learning and student outcomes for the “ The Role of the BSN Nurse in Promoting Community Health” course. The new technology will be crucial in promoting student-centered learning in the institution including aspects of student engagement, collaborative practice in community health nursing, and promotion of evaluation practices for the instructors.

Filling the Curriculum Gap

The current technology used for learning in the institution provides limited exposure to students as they prepare to deal with the changing and evolving nursing world. Adequate preparation is required for students to enable them to make good decisions as they handle patients in the community. Canvass LMS technology will allow students to utilize different learning resources in the online environment and foster collaborative practices in nursing. Additionally, the platform will engage students, allow for interaction with instructors, and enhance student evaluation using a variety of measures apart from the routine classwork evaluation.

Significance of the Proposal

The nursing education curriculum should be strategically cultivated to guarantee an appealing, stimulating, and meaningful learning experience for students. This proposal focuses on the use of technology in nursing and it introduces students to new ways of learning in the online environment. The Canvass LMS platform will provide students with a flexible environment to develop their skills and to learn ways of dealing with the ever-changing patient population. The proposal also allows the instructors to train, observe, and evaluate students in a different learning environment while meeting the expected outcomes of the course.

References

Fernández, A. R., González, F. S., Merino, P. J. M., & Kloos, C. D. (2017). A data collection experience with canvas LMS as a learning platform. In LASI-SPAIN (pp. 109-123). http://ceur-ws.org/Vol-1925/paper11.pdf

Foronda, C. L., Alfes, C. M., Dev, P., Kleinheksel, A., Nelson, D. A., OʼDonnell, J. M., & Samosky, J. T. (2017). Virtually nursing: Emerging technologies in nursing education. Nurse Educator, 42(1), 14-17. DOI: 10.1097/NNE.0000000000000295

Huddle, C. (2019). Benefits, concerns, and prospective use of technology within nursing education. Canadian Journal of Nursing Informatics, 14(3), 21-47. https://cjni.net/journal/?p=6340

Raja, R., & Nagasubramani, P. C. (2018). Impact of modern technology in education. Journal of Applied and Advanced Research, 3(1), 33-35. DOI: 10.21839/jaar.2018.v3iS1.165

Robb, M. (2019). Potential advantages and disadvantages of digital textbooks. Nurse Author & Editor, 29(4), 6. https://doi.org/10.1111/j.1750-4910.2019.tb00054.x

Serdyukov, P. (2017). Innovation in education: What works, what doesn’t, and what to do about it?. Journal of Research in Innovative Teaching & Learning, 10 (1), 4-33. https://doi.org/10.1108/JRIT-10-2016-0007

Singh, F., & Masango, T. (2020). Information technology in nursing education: Perspectives of student nurses. The Open Nursing Journal, 14(1). DOI: 10.2174/1874434602014010018

Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with lean’s system approach for change. Online Journal of Issues in Nursing, 21(2). DOI: 10.3912/ojin.vol21no02man04

Appendix A: Table 1. Literature Review Summary table

Table 1. Literature Review Summary Table
First Author (PubYear)	Title	Purpose	Context	Findings	Relevance	Strength of Evidence
Raja & Nagasubramani, 2018	Impact of Modern Technology in Education	This article aimed to review the importance of technology and its impact on education today.	The population of interest was students taking online learning courses.	Findings suggest that technology has both positive and negative effects on education.	This article is relevant to the proposal of technology use in nursing education because it highlights potential benefits to the students and expected negative effects.	Level VII/ Narrative Review Strengths: The study provides evidence from numerous research regarding the effects of technology in education. Weakness: There was no evaluation of selected articles for validity.
Singh & Masango, 2020	Information Technology in Nursing Education: Perspectives of Student Nurses	The article aimed at explaining and describing the perspectives of student nurses on the use of information technology in nursing education.	The population of focus was nursing students registered for basic and post-basic qualifications. 244 students completed the analyzed questionnaires.	The respondents acknowledged the importance of IT in nursing education and demonstrated positive attitudes towards the innovation. Gaps in IT training and continued IT support were observed.	This article is relevant to the proposal of technology use in the community health course because it provides evidence that students are ready to learn using technology and highlights gaps that should be filled by nursing educators.	Level IV/ Descriptive study Strength: The study utilized a large population sample and a detailed analysis of data using various tools to provide accurate information. Weakness: The study population was only selected from one nursing institution, thus the results cannot generalize other populations.
Huddle, 2019	Benefits, Concerns, and Prospective Use of Technology Within Nursing Education	The purpose of this article is to explore the role of technology and its value to nursing students, nurse educators and educational facilities.	The population of focus was for nurse educators, curriculum designers, and nursing students.	Findings suggest nursing education utilizes different modes of technology including mobile phones, simulation learning, and the use of e-books. It is also observed that technology is a key component in providing excellent patient care.	This article is relevant to the proposal because it identifies the crucial role played by technology in promoting patient-centered care. The article also prepares nurse educators and institutional administrators on what is expected of modern technology use in nursing education.	Level VII/ Narrative Review Strengths: The article offers a breadth of literature coverage regarding the use of technology by students and implications to nursing educators. Weaknesses: The literature review method is too subjective and does not present important criteria for eliminating bias.
Foronda, 2017	Virtually Nursing: Emerging Technologies in Nursing Education	The purpose of this article to present newly emerged products and systems for improving nursing education.	The population of focus was one college-level nursing and one pre-hospital group from an emergency care program.	Findings suggest that in a classroom environment meant to produce clinical scenarios as accurately as possible, students perceived fidelity as an influence in accepting the Simulation-Based Learning Modality.	This article provides insight into the perceptions of students to new technology use and how technologies might present opportunities to improve teaching.	Level VI Qualitative Study Strength: This study analyzes technology trends and contributes to the student’s acceptance of SBL. Weakness: The findings cannot be used to generalize other populations because data were collected from one educational setting.
Serdyukov, 2017	Innovation in education: what works, what doesn’t, and what to do about it?	The purpose of the article was to present an analytical review of the educational innovation field in the United States.	The population of focus was the nurse educators and curriculum developers in an academic setting in the US.	Findings indicate that the US education badly needs effective innovations of scale that can help produce the needed high-quality learning outcomes across the system.	This article is relevant to the proposal of technology in nursing education because it identifies the focus of educational innovations and provides evidence for the need for technology that promotes learning.	Level I/ Systematic Review Strengths: The study utilizes a variety of literature and provides practical recommendations on the use of technology in education. Weaknesses: The study does not clearly point to the summaries of the included studies and the settings used by researchers.

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