Crisis in Competency: A Defining Moment in Nursing Education

Joan M. Kavanagh, PhD, MSN, RN, NEA-BC, FAAN; Patricia A. Sharpnack, DNP, RN, CNE, NEA-BC, ANEF, FAAN


Online J Issues Nurs. 2021;26(1) 

In This Article

The Paradigm Shift

Densen (2011) accurately predicted that by 2020, medical knowledge would double every 73 days. Today, awash in accelerated knowledge creation and sweeping innovation, professionals in the healthcare and higher education find themselves facing isomer-like challenges to provide value, positive outcomes, access, and affordability for their consumers--or become obsolete (Kavanagh, 2019). This opportunity necessitates a paradigm shift in education that moves us from cohort-based teaching and learning to personalized adaptive learning (AL), focused not on time but competency. The Landscape of Change paradigm shift can be visualized in the Figure 1.

Figure 1.

Landscape of Change
Preparing future nurses as knowledge workers is the required and essential pivot…

Adaptive learning (AL) platforms deliver customized instruction to students based on past knowledge and adjust delivery of content based on distinct preferences and variances in knowledge acquisition (Hinkle, Jones, & Saccomano, 2020; Sharma, Doherty, & Dong, 2017). Preparing future nurses as knowledge workers is the required and essential pivot, supported by technology and underpinned by AI. The burgeoning world of AI is positive, disruptive innovation and creates the ability for educators to envision and design individualized AL experiences that will accelerate the pace of learning and potentially, knowledge use (Hinkle, Jones, & Saccomano, 2020; Samadbeik et al., 2018).

Strategies such as spaced learning, bridging, and chunking of information are excellent examples of evidence-based tactics to decrease cognitive load and promote memory and learning (Kelter, Steward & Zamis, 2019). Yet, despite the substantial evidence that brain-based, active learning in educational design leads to students engaged in deeper thinking and learning, the move to consistently apply cognitive neuroscience to education remains in the nascent phase of adoption (Carr & O'Mahony, 2019; Deslauriers, McCarty, Miller, Callaghan, & Kestin, 2019; Pilcher, 2017; Remtula, 2019). The thought that these innovative technologies will guide educational transformation assumes that educators will accept and use the evidence, and these technologies, to engage learners.

Research findings have indicated that educators do not quickly accept new technologies. Even when they do, they are used to support prevailing teaching practices, rather than to develop new pedagogies (Grainger, Liu, & Geertshuis, 2020). In just a few short years, the digital revolution fueled by AI will be commonplace; but will we be ready? The time is now to embrace digital disruption, including immersive learning technologies that can transform education.

Virtual reality (VR), augmented reality (AR), and mixed reality (MR) technologies enable users to interact with and control virtually displayed components within virtual and physical environments (Carroll, 2021; Remtula, 2019; Weinstein, Madan & Sumeracki, 2018). These rich, immersive technologies will continue to evolve as powerful and essential tools in clinical education. This shift requires a holistic view of education and pedagogies that empower both students and faculty as life-long learners. Education scholar Dennis Shirley (2017), author of The New Imperatives of Educational Change, reminds us of the power of the present moment. There is cause for hope and optimism, but past success does not entitle us to future success; we must plan for success and move quickly.