it is known to nursing educators that the clinical components of their respective programs are designed to help students become able to transfer theoretical knowledge into practical wisdom (benner, sutphen, leonard, & day, 2009). instructors teach students the ‘what’s and whys’ of nursing from the classroom, and help them to ultimately be able to consider the ‘what-ifs and why-not’s from the patient care setting. students are given valuable experiences in nursing practice, hands-on time at the bedside, front-line activities consistent with their chosen career paths- indeed a meaningful and formative approach to professional education. informatics competency is a single, yet overarching, skill set required by the nursing professional at all levels of practice (cronenwett et al., 2007); the quality of clinical experience currently being offered in regards to informatics can be enhanced, however, as i propose herein.
what are the overlying guidelines in teaching clinical informatics competence, and how can students actually become competent in this domain of their professional education? qsen defines informatics competency as the ability to "use information and technology to communicate, manage knowledge, mitigate error, and support decision making" (
qsen website, n.d.). aacn’s essential iv: information management and application of patient care technology states “knowledge and skills in information management and patient care technology are critical in the delivery of quality patient care” (american association of colleges of nursing [aacn], 2008, p. 3). the problem, however, lies in the limited opportunities currently offered to students to help them achieve these important foundational goals.
with these directives in mind, i propose the development of a formal ‘off-unit’ nursing student rotational experience. this could be developed collaboratively with nursing school program and clinical institutional leadership, including representation by nursing informatics staff. this experience could be designed to allow a non-clinical observational rotation (‘shadowing’) activity within the auspices of facility-specific organizational guidelines. the rotation can be established as an in-situ setting- for example, as an observer within the nursing informatics department, allowing for probable changes in project content, focus, committee membership, and like issues. students could be given specific experiential objectives to meet for this rotation, which could be assessed by assigned written and/or oral reports and discussions.
as a non-clinical rotation, this could be offered in addition to other experiences such as observations in the icu and the or, wherein all students of a clinical group are given the opportunity to be involved, as is possible. such an experience can hopefully help students to “value the knowledge that can be acquired through simple observations and interactions that do not necessarily involve the delivery of hands-on nursing care” (o’connor, 2006, p. 140), as well as to foster the desired knowledge, skills and attitudes involved in achieving informatics competency.
to date, this proposal has been discussed with nurse informaticists working ‘on the front lines’ in busy acute care hospitals, and with several nursing education leaders and faculty; their responses have been mixed, in terms of their levels of acceptance and perceived feasibility. for instance, qsen’s own linda cronenwett recently reminded me that “well…we’re not trying to develop informatics specialists” (l. cronenwett, personal communication, october 27, 2011), and recommended faculty/ student collaboration to identify those best suited to/ more interested in this particular clinical experience. i believe that nursing educators can incorporate this proposed clinical experience into current programs of nursing, given the collaboration and cooperation of professional nurse informaticists. such an experience can strongly enhance the understanding, analysis, interpretation and foresight/ projection of students’ knowledge, skills and attitudes related to healthcare informatics.
i strongly encourage all clinical instructors, nursing informaticists, nursing faculty, students and other healthcare professionals to consider this proposal and to offer their insight and suggestions as to its potential for successful implementation. your input is welcome and securely solicited by means of an online survey: http://www.surveymonkey.com/s/w5zgnbg
american association of colleges of nursing. (2008, october 20). the essentials of baccalaureate education for professional nursing practice
(pdf document). retrieved from: www.aacn.nche.edu/education-resources/baccessentials08.pdf
benner, p., sutphen, m., leonard, v., & day, l. (2009). educating nurses: a call for radical transformation
. san francisco, ca: wiley, john & sons.
cronenwett, l., sherwood, g., barnsteiner, j., disch, j., johnson, j., mitchell, p., sullivan, d. t., & warren, j. (2007). quality and safety education for nurses. nursing outlook
(3), 122-131. doi: 10.1016/j.outlook.2007.02.2006
o’connor, a. b. (2006). clinical instruction and evaluation: a teaching resource
(2nd ed.). sudbury, ma: jones and bartlett.
qsen website. (n.d.). (http://www.qsen.org/definition.php?id=6