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Nursing Education
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About the NLN

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Hallmarks, Indicators, Glossary & References

In general, “hallmarks of excellence” can be thought of as characteristics or traits that serve to define a level of outstanding performance or service. The following statements serve to define “hallmarks of excellence” in nursing education. For each of the 30 “hallmarks,” we offer suggested “indicators” … questions faculty may wish to discuss with one another to help them determine the extent to which their program(s) are achieving that “hallmark.” These “indicators” are not intended to be complete or all-encompassing lists; instead, they are suggestions for the type of things faculty may want to address as they strive to achieve a level of outstanding performance or service. Finally, the NLN Hallmarks of Excellence in Nursing Education© have been developed to be relevant for all types of programs and all types of institutions; exceptions to this are noted.

STUDENTS

Students are excited about learning, exhibit a spirit of inquiry and a sense of wonderment, and commit to lifelong learning

  • Do students come to class and clinical with references they have found on their own and use the information discovered to contribute to discussions?
  • Do students brainstorm together about concepts presented in class, references read, clinical experiences, and other learning experiences they have had?
  • Do students question why things (e.g., approaches to patient care, the design of the curriculum, the way clinical experiences are structured, existing policies, etc.) are done the way they are?
  • Do students ponder “What if” questions?

Students are committed to innovation, continuous quality/performance improvement, and excellence

  • Do students ask for critical/constructive feedback and then use that feedback to make improvements in their performance?
  • Are students open to trying new things?
  • Are students satisfied with mediocrity and merely “getting by,” or do they “push” themselves and one another to do their absolute best?

NOTE: Words in BOLD and underlined are defined in the Glossary

Students are committed to a career in nursing

  • Do students express anticipatory excitement about continuing their education, pursuing graduate study, assuming leadership roles in their employment setting and in the profession and becoming actively involved in professional associations, writing for publication, as well as the contributions they hope to make to the nursing profession?
  • Can students propose a realistic 5- and 10-year career trajectory for themselves?

FACULTY

The faculty complement includes a cadre of individuals who have expertise as educators, clinicians, and, as is relevant to the institution’s mission, researchers

  • Does the faculty selection process include specific hiring criteria that deliberately search for candidates whose excellence in education, clinical practice or research will help create a balanced cadre of full-time faculty?
  • Do faculty job responsibility statements specifically address the expert behaviors required for the roles of educator, clinician, and researcher?

The unique contributions of each faculty member in helping the program achieve its goals are valued, rewarded, and recognized

  • Are the unique contributions of faculty whose expertise is in education valued, rewarded, and recognized?
  • Are the unique contributions of faculty whose expertise is in clinical practice valued, rewarded, and recognized?
  • Are the unique contributions of faculty whose expertise is in research valued, rewarded, and recognized?
  • Do criteria for faculty reward and recognition acknowledge that one’s expertise and significant professional contributions may be in education, practice, or research?

Faculty members are accountable for promoting excellence and providing leadership in their area(s) of expertise

  • How are faculty expected to demonstrate expertise?
  • How do expert faculty provide leadership to other faculty regarding their area(s) of expertise?
  • What sanctions are in place if faculty expectations related to promoting excellence and providing leadership in their area(s) of expertise are not met?

Faculty model a commitment to lifelong learning, involvement in professional nursing associations, and nursing as a career

  • Are faculty expected to continue learning and acquiring knowledge in their area of expertise through CE courses, certification, post-master’s courses, post-doctoral courses, or other formal or informal mechanisms?
  • Do most faculty make significant contributions to state, national, and/or international professional organizations?
  • Do faculty express excitement about a lifelong career in nursing when talking with students and with one another?

All faculty have structured preparation for the faculty role, as well as competence in their area(s) of teaching responsibility

  • Do all full- and part-time faculty receive an in-depth orientation to the faculty role?
  • Is there a mentoring program in place to assist faculty as they progress in their career?
  • Is an established set of faculty competencies used to prepare individuals for the faculty role and help them maintain competence or expertise in that role?

CONTINUOUS QUALITY IMPROVEMENT

The program engages in a variety of activities that promote excellence, including accreditation from national nursing accreditation bodies

  • Does each program seek and maintain national nursing accreditation?
  • Does the strategic plan utilize a continuous quality improvement process in which faculty, students, administrators, alumni, and community partners participate?
  • Is program willing to try new things?

The program design, implementation and evaluation are continuously reviewed and revised to achieve and maintain excellence

  • Is there a mechanism in place for continuous review of program design, implementation, and evaluation?
  • Are revisions made that allow the program to keep current with changes in health care and health care economics, trends in health care delivery systems, trends in education, societal changes, research findings, and changing expectations of nurses?

CURRICULUM

The curriculum is flexible and reflects current societal and health care trends and issues, research findings and innovative practices, as well as local and global perspectives

  • Are there opportunities for students to take electives that match their interests?
  • Are there opportunities for students to take courses in a sequence that makes sense to them or that allows them to study areas when they have learning needs in that area? Are “open, uncommitted” areas available throughout the curriculum that allow faculty to address new issues, current trends, and scientific developments without having to wait for a major curriculum revision?
  • Is the curriculum regularly refined to incorporate current societal and health care trends and issues, research findings, innovative practices, and local as well as global perspectives?

The curriculum provides experiential cultural learning activities that enhance students’ abilities to think critically, reflect thoughtfully, and provide culturally-sensitive, evidence-based nursing care to diverse populations

  • Do all students have an extended, relatively intense learning experience with individuals from cultures other than their own?
  • How do faculty draw on learning experiences to enhance students’ abilities to be culturally-sensitive in the care they provide?
  • How do faculty help students heighten their awareness of their own values, biases, and stereotyping?

The curriculum emphasizes students’ values development, socialization to the new role, commitment to lifelong learning, and creativity

  • How much class time is devoted to self-reflection, values clarification, analysis of what it means to be a nurse in the 21st century, and developing and living one’s commitments to the profession, lifelong learning, career development, etc.?
  • To what extent are students allowed and encouraged to be creative?
  • How do faculty respond to students who are “different” in terms of their approach to doing assignments, the ways they learn, the way they think, and how they set priorities?

The curriculum provides learning experiences that prepare graduates to assume roles that are essential to quality nursing practice, including but not limited to roles of care provider, patient advocate, teacher, communicator, change agent, care coordinator, user of information technology, collaborator, and decision maker

  • What learning experiences give students the opportunity to develop confidence in their ability to advocate for patients/families, teach individuals and groups about health care, serve as a member of a multidisciplinary team, serve as a leader of a nursing team, facilitate change, manage conflict, and make decisions that affect their own well being and the health of the patients/families for whom they care?
  • How are students helped to develop confidence in their ability to use technological resources and manage large amounts of information?
  • How do faculty help students develop their writing skills, ability to speak to groups, ability to argue convincingly, ability to listen effectively, and other effective communication skills?

The curriculum provides learning experiences that support evidence-based practice, multidisciplinary approaches to care, student achievement of clinical competence, and, as appropriate, expertise in a specialty role

  • To what extent does each clinical experience help students develop their ability to provide culturally-competent, evidence-based care to patients/families/ communities experiencing a wide range of health problems?
  • Do graduate students have learning experiences that help them develop as experts in the full scope of their new role (i.e., advanced practitioner, educator, administrator, consultant, etc.), as members and leaders of multidisciplinary teams, and as professionals whose services (i.e., primary care, public health, teaching and curriculum development, etc.) are evidence-based?

The curriculum is evidence-based

  • What research has been used to determine how the curriculum is designed?
  • How is current research used to help faculty determine when to make changes in the curriculum and what those changes will be?

TEACHING/LEARNING/EVALUATION STRATEGIES

Teaching/learning/evaluation strategies are innovative and varied to facilitate and enhance learning by a diverse student population

  • Are teaching and learning strategies varied to meet the needs of diverse student populations?
  • Do faculty document the research that supports their selection of specific teaching/learning/evaluation strategies?

Teaching/learning/ evaluation strategies promote collegial dialogue and interaction between and among faculty, students, and colleagues in nursing and other professions

  • Are informal, open forum opportunities in place where faculty, students and colleagues in nursing and other professions can discuss current teaching/ learning strategies and evaluate their effectiveness?
  • How are student evaluations of teaching and peer review findings used to stimulate dialogue about the nature of excellence and innovation in nursing education?

Teaching/learning/evaluation strategies used by faculty are evidence-based

  • Do faculty document evidence-based research that support strategies used in the program?
  • Do faculty regularly review pedagogical research reports (from nursing and other disciplines) and revise their teaching/learning/evaluation strategies based on findings from those studies?

RESOURCES

Partnerships in which the program is engaged promote excellence in nursing education, enhance the profession, benefit the community, and expand service/learning opportunities

  • What are the criteria the nursing program uses to determine the agencies/ organizations with which it will partner?
  • How are partners engaged with faculty and students to achieve excellence in the nursing program?

Technology is used effectively to support teaching/learning/evaluation processes

  • To what extent is state-of-the-art technology available to support the nursing program?
  • How are faculty and students prepared for/supported in the use of technology for teaching and learning?
  • What commitment has the nursing program made to integrate the use of technology throughout the program?
  • Is technology used appropriately and effectively to promote and evaluate student learning?

Student support services are culturally-sensitive, innovative, and empower students during the recruitment, retention, progression, graduation, and career planning processes

  • Do students of all backgrounds report that the recruitment and admission process was a welcoming one that acknowledged their unique needs?
  • Do students of all backgrounds express comfort about seeking out and using the student services that are available to them?
  • Do students of all backgrounds report satisfaction with the extent of support they receive throughout the program, at graduation, and in relation to entering a new career?
  • Do students of all backgrounds feel empowered?

Financial resources of the program are used to support curriculum innovation, visionary long-range planning, faculty development, an empowering learning environment, creative initiatives, continuous quality improvement of the program, and evidence-based teaching/ learning/evaluation practices

  • Do the resources available to faculty, students and administrators support efforts to be innovative, continually develop as members of the nursing profession and the academic community, and enact needed change?

INNOVATION

The design and implementation of the program is innovative and seeks to build on traditional approaches to nursing education

  • Can faculty, students, and alumni identify the features of the program that are truly innovative and serve to set it apart from and distinguish it from other programs?
  • Is there administrative support for faculty to be innovative in their approach to teaching and learning, as well as in their approach to the design, implementation and evaluation of the curriculum?
  • Has the faculty made a commitment to challenge traditional approaches to nursing education and implement more innovative, evidence-based approaches?
  • Do most faculty utilize innovative approaches in the design and implementation of the course(s) for which they are responsible?
  • Do faculty and students systematically evaluate the impact of innovative teaching and curriculum approaches on student learning, student satisfaction, and other student-centered outcomes?

The innovativeness of the program helps to create a preferred future for nursing

  • Is the program structured in such a way that faculty, students, and alumni are prepared to and do shape a new reality for nursing and nursing education?
  • Do faculty, students, and administrators engage in discussions about what kind of future they envision for nursing and nursing education?
  • How do faculty workloads support faculty in their efforts to create a new future for nursing education, nursing practice, or nursing research?

EDUCATIONAL RESEARCH

Faculty and students contribute to the development of the science of nursing education through the critique, utilization, dissemination or conduct of research

  • Do faculty and students engage in conversations about research findings related to teaching and learning?
  • Are faculty and students involved in pedagogical research that contributes to the development of the science of nursing education?

Faculty and students explore the impact of student learning experiences on the health of the communities they serve

  • What strategies are used to systematically document the extent to which student learning experiences affect health care outcomes for the populations they serve?
  • Do leaders in partner healthcare facilities report improved patient care outcomes or more effective nursing practices in areas where students have extended learning experiences?
  • What long-term commitment has the nursing program made to improving the health of selected populations through student and faculty teaching and learning activities?

ENVIRONMENT

The educational environment empowers students and faculty and promotes collegial dialogue, innovation, change, creativity, values development, and ethical behavior

  • Do faculty and students engage in collegial dialogue about what constitutes a positive teaching/learning environment and the roles of both faculty and students in creating such an environment?
  • Do faculty, students and partners engage in thoughtful, sustained, collegial dialogue about the teaching/learning environment?
  • Do faculty, students and partners think the educational environment empowers a diverse student population, promotes creativity and innovation and prepares graduates for today’s uncertain, constantly changing healthcare environment?

LEADERSHIP

Faculty, students, and alumni are respected as leaders in the parent organization, as well as in local, state, regional, national, or international communities

  • Do faculty hold influential positions on institutional committees, task forces, or other similar bodies?
  • Are faculty and alumni appointed to, invited to serve on or elected to prominent boards, institutes, or other similar bodies (e.g., Presidential Committee on Aging, IOM, health care partner boards/committees)?
  • Do students bring resolutions to NSNA or proposals to the school of nursing/ institution that will influence change?

Faculty, students, and alumni are prepared for and assume leadership roles that advance quality nursing care; promote positive change, innovation, and excellence; and enhance the power and influence of the nursing profession

  • Do faculty or alumni serve on committees or boards of health care partner institutions that address quality nursing care issues?
  • Do faculty, students, or alumni receive awards in recognition of their contributions to the institution, profession, local community, or health care?
  • To what extent do the curriculum and faculty development activities focus on the development of leadership knowledge and skills?

    Prepared by the National League for Nursing Task Group on Nursing Education Standards: April 21, 2004

    Copyright, National League for Nursing, 2004

    GLOSSARY


    Competence: The application of knowledge and interpersonal, decision making and psychomotor skills in the performance of a task or implementation of a role.

    Competency: A principle of professional practice that identifies the expectations required for the safe and effective performance of a task or implementation of a role.

    Continuous Quality Improvement: A comprehensive, sustained, and integrative approach to system assessment and evaluation that aims toward continual improvement and renewal of the total system.

    Creativity: A process that calls upon an individual's curiosity, inquisitiveness and ability to generate new ideas and perspectives that result in products and practices unique but useful.

    Curriculum: The interaction among learners, teachers, and knowledge -- occurring in an academic environment -- that is designed to accomplish goals identified by the learners, the teachers, and the profession the learners expect to enter. It is more than a collection of courses or the sequencing of learning experiences, and it is more than an outline of the content to be "covered" during an academic program.

    Empowerment: Enabling experiences that foster autonomy, choice, control, and responsibility and that encourage individuals to display existing abilities, learn new abilities, and continually grow.

    Ethical Behavior: A system of moral conduct based on one’s personal beliefs, values, customs and character, as well as those of one ’s profession.

    Experiential Cultural Learning: Purposefully-designed learning experiences that help students gain greater understanding of, insight to, and sensitivity regarding (a) the practices and beliefs of people whose culture, history, and life experiences are different from their own, and (b) the meaning that people give to their life experiences.

    Evidence-based Nursing Care/Practice: The provision of nursing care to individuals, groups and communities that evolves from the systematic integration of research findings related to a particular clinical problem. Intervention strategies are designed based on the evidence garnered through research, questions are raised about clinical practices that lead to new research endeavors, and the effectiveness of interventions are systematically evaluated in an effort to continually improve care.

    Evidence-based Teaching Practice: Using systematically-developed and appropriately-integrated research as the foundation for curriculum design, selection of teaching/learning strategies, selection of evaluation methods, advisement practices, and other elements of the educational enterprise.

    Excellence: “Striving to be the very best you can be in everything you do--not because some … ‘authority figure’ [demands it], but because you can’t imagine functioning in any other way. It means setting high standards for yourself and the groups in which you are involved, holding yourself to those standards despite challenges or pressures to reduce or lower them, and not being satisfied with anything less than the very best.” (Grossman & Valiga, 2000, p. 214).

    Expertise: Having or displaying special skill, knowledge or mastery of a particular subject, derived from extensive training or experience.

    Global Perspective: Knowledge about and critical understanding of global issues that enable an individual to (a) effectively address those issues; (b) acquire values that give priority to ecological sustainability, global interdependence, social justice for all the world’s people, peace, human rights, and mutually-beneficial processes of economic, social, and cultural development; (c) develop the will and ability to act as mature, responsible citizens of the world; and (d) develop a commitment to creating acceptable futures for themselves, their communities, and the world. Such a perspective is critical in light of the increasing connectivity and interdependence of the world ’s social, economic, educational, and other systems.

    Innovation/Innovative Practices: The adoption of new ideas, change in the core structure of systems and using unique approaches to manage familiar situations. In education, it refers to dramatic change in “the nature of schooling, learning, and teaching and how curricular designs promote or inhibit learning, as well as excitement about the profession of nursing, and the spirit of inquiry necessary for the advancement of the discipline” (National League for Nursing, 2003, p. 1).

    Leadership: A “complex, multifaceted phenomenon [that involves the elements of] vision, communication skills, change, stewardship, and developing and renewing followers” (Grossman & Valiga, 2000, p. 11). Tasks assumed by the individual who chooses or agrees to “make a difference in the lives of others and in the directions of groups and organizations” (Grossman & Valiga, 2000, p. 18) include envisioning goals, affirming values, motivating, managing, achieving a workable unity, explaining, serving as a symbol, representing the group, and renewing (Gardner, 1990).

    Partner/Partnerships: An alliance between individuals or groups in which all parties mutually develop goals, collaborate to achieve those goals, and benefit from the alliance.

    Pedagogical Research: Systematic inquiry into all aspects of the teaching/learning process, including how students learn, effective teaching strategies, effective assessment or evaluation methods, curriculum design and implementation, program outcomes, learner outcomes, environments that enhance learning, and other components of the educational enterprise.

    Preferred Future for Nursing: “What should happen or what we would like to see evolve … Creat[ing] the future we want and orchestrat[ing] events and situations to achieve the goals we set for ourselves and to fulfill the roles we envision for ourselves” (Valiga, 1994, p. 86).
    Reward: Recompense made to or received by an individual for some service or merit. In the educational environment, traditional faculty rewards are tenure, promotion, and salary increase. Other types of rewards for faculty are those that derive from factors that motivate individuals to pursue the faculty role, including autonomy, belonging to a community of scholars, recognition, and efficacy (i.e., having an impact on one's environment).

    Science of Nursing Education: An integrated, systematically-developed body of knowledge that “address[es] questions related to student learning, new pedagogies, graduate competencies, program outcomes, innovative clinical teaching models, effective student advisement strategies, recruitment and retention strategies, and other elements of quality nursing education ” (Tanner, 2003, p. 3).

    Socialization to the Role: A process whereby an individual learns about the intricacies of a new role she/he will assume. Those "intricacies" involve an historical perspective on the role, legal parameters related to the role, common issues regarding role implementation and projections about anticipated changes in the role, as well as the knowledge, skills and values required to successfully implement the role. Such socialization occurs through formal education, mentoring, on-the-job experiences and other means, and it occurs whenever an individual prepares to move into a new role (e.g., RN, nurse manager, faculty member, advanced clinician, researcher, etc.).

    Spirit of Inquiry: A “yen to discover” (Van Bree Sneed, 1990, p. 36). “Asking questions to satisfy one’s curiosity” (p. 37).

    Structured Preparation for the Faculty Role: “The nurse educator role requires specialized preparation… There is a core of knowledge and skills that is essential if one is to be effective and achieve excellence in the role. That core of knowledge and skills entails the ability to facilitate learning, advance the total development and professional socialization of the learner, design appropriate learning experiences, and evaluate learning outcomes. … It is critical that all nurse educators know about teaching, learning and evaluation; and nurse educators who practice in academic settings also must have knowledge and skill in curriculum development, assessment of program outcomes, and being an effective member of an academic community, among other things. … Competence as an educator can be established, recognized, and expanded through master’s and/or doctoral education, post-master’s certificate programs, continuing professional development, mentoring activities, and professional certification as a faculty member.” (National League for Nursing, 2002)

    Student Support Services: Services that promote the comprehensive development of the student and help strengthen learning outcomes by reinforcing and extending the educational institution’s influence beyond the classroom. Such services include but are not limited to admissions, financial aid, registration, orientation, advisement, tutoring, counseling, discipline, health, housing, placement, student organizations and activities, cultural programming, childcare, security, and athletics.

    Technology: The use of science and the application of scientific principles to any situation, often involving the use of sophisticated equipment and computers.


    Traditional Approaches to Nursing Education: Teacher-directed, highly structured approaches that rely heavily on the delivery of content through lecture, the evaluation of learning through multiple-choice examinations, highly structures and relatively inflexible curriculum designs, and strict adherence to policies. The focus is on cognitive gain, “covering” content, a simple-to-complex approach, problem-solving and efficiency.

    Values Development: The evolution of personal principles, character, and customs that provide the framework for making decisions about one’s daily actions. Values are the product of one’s life experiences, give meaning and direction to life, and are influenced by family, friends, religion, culture, environment, education and other factors.

    Wonderment: “Awe, astonishment or surprise; something producing wonder; puzzlement or curiosity” (Webster’s II New College Dictionary, 1995, p.781 ).



    REFERENCES

    Gardner, J. W. (1990). On leadership. New York: Simon & Schuster.

    Grossman, S. & Valiga, T.M. (2000). The new leadership challenge: Creating the future of nursing. Philadelphia: F.A. Davis.

    National League for Nursing. (2002). The Preparation of Nurse Educators [Position Statement]. New York: National League for Nursing.

    National League for Nursing. (2003). Innovation in Nursing Education: A Call to Reform [Position Statement]. New York: National League for Nursing.

    Tanner, C.A. (2003). Science and nursing education [Editorial]. Journal of Nursing Education , 42(1), 3-4.

    Valiga, T.M. (1994). Leadership for the future. Holistic Nursing Practice , 9(1), 83-90.

    Van Bree Sneed, N. (1990). Curiosity and the yen to discover. Nursing Outlook, 38(1), 36-39.

    Webster’s II New College Dictionary. (1995). Boston: Houghton Mifflin Company.

    BIBLIOGRAPHY

    Catalano, J. (1996). Nursing now. Philadelphia: F.A. Davis.

    Diekelmann, N. (1995). Reawakening thinking: Is traditional pedagogy nearing completion? [Guest Editorial]. Journal of Nursing Education, 34 (5), 195-196.

    Ellis, J.R. & Hartley, C.L. (2001). Nursing in today’s world: Challenges, issues, and trends (7th ed.). Philadelphia: Lippincott.

    Johnson, B., & Webber, P.B. (2001). An introduction to theory and reasoning in nursing. Philadelphia: Lippincott, Williams, & Wilkins.

    Marcy, M.B. (2003). Why foundations have cut back in higher education [Point of View]. Chronicle of Higher Education, 49(47), B16.

    Mish, Frederick. (2001). Merriam-Webster's collegiate dictionary (10th ed.). Massachusetts: Merriam-Webster, Inc.

    National Council State Board of Nursing (1996). Assuring competence: A regulatory responsibility [Position Paper] [Electronic Version]. Retrieved July 31, 2003, from www.ncsbn.org

    O'Toole, M (1992). Miller-Keane encyclopedia and dictionary of medicine, nursing and allied health. Philadelphia: Saunders.
    Short, P. (1994). Empowering students: Variables impacting the effort. Education, 114 (4), 503-519. Wergin, J. F. ( 2001). Beyond carrots and sticks. Liberal Education, 87(1), 50.

 
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