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Four Principles to Transform How Nursing is Taught

By February 18, 2021June 6th, 2023No Comments
Group of nursing students

I recently discussed on Facebook and YouTube Live, four essential principles that are critical to a paradigm shift in nursing education. 

KeithRN was built on a vision to strengthen and transform nursing education and shrink the gap between how nursing is taught and how nursing is practiced. When educators implement educational best practices, students are prepared for both nursing practice and licensure!

Educating Nurses: A Call for Radical Transformation by Dr. Patricia Benner and her coauthors (2010) validated the academic-practice gap that I was experiencing as a new educator. This research demonstrated the need for a paradigm shift to transform and strengthen how nursing is taught. 

Through KeithRN, my goal is to empower educators to embrace change and how to realize needed radical transformation by integrating these four ways of teaching. 

Paradigm shifts:

  1. Contextualize content to the bedside of patient care. Content and concepts need to be contextualized to real-world patients. How can students apply knowledge to the bedside? Bring case studies and active learning into your classroom. Download my free COVID-19 case study as a first step!
  2. Integrate classroom and clinical learning. Bring clinical realities into your classroom. Instead of having two silos of classroom and clinical teaching, integrate them so they come together to make the classroom more like clinical.
  3. Emphasize clinical reasoning. Benner defines clinical reasoning as the ability of the nurse to think in action and reason as a situation changes. The ability of the nurse to understand and apply what they know is clinical judgment. Clinical judgment is an outcome that you can’t teach. You need to teach students to critically think and clinically reason for them to develop clinical judgment.
  4. Emphasize professional identity formation. We need to emphasize the formation of a professional nurse identity with our students. Thinking like a nurse is important, but do they know how to act and care like a nurse? How is their ethical behavior? What is the character of a nurse that needs to be enacted? Honesty and integrity are critical. Cheating and plagiarism must be cut off at the root to transform nursing education. Being a nurse isn’t just something you do, it’s who you are.

So, what is your greatest fear that keeps you from implementing this needed change?

Nursing knowledge is doubling every seven years! We have all the knowledge we need to move forward, so why are we stuck? What fears are keeping us from changing?

  • Failure. No one wants to look like a fool in front of their students. Your students might resist or not like the extra work. But it’s important to try new things, step out of your comfort zone and find what works. Best practice needs to be our guide and we must stay the course. The tools and strategies are available to you. As long as you are putting forth your best effort, you will succeed!
  • Push back from students. We fear our students’ judgment. My students resisted active learning in Med Surg, but by the third lecture they started to see the value and the relevance of active learning. Do the best that you can and you will be successful if you are implementing best practice. Then you can step out of the boat with confidence.
  • Not teaching what I should and not covering enough. What are the essential aspects of a practice-based lecture? Look at the most important concepts in your content. Use simple principles to narrow the funnel that you teach. This begins by emphasizing pathophysiology!
  • Getting out of my comfort zone. As educators we’re being stretched in so many ways. Know you are not alone and that you have a community to support you. Look to your faith and know that strength sometimes needs to come from outside of ourselves. You have a partner with KeithRN and resources and tools that support you as well.
  • Change is scary. Educational best practice needs to inform the change. As we implement paradigm shifts, use practical tools and strategies as well as your lens of practice to create change.
  • Feeling overwhelmed. A journey of 1000 miles begins with a first step. There’s a lot of work to be done, but we can only change one lecture at a time. Make a classroom lecture active. Use a case study to engage your students. 
  • Getting faculty on board to change. Principles of educational best practice are not optional! Share these paradigm shifts with others. 

Keith’s Closing Thoughts

Transforming how you teach can be scary, so what can you do to overcome your fears?

  • You cannot implement needed change alone. You need a trusted colleague to collaborate with and work through problems with. Two people are better than one and can help each other succeed. I’m available, as always, at
  • Expect resistance. As an educator, expect that students will resist. If you are implementing best practice, don’t let discouragement deter you.
  • Have faith in something bigger than yourself. The need to transform nursing education is the end goal. Let your faith and truth always be your guide!

To learn more, watch the video of this conversation:


Keith Rischer – Ph.D., RN, CCRN, CEN

As a nurse with over 35 years of experience who remained in practice as an educator, I’ve witnessed the gap between how nursing is taught and how it is practiced, and I decided to do something about it! Read more…

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