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Introduction
- University of Wisconsin Press
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Introduction Nancy L. Diekelmann, Pamela M. Ironside, and Morgan Harlow Do faculty in the health professions, even as they support the need to implement innovation and reform, continue to teach as they were taught and for a healthcare system that no longer exists? A rapidly changing healthcare system, the shift to community-based care, and increasing diversity in student populations are challenging health professions schools. Yet curricula in many of these schools continue to reflect the assumptions of hospital-based practice, merely adding clinical experience in community settings. The industrialization of healthcare and the explosion of bioscience technologies call for a change in the way health professionals practice, and consequently in the way they are taught (Eitel, Kanz, Hortig, & Tesche, 2000; Jones, McArdle, & O’Neill, 2002; Kassebaum & Cutler, 1998; Shatzer, 1998). But how do teachers teach to a healthcare system in persistent transition? What possibilities exist for substantive reform? Teaching the Practitioners of Care: New Pedagogies for the Health Professions gathers interpretive, educational research in the health professions to complement the current reform in conventional approaches. This gathering is not an attempt to devalue conventional pedagogy (outcomes education) in order to create a place for new approaches to health professions education. Rather, the interpretive pedagogies co-occur 3 4 diekelmann, ironside, and harlow with other approaches, including conventional pedagogies. The studies in this book provide evidence and insights upon which teachers can initiate educational research and reform in their own classrooms and clinical settings. At a time when interpretive pedagogies are being developed in every discipline (Armstrong & Koffman, 2000; Berger & Ai, 2000; Kassebaum & Cutler, 1998; Neistadt, 1999), and there are calls for reform in medical education, pharmacy, and nursing (Fox, 1999; Iglehart, 2000; Lesky & Yonke, 2001) the voices gathered together in this second volume of the book series Interpretive Studies in Healthcare and the Human Sciences are timely and originary in bringing to the health professions substantively new pedagogies for transforming extant curricula. Herein are the insights of teacher-scholars who are developing and evaluating the new pedagogies in their teaching practice. Toward Pedagogical Literacy The need for faculty members to increase their pedagogical literacy has never been greater. Students in nursing often describe experiences that indicate they are “on strike,” as evidenced by their use of resistance, silence, nonperformance, lateness, and absence (Diekelmann, 1991). According to Shor (1986), students resist any process that disempowers them and denies subjects important to them. Even as faculty members acknowledge these problems, as many are doing, teachers continue to teach as they were taught. This is in large part because faculty skills and pedagogical literacy are at a critically low level. Furthermore, across the nation there is a serious and growing shortage of nursing faculty (DeYoung & Bliss, 1995; Post & Louden, 1997); it is expected that approximately one third of current faculty will retire between 1992 and 2006 (Plater, 1995; Post, 1997; Ryan & Irvine, 1994). No less significant is the ongoing problem of a shortage of nursing faculty educated as teachers (Princeton, 1992). Part-time and clinical adjunct faculty in nursing increasingly are providing instruction, even though most have not had preparation in teaching (DeSevo, 1995). These part-time and adjunct faculty have not had access to faculty development initiatives that emphasize knowledge, skills, and socialization to the role of nurse educator in order to adequately prepare students for changing healthcare environments (Benner, Hooper-Kyriakidis, & Stannard , 1999; Choudry, 1992; Diekelmann, 2001, 2002; DeSevo, 1995; Introduction 5 Norton & Spross, 1994; Opdycke, 1999; Sheehe & Schoener, 1994; Young, 1999). In graduate nursing programs emphasis is placed on research and the preparation of doctoral students, often to the exclusion of teacher preparation coursework and practica (American Association of Colleges of Nursing, 1995). Many disciplines believe that winging it for a semester or two as a teaching assistant is all the preparation a person needs in order to go on to teach the discipline. Likewise, teacher preparation coursework is often nonexistent in many health professions graduate curricula. At precisely the time when health professions faculty most need to increase their pedagogical literacy and expand their teaching skills to respond to the challenges of contemporary teaching and healthcare environments , funding for faculty development is declining. Without substantive reform, however, the quality of health professions education for students will be at increased risk for failure. Creating Student-Centered Pedagogies A revolution is needed in nursing education no less dramatic than the one instigated by Florence Nightingale. Sr. M. Mooney, personal communication, April 2000 We are supposed to be learning how to care for people . . . in...