The Privilege and Challenges of Teaching in Professional Programs

teaching nursing students

Those of us who teach in professional programs have some unique instructional challenges. Certainly, like everyone else, we have content that students need to learn—and, like everyone else, we have too much content and struggle to get through it all. We’re also alike in that we want our students to develop lifelong learning skills, such as problem-solving and critical thinking. And yet, on top of this, all students in professional programs have skills related to the profession that they must truly master—a matter complicated by the fact that whether it’s a culinary program, welding, woodworking, occupational therapy, social work, or computer repair, most students begin these programs having none or very few of these skills. Moreover, unlike many of the more traditional academic majors, in our programs we are also expected to teach students how to act like professionals in our fields. And finally, the reputation of our programs depends on how well our students perform in all of these areas, as measured by a certifying exam that students must pass in order to work in the profession. Indeed, professional education has its challenges which those of us teaching in the programs along with the rest of the academic community need to regularly consider.

I’ll use my own program to further explore what makes teaching in professional programs at once challenging and rewarding. For decades, I have taught in a Faculty of Nursing at the graduate and undergraduate levels. Our undergraduate students come to us with high grade point averages, or if they are transferring into our After Degree program (meaning they have a degree in another discipline, such as science, and then take our two-year program to a Bachelor of Science in Nursing), their grades need to be competitive.  In the undergraduate program, students take theory and clinical courses and the theory courses are approved by the university.  The nursing regulatory body determines the exact number of hours students spend in each clinical area. After completion of the program, students write a North American examination before they can enter nursing practice.  Because most of our students must work part time to pay escalating tuition costs, they become experts at time management. To say it more directly, nothing is easy for students in our programs or in other regulated programs at the University of Alberta, and I suspect that is true of professional programs offered elsewhere.

Preparing students to be professionals in a regulated discipline means they must have foundational knowledge in their discipline, plus courses in related areas such as ethics, legal issues, history of the field as well as current trends and issues. In many fields, the content of the curriculum is closely monitored by those in the field or by professional boards or associations who prescribe what graduates should know and be able to do. Those of us teaching in a professional area, do not have as much curricular freedom as other faculty do. We have a responsibility to equip students with the knowledge and skills needed in the profession.

Like all students, those in professional programs need to acquire lifelong learning skills. In nursing, for example, students need to know how to seek out and evaluate evidence. They must have good communication skills and know how to work in multidisciplinary teams and deal with cultural diversity. They are expected to engage in self-reflection and become more self-aware as they progress through the program. Critical thinking skills are vital in all professions. Students can’t get by just memorizing facts. They need to understand phenomena and in the health profession they must come to these understandings quickly and in situations that are ambiguous, fluid, and high risk. These skills are taken seriously in the profession and if students don’t have them, there are consequences. They can be fined for behavior not deemed professional and in severe cases, they can lose their license to practice.

Then there are those professional skills students need to acquire. You can’t be a nurse if you don’t know how to start an IV, and that’s only one of many sophisticated professional skills we must teach our students. In nursing programs and many other professional programs, these skills are learned in labs but then practiced in a professional setting. Students cannot function as professionals if these skills are absent, or in our case, if they practice them in an unsafe way that puts a patient at risk.

If students are not acquiring these necessary skills at professionally competent levels, we are obligated to respond. Students fail the course or, in some circumstances, may be required to withdraw from the program. If a nursing student is not performing well professionally, the professor must do more observations, documenting what is seen and give extra feedback. Unfortunately, professional curricula are linear and cumulative, so students who are not performing at the level they should be, often cannot simply repeat a course. They may be put back an entire year to learn foundational knowledge they missed. Given the investment of students in their education, it is not uncommon for them to formally appeal the decisions faculty make and with some students, frequently their parents get involved in this process.

Socializing students into the profession presents another set of interesting challenges. In our program students must be taught to “behave and think like nurses”. This makes us similar to other professions whereby students in their chosen profession must behave and think like an engineer, or dentist. or pharmacist. In nursing, this means students are expected to be ethical, able to interact with the public, trustworthy, and display evolving competencies. Modeling plays an important role in learning professional behaviors. Those of us who teach must always be mindful of the need to look, act, and speak like professionals.

Teaching in professional programs presents faculty with a number of unique challenges and special demands. Again, I’ll use nursing as an example. For nursing instructors who teach in the clinical areas (and that means in a hospital or other off-campus health facility), they can easily spend 16 hours per week in the clinical setting, leaving little time for research, service, and life at home. Ironically, in my field, it is the pre-tenured professors who most often teach in the clinical area because they have more recent experiences there. Like the students, they quickly become time management experts.

Professors in most of these programs also must maintain their professional credentials. They can’t teach nursing without keeping my nursing license current. Other professional obligations include service to the profession on various committee and/or regular interaction with those practicing the profession.  One difference between many of us in professional programs and professors in other faculties is the control over time and the high value place on service work. The service work is built into serving the profession and is layered from local, to national and international committees and conferences. Accreditation is another time-consuming obligation.  Institutional accreditation is not enough. Most professional programs must be accredited on their own merits. As with institutional accreditation, the process involves a lot of time and committee work.

And so why would anyone choose to teach in a professional program? I’ll give you an example. Recently, two nursing colleagues and I was travelling home in the middle of a very cold night when we spotted a severe car accident on the other side of the highway. We stopped and volunteered to help, much to the relief of the police already there on the scene. The ambulance and fire departments were on their way but this was way out in the country so it was taking them time to get there. We were able to help. Nurses, like many others who teach in professional programs, serve our communities and doing so is a source of pride and great satisfaction.

I also teach because I’ve seen what programs like these can do for students.  When my nursing students start the program, many are shy, introverted, and lack self-confidence. By their fourth year, I’m seeing strong, self-assured, soon-to-be professionals. They know how to think deeply and openly communicate with professionals in their own field, other fields, and members of the public. They cross that stage at convocation with a slight swagger, rightly proud of their accomplishments. I applaud, smile, and feel that same slight swagger as I walk to congratulate them and their families.

I would like to acknowledge Drs. Lolita Paff and Maryellen Weimer for their feedback as I was writing this article.

Olive Yonge, vice dean, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.

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