25. Those who can do!

Resolution submitted by the RCN Association of Nursing Students

That this meeting of RCN Congress asks if there should be a requirement for nursing lecturers to maintain practice competence to support their relevant academic knowledge

Report on this debate

The proposer described the challenges for nursing students and lecturers over the provision of clinically credible and competent education to students. Standards appear to be confusing and need review. Delegates, including students, gave evidence of mixed experiences. The view of lecturer practitioner roles was that they didn’t work particularly well due to excessive demands on the post-holders.

Nursing students want their pre registration education and lecturers to:

work within a recognised clinical academic career framework
be linked to a knowledge and skills framework
enhance and maintain their clinical credibility and competence
provide clinical knowledge that is contemporary and relevant.

Following a procedural motion it was decided to refer this matter to RCN Council for further review of the evidence and information and to work with educators, RCN staff and members, to develop an agreed clinical academic career framework or pathway.

Background

The last 50 years has seen major changes in the role of nurse lecturer in pre-registration nurse education. During this time there has been frequent debate relating to the need for nurse lecturers to maintain their clinical competence and clinical credibility, in order to successfully fulfil their role.

Until the 1960s, responsibility for classroom teaching rested upon nurse tutors within hospitals; practical teaching took place on the wards or was led in the community by clinical teachers. Following a major review of pre-registration nurse education in the 1980s, the two distinct roles of teacher and clinical teacher were replaced by a single grade of teacher, with in-practice support being provided by mentors. The role of the nurse lecturer was further challenged in 1995, when the last of the ‘old style’ schools of nursing in the UK were fully integrated into higher education, and detached legally, organisationally and financially from health authorities.

As a result, the funding of nursing education differs from the way health care is funded generally; funding is provided through the UK departments of health (or the DHSSPS in Northern Ireland) and managed through contracts between NHS commissioners and higher education institutions. This means universities are governed by different financial and quality drivers, receiving no income for the practice element of any teacher’s role.

Nurse lecturers juggle multiple and very different demands, including research activity, publications and some income generation ― all of which are requirements of the university sector. It is generally accepted that nurse lecturers must engage with practice settings, although it is generally unclear as to what this clinical role is or should be. Attempts have been made to formalise the clinical role of nurse lecturers by developing link teacher roles, involving supporting students on placements and clinical assessments. Some clinical supervisor roles have also been developed, which also require the nurse lecturer to include clinical teaching.

Whilst great importance has been placed on the need to remain clinically competent and clinically credible, there has been little debate on what being clinically credible actually means.