Dean Emerita, Christine E. Lynn College of Nursing, Florida Atlantic University
Director, Anne Boykin Institute for the Advancement of Caring in Nursing

The Anne Boykin Institute for the Advancement of Caring in Nursing, founded 10 years ago as part of Florida Atlantic University’s Christine E. Lynn College of Nursing, held its 8^th Summer Academy focused on Re-imagining Nursing Education through Caring Science.  The two-day virtual event occurred on June 1 & 2 attracting 50 participants from across the U.S and eight other countries. The dialogic format of the Academy is based on the Dance of Caring Persons model of relating (Boykin & Schoenhofer, 2001) and improvisational learning (2013). 

Participants receive a Structured Improvisational Learning Plan several weeks in advance of the Academy that includes questions for reflection and resources to inform the reflection. Evocateurs for each session facilitate the dialogue. Enrollment is limited to 50 participants to promote engagement in a meaningful dialogue.  During each Summer Academy an artist-in-residence is selected to aesthetically re-present through their medium of choice the meanings they acquired during the Academy.  This year Mikhaella Norwood, a poet, activist, performance artist, and founder and CEO of Freelife Productions, LLC, served as the artist-in-residence. She read several of her poems each day, and at the conclusion of the Academy presented a poem that re-presented her experience.

Here I will provide a synopsis of the ideas that came out of each of the sessions.  Some of this summary will read as disconnected and without sufficient context. It is not possible to represent the depth of the dialogue; instead this is an attempt to share some of the meaningful ideas that surfaced during the dialogue.

The first session focused on the question, “In what way does Caring Science offer opportunities to humanize nursing education?” Humanizing nursing education was linked to concepts such as respect for personhood, protection of dignity, assuring equity and equal treatment, fostering creativity and authenticity, appreciating uniqueness and diversity, creating safe learning environments, honoring values, believing in becoming, and inviting creative emergence.  These concepts were linked to caring philosophies and theories (Boykin & Schoenhofer, 2001; Mayeroff, 1972, Roach, 2002; Smith, 2020; Watson 2018). Participants described the need to shift educational models in nursing from authoritative to participatory, through creating a culture of caring that embodies values/concepts such as: compassion, lovingkindness, honesty, respect, humility, courage, trust, patience, commitment, mutuality, self-reflection/understanding and human flourishing. Participants described learning as meaning-making and emphasized the importance of faculty modeling a humanistic, caring way of being with others including students. Several participants talked about how dehumanizing experiences as students shaped their knowledge of what not to do and how not to be when they became teachers.  Participants shared specific actions that they’ve incorporated to humanize the teaching-learning process such as: inviting and sharing stories, focusing on context over content, using “icebreaker” exercises to invite reflection and come to know each other in a class, abandoning lecture for “flipped classroom” strategies such as teaching from nursing situations (Barry, Gordon & King, 2015) or using emancipatory learning strategies such as Peace and Power (Chinn, 2013).

The second session focused on the question, “How do we bring caring knowledge to guide us in responding to contemporary and historic issues in nursing education?” Participants emphasized that faculty are accountable to teach the discipline of nursing and knowledge of Caring is essential to disciplinary knowledge (Smith, 2019). References were made to the new ANA Definition of Nursing (2021) that clearly defines nursing as integrating the art and science of caring:

Nursing integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses and advocacy in the care of individuals, families, groups, communities, and populations in recognition of the connection of all humanity (ANA, 2021, p. 1).

The new AACN Essentials: Core Competencies for Professional Nursing Education (www.aacnnursing.org) that include the domains of Knowledge for Nursing Practice and Person-Centered Care (Domains 1 & 2) and the concepts of Compassionate Care and Diversity, Equity and Inclusion, Ethics, and Communication, are informed by Caring Science. The theories in Caring Science provide the substantive knowledge necessary for the competencies. A participant noted that in a competency-based curriculum model, it is incumbent on faculty to identify and assure caring competencies.  Some participants identified the need for reframing evaluation, measurement of curricular outcomes, and accreditation from a Caring Science-based perspective. Both “words and numbers”, qualitative and quantitative approaches, are necessary to provide important insights for discerning student learning. Several participants perceived that there is a growing awareness of the importance of Caring Science in nursing education, and they viewed this as hopeful. Many educators have excellent exemplars or “pearls” that are valuable for re-imagining nursing education through Caring Science. These can be shared with colleagues or disseminated more widely through presentations or publications. Nursology.net has sections for educational exemplars illustrative of nursing theory.

The question guiding the third session was: “Nursing education takes place in a highly colonized institution of the Academy (higher education). How can we re-envision values/structures/ strategies/systems in higher education to honor and support all persons?” In this session participants were called to examine the history of colonization of our educational structures and the emergence of structural racism from 1400s to the present day. The evocateurs invited participants to deconstruct the structures, processes and the actual syllabi by reflecting on the underlying assumptions about teaching, knowing and learning that originate in Eurocentric coloniality and continue to be foundational to our view of “education”. This awareness is the first step toward seeing the world through a decolonized lens. Participants shared their experiences as faculty and called for courageous conversations to address racism in nursing education. This is “inside-out” work. The message was, “We are complicit in maintaining the structures of racism” and we need to listen to our students and faculty of color who are experiencing racism in our nursing programs.” We need self-reflection and professional development for faculty. Social justice is caring at a community/population/societal level.

“What is the future of nursing education grounded in Caring Science?” was a question that guided dialogue in the fourth session.  Participants cited bell hooks’ (1998) and Paulo Friere’s (2005) concepts of an engaged pedagogy, one that leads us to respect and care for the souls of our students… a pedagogy of the heart. In the way of science – only love helps bring forth knowledge of the human condition. Science with love is the essence of a Caring Science-based approach to teaching.  Given this, what are ways we can “open up” our teaching-learning environments to liberate our students?

Each Summer Academy ends with a clear action plan in which participants are invited to move ideas forward to create change. The question was, “What ideas should we move forward in advancing the knowledge of Caring Science in nursing education?” The actions plans can be realized through things like writing papers that might change practice, engaging in political action, developing products that can guide policy. Participants formed groups to work on a variety of projects.  

The 2023 Summer Academy will focus on Advancing Caring Science through Aesthetic Knowing.  The date has not been set. It will be announced on the Anne Boykin Institute website, and all participants will receive a Save-the-Date notification.  This Academy on Re-imagining Nursing Education through Caring Science was both an individual and collective leap toward transforming the current structure/processes/ strategies/systems of nursing education toward a more humanistic, caring-centered praxis. 

References

AACN (2021). AACN Essentials: Core Competencies for Professional Nursing Education. Washington, D.C.: AACN.

ANA (2021). Scope and Standards of Nursing. Silver Springs, MD, ANA.

Barry, C., Gordon, S. & King, B. (2015). Case Studies in Caring Across the Practice Spectrum. New York: Springer.

Boykin, A. & Schoenhofer, S. (2001). Nursing as Caring: A Model for Transforming Practice. Sudbury, MA: Jones & Bartlett.

Chinn, P.L. (2013). Peace and Power: New Directions for Building Community. 8^th edition. Burlington, MA: Jones & Bartlett.

Crowell, S. & Reid-Marr, D. (2013). Emergent Teaching: a Path of Creativity, Significance, and Transformation. New York: Rowman & Littlefield.

Friere, P. (2005). Pedagogy of the Oppressed 50^th Anniversary edition. New York: Continuum.

Hooks, b. (1998). bell hooks’ engaged pedagogy: Transgressive education for critical consciousness.  Westport, CT: Bergin & Harvey.

Mayeroff, M. (1972). On Caring. New York: HarperPerennial.

Roach, M.S. (2002). Caring: The Human Mode of Being: A Blueprint for Health Professionals. (2^nd  rev. edition). Ottawa: Canadian Health Association Press.

Smith, M.C. (2020). Marlaine Smith’s theory of Unitary Caring. In Nursing Theories and Nursing Practice 5^th edition. M. Smith (Ed.). Philadelphia: F.A. Davis. pp. 493-502.

Smith, M.C. (2019). Regenerating nursing’s disciplinary perspective. Advances in Nursing Science, 42(1), 3-16.

Watson, J. (2018). Unitary Caring Science: Philosophy and Praxis of Nursing. Boulder, CO: University of Colorado Press.