Erin Dolen, MSN-Ed, RN, CNE
Catherine Quay, MSN, RN-BC, CNE
Last year, we conducted a study with Dr. Jane K. Dickinson as part of our doctoral program in Nursing Education at Teachers College Columbia University, that explored the use of nursing theory to guide nursing doctoral research. Our findings revealed that doctoral nursing students rarely use nursing theory to guide their work. Reflecting on these results, we realized we had more questions than answers, and we started to discuss what this means for us as educators.
Nurse educators are responsible for preparing students to be future nurses and leaders in healthcare. Yet, the increasing number of nurses leaving the profession due to burnout, compassion fatigue, and moral distress makes us wonder if we are preparing them for the current environment they are being immersed in. Are we giving nursing students the tools they need to be successful nurses in today’s environment? And can these tools be found in the profession’s theory, values, and knowledge? We believe so.
Our research has shown that nursing theory is not commonly being used to further enhance nursing science. This finding leads us to believe that nursing students are not being taught the importance of nursing theory and the significance of how understanding nursing theory helps guide them in their practice. Understanding the application of nursing theories, such as Orem’s (1971) Self Care Theory, Watson’s (1997) Theory of Human Caring, and King’s (1971) Conceptual System, can provide a foundation for holistic nursing practice and self care. We believe that seeing the connection between nursing theories and their own practice can help nursing students build resilience and find alignment with their personal value system.
Through our own doctoral education, making the connection between theory and our practice as nurses and educators has given us a more in-depth understanding of the nursing profession, which has provided us with a true sense of professional belonging and connection to our personal values. For example, in our doctoral nursing theory course, we were introduced to Chinn and Falk-Rafael’s (2018) Critical Caring Pedagogy (CCP). We found an immediate connection between what was discussed in CCP and our own practice. Suddenly, how we approached nursing care and nursing education made so much more sense. We finally had a rationale for why we do what we do and a language to communicate our values as nurse educators.
If finding understanding and our voice through connecting to nursing science and values can help us, it could potentially help other nursing students and nurses navigate the challenges they face in the current healthcare system. More than ever, the profession needs to fall back on our scientific foundation to solve the issues of nurse burnout, fear, and a potential loss of our authentic nursing voice at the bedside. For example, a thorough understanding of Carper’s (1978) patterns of knowing can help a nurse see these patterns threaded through their practice, which can give them meaning, purpose, and an understanding of what they do as nurses. More importantly, it can give them a language that allows them to advocate for themselves as nurses and the nursing profession. The ability to fall back on this meaning and understanding allows one to remember why they chose to be a nurse in the first place.
Our hope is that we can better prepare future nurses by addressing some of the questions raised by our research through nursing education. Nursing faculty have an opportunity to develop innovative ways to infuse and engrain patterns of knowing, nursing values, and nursing theory into the curriculum. Engaging students in nursing science at all levels of education can help them develop a deeper understanding of nursing knowledge, can further clarify the connection between theory and practice, and can lay a foundation for future nursing theory-guided research. Nurse educators can guide students in making the connection between what they are learning in the classroom and what they experience in the clinical setting. One strategy we recommend would be to use resources such as nursology.net: have the students identify a theory that best describes their own perspective of nursing care. Help students bring theory to life by asking them to reflect on a personal clinical experience that demonstrates how their chosen theory guided their actions. Learning strategies, like these, can facilitate the student’s ability to communicate to others what nurses do and why they do it. Developing this ability and the use of a common language will serve to strengthen nursing’s vision and promote nursing practice that is based on nursing science.
Acknowledging and being able to discuss the value in nurses’ professional knowledge and a clear connection between theory, education, and research enhances the unique nursing perspective and lays a foundation for future research and new knowledge development. Through future nursing education research, we can identify evidence-informed, active learning strategies that will enable nurse educators to successfully prepare nursing students for the professional challenges they may face and to keep them engaged and fuel their excitement about nursing science throughout their educational journeys.
Carper, B. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-24. https://doi.org/10.1097/00012272-197810000-00004
Chinn, P.L. & Kramer, M.K. (2018) Knowledge development in nursing: Theory and process (10th ed.). Elsevier.
King, I.M. (1971). Toward a theory for nursing: General concepts of human behavior. Wiley.
Orem, D.E. (1971). Nursing: Concepts of practice. McGraw Hill.
Watson, J. (1997). The Theory of Human Caring: Retrospective and prospective. Nursing Science Quarterly, 10(1), 49-52. https://doi.org/10.1177/089431849701000114
About Erin Dolen and Catherine Quay
Erin is an Assistant Professor of Practice at Russell Sage College in Troy, NY. She is a doctoral candidate in the EdD Nursing Education Program at Teachers College, Columbia University. She has her MSN with a focus in Nursing Education from Excelsior College. Erin has her national certification as a Certified Nurse Educator. Her nursing background is in emergency medicine. She lives in Delmar, NY with her husband and two children. Catherine Quay, MSN, RN-BC, CNE is an Assistant Clinical Professor and gerontology course chair in the undergraduate nursing program at Drexel University.
Cathy received a master’s degree as a family nurse practitioner from Pace University, is a board certified gerontological nurse, and a certified nurse educator. She is currently an EdD candidate in nursing education at Teachers College Columbia University. Her research interests focus on fostering empathy and decreasing bias in future healthcare providers to better prepare them to address health disparities and to care for an increasingly diverse population.
11 thoughts on “How Does Nursing Theory Fit into Nursing Education?: From the Perspective of Two Nurse Educators”
Thanks for this great post, you are so right in saying:
“Engaging students in nursing science at all levels of education can help them develop a deeper understanding of nursing knowledge, can further clarify the connection between theory and practice, and can lay a foundation for future nursing theory-guided research. Nurse educators can guide students in making the connection between what they are learning in the classroom and what they experience in the clinical setting”.
Thank you for your comment and support!
Good morning, In Colombia-South America nursing schools make efforts to use nursing theory, but nevertheless writing our own stories or nursing narratives has allowed our students to strengthen knowledge patterns, to recognize moments of care in the metaparadigm and have visibility from what we live, feel and write. Congratulations for this important Article, which I will continue to quote with my students.
Oscar Javier Vergara Escobar
Professor of Epistemology of nursing knowledge
Thank you for your comment Oscar. I couldn’t agree more with your statement regarding “writing our own stories”. Our stories are able to bring the nursing theory practice connection to life and I believe, help us find strength in our nursing voice.
It sounds like you are doing some great work in Columbia. Best of luck.
I’m afraid very few nursing faculty teach any nursing science…and many aren’t familiar with the idea of nursing science. Hopefully articles like this one will help awaken some minds.
We hope so too! It is unfortunate that nursing science often gets squeezed out of the curriculum. Thank you for your comment.
Thanks for the great post! I’ve been teaching nursing theory to graduate students for over 10 years. Three years ago I started using a middle-range nursing theory text (Smith & Liehr, 2018) and noticed a shift in my students’ perceptions about nursing theory in practice. I discovered this text on Nursology.net. I’m so thankful for this site snd the ability to connect with other nurse educators on this important part of nursing curriculum.
Thank you for sharing, this is a great resource.
The NLN used to require Nursing Conceptual Models for accreditation. I worked in SONs that used Rogers SUHB, the RAA and the Neuman Systems Model. Curricula were based very successfully on the models. I know many other nurse educators had the same experience.
Thank you for bringing hope to the future use of Nursings’s disciplinary knowledge. Please take courage as you move forward! We do very much need nurse scholars who will integrate nursing knowledge into our foundational pre-licensure and graduate curricula. Unless we fully embrace our epistemology- our fundamental patterns of knowing in nursing -our nursing care is empty and robotic.
Gracias, por su trabajo tan intereante en el campo de la educación de enfermeríamejor aún por rescatar el enfoque del conocimineto que emana de la ciencia de enfermería. Si bien es cierto desde la formacion básica en enfermería los educadores de enfermería podemos rescatar estas teoría que permiten hacer resaltar y utilizar elemntos fundamentales de las teprias de enfermería, el conocimiento disicplinario juega este papel fundamental que sustenta la práctica del cuidado. En México he realizado un estudio acerca de las materias que se estudian que tienen que ver con las teorías y modelos en enfemrería y para mi sorpresa es una incorporación muy bajo o nula a los planes de estudio. Por ello considero ello como señalan ustedes Dolen & Quay su estudio que ha demostrado que la teoría de la enfermería no se usa comúnmente para mejorar aún más la ciencia de la enfermería, no se observa unicamnete en su país si no en otros contextos también.
Thank you for your very interesting work in the field of nursing education, even better for rescuing the knowledge approach that emanates from nursing science. Although it is true from basic training in nursing, nursing educators can rescue these theories that allow us to highlight and use fundamental elements of nursing teprias, disciplinary knowledge plays this fundamental role that supports the practice of care. In Mexico I have carried out a study about the subjects that are studied that have to do with the theories and models in nursing and to my surprise it is a very low or non-existent incorporation into the study plans. For this reason, I consider that, as Dolen & Quay point out, your study has shown that nursing theory is not commonly used to further improve nursing science, it is not only observed in your country but also in other contexts.