Clinical scholarship and adult learning theory: a role for the DNP in nursing education.

Preparation for successful nursing educational out- comes begins with a solid foundation in learning theory. Two adult instructional theorists provide excellent frameworks that can be used to prepare students for licen- sure and practice. Gagne's Hierarchy of Knowledge out- lines nine events that progress from foundational knowl- edge to higher levels of learning. Keller's ARCS Model of Motivational Design centers the learning process on attention, relevance, confidence, and satisfaction. A com- parison of these theorists is presented as a framework to maximize the nurse educator's effectiveness in the class- room and clinical setting. It is argued that the Doctor of Nursing Practice (DNP) degree offers the skills required for effective teaching, exceeding the program offerings of a master's program.Nursing education represents a unique combination of theory, application, and practice. The DNP degree has fo- cused on the development of advanced competencies for increasingly complex clinical, faculty, and leadership roles, enhanced knowledge to improve nursing practice and pa- tient outcomes, and enhanced leadership skills to strength- en practice and health care delivery (Hathaway, Jacob, Steg- bauer, Thompson, & Graff, 2006). Faculty with the DNP are advanced practice nurses (APNs) with clinical expertise who can bring theoretical concepts to life with authority in the classroom. As an APN with expertise in a particular area of patient care or population, the DNP provides a bridge between the theory and practice of nursing.The Importance of TheoryTanner (2009) notes that nursing's content-laden curricu- lum fails to provide the case-based experiential learning necessary to develop clinical judgment in nursing stu- dents. DNP faculty educators add dimension and breadth to the theoretical fundamentals and clinical experiences within the core nursing education program.Adult learners, according to Knowles and colleagues, are self-directed, experienced, and oriented and motivated to learn (Knowles, Holton, & Swanson, 2005, p. 62). The Knowles approach to adult learning is experiential, em- ploying problem solving with a focus on topics of immedi- ate value to the needs of the learner. Clinical scholars who have the capacity to translate research, shape systems of care, and ask questions to improve performance (Institute of Medicine, 2011), DNP educators are adept at applying adult learning theory to link theoretical concepts to clini- cal practice.A quality learning experience creates an opportunity for students to provide feedback to the educator and, like- wise, for the educator to assess the learners' performance. These encounters provide the underpinnings for continued learning throughout a nurse's career when technological advances and increasingly complex care require continu- ous education in the practice arena. Noddings (2003) asks, What sort of practice is teaching? (p. 248). Exploring this question to gain a better understanding of ways to en- gage the learner motivates educators to perfect the prac- tice of teaching. Uncovering educational theories provides a reciprocal grounding for teacher and learner central to the preparation of educators. As educators discover the instructional framework that fits their own personal teach- ing style, they can accentuate the learner's style, maxi- mizing the assimilation of the vast array of concepts into a competent knowledge base. An effective educator uses instructional design to keep learners engaged and assists students to continue learning.Gagne and KellerRobert M. Gagne and John Keller provide excellent frame- works for teaching the nursing concepts that prepare adult nursing students to attain licensure and to practice compe- tently. Gagne built upon behaviorist and cognitive theories to identify diverse levels of learning that correspond to dif- ferent types of instruction. The five major types of learning levels are: verbal information, intellectual skills, cognitive strategies, motor skills, and attitudes. …