Episode 469

A Partner for Nursing Programs: Dr. Kathy Chappell, CEO of the Accreditation Commission for Education in Nursing

04-17-2024

There are more than 2,600 colleges and universities with nursing degree programs in the United States, offering a mix of options from associate-level degrees to doctorates. Ensuring that those programs deliver high-quality education is the focus of today's guest, Kathy Chappell, PhD, RN, the CEO of the Accreditation Commission for Education in Nursing, also known as ACEN. “We have this regulatory compliance function as an accreditor, but at the end of the day, it's about high-quality education for nurses. We want their students to excel so it's really our job to be their support and partner in understanding and meeting the standards,” Chappell tells host Hillary Acer. The veteran clinician and educator says ACEN is also assuming the role of partner in the broader cause of addressing the nursing shortage by using its influence to support the expansion of education programs, which she thinks should be a national priority. “I would consider it to be a public health crisis. I really do. I think it's as critical as the COVID pandemic.” This is a great scan of nursing education that includes a discussion of international accreditation, interprofessional education and the challenges nursing programs face in preparing students for a very demanding profession. Mentioned in this episode: https://www.acenursing.org/

Transcript

Hillary Acer: Hi, I'm Hilary Acer, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and healthcare. 

 

There are more than 2,600 colleges or universities that offer a nursing degree program in the United States, offering a mix of options from associate-level degrees to doctorates. Ensuring that those programs are delivering high-quality education is the focus of today's guest, Dr. Kathy Chappell, the CEO of the Accreditation Commission for Education in Nursing, also known as ACEN. 

 

Dr. Chappell earned bachelor's, master's, and doctoral degrees in nursing herself and is an accomplished researcher and clinician with extensive experience leading credentialing programs at professional organizations and health systems in the U.S. and globally. She's currently serving on boards affiliated with the World Health Organization and National Academy of Medicine. 

 

Thank you so much for joining us today, Dr. Chappell. 

 

Dr. Kathy Chappell: I'm thrilled to be here, thank you. And thank you for inviting me. 

 

Hillary:  I'd love to start with learning more about you and what first got you interested in healthcare and nursing. 

 

Dr. Chappell: I will have to say that it was probably watching TV shows like Emergency and MASH. I remember as a small child watching, you know, the healthcare team that cared for patients that were flown in from war and thinking, I would love to do that. That's really what got me started, I think…this fascination with not only the care team at that time, trauma, and the science of healthcare. I was always really interested in science, and how things worked. I think this was kind of the right field for me. That's what really drew me to it. 

 

I started out working in a doctor's office doing just a lot of mundane tasks -- insurance billing and things like that. It exposed me to the environment, but honestly was a little boring. So, I was able to then rotate into the doctor's office's lab. I worked in an emergency room while I was in nursing school, and then immediately kind of started to pursue that type of a career, ER and ICU nursing, primarily, clinically. And then I've done a lot of different roles in nursing over the time. 

 

Hillary: Yeah, we'll definitely get into all of the roles that you've had over your nursing career. But it's funny, you brought up the kind of pop culture influence in your nursing journey. When I was younger, I used to watch ER with my sister, too. And we used to just play games, pretending to be doctors and saving people's lives and all sorts of things. 

 

Dr. Chappell: Absolutely. It's amazing how the shows that were on at the time, right, influence kind of the paths that we take. I even went back to LA and saw the emergency museum and the original ambulance and the original fire station that they were dispatched out of on the show. It’s still there and it's an active working station. So, it was fascinating.

 

Hillary: Wow. And so you started to touch on some of your early career in nursing and the clinical side of things, but you've also progressed through a number of administrative roles in nursing education and research. How did you decide what steps to take along that journey and how did you make those choices in moving out of clinical and into these broader roles? 

 

Dr. Chappell: Like I said, when I first started, I was in some really high acuity settings. I was in a Level I trauma center in Washington, D.C., and then one just outside of D.C. in suburban Virginia and I loved the clinical care, but it is very demanding. I had two small children over those years and decided that I needed to move into a different role that was a little bit better balanced for me, but still enabled me to use my clinical skills and clinical expertise. So, I changed to be a hospital supervisor for a large Level I trauma center. And I will say that that clinical experience really was an asset. A hospital supervisor is like the conductor of an orchestra, right? It's getting patients through and making sure that patients are safe. I did that on a lot of evenings, night shifts, weekends, so I could be home with my kids at the time. It was a job I thoroughly enjoyed. I enjoy kind of being that person in charge of making sure that the system worked well on any particular shift.

Then over time, I moved into a system level role and I was responsible for anything that had to do with all nursing students that were coming to do their clinical rotations or their preceptorships. I was also responsible for nursing research. As you change in administrative responsibility your influence is broader, but it's not delivering direct care. I did try and stay in direct care for a little bit as I escalated in those roles, but it's really difficult to stay up to date clinically when you're not taking care of patients all the time.

 

So after the hospital supervisor role, I was recruited to run some programs for the credentialing arm of the American Nurses Association, ANCC, and I use that experience and education at the clinical setting, looking at credentialing organizations across it really into continuing education for the practicing nurses. I was also responsible for research and certification, developing certification exams for nurses and advanced practice nurses. Then I just took this role as the CEO of ACEN, a fabulous role, at the right time in my career. It was a great time to look at how you really influence an accrediting body and drive the profession forward on behalf of the nursing profession through the lens of education. So, it's wonderful. 

 

Hillary: What an amazing journey from Level I trauma centers to hospital supervisor to working with the ANCC and now with ACEN. You've had such diverse roles and it sounds like some amazing impact on both patients and students, and now more broadly, as you mentioned, on the systemic level. 

 

Dr. Chappell: Yeah. That's one of the best things about nursing, right? When you do one part and you go, “Oh, that was great for this stage of my life. Or I'd like to go from acute care to home care. I'd like to go work for Boeing as a nurse.” You just have so many opportunities as a nurse. It's been a blessed profession. It really is. 

 

Hillary: Yeah. I love that. And I know a lot of our audience members are trying to find that same balance, whether they're a caregiver of young people or a nurse or maybe it's just a young kid or maybe elderly parents or, you know, they just have other interests. So, thank you for sharing your path and hopefully inspiring those listening. I also was curious to hear about your two young kids. Obviously, they followed your path in some ways so they must have appreciated your work….seeing you have this much impact in different ways in healthcare. 

 

Dr. Chappell: Well, my kids are twenty-six and thirty now, so they're not little ones anymore, but they each have degrees in a science-based professions and then decided to go into nursing through a second degree program. So I'm thrilled. I am thrilled that they finally came around and want to be nurses and they're doing fantastic and they'll be great nurses. But it's been interesting. 

 

Hillary: Hopefully they're leveraging your expertise and getting all the advice. 

 

Dr. Chappell: I hope so. It's been interesting being a parent of a nursing student today and kind of reflecting on how I was educated as a nurse way back when. It's different. It's more flexible, but it also asks a lot of students today compared to my going and sitting in a classroom every day and going to clinical. It was very structured with somebody lecturing at me every day. Now it’s a model that's a lot more, I think, student driven and a lot of expectations on students to take responsibility for some of their own learning, which is a great lifelong skill. But it's a skill that needs to be learned, and so it's been fascinating to watch. I'm their biggest cheerleader from the back, but it's their responsibility to do the work. 

 

Hillary: I think it's really interesting to kind of look at the different trends and how education has changed. I know Osmosis has obviously been a big driver of some of that change in the medical education space. You know, we developed a lot of online supplemental learning materials for students to learn more flexibly and to have that personalized learning component. But you're absolutely right. It is on them to watch the video and sit down and kind of have that discipline. So, that's a really important skill.

 

Dr. Chappell: It is a really important skill over your life. It's not good to just sit and have somebody tell you things. To be an active learner, to seek out resources is what we want learners to do, no matter where they are, no matter if they've been in practice thirty years and they see something they haven't seen since they graduated from school, that they are able to seek out and find their own resources. You have to do that and all the materials that are available today are so incredible. It's really valuable.

 

Hillary: And hopefully it's become a little bit easier for people to seek out those resources from a quick Google search, maybe, or with AI tools coming on online shortly. It seems like at least it's becoming easier to find them. So hopefully more positive trends in the future. 

 

Dr. Chappell: I think so. 

 

Hillary: Well, as part of your path, you mentioned your most recent role as being CEO of ACEN, and I'd love to get a better overview of the organization and its mission and maybe some of the core goals that you all have as an organization for the upcoming year.

 

Dr. Chappell: Sure. So we are the oldest nursing programmatic accrediting agency in the United States, probably actually the world, but I know we are in the United States. We've been accrediting programs since the 1930s. We are recognized by the Department of Education which relies on accrediting organizations to ensure the quality of educational programs that students go through. We've had that recognition since 1952. We accredit organizations from licensed practical nursing programs through a clinical doctorate and we can accredit programs that use distance education as well as in-person education. 

 

We also function as something called a “Title IV gatekeeper.” That means for certain types of nursing programs we have a heightened level of responsibility in ensuring that if they get federal student aid, we make sure that it's being used responsibly within the school, so that's a pretty high level of rigor. We're also recognized by the Council of Higher Education Accreditation -- it's called CHEA -- and we've had that recognition since 2011. We are the only nursing accrediting agency recognized by CHEA and same thing across all the different levels of programs. We accredit both within the United States we also accredit programs internationally. We've had significant interest from different areas of the world in adding a U.S based accreditation to their school's accreditation. Some areas in the world have an in-country accreditor and they want to add a U.S based accreditor, and some don't have any accreditation system at all and so they're seeking what I would consider the to be gold standard. The U.S is pretty advanced in the world for accreditation and frankly for certification so we're very proud of our history.  

 

All of our nursing leaders have been faculty and they've been peer evaluators. They have walked every

part of what nursing schools do and now they're sitting in this role looking at evaluating those programs against our standards but really as a supportive partner, not as a punitive force, e.g. “you colored outside the lines and we're going to implement some sort of penalty for that.” We have their goals in mind too, right? We want them to be great nursing programs we want their students to excel so it's really our job to be their support and partner in understanding the standards and meeting those, and I think we do a fantastic job.

 

Hillary: Wow, that's a really great overview. So, 1930s…you are coming up in a couple years on your 100 year anniversary. But, yeah, I find that these kind of governing bodies tend to be in tension at times with the organization’s goals and maintaining standards which is so important across the healthcare field. So, I love that you mentioned really being a partner with them and really trying to understand their goals and working together on things. 

 

In terms of accrediting a nursing program, can you give us a sketch of what actually goes into that and what that process looks like? 

 

Dr. Chappell: Sure. So, we develop standards which are pretty consistent across accrediting bodies and not just within nursing, but also across the health profession. So, medical schools and PA schools have similar standards.

They're not a secret. They're on our website and everybody posts them openly. But, we have a set of standards that schools have to comply with. So, the process is they look through our standards and they write a narrative documentation that says how they meet our standards. For instance, this is the faculty we have. This is how we ensure that they're competent to be great faculty. These are the resources that we provide our faculty. This is our curriculum for students. This is how we administer that curriculum, et cetera. 

 

So when the nursing school or program writes that, we call that a self-study and they send us that documentation about every eight years, sometimes shorter if they have issues, but, they send us that document and they send us supportive evidence. Then we have three reviewers. It's a peer review process. So, they'll read the narrative and they'll look at the supplemental documents and then they go on site for a site visit.

 

We send at least three people who visit the school and they validate that the school is doing what they say they're doing, basically. Then they come back and they write a summative report and that goes to a review board. Again, a peer-reviewed process. They're all nursing faculty. They review everything that's been in the report

and was written and seen on site and then they make a recommendation for accreditation to our governing body, which is the board of commissioners. Then the governing body makes that final accreditation decision. There can be some follow-up or reporting if needed, or if the program's in full compliance, we see them again in eight years, other than a kind of an annual monitoring report. And that's a process that really all the creditors use. 

 

Hillary: It's so interesting to get the details of how it works. And I love that there's the peer review process, which is interesting because you then have people with direct experience going in and helping to measure. 

 

Dr. Chappell: Correct, correct.

 

Hillary: So that's really interesting. You have this aerial view of all these nursing programs, and I'm guessing you've gained some insights into some of the challenges they're facing and some of the, maybe, concerns across nursing education. Are there any specific challenges or concerns that ACEN in particular is seeking to address or improve?

 

Dr. Chappell: Schools are being asked to do so much and get students through high quality programs into a profession that is very demanding and asking a lot of new graduates as they enter. They are particularly challenged by recruiting and retaining faculty. There's a bill now called the FAN Act that's going through Congress looking at further investment in nursing faculty and nursing education. It is kind of the bottleneck. We have a lot of people that want to get in to the profession, but we're bottlenecked by the amount of students that can be taught because of faculty shortages. We have some great faculty out there who are incredibly committed. We just need more that can help support the process. 

 

So as an accreditor, we certainly go into programs and look at the resources that the school has. We look at the quality of their faculty and the support that's given to them. But beyond our criteria, I think we also have an advocacy role to help in any way we can and use our levers to increase investment in nursing education  And we work to kind of elevate what we do with that mission-driven purpose of ensuring that we have great, high-quality programs for nursing students no matter where they are. If they're initial entry into practice or if they're advancing their career, we want to make sure that they have a fabulous experience, and also that the faculty that are teaching them are in a positive environment for them. So, I think that's primarily what we're looking at. We have this regulatory compliance function as an accreditor, but at the end of the day, it's about high-quality education for nurses no matter where they are in their career. 

 

Hillary: Yeah, it's really interesting because I want to talk about the nursing shortage as well, but you're far more upstream from that at the actual education piece and how many faculty we need. One of the things that I've learned about the nursing profession and education since joining Osmosis is just how many different types of degrees there are and also just how many nurse educators you need to staff those programs and also just how many nurses we have really as kind of the backbone of our healthcare system. It's a huge percentage of those providers who are actually working directly with patients and also just quite varied in the different types of programs that are offered. 

 

Dr. Chappell: It is. It is, which is both a challenge and it's an asset, right? There are multiple different pathways you can enter into to go into the profession of nursing. Both my kids are certified nursing assistants because I wanted them to see exposure to what they potentially might be going into. And that was a great way of saying, look, test the profession out. If you work as a CNA and you hate it, then don't go to nursing school. But if you love it and you know that this is the place you should be, which is what happened with both of them, then you have these skills that you're taking with you into your nursing program. 


One of my kids is in an associate program because she has a baccalaureate degree. The other one's in a second degree baccalaureate program, which is a very fast paced, intense program and that was right for them. But they were able to enter in the place that fit them both the best.  

 

I'm a big proponent of academic progression. So with the one who's entering as an associate degree, I'd love to see her go on and get her baccalaureate degree and master's degree. The one that's going through the second degree program already wants to go to anesthesia, be a CRNA, and she's got that mapped out. So, we provide a lot of different pathways into the profession that meet people where they are and continue to support them along the journey. 

 

Hillary: I was just going to add that, yeah, it sounds like this flexible learning that students need more of today that really does meet them where they are and allows them to have journeys that kind of complement the other things that they may have going on in their life. Or as I said, just kind of dip a toe in and see if this is the right field for them.

 

Dr. Chappell: And also the ability to earn a living. If you go through an associate degree program and you can start working as a registered nurse and earning a salary for yourself and your family, and then continue your academic progression to get a baccalaureate degree while you're still working, you know, we're really providing an opportunity to elevate people's lives by earning a salary and that's important. That's how we raise people's well-being within communities is by giving them access to opportunity to education. It’s a life-changing opportunity. 

 

Hillary: Yeah and the barriers to continuing that education often are financial. 

 

Dr. Chappell: They are, yeah. 

 

Hillary: So I love the ability to start earning money and supporting families or whatever they may have as well as going back to school and continuing to increase their earning potential through more degrees and further education. 

 

Dr. Chappell: That's exactly right. And most employers will provide some sort of tuition reimbursement, or many do. So, once you start working you're eligible for tuition support or reimbursement, then that enables you to continue your academic progression with less burden. 

 

Hillary: Well, and this gets back to the nursing shortage, which we started to touch on briefly. As you know, there are constant calls for expanding nursing education programs, and that's something that we try to do within Osmosis…to support these nursing education programs with these supplemental materials so they can reach more students and they can offer more personalized learning. There are a number of challenges to that, of course, but what is your take on that capacity to do that without sacrificing the quality of education? 

 

Dr. Chappell:  I would consider the need for expanding nursing education programs to really be a public health crisis. I really do. I think it's as critical as the COVID pandemic. We desperately need to be able to expand our capacity and help more people enter the profession and serve whatever population or community they're in. I think we have something like five million nurses in the United States now. It seems like so many, but the need is so great. 

 

I spoke about the need to attract and retain faculty, but the tools and resources that are provided to faculty that help them do their job well are just as critical. The tools and resources that you develop that are available to faculty in schools enable them to help individual students learn in the way that they can be most successful. I mean, I started with a textbook and a highlighter and often then rewrote my notes. That's how I learned, right? My kids don't learn like that. My kids learn online, seeking out resources, Googling. Wikipedia is not, you know, an evidence-based resource, however, it often can point you in a direction. 

 

But the ability to access things where they are, when they want to learn, and how they want to learn is critical. And those tools that you develop for not only pre-licensure students who are entering and learning the profession, but those who are already in practice and need to skill up because they're changing their clinical setting or they want to move to a different type of nursing are just as critical. Those nurses have more tools in their toolbox, right? If they've already worked, they have skills that they can draw on, but they constantly need to develop new skills that they need as their environments change. So it's a different way of learning. 

Hillary: That's a really important point. And on the student side, one of the reasons we hear from institutions or why they choose to implement tools like Osmosis is that it actually helps with their student retention, right? If students can find, okay, hey, I really am a visual learner or I like watching videos or listening to videos or I can pause and rewind, then they actually stay in the program longer because they can learn the way that works best for them. So, it's good to see that trend continuing. But it's really interesting you point out that the nursing shortage is really a public health crisis. I think this is so important because it's something that you have to plan for years in advance to actually meet the needs of today. I don't know if you can speak a little bit more to the shortages or maybe what changes we really need to see happen and how soon. I would love to hear any other guidance on how we can kind of push for that change. 

 

Dr. Chappell: If there was an easy solution, somebody would have invented it, right? 

 

Hillary: That's fair.  

 

Dr. Chappell:  It's a complex, multifaceted problem. It's schools that need faculty and resources to be able to expand and to take more students in and through the programs; it's supporting hospitals and healthcare settings and systems that are really stretched trying to care for the patients that are there, and then asking them to do -- particularly the nurses -- one more thing, right? And now we have nurses that need to learn because they're moving from a med surg unit into an ICU. We have students that are there who are pre-licensure students. The challenges are large. They really are. And it's going to take an investment, not only, I think, from a federal standpoint. I think those kind of academic practices partnerships that bring organizations and communities together in order to try and solve problems are often at the local level pretty successful. 

 

I think we need to look at nursing education. There is work in this area that's being done, but how innovative can we be as educators? Right now we have most nursing students that have to go through a hospital and there are clinical rotations -- particularly in areas like peds and OB and psych -- that are bottleneck areas. I think we need to look at where else can you learn about peds, OB, and psych that's not in a hospital. Where else can we be embedding into communities opportunities to educate nurses that might look different than what we're doing currently or have done traditionally? But maybe just as effective is, you know, going into your grocery store, taking blood pressures all day long and talking with patients there. But really embedding education into the communities where schools and students are in different models. I know we have a lot of really smart thought leaders in this country that are looking at different ways that we can address this crisis and we need to continue that investment and focus for the American public. 

 

Hillary: I hope so. Yeah, for us and all of our loved ones who depend on this health care system. 

 

Dr. Chappell: Absolutely. Absolutely.

 

Hillary: So, yeah, I hope to see some changes. And thanks for pointing out just all the different components. I was speaking with Dr. Mensik-Kennedy, the president of the ANA, last week, and she pointed out a stat that I was so shocked to hear, which was over 30% of nurses are asked to work overtime every week or may even be working overtime. That's just another side of the problem where nurses are experiencing burnout and fatigue. There's just not enough staff to actually deliver care as needed. 

 

Dr. Chappell: Yeah. And then the huge amount that leave the profession within the first couple years because the environment is not what they expect and are willing to stay with. So we've put all this effort into educating them and then they get into practice and just say, “no, I'm not going to do this”. It's sad. It really is. We need them. 

 

Hillary: Yeah, definitely. I think for everyone's sake, we need them. 

 

Dr. Chappell: Yeah.

 

Hillary: Well, getting back to your organization and as you put on your CEO hat, what are some of the things that ACEN is trying to make change in over the next several years? Or what are some of your key priorities?

 

Dr. Chappell: So, you know, I spoke about really supporting our nursing programs and our nursing faculty to achieve success. We do a lot of guiding and mentoring and teaching organizations…doing things like sharing best practices and trying to help faculty and programs learn from each other. It's one thing as an accreditor to say “here's the standard” but it's nice when you're able to look at another nursing school and think, “man, I never thought of doing something like that but I could do that in my school.” So, to echo that approach about being a continued supportive partner for schools, even with our regulatory role, we started more and more working collaboratively in partnerships both within nursing and across the profession. 

 

We have the membership organizations that support schools of nursing that we work with and there are areas that we can be aligned in terms of advocating together for change. I think as an accreditor, we try and use our levers wherever we can. We collaborate within nursing, but also across the professions. We have accreditors in all types of specialties -- those that do medical schools or do PA schools. We're in organizations where we have accreditors for schools of music and schools of pastoral care and every type of accreditation or every type of different profession. So, we collaborate together and we learn best practices. One thing accreditors do is they put standards in place that drive the profession in the way that we feel it needs to go to evolve, and so we do learn from each other.

 

We have to manage growth. We are continuing to grow both within the United States as schools of nursing expand. We have to accredit them. So we grow both within the United States and, as I mentioned, outside the United States. We have certain areas in the world that are very interested in pursuing accreditation with us, and that's been an expanding area of business. 

 

And then I think, you know, what we talked about, continuing that faculty support in whatever way we can, both through our standards, but also there's been a real investment in interprofessional education, not just isolated within the profession of nursing. When you go into practice, you're working with physicians and you're working with PAs and you're working with respiratory therapists and social workers. So investing and supporting interprofessional education is really important and so is competency-based education. It’s not just looking at time and seat, but looking at what you can see as a metric of learning…what are you able to demonstrate in practice and how do we assess what you're demonstrating in practice is an area that we're focusing on.

 

Hillary: Got a lot on your plate and those are all exciting areas. Maybe just a couple of things I'll highlight that I find really interesting are the interprofessional trajectory. We have actually a leadership community within Osmosis of medical students, nursing students, PA students, dental students. We used to have them as separate programs and just over the last year we've combined them because it mimics what they're experiencing when they get into clinical practice. They're learning a lot from each other and how to work with different approaches to medicine and different approaches to treatments and all sorts of really interesting things. So, I love that. 

 

Dr. Chappell: Yeah, I do too. I think respect for each other, you know, really understanding the roles that each of the professions have, dispelling some myths about each other across the professions…it's really how we work.

 

Hillary: Yeah. And the strengths of each of the professions. In fact, our CEO, Shiv Gaglani, just made a post recently on LinkedIn -- he's back in medical school -- and pointed out something around scrub technicians, you know, that he had never really heard much about the profession, but boy, did they do a lot of work. And so that was a good reminder to dig a little bit deeper in some of these stereotypes or some of the common things you hear. 

 

The second thing I'll highlight that you pointed out was related to just this kind of open mindedness and growth mindset, and especially as an accreditor for education institutions. It seems like it's so important that you actually continue to use best practices and kind of lean on those learning science tools and evidence that we already know about and actually integrate that. So, you're having these collaborative sharing sessions and you're bringing people together across different fields, different organizations. I think that's a really neat way to be working in this day and age.

 

Dr. Chappell: It's how we have to work, right? We have to work in partnership with it. I think if you go back to the interprofessional education movement, it's really about errors in the practice setting and how we have to be able to work collaboratively as teams in order to effectively care for patients. That we have a responsibility to do that to prevent errors from happening in practice because we're there supporting each other. So if we don't roll that back into education, then we're launching people into the practice setting and asking them to work collaboratively across the professions and we've never given them an opportunity to do that while they were learning how to be a healthcare professional. So, it's so important to do that very early in the education process.

 

Hillary: Yeah, that's a really good point. We want to reduce the clinical errors for sure. 

 

Dr. Chappell: Yes, absolutely. 

 

Hillary: So, Osmosis is focused on educating nursing students, medical students, but also, you know, continuing healthcare professionals in their lifelong education and we love to fill in knowledge gaps. I'm just curious if there's a certain topic that you would have particular interest in Osmosis creating more educational content around? 

 

Dr. Chappell: I think there's a couple areas. I think the first is, we take great clinicians and we ask them to be teachers, but we don't really teach them how to teach. Just because I'm a great ER nurse doesn't mean that I have the skills to teach how to be a great ER nurse. So, that's an area that I think we have to educate people on. Whether we're in a formal faculty role or whether I'm a clinician precepting a student, part of being a healthcare professional is also being a teacher. We focus a bit more on teaching patients. That was certainly part of my nursing curricula in school, you know, how do I teach a patient about safety with medication, etc. But we don't necessarily teach you how to teach another clinician. So, I think an area of opportunity is really skilling up clinicians to be teachers and to understanding what the educational science is, and how to use formative feedback and summative feedback. How do you assess for learning versus assess of learning? Those are two different things. How do we give feedback in a way that is helpful? How do we have crucial conversations? I think those are areas that would be incredibly helpful. 

 

Because again, to go back to the nursing faculty shortage, we really have to skill up not just those within schools of nursing or schools of another health profession, but across everybody that you're responsible for as a teacher. I think you all talked about kind of a flipped classroom model. We're not in a place where we need knowledge regurgitation. I don't need somebody to just regurgitate a fact to me. That's not a helpful measure of learning. What's helpful is that you can apply it in context, so we should be assessing your ability. You can learn what an antihypertensive is on your own, you can read that, you can watch a video. But when it's used, what are the side effects of antihypertensives in an elderly person. Now I'm on a med surge unit, and these are the patients…it's application in context. And so the ability to use tools and resources to learn the facts about something, and then use our more limited time together for application of those facts and context is an opportunity, I think, that you all provide a lot of the tools and resources, and then the faculty need to use that in-person time as effectively as possible. 

 

We also talked about interprofessional and competency-based education, which I think are really important topics. People in general believe in interprofessional education or competency-based education. They want to know how to best do it, right? How and when do you bring students of the different professions together? What are the most effective strategies to engage them as learners collaboratively versus kind of parallel play or something like that? So, those are areas where I think it would be very helpful to have additional support. 

 

Hillary: These are really great topics. And some of them we cover a little bit, but others we haven't touched on yet. I think we have something called “how to teach and learn in the health professions” and we do try to highlight some of the best practices in learning science and really focus on educators though, not necessarily clinicians. So, there are some gaps that we can hopefully fill in the coming years. And you mentioned the interprofessional community or professional education, as well as competency-based education and just the nuances there that are a little bit more difficult to tease apart. How do you apply that versus how do you just teach, you know? So, really fascinating topics. Thanks for sharing all this. 

 

Our last question of the day…we'd love to highlight some advice from your career as a trauma nurse and then going into various different administrative roles, now overseeing an accreditation organization. What advice do you have for early health career professionals about meeting the challenges of healthcare today?

Dr. Chappell: I would say to the greatest extent you can, try to stay positive no matter what experience you have. I had a student one time who wanted to be in pediatrics and the rotation that was available was cardiovascular nursing. She had a summer nurse externship, but she came back every year to the students that I had in this program. And she said, you know what? I learned in that experience a lot of different things about caring for cardiovascular patients. I also know I don't want to be a cardiovascular nurse, but that's okay. You know, she learned something about what her future career would look like and she did a fabulous job. It’s just as important to know what areas are just not for you as it is to know the areas that you like and really are professionally rewarding. There's so many different ways you can go that that's fine. 

 

I think seeking out a mentor and seeking out a cheerleader is important because these programs are hard. They're very difficult. You need somebody who just says to you, keep going, you'll be great. You need that kind of balance to say, you know, it's okay to be scared, it's okay that it's tough, but you'll be fine. 

 

I think that the last thing is I always enjoy somebody who says yes to me, and I say that with this context: I've precepted a lot of people, I've mentored a lot of people, and I've asked them kind of to stretch themselves because that's what teachers do. The ones that are most successful are the ones that say, yes, I'll try. They may not be successful, but if I'm their preceptor, I'm their teacher, I'm not asking them to do something that I don't think they're capable of. I'm asking them to lean in and to try. 

 

Those people that I've had over the years that have said yes -- even when they're scared, even when they're not sure that they are as confident in themselves as I am of them -- they've excelled because I knew they were capable of it. They might not know that they were capable of it, but I knew that they were. There’s a couple of them that I can think of who are international leaders right now. They didn't start as international leaders. They started as analysts in different things, but they believed enough in my belief, my confidence in them that they tried and they're great. 

 

Hillary: Wow. That's really powerful. And they're very lucky to have you. I hear a little bit of the mom of two nursing students in there, as you said, you were their biggest cheerleader and clearly have done that and more for a number of the students and health professionals you've mentored. It's really, it's really wonderful advice, probably applicable to not just nursing students, but everyone. 

 

Dr. Chappell: Not just nursing students. Yeah. 

 

Hillary: Well, thank you so much for joining us today, Dr. Chappell. It's been such a pleasure chatting with you. Some really amazing topics we've covered and I look forward to hopefully staying in touch.

 

Dr. Chappell: Thank you. Thank you so much. And yeah, I hope it's helpful to your listeners. I truly have enjoyed chatting with you too. 

 

Hillary: And with that, I'm Hillary Acer. Thanks for checking out today's show. Remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.