Elsevier Healthcare Education White Papers

Put the latest research findings and best practices to work in your program with the guidelines and information presented in our white papers.

Simulation in Nursing Education: Which Type to Use and When?

Helen Murphy, BS, RDMS, CHTS-TR

With a growing shortage of registered nurses, many are wary of accepting the added responsibility of training pre-licensure students in clinical sites. One way to prepare nursing students in a safe environment is with simulations. In this whitepaper Elsevier Digital Product Educator, Helen Murphy, discusses the growth of simulation in nursing education, the different types of use in the classroom, and how to decide which is right for your program to prepare students for clinical practice.

Preparing Students for Human Patient Simulation Learning Activities

Helen Murphy, BS, RDMS, CHTS-TR

When faculty are prepared, and resources are available before a Human Patient Simulation (HPS), it's been proven that critical thinking skills, clinical reasoning, and student knowledge are enhanced. In this whitepaper Elsevier Digital Product Educator, Helen Murphy, shares an overview of guidelines for preparing the optimal student experience throughout an HPS.

Learning Gets Real: A Hands-On Simulations Guide for Teaching Tomorrow's Clinical Practitioners

To help you navigate the number of simulation tools, ideas, and strategies, leading expert educators have created the Simulation Solutions Guide. This complimentary download includes peer-to-peer tips, strategies, and advice to most effectively optimize your use with simulations — whether your program is just getting started or is seasoned with simulations.

Tim Bristol, PhD, RN, CNE, FAAN
Susan Sportsman, PhD, RN, ANEF, FAAN
Sheila Searles, MSN, RN
Cami Weber, MSN, MBA, RN, CHSM
Donna Walls, PhD, RN, CHSE
Helen Murphy, BS, RDMS, CHTS-TR

The Nursing and Health Profession Disciplines - Forecast Report

Elsevier has compiled the following information on anticipated areas of growth and decline in disciplines related to nursing and health profession programs for both traditional and private-for-profit institutions. This report includes data from the U.S. Bureau of Labor and IPEDS (Integrated Postsecondary Education Data System) to provide insight into nursing and health profession disciplines you may want to consider adding to your program, and to determine if any of your current offerings are experiencing a nationwide decline.

Critical Thinking and Evidence-Based Clinical Decision-Making: Required Skill-Sets in Dentistry

Satheesh Elangovan, BDS, DSc, DMSc and Michael G. Newman, DDS, FACD

There are thousands of articles published in dentistry each year, but despite the plethora of data, there is limited evidence for many day-to-day clinical questions. To help answer these questions, dentists need to improve their critical-thinking and problem-solving skill sets. Co-Editors and Professors of Dentistry, Satheesh Elangovan and Michael G. Newman share strategies for improving the clinical decision-making skills of today's dental student.

Learning Gets Personal: How Adaptive Learning and Personalized Education Fit into Your Program

To help you navigate the number of personalized educational tools, ideas, and strategies, leading expert educators have created the Adaptive Learning Guide. This complimentary download introduces you to adaptive learning technology and demonstrates how it can be used to measure student learning and aptitude, improve retention, boost program outcomes, and enhance overall instruction.

2018 Scientific Evidence for Elsevier HESI Exams and Products

Nurse educators require educational tools that assist them in supporting students to be successful in the program and on the licensing and certification exams. Cumulative testing is well supported in the educational research literature, both as a learning tool for elementary and college students and as a tool to obtain data for remediation and program revision. Download our whitepaper on the 2018 Scientific Evidence for Elsevier HESI Exams and Products.

Effective Use of Digital Products – Introducing the Bucket Strategy

Megan Ubben, Digital Product Educator at Elsevier

The purpose of this paper is to discuss how to effectively plan a nursing course using digital products. I developed the Bucket Strategy as a way to determine the best placement of digital products in your course.

As a novice, or even as a skilled educator, it is easy to become overwhelmed with all the digital resources available! Elsevier’s digital products such as HESI, Sherpath, Elsevier Adaptive Quizzing, Clinical Skills, and SimChart®, are all great tools to incorporate into a course but it can be overwhelming to understand how to use them effectively. This is a common theme echoed among nurse educators as they adopt new digital products.

The Challenges Ahead for Texas Nurse Educators

Elsevier’s commitment of the education of nurses through its support of faculty is long-standing. In today’s environment, a major problem in nursing education is the SHORTAGE OF QUALIFIED NURSING FACULTY. Unfortunately, there is a direct relationship between the number of nurse educators available and the number of undergraduate and graduate nursing students who can be prepared for the nursing educational work force.

This concern in Texas drove the development of the conference, Challenges for Texas Nurse Educators, held on February 17, 2017. This conference was designed to 1) confirm that the shortages identified in the literature accurately illustrate the current experience in Texas and 2) explore reasons for the insufficient number of nurse educators in Texas and strategies to resolve this issue. The conference was funded by the Texas Action Coalition, Texas Team: Advancing Health for Texas, RWJF Coalition through shared funds with the Foundation of the National Student Nurses Association. The participants of the workshop heard leaders from the National League of Nursing, American Association of Colleges of Nursing, Organization of Associate Degree Nursing, the American Organization of Nurse Executives, Texas Board of Nursing, Texas Nurses Association and the Texas Higher Education Coordinating Board and then participated in group discussions. From these conversations came recommendations to address the nurse faculty shortage in Texas.

The members of the Team Texas Task Force involved in this project recognized that the concerns from Texas nursing programs are no different from those of other nurses across the country. Thanks to the support of Elsevier, we would like to share this work and invite our colleagues across the country to adapt it to meet the needs in their environments.

Susan Sportsman, PhD, RN, ANEF, FAAN
Managing Director, Collaborative Momentum Consulting

On Behalf of the Texas Team Education Task Force

Patricia Allen, EdD, RN, CNE, ANEF, FAAN, Chair
Professor, Texas Tech University HSC,
School of Nursing

Carol Boswell, EdD, CNE, ANEF, FAAN
Professor, Texas Tech University HCS
School of Nursing

Joyce Batcheller DNP, RN, NEA-BC, FAAN
Nurse Executive Advisor, Leadership
The Center for the Advancement of
Healthcare Professionals
AMN Healthcare

Sharon Cannon, EdD, RN, ANEF
Regional Dean and Professor
Texas Tech University HSC,School of Nursing

Michael Evans, Ph.D., FAAN
Professor and Dean
Texas Tech University HSC,
School of Nursing

Marvella Starlin, MSN, RN
Director of Nursing Education
Cisco, College

Jayson T. Valerio DNP, RN
Interim Dean
Nursing & Allied Health Division
South Texas College

Innovation in Radiography Education: The College of Health Care Professions

Susan Sportsman, PhD, RN, ANEF, FAAN

In the 2014-24 Employment Projection Summary, the U.S. Bureau of Labor Statistics predicts that jobs for radiologic technologists in the U.S. will grow 9%, faster than the average of all occupations. This continued growth is driven by the aging of the population, technological advances, and changes in the delivery and reimbursement of health care in the U.S. These factors influence the need for innovative educational approaches to meet the needs of the growing number of patients needing services AND to provide an avenue for professional growth for many providers who wish to expand their scope of practice.

Deepen Students' Understanding of Clinical Practice with Use of Debriefing

Susan Sportsman, PhD, RN, ANEF, FAAN

Debriefing is a means of “assisting the learner in analyzing, interpreting and assimilating events in an attempt to bridge the gap between merely experiencing a situation and actually making sense of what happened.” In short, debriefing involves a retrospective assessment and interactive discussion regarding the students’ performance after clinical events occur. The goal of these conversations is to explore actions and thought processes through active reflection to improve future performance.

Strategies for Encouraging the Acceptance and Successful Implementation of a Concept-Based Curriculum

Susan Sportsman, PhD, RN, ANEF, FAAN

Dean Margaret Ashbury has a dilemma. She has been concerned about content saturation in the Associate Degree in Nursing (ADN) program of the college. This concern has grown as NCLEX-RN® first-time pass rates have been dropping over the last two years. This is not surprising, given that the nursing curriculum has not been updated in 12 years. 

Starting Off Right: The Successful Nursing Candidate

Tim Inverso MSN, RN, CEN, ACNS, BC; Amy Leach MSN-ED, RN; and Cami Weber MSN, RN, MBA

In the midst of increasing pressures on nursing programs to maintain high retention and pass rates, this timely article identifies several strategies for how to assess potential students’ capacity for success. Topics include setting admission criteria, identifying at risk students, and understanding the role that learning styles, life styles, and diversity play in student success.

Future Needs for Healthcare Providers

Susan Sportsman, PhD, RN, ANEF, FAAN

Health professions education leaders must project the labor needs of a rapidly changing healthcare environment in order to choose programs that best match the need for employees in their own locale. For the last several decades, with some exceptions, the healthcare provider labor market has been characterized by severe shortages. Today, determining the current and future need for healthcare providers is increasingly complex, influenced by the growth in the elderly population, unknown results from recent changes in healthcare reimbursement, expanding technology, and changing delivery models, as well as new research related to human functioning. This white paper is designed to help health education leaders make wise decisions regarding personnel needs of healthcare employers.

Quality and Safety Education for Nursing: From Classroom to Clinical Experience

Kristin Oneail, MSN, RN; and Chris Koffel, PhD, RN

Started by a small group of nursing experts ten years ago, QSEN competencies are now a national movement influencing nursing education, nursing regulation, and nursing practice. Find out how integrating QSEN competencies into nursing education and clinicals can help ensure these patient safety and quality measures can become the standard in nursing care.

Concept-Based Curricula in Nursing: Perceptions of the Trend

Susan Sportsman, PhD, RN, ANEF, FAAN

There is so much “buzz” in the nursing education community regarding the potential of a concept-based curriculum to improve student outcomes. However, there is little documentation regarding the number of nursing programs currently implementing this type of curriculum or the effectiveness of such programs. In April 2013, Elsevier Education partnered with Hanover Research to launch a nationwide study on concept-based curriculum in nursing.

The Concept-Based Curriculum: Key Points for a Transition

Janine L. Dailey, RN, MSN

A concept-based curriculum promotes higher-level thinking and lifelong learning as students explore the concepts and related exemplars using a learner-centered approach. Rather than memorizing content, students learn the concepts and their application to common disorders. There are numerous benefits to using a concept-based curriculum, but the transition takes a great deal of planning and effort to be carried out.

Best Practices in Proctoring HESI Tests

Kim Brunnert, PhD

There are many reasons to have an exam proctored and many strategies for proctoring. The primary reason that HESI requires proctors is to ensure the highest possible validity for each exam score. Another purpose is to protect our intellectual property (and keep the costs of exams as low as possible). If a student shares the content of an exam, HESI can no longer use that exam and has to create another. While it might sound like the more important purpose is to prevent the theft of the content, in fact, the more important point is to ensure that exam validity stays high.

Classroom Activities to Engage Students

Michelle Deck, RN, MEd

An essential skill needed to be an effective educator is the ability to engage a diverse group of learners throughout a lesson, whether it is a short one or a long one. The abundance of content that must be learned and mastered by nursing students can be overwhelming. Using active learning strategies can be the solution to this challenge. Some participants experience these and call them “games.” However there is a big difference between a game and an interactive learning activity (ILA).

The EHR Imperative: Situated Learning is Successful Learning

Tim Bristol, PhD, RN, CNE, FAAN

Situated learning can be described as learning in context. While this serves as a basis for simulation, the challenge we have in nursing education is that many high-level concepts are explored in artificial environments that look nothing like reality.


Now with the EHR, we can better help students in the classroom setting visualize the concepts being learned. Using the EHR in class enables students to bring their critical thinking into focus. While we would like every student to be standing next to a high-fidelity mannequin during each class or lecture, we know that is not possible. However, having each student in front of an EHR is very possible and allows simulations to be a part of class.

Great Coaches: Not Only for the World of Sports

Patricia Allen, EdD, RN, CNE, ANEF, FAAN

Recall a past sports team experience. Now, think about a previous sports coach and the qualities exhibited by this coach. Chances are, the qualities you admired most were the coach’s passion for the sport and his/her expertise in guiding the team to victory. Transferring these qualities of passion and expertise to clinical instruction is a very effective clinical teaching methodology.

One Texas school of nursing decided to employ practicing BSN nurses who were passionate about the profession and were experienced clinicians, to serve as “coaches” for second-degree baccalaureate students’ clinical learning. This type of coaching fosters learner confidence and builds competence and expertise as the “coach” engages/teaches the student in the practice environment…

Active Learning in the Classroom: Using E-Books

Rachel Thompson, MSN, RN

We are in an era of health care education that is saturated with technology. The millennial generation of students that occupies so much of our classroom today has technology infused into nearly every aspect of their lives. In light of this, it seems prudent that technology be used and incorporated into the classroom.

Technology integration into higher education has been an area of much discussion in recent years. National accrediting bodies, as well as major stakeholders, are interested in the effectiveness of both integration methods and products (Javeri & Persichitte, 2007). Health care science programs should incorporate electronic textbooks (ebooks) into their curriculum and educate students as they prepare to graduate (Cibulka & Crane-Wilder, 2011)…

Flipping the Classroom

Tim Bristol, PhD, RN, CNE, FAAN

In most disciplines, especially those related to healthcare, teaching content and facts is no longer plausible. Content overload has become a common problem that administrators and faculty are dealing with at all levels of academia. To think that an allied health department could provide a student with every fact they need to know before graduation is not even considered a possibility (Giddens & Brady, 2007).

Combining the reality of content overload with the fact that today’s learners are expecting variety and engagement, leads to a call for change. Employers are expecting a graduate that is creative and possesses strong critical thinking skills. Society is creating a standard that the learner should be in charge of their own customized educational experience. These challenges are prompting academia to rethink the way post-secondary education is developed and delivered…

The Pedagogy of Civility: Innovative Strategies to Create an Engaged Learning Environment

Cynthia M. Clark, PhD, RN, ANEF, FAAN

For many nurse educators, the start of a new semester beckons and thoughts turn to preparing for classes and welcoming a new group of students. For some, this is an exciting and much-anticipated experience, for others — dread begins to set in as the joy of teaching wanes. Let’s take a moment to consider your motivation for teaching. Do you consider teaching a calling? Do you teach because you've been doing it for such a long time that you can't imagine yourself doing anything else? Are you teaching for the pure joy of it? Or is it a combination of many factors?

Perhaps academic incivility has not impacted your enthusiasm for teaching, for others, maybe it has. In either case, creating a safe, civil, engaged teaching-learning environment is important for students and faculty alike. However, many faculty lack formal education and training on ways to prevent and address academic incivility. This is not something we grasp without instruction and practice…

Adaptive Learning in Nursing Education

Susan Sportsman, PhD, RN, ANEF, FAAN

The diversity of aptitude and ability among students is not new; over the years, faculty has tried to move beyond a "one-size-fits-all" learning plan to provide personalized services through a variety of strategies. Instructors may challenge excellent students with extra-credit work. They may assign some type of supplemental instruction for students who don't immediately grasp the principles under discussion. Although these strategies may help some individual students, they are not particularly powerful and certainly not scalable. In today's educational environment where cost and quality are equally important and often in conflict, new methods must be found for addressing the variety of learning needs among students.

Adaptive learning has the potential to address a wide range of student learning needs, while moving all students toward desired competencies. Adaptive learning systems meet students where they are in their own learning process and help them take responsibility for their own learning...

Insuring the Success of the Hispanic Nursing Student

Josefina Lujan, PhD, RN

This White Paper responds to the need to identify best practices that insure the success of the Hispanic nursing student to diversify the nursing workforce. The Institute of Medicine (IOM) in its landmark 2010 report: "Initiative on the Future of Nursing" echoed the recommendations of the US Office of Minority Health (OMH) and other federal, state and private healthcare agencies and institutions calling for the diversification of the US nursing workforce. This diversification is essential so that culturally and linguistically competent care may be provided to the rapidly growing Hispanic population that currently accounts for approximately 14% of US residents (HRSA, 2013).

A significant number of strategies have been developed and implemented to recruit Hispanics into the nursing workforce, with varying success (Tomas Rivera Policy Institute, 2007). Many of these recruitment strategies are costly and laborious. Regrettably, recruitment strategies can be thwarted when newly recruited Hispanic nursing students do not succeed in the completion of nursing studies in a timely manner...

A Three-Tiered, Blended Approach to Improving First-Time Test-Taker Pass Rates on the NCLEX-RN® Exam

Deborah E. Jones, PhD, RN, CNE; and Donna Pendergraft, MSN, RN

Graduates of approved nursing programs must be able to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) in order to gain employment as a practicing nurse. Because schools of nursing are regulated by their State Board of Nursing, the first-time test taker's pass rate is used as a measure of program integrity and can potentially call into question the program's viability and sustainability. Furthermore, the NCLEX-RN® pass rate is viewed as an outward measure of the nursing program quality (Giddens, 2009). As a result, nursing programs must be proactive in preparing their graduates to pass the NCLEX-RN® on the first attempt.

This paper offers a three-tiered, blended approach to an immediate improvement in pass rates for first-time test-takers of the NCLEX-RN® exam for nursing programs enrolling a high percentage of minority students. This approach blends faculty development, student engagement, and curriculum development. These strategies for success are drawn from the experience of a school that moved from an NCLEX first-time test-taker pass rate of 45.1% in 2008 to 85.1% in 2012...

Coping with Burnout

Susan Sportsman, PhD, RN, ANEF, FAAN

The multiple demands placed on educators in today's health care programs can result in stress, and perhaps even burnout. The complex environment in which we work is unlikely to change significantly. Instead, we must change our responses to these stresses, so that we can be the teachers we hope to be. This paper offers strategies to help you manage your response to the multiple demands upon your time.

Burnout can be defined as a prolonged response to chronic emotional and interpersonal stressors on the job. It is characterized by three dimensions: emotional exhaustion, cynicism, and professional inefficacy. An educator who is usually dedicated and helpful begins to become disengaged from full participation in their job and exhibits indifferent feelings about their students. This type of emotional exhaustion is a key characteristic of the syndrome — that tired and fatigued response that makes it easy to depersonalize interactions with students...

Developing a Testing Policy: The Foundation for Curricular Excellence

Marguerite Ambrose, PhD, RN, ACNS; and Cheryl L. Mee, MSN, MBA, RN, CMSRN

To promote curricular excellence, evaluation data are often used to drive the curriculum with the ultimate goal of achieving designated outcomes, such as consistently high pass rates on licensure examinations. The first step in developing a curriculum that is driven by evaluation data is to establish a school-wide testing policy.

This policy should address the formulation of a testing committee, the methods used to conduct internal and external curriculum evaluation, the consequences associated with students' scores, and the role students play in the testing process. The purpose of this paper is to describe the composition of a testing committee that is charged with designing a testing policy, and to define the content that should be included in that testing policy...

Grading as a Means of Improving Student Writing

Laura Woods Fidelie, JD, MBA

Educators face a tremendous challenge in teaching students to write. Many teachers and professors who have considerable skill and experience in teaching, still experience angst and trepidation at the thought of grading a looming stack of student essays. We clearly know that there is an epidemic problem with writing among college students.

As someone who teaches an intensive writing seminar each semester, I frequently discuss this issue with my colleagues. Each time the topic is broached, every person has a long litany of stories to share about the horrific writing that students have submitted in their courses. I have seen these predicaments with my own eyes as well. I recall a single sentence in an undergraduate research paper that covered well over a full page, as well as a graduate student who submitted a paper that I was sure must have been somehow switched with a school assignment written by his elementary-aged child. It hadn't...

Strategies for Retention: Using a Retention Specialist to Increase Retention of Undergraduate Nursing Students

Karen J. Polvado, DNP, RN, FNP-BC

A sustained shortage of nurses in the U.S. is the driving force behind an increased number of nursing students across the country. This increase of nursing students translates to an increase in the number of non-traditional students for many nursing programs, i.e. international students (non-U.S. educated and English as a second-language), older students, students with family commitments (married and/or with children), students who commute, and students from minority and/or underprivileged backgrounds. By 2020, 46% of the nation's total college enrollments will be students of color; there will also be an increase in low-income, first-generation college, older adult, and non-native students (Farrell, 2009). Students with non-traditional characteristics experience an increased risk of attrition (Igbo, et. al., 2011).

The potential decline in retention puts pressure on faculty to provide significant support to help students stay in school. Factors affecting retention of this non-traditional population of students is similar to that of traditional students and can be divided into three categories: financial, personal, and academic (Williams, 2010). Faculty involvement with students is an important aspect of retention (Farrell, 2009; Williams, 2010). However, nursing or health professions faculty might not be equipped to help students with financial, personal, and academic barriers to graduation...

"Just tell me what is on the test!"

Susan Sportsman, PhD, RN, ANEF

All faculty members have heard students say, "Just tell me what is on the test!" Translated, this response generally means, "There is too much content for me to comprehend — I have a life/family/work — and I can't manage it all!" Faculty also report that students say, "I hate participating in active learning in class. I want teachers to teach me — I am not paying money to teach myself."

The goal of all nursing and health professions education is to prepare students to be safe and effective clinicians. Despite students' desire for faculty to simply "tell them what is on the test," the research related to effective learning is clear: Student engagement improves student learning outcomes. These outcomes typically include academic success (GPA and credit completion ratios) completion and grades in developmental and gateway courses, persistence (enrollment across time), and degree completion (McClenney, et. al., 2001)...

Preceptor Training and Support

Susan Sportsman, PhD, RN, ANEF

Preceptors play an important role in the education of nurses and health professionals. Not only do they "extend the reach" of faculty, they also allow more students to be prepared by providing real world experiences. The preceptor is usually an experienced clinician who facilitates and evaluates student learning in the clinical area over a specified time frame. Preceptors take responsibility for the student in the clinical area, in addition to other responsibilities they hold as part of their professional role. Stokes & Kost (2012) suggest that the "preceptor model is based on the assumption that a consistent, one-on-one relationship between the student and the provider provides opportunities for socialization into practice and bridges the gap between theory and practice."

Although the specific preceptor model may vary among different nursing and health professions programs, the need to prepare the preceptor for their role and continue to offer support throughout the training cycle is critical. This white paper suggests strategies to ensure that the preceptor experience is positive for the clinician, students, and faculty...

Interprofessional Education

Susan Sportsman, PhD, RN, ANEF

A major criticism of the U.S. health care delivery system is the lack of care coordination for patients. When more than one discipline is involved and the roles and focus of their work are different, communication and collaboration is exponentially more difficult and the impact on patient care is more acute. Therefore, strategies to encourage interprofessional collaboration (IPC) are important to ensure patient safety.

Unfortunately, health care professionals of all types have traditionally been taught — and later practice — in silos. As a result, identifying competencies necessary for interdisciplinary collaboration was important for successful implementation of projects that required IPC. As the practice environment slowly began to encourage IPC, it became evident that students should have interprofessional experiences prior to graduation in order to begin developing collaboration competence...

Retention: Processes to Increase Graduation Rates

Susan Sportsman, PhD, RN, ANEF

The ongoing shortage of nurses and other health professionals requires a continued push by educators to increase the number of new graduates entering the work force. This is typically achieved by increasing the number of students admitted to professional programs. As effective as this strategy may be, it often results in untoward consequences, including stretched human, fiscal, and physical resources that impact students, faculty, and partnering clinical agencies. Many schools are opting for improving the retention of students who have already been admitted as a means of increasing the number of graduates each year.

There are three general categories of factors that most often affect students' ability to stay in school: financial, personal, and academic. Retention strategies that target these areas pay major dividends in improving program graduation rates...

Clinical Judgment: What Does This Mean and What Can We Do About It?

Nursing and Health Professions faculty agree that the ultimate academic goal for new graduates is to be able to "think like a clinician." Yet, what does "thinking like a clinician" actually mean? How can faculty structure learning activities so that students develop a beginning level of competence in this skill?

This White Paper discusses the underlying thought processes clinicians use in making clinical judgments and suggests some strategies to encourage students to integrate this approach into their clinical practice. A bibliography of selected articles highlighting teaching–learning strategies designed to encourage critical thinking is also provided...

RN-to-BSN Education: The Imperative for Rapid Change

Susan Sportsman, PhD, RN, ANEF

Nursing is unique among all health professions because it has multiple educational pathways leading to an entry-level license to practice. The variety and volume of available pre-licensure nursing education programs has increased access to nursing education throughout the country. However, the question of the extent to which each type of education prepares the nurse for the current practice environment has been debated by nurses, nursing organizations, academics, and a variety of other stakeholders for more than 40 years.

While this discussion has been evolving, the competencies necessary to practice, particularly in the areas of community and public health, geriatrics, leadership, health policy, quality, safety, systems improvement and change, research and evidence-based practice, and inter-professional collaboration have expanded (IOM, 2011)...