Critical thinking and clinical competence: results of the implementation of student-centered teaching strategies in an advanced practice nurse curriculum.

The nursing profession has advanced dramatically over the past 50 years. People are living longer, technology is advancing at a rapid rate, and patients are presenting more critically ill. The recent move in the US and other countries away from secondary and tertiary care towards primary care will have a dramatic impact on the practice of nursing as the focus of treatment is aimed at prevention and maintenance of health. Budgetary constraints and a shrinking nursing workforce have added additional strain on the ability of nurses to remain clinically competent in this fast-paced healthcare environment. In addition, the demographics of students have shifted, with more adult and ethnically diverse students entering various nursing programs. These changes have compelled schools of nursing worldwide to revise their approach to student education to keep up with the challenge associated with these influences. Terms such as problem-based learning, critical thinking, evidence-based practice, and student-centered teaching strategies have replaced traditional terminology typically linked with education and practice. However, it appears that not all centers of nursing education have embraced the need to change to new methods of teaching and continue to teach as they were taught. This article will detail the approach used to develop and implement problem-based learning in an advanced practice nurse curriculum in the US. The results and recommendations for implementation are discussed based upon student and nurse educator feedback.