Nursing Education Challenges in the 21st Century

In recent years, the healthcare system's demands have intensified and will likely continue for the next several decades. An aging population with more complex and chronic comorbidities, as well as potential staffing shortages, mean nurses must be efficient care providers and ready to practice at the top of their scopes. Instructors should revise nursing curricula routinely to ensure it fosters the robust skillsets necessary to function in a changing healthcare landscape.

What Are the Major Factors Affecting the Nursing Workforce? 

Several factors are affecting the nursing workforce and providers' ability to deliver consistent patient-centered care. Those include:

Staffing shortages. The healthcare industry has a serious need for more educated professionals. "By 2030, the World Health Organization estimates a global shortage of 18 million health workers due to retirement, increased burnout and insufficient educational resources," says Brent Gordon, president of Elsevier Nursing & Health Education, a company that specializes in healthcare textbooks and digital learning tools. This further exacerbates the stress on remaining workers and reinforces the need to operate at top efficiency to meet growing patient demands.

Complex decision-making and problem-solving needs. Nursing has become a more complicated and demanding profession. "Over the past decade, increasing patient acuity and greater responsibilities are requiring nurses to make complex clinical judgment decisions," says Gordon. "However, [a 2017 Nursing Education Perspectives study found that] only 23% of new graduate nurses demonstrated practice readiness on entry-level assessments by being able to identify and manage a clinical change of status." Without core competencies, it is increasingly difficult for nurses to make informed decisions, manage complex care or solve problems.

Ineffective communication and collaboration. Nurses must be the ultimate communicators and collaborators. They must develop trusting relationships with patients and their families to identify needs, target interventions and relay information to colleagues. According to a study conducted by the Risk Management Foundation of Harvard, "poor communication has been shown to be a main driver of preventable medical errors, contributing to more than 30% of medical malpractice claims involving patient harm," says Gordon.

How Is Nursing Education Evolving to Meet These Challenges?

Degree curricula in Registered Nursing to Bachelor of Science in Nursing programs are often modified to ensure students develop the skills to thrive in this intense and rapidly changing environment. Recently, the American Association of Colleges of Nursing (AACN) updated its nursing education guidelines and now recommends a competency-based and assessment model.

In a June 2020 American Nurse Journal article, Deborah Trautman, PhD, RN, FAAN, AACN president and chief executive officer, said that this shift "will ensure equitable learning experiences and achieve a consistent level of competency in domains such as primary care, coordination of care, public health and population health management."

Virtual learning is another way education is changing, especially for nurses with limited time or travel resources. "Although e-learning tools were increasingly utilized prior to the pandemic, COVID-19 has accelerated the need for digital solutions, such as virtual reality (VR) simulations of patient scenarios," says Gordon.

Employers and universities can use VR technology to support large-scale education initiatives that improve clinical decision-making skills and evidence-based practice. "In fact, an NCSBN National Simulation study revealed that virtual simulations can replace up to 50% of physical clinical hours, providing a safe and standardized environment to practice clinical assessment skills," says Gordon.

A New Approach

The healthcare landscape is increasingly dynamic, requiring nurses to practice at the top of their scopes and with unprecedented clinical intensity. Nurses must develop competencies across several domains and function in many roles, from support and bedside care to primary communicator and collaborator. Improvements in nursing education can help address these challenges.

Learn more about the University of Rhode Island's online RN to BS in Nursing program.


American Nurse Journal: Partnerships and Innovation: The Future of Nursing Education

CRICO: Press Release: Failures in Communication Contribute to Medical Malpractice

Gordon, B. (February 2021). Email interview.

National Council of State Boards of Nursing: Simulation Study

Nursing 2021: Meeting the Challenges of Nursing Staff Education

Nursing Education Perspectives: A Crisis in Competency: The Strategic and Ethical Imperative to Assessing New Graduate Nurses' Clinical Reasoning

STAT News: Communication Failures Linked to 1,744 Deaths in Five Years, US Malpractice Study Finds

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