NPD Practitioners With Dual Roles: A Fusion of Expertise

The nursing field continues to evolve and transform through the span of expert work across specialties. Nursing professional development (NPD) practitioners, who often hold multiple credentials and certifications, are particularly situated to be collaborative agents in their workplaces.

In this article, Elsie Alabi-Gonzalez, MSN, RN, CNE, CNEcl, MEDSURG-BC, PCCN, Jennifer Myles-Clair, DNP, MSN, RN, NPD-BC, CCRN-K, CNE, Lesley H. Stephens, MSN-Ed, BSN, NPD-BC, RNC-OB, CNE, and Rubie Rose Costales MSN, RN, PMH-BC, NPD-BC, share their unique experiences and the learning they have gained as NPD practitioners who have taken on dual roles as clinical instructors.

Through their journeys, you’ll learn practical strategies they utilized and how their experiences benefited their own growth, ultimately exploring the value of taking on a dual role as a way to shape the future of nursing—one student at a time.

Can you share your experience as an NPD practitioner who also serves as a clinical instructor? 

Elsie: My dual role as a full time academic nurse educator and NPD practitioner affords me the distinct privilege of seeing the full spectrum of nursing education. This opportunity allows me to observe and experience, firsthand, the challenges new graduates face during the transition from student to clinician. My NPD background has really influenced my role in academic nursing education because I create practical learning activities that help to bridge the student-practice gap, which help new graduates in the transition to nursing. Based on the trends and gaps that I observe in practice, I have created simulation scenarios to address the knowledge and/or practice gaps in the academic setting.

Jennifer: Currently, I have the perfect role. As an NPD practitioner, I collaborate with a team to coordinate the educational activities of academic organizations and have worked part-time as a visiting professor. I obtained an LPN instructor role in 2012 and continue to instruct clinical rotations when time permits. I later became an NPD practitioner in 2018. The experience in nursing professional development and academia has enhanced my ability to be successful in both settings. In preparing for NPD (2018) and certified nurse educator (CNE/2021) certifications, I noted similarities in the content. The roles complement one another.

Rubie: After completing my graduate studies in nursing education, the department head invited me to join as an adjunct faculty. I became a clinical instructor while at the same time serving as an NPD practitioner in a large hospital system. My graduate degree centered on adult learning, incorporation of teaching philosophies, and the utilization of teaching methodologies. As a clinical instructor, I was functioning as a learning facilitator, advocate, and supporter of nursing students who were eventually transitioning to the clinical setting. As an NPD practitioner, I had the viewpoint of the length and breadth of the entire nursing practice continuum. I was able to support the bridging of nurses across learning and practice environments, their professional stages, and roles. My role as a clinical instructor was enhanced by my NPD background as I was able to view and understand roles and support professional and environmental changes throughout the nursing care continuum cycle. As such, I was able to direct, educate, and support my students along that continuum of professional and environmental change.

What specific strategies or approaches have you found effective in leveraging your NPD knowledge to enhance the learning experience of nursing students as a clinical instructor?

Jennifer: As a clinical instructor, I facilitate learning while leading and mentoring students. This aligns with the Nursing Professional Development Practice Model. Observation and assessment of current knowledge guide student activities throughout the clinical experience. All students are challenged clinically during the experience.

I have witnessed students who perform well in didactic and struggle in the clinical setting. This allows me the perfect opportunity to facilitate learning by providing experiences with patient communication, clinical judgment, and nursing skills. The selection of patients for this student is intentional to ensure they are prepared to enter the workforce. Selecting patients intentionally allows for critical thinking but ensures they can also create safe environments and use clinical judgment.

Lesley: One of my most successful strategies is to remember the principles of adult learning, and to remember that these are not “just students”—they are my future colleagues and the future of this profession. Demonstrating respect to them is key. I always rounded on the labor and delivery (L&D) and postpartum units prior to meeting with the students each morning. We would discuss the different patients and learning experiences available on the unit, and the students were allowed to request where they would like to be. We would also set goals of things they would like to accomplish by the end of the shift, e.g. see a delivery or round with the lactation nurse. I wanted them to have at least some control over their learning experience, and I also wanted each of them to have a voice. In the post conference, they were all required to talk about at least one thing that stood out from that day—positive or negative. I love for them to learn from each other, not just from me. Learning should be fun whenever possible.

Rubie: An effective strategy that promoted active learning was engaging students in environmental scanning. Health care is evolving. Monitoring health care trends, changes in legislations and practices, and technological advances impacts the why and how the students deliver care. This approach enhanced my ability to anticipate my students’ learning needs. I trained students to identify trends, changes, and gaps in practices that can potentially impact patient outcomes. Environmental scanning affords the learner to critically think, plan, and shift strategies to meet changes proactively. Effective partnerships enhance the mutually shared goal of developing nurses who are competent. My relationship with community academic partners strengthened when functioning as a clinical affiliation’s specialist. I knew that appropriate student placement depending on their skill level was critical to a successful clinical rotation. Finding alternatives to support learning experiences in the face of placement shortages and unexpected challenges in the care setting was paramount. Clinical leaders were approached proactively to allow students for observation experiences within the hospital environment.

Another effective strategy is the promotion of a culturally diverse nursing education. As a minority, I understood how receiving culturally competent care can impact outcomes. The rapid growth in ethnic and racial diversity and shortage of diversity in the nursing workforce is met by incremental gains.

My experience as a clinical instructor and NPD practitioner has enabled me to participate in the creation of topics in the New Graduate Nurse Residency (NGNR) curriculum. I had input in the creation of the virtual simulation and assisted in the development of a rounding tool used to support the new graduate nurses. The rounding tool correlated with increased retention rates. We were able to bridge gaps between academic curriculum and the practice setting environment.

How do you balance your responsibilities as an NPD professional and a clinical instructor? What challenges have you faced, and how have you overcome them?

Elsie: One of the challenges I faced initially as an academic educator who is also an NPD practitioner is that in academia, I have the same group of students in one semester so it is easier to manage the progress of the group. When in the NPD role, I work with nurses at different competency and experience levels at the same time (from new graduate orientee to expert nurse). The scope of practice for both roles are very different, yet intersect periodically. It was challenging at first to straddle both roles concurrently. My mentor has been instrumental in providing guidance and support. Attending webinars and continuously seeking learning opportunities in both roles keeps me updated.

Lesley: My biggest challenge by far was keeping up with grading/responding to assignments. While the groups were small, I liked to write a lot to each individual student—especially to point out things I noticed that they were doing well and to make suggestions about things to look for or try at the clinical. I finally had to designate Sunday afternoons and evenings as my protected time that I had to keep reserved for grading. Having a set grading schedule made all the difference, and kept things from getting too hectic!

Rubie: One of the challenges that I have encountered as an NPD practitioner and clinical instructor was seeing gaps that are not in alignment with community needs. Our challenge was the difficulty changing the curriculum due to scheduled revision cycles. An experience I had was that while teaching clinical in an area hospital in the South Side of Chicago, there was no mention of social determinants of health and health care disparity. The curriculum has since changed to address this gap and shortfall, but it took time to adapt to this need. Social determinants of health were focused upon in new graduate nurse residencies several years before change occurred within the nursing school curriculum. It is through environmental scanning and the identification of practice gaps that allowed me to introduce this concept to my students. Fast forward to this time, some academic partners have actively reached out so they can align and tailor their programs according to transition to practice guidelines.

As a clinical instructor, I also find a troubling increasing propensity for students to immediately gravitate towards the electronic record. The time spent is on the computer instead of developing and nurturing therapeutic relationships with patients and teammates. I understand that requirements dictate timely completions and deliverables of assignments, but the opportunity for health teaching and promotion is missed. Students end up burnt-out with elevated levels of anxiety. As an NPD practitioner and advocate for personal and professional growth, prevention of compassion fatigue and burnout amongst novice nurses needs to be prioritized. To meet the demands of student requirements, I provided varying clinical activities and structured clinical experiences so students can genuinely enjoy the experience.

In what ways has your dual role as an NPD professional and a Clinical Instructor contributed to your own professional development and growth?

Elsie: As an NPD practitioner and academic nurse educator, it is imperative that I remain current on best practice, maintain competency, and utilize evidence-based strategies to implement change. Being an NPD practitioner has made me a more effective academic educator. I have grown tremendously as an educator; I have an overview of the breadth of nursing education from student to practitioner.

Jennifer: I have grown professionally by obtaining certifications in both specialties. I continue to develop by attending educational offerings, obtaining more resources, and implementing strategies, when possible, in my areas of work.

Lesley: Because I had been out of the L&D/postpartum areas for a while, it was wonderful to bring my personal knowledge back up to speed. I had been certified in inpatient obstetrics back in the 1990s. I retook the test and was able to get recertified in inpatient OB. I was so proud of myself—and it definitely helped me catch up on some practice changes. This experience also reminded me of the unique humility that is required in order to learn new things—both for myself and the students. Being able to role model how to give AND receive feedback, how to look for answers (because we never know it all), and how to embrace the joy and fun of learning was very meaningful to me. I found this to be an extremely positive experience, and I am looking for ways to promote opportunities for our nurses on the floors to become clinical instructors as well. Also a wonderful side note—working as a clinical instructor was a remarkably successful recruitment tool. Out of my first semester of students (32 students total in three groups), we hired 10 students! I was so proud!

NPD practitioners utilize their skills across disciplines, specialties, settings, and target learners. From creating pre-licensure immersive learning experiences to fostering role transition to practice in nursing professional development, these NPD practitioners and clinical instructors exemplify the spirit of adaptability and innovation. Their dual roles allow them to leave an unique and significant impact on the students and nurses they have and will support.