The The Institute of Medicine (IOM) Effects on Nursing

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The Institute of Medicine (IOM) provided ten significant recommendations for transforming health professions education in order to improve quality and dynamic needs of patients. These recommendations, if adopted, would have significant impacts on nursing education, training, and practice. All these recommendations aim at providing effective methods of incorporating a myriad of competencies into health professions education. Overall, the recommendations cover “oversight processes, the practice environment, research, public reporting, and leadership” (Greiner and Knebel, 2003, p. 137).

The IOM believes that the first basic approach to reforming education and practice in nursing involves the articulation of a shared language. This shall enable health care professional to communicate and collaborate with each other at the same level. In addition, a common language would be useful in informing the interdisciplinary proceedings about core issues. Stakeholders, both private and public oversight institutions, in nurse education would then adopt the agreed upon set of competencies into their practices.

The IOM believes that a lack of common language in nursing education and practice has led poor developments in interdisciplinary team skills. Thus, a major reform in the nursing curriculum is necessary, but it must provide a common language and terms for coordinating courses and training activities. Besides, the committee has recognized that a lack of common language has hampered implementation of various proposals in nursing education and practices. It would also ensure that nurses and educators adhere to strict standards in health professions education.

The IOM recognizes that developing a shared language is not simple. As a result, it calls on other stakeholders to support such interdisciplinary efforts with the purpose of achieving general standards on “a core set of competencies that include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics” (Greiner and Knebel, 2003, p. 124).

The IOM has observed that there has been an increasing concern about patient safety. As a result, it has recommended that oversight institutions should incorporate competencies in nurse education and practice. This also accounts for differences in geography, patient characteristics, and the demand by the public and financiers for a greater accountability. The IOM believes that developing core competencies should focus across national, state, and local levels with an oversight framework, accreditation, licensing, and certification in both private and public institutions. Integrating core competencies in oversight processes also requires inputs and cooperation of other institutions.

On this note, the IOM recommends that accreditation institutions should revise and improve their standards so that nursing education programs can reflect outcome measures. The aim is to provide knowledge in both academic and informal education for effective delivery of patient care through core competencies. However, this can only occur through coordinated efforts among institutions.

Still, the IOM recommends that all health professional bodies should ensure that licensed health care professionals show their abilities to provide effective patient care based on the core competencies. In other words, nursing professionals must demonstrate competence in technical areas, assessment and evaluation of patient safety and outcomes, and provide evidence-based assessment. The recommendation seeks to ensure that nurses demonstrate competence in these areas from time to time.

Kathleen Kalb agrees that core competencies are “a valuable resource for nurse educators and have the potential to transform nursing education by inspiring excellence in nurse educator practice” (Kalb, 2005, p. 219). Therefore, it is imperative to incorporate core standards of practice into “the nurse educator curricula, roles of faculties, and assessment processes” (Greiner and Knebel, 2003, p. 130). In addition, the IOM also notes that accreditation institutions should ensure that certificate holders are competent during their career and show their abilities by delivering effective patient care that shows the five core competencies and other standards.

The IOM also recognizes the importance of training environment. The committee looks at a broad approach to nursing education, which include both formal and informal aspects, norms, cultures, informal interactions, and aspects of the environment because they shape attitudes and values of health care professionals.

Several challenges inhibit the integration of five competencies in practice. In this case, nurses and other students in health care fail to get real-life training that has positive imprint in their careers due to a disconnect in the system. There are also time barriers, internal resistance from the nursing profession, oversight challenges, and a lack of political will to initiate reforms. On financial constraints, the IOM recommends that institutions affiliated to education and practice in nursing should lead in “developing and funding educational centers in order to show the partnership between practice and education” (Greiner and Knebel, 2003, p. 131). In addition, such centers should transform existing innovative institutions to modern training centers for teaching and evaluating competencies.

There are also financial discrepancies in services health care stakeholders provide and what supportive financial structure like Medicare offers. In this regard, the IOM argues that the Centers for Medicare and Medicaid Services (CMS) should take the initiative and fund experiments. This is an effective method of providing incentives for stakeholders to adopt interdisciplinary methods in their educational programs and practice environments. The aim is to offer training opportunities that account for the five core competencies.

The committee notes that evidence of the effectiveness of the educational intervention is critical for facilitating changes in nursing education. However, a lack of sound evidence that shows the relationship between health care quality outcomes and health professions education with regard to teaching strategies has hampered changes in curricula. The IOM notes that a substantial amount of public fund is available for health professions education.

However, the system lacks accountability mechanisms that can ensure effective utilization of public funds in health care education. Still, the available research is not about specific disciplines. As a result, it does not show the current practice conditions in which professional roles and responsibilities have common and related characteristics.

Therefore, the IOM notes that any attempt to reform a curriculum must be sound to stakeholders because the current one already has too many contents. Adding new topics may look overambitious because it will require new resources, changes in teaching strategies, and changes among oversight institutions. A study cited by the IOM noted that most accreditation institutions were not willing to take risks or change their practices until the proposed changes had undergone thorough scrutiny and validation. The committee also noted that current practices (traditional curricula) only promoted the status quo of the past while situations had changed.

The IOM observed that the Agency for Healthcare Research and Quality (AHRQ) and other private institutions should “offer the required support in research projects, which aim at supporting the core areas of competencies” (Greiner and Knebel, 2003, p. 134). They should support studies that explore that association between core competencies and public and individual health, and evidence-based education. Such studies should consist of a team with members from other disciplines. In addition, the IOM also noted that the AHRQ ought to work with other leaders from health care areas in order to develop effective tool for “evaluating the core competencies, provide national standards, goals, and report to the public concerning achievements annually” (Greiner and Knebel, 2003, p. 135).

The committee also advocated for effective leadership in health professions education. It notes that the oversight framework consists of various institutions with diverse requirements and ideologies, but it experiences pressure to show high-levels of accountability. The IOM observed that institutions have received numerous requests that urge them to introduce new items in their curricula. In addition, key professionals in the areas of nursing and pharmacy are not enough as funding challenges have forced some institutions to reduce leadership roles in their institutions. The committee noted that it was advisable for a team of interdisciplinary areas to conduct a summit of leaders and review their challenges, targets, and achievements in order to prepare health professionals to meet modern challenges.

Conclusion

The IOM recommended several approaches with aim of transforming health professions education in order to achieve high standards of quality and provide quality care to patients. All recommendations focused on “incorporating core competencies into health professions education” (Greiner and Knebel, 2003, p. 137). In all, these recommendations include areas that focus on “oversight processes, the practice environment, research, public reporting, and leadership” (Greiner and Knebel, 2003, p. 137).

The committee notes that implementing these recommendations in health professions education is not a simple task. Therefore, it calls for coordination and collaboration among institutions in the health care sector to ensure effective implementation of the recommendations. The aim is to share information to allow health professions education to develop core competencies that shall ensure that health professionals are competent and can deliver quality care.

The committee believes that these recommendations can transform nurse education and practice because they originate from various studies and leaders who have shaped health professions education.

References

Greiner, A., and Knebel, E. (Eds). (2003). Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press.

Kalb, K. (2005). Core Competencies of Nurse Educators: Inspiring EXCELLENCE in Nurse Educator Practice. Nursing Education Perspeclives, 29(4), 217-219.

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The The Institute of Medicine (IOM) Effects on Nursing

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