Nursing education in uncharted waters: Are we successfully navigating the industrial revolutions ahead?
Institution at which work was performed: Johns Hopkins University
What does this paper contribute to the wider global clinical community?
- COVID-19 led to increased use of technology in nursing education.
- Fourth industrial revolution offers a variety of technology options that nurse educators should explore, while being cautious of challenges associated with their use.
- It is important for nurses to be aware of the emerging fifth industrial revolution that offers a symbiotic approach to integrating interactions of humans with artificial intelligence.
As technologies continue to revolutionise health care, the nursing industry must examine how effectively we utilise technology to prepare nurses to thrive and lead. The emergence of the fourth industrial revolution (Industry 4.0) has yielded technologies that have and will continue to revolutionise health care through the use of digital transformative technologies characterised by Artificial Intelligence (AI), Internet of Things (IoT), the cloud, big data and mobile data access. The questions that now arises, in the fifth revolution, where we will see a broader integration of AI into health care, will nurses be prepared to navigate this new environment?
1 HEALTHCARE ADVANCEMENTS
Today, the global healthcare ecosystem begs for new processes, models, systems and products that achieve the quadruple aim to better manage not only the populations but to lower cost, and improve patient and clinician experience (Hefner et al., 2021). Industry 4.0 is challenging traditional conceptualisations of health by transforming diagnosis, treatment, monitoring methods, and the relationship between health professionals and their patients, and the greater population. These new methods alter the management and organisation of health systems, including access to health care. Industry 4.0’s impact has been mostly positive using mobile technologies, smart home health care, precision medicine, robotic surgeries, and machine learning and artificial intelligence to predict morbidity and mortality, to accurately diagnose and to execute preventable measures (Phillips et al., 2019).
New health technology stakeholders and healthcare delivery models have entered the market with the evolution of Industry 4.0. These new stakeholders are operating either as standalone providers or in partnership with existing suppliers, creating value chains and bringing products from conception directly to intended use and beyond. The use of digital devices (i.e. oxygen saturation devices, blood pressure monitors and electrocardiograph monitors) that can empower patients to self-advocate and control their care allows them to make better decisions related to their health. Changes are also occurring at the policy level where eHealth programs are being implemented to increase access to care. Healthcare professionals are among the least likely to be replaced by computerisation or automation, but we need to make sure that these healthcare professionals are educated appropriately to promote constructive integration between people, processes, products of technologies and economic opportunities (Davenport & Kalakota, 2019).
2 NURSING EDUCATION
In education, we acknowledge it is time to revisit traditional teaching pedagogies and make thoughtful shifts in teaching-learning in response to the impending changes in higher education (Pears & Konstantinidis, 2021). The American Association of Colleges of Nursing's vision for academic nursing has incorporated the use of informatics and technology within the Essentials to support healthcare processes and clinical thinking to positively impact patient outcomes.
Students do not learn optimally by lectures and are seeking choices or options for asynchronous and interactive experiences. Mobile devices and tablets offer students the flexibility to access and control the development and sharing of knowledge. These devices are also motivating students to become self-directed, lifelong learners. The developments during Industry 4.0 allow students to create and apply new knowledge using digital tools. These digital tools have also enabled us to pivot from traditional in-person classes to online classes fostering inclusivity and socially connected learning for all students. Both digital innovation and technology can increase the diversity of educational participation; pedagogy now transcends the limits of time and space (Herodotou et al., 2019).
The effects of Industry 4.0 on health education are characterised by the fusion and amplification of emerging technologies such as breakthroughs in AI, automation and robotics. These effects are multiplied by the far-reaching connectivity between billions of people with mobile devices and unprecedented access to data and information. These breakthroughs in science and technology have had a profound effect on our health professional education systems affording us new opportunities to prepare healthcare professionals with the appropriate skills to evolve with the future of health care.
The incorporation of new technologies to improve education is happening at a fast pace, and nurses should leverage these advances. The value of soft skills, however, should not be overlooked as we anticipate more advancements needed before machine learning and AI can, if ever, be effectively utilised for creative problem-solving, people management and social intelligence. The value of the nurse's strong interpersonal and soft skills will remain strong even with the broader application AI, which continues to lack human connectivity and emotion.
3 NURSING EDUCATORS
As nurse educators, we seek to shape proactive and intuitive thinkers who are adaptable to future breakthroughs. Nursing educators strive to leverage the physical, virtual and digital world to harness new technology-based opportunities, pilot them, learn from them and adapt to ensure that we prepare practice-ready nurses who will be ready to work with rapidly advancing and changing technologies in diverse clinical settings. Understanding core digital competencies and ascertaining what future nurses need will require an understanding of the skills that nursing faculty need to successfully adopt technological advances in educational environments. In addition to preparing practice-ready graduates, nurse educators also need to upskill existing nurses through continuing professional development initiatives. The Future of Nursing 2020–2030 report by the National Academies of Sciences, Engineering and Medicine provides a roadmap to address future healthcare challenges, including inequities.
While technological innovations may help to identify and prevent disparities, careful thought needs to be given when designing and deploying solutions in real-world scenarios. The disparate impact and shortcomings of early iterations of surveillance educational software that utilised computer vision/AI have been well-documented. For example, black students were routinely falsely flagged for suspicious behaviour during online examinations and endured unwarranted scrutiny and stress (Clark, 2021). Situations like these should never occur. Thorough examination and assessment of intelligent technologies should occur before deployment to mitigate disparate risk.
To educate both nursing students and practising nurses, we must appreciate the value of interaction among learners, co-learners and teachers as a vital aspect of the educational experience. With the COVID-19 pandemic, many student cohorts have been dispersed throughout the globe and find themselves accessing educational content online in various formats. This presents a timely opportunity to collect and harness newly available data on the use of alternative, technology-based education on a global scale. Higher education institutions can use machine learning to better understand the unique patterns of student performance and deliver tailored education (precision education) to meet the demand of the nursing profession while considering learners' needs and preferences.
4 NURSES AS CHANGE AGENTS
Nurse educators must successfully navigate a range of challenges in the uncharted waters of Industry 4.0. We consider that key challenges, as well as opportunities, include the following:
4.1 Change in mindset
Healthcare institutions should empower nurse educators to adopt innovative strategies and new technologies. As a community, we need to honour traditional methods, but be prepared to integrate those methods with the changes that are coming.
4.2 Maintain humanness
There is a disconnect between human beings and technology as automation and robots take over several tasks. We need to engage in scientific discourses exploring responsibility, ethics and morality in automation and artificial agents.
4.3 Balance risk with privacy and security
Policies and standards will need to be adopted or created to mitigate the negative impact of new cybersecurity and privacy issues, such as phishing, malware and ransomware, as they are discovered.
4.4 Limited resources
Funding and resources are required for nursing schools to be strategic in prioritising needs for advanced technology such as virtual reality, augmented reality, AI, machine learning and robotics, among others.
4.5 Digital divide, inequality and inclusiveness
Inequality is a concern for digital nursing education since approximately 40% of the world's population does not have access to the Internet (Kemp, 2021). We need to identify ways to reach underserved populations so that technologically enhanced nursing education can empower individuals to become part of the nursing workforce.
5 LOOKING FORWARD: THE NEXT INDUSTRIAL REVOLUTION
While harnessing the power of Industry 4.0 to individualise and strengthen nursing education, the fifth industrial revolution approaches—the symbiotic integration and interaction of humans with artificial intelligence. With a human-centric model, collaborative robotics will upskill labour and drive sustainable and resilient improvements in service delivery for dynamic environments. Educators need to consider this future as we continue to leverage technology to improve the learning experience and optimal educational outcomes.
Nurse educators can shape the future of nursing and maximise technology benefits by successfully navigating the challenges in health education in the fourth and fifth industrial ages. As nurse educators and students experience drastic shifts in the profession, we need to ensure access and utilisation of available innovations and technologies rather than maximising the pitfalls accompanying change. This will require thoughtful and intentional activities to leverage opportunities and aggressively challenge entrenched professional norms. Broad engagement in discussion and debate is necessary to embrace the future ahead. This should occur across all spheres of our profession in policy, practice, education and research.
ACKNOWLEDGEMENTS
None.
CONFLICT OF INTEREST
No conflicts of interest.
Funding information
None.
