https://www.infirmiere-canadienne.com/blogs/ic-contenu/2024/09/03/modules-en-ligne-contre-lagisme
Courses can help nurses who feel ill prepared to care for this growing demographic
By Sherry Dahlke, Kelly Baskerville, & Cherryll de la Cruz
September 3, 2024
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Enhancing nurses’ perceptions and skills in working with older adults cannot be overstated. It is essential to create a shared goal and vision that strengthen the integrality of the nursing profession, rooted in health across the lifespan and sustained by a collaborative and supportive team culture.
Takeaway messages:
- Nursing education is needed to address ageism and perceptions related to older people among nurses and nursing students in all settings.
- On-demand e-learning modules, like those from the Alberta Gerontological Nurses Association, provide an opportunity to educate nurses and can accommodate a variety of needs and schedules.
- The best work has no impact if nobody sees it! In addition to nursing education providers, specialty practice groups, such as professional associations, have significant potential to disseminate knowledge, put learning into action, and leverage social change through advocacy.
Older people are increasingly present in health-care services as the world population ages (United Nations, 2023). Yet, nurses must care for them in health-care facilities that are institutionally ageist because they expect older people, who often have multiple co-morbidities as well as an acute illness, to fit into institutions that were designed for younger people with one condition (Kojima, 2018).
In these ways, unconscious negative stereotypes of older people as dependant are perpetuated in health care, nursing culture, and nursing education (McAllister et al., 2020). Research suggests that nurses are graduating with inadequate education to care for older people, who are the population they are most likely to encounter (Dahlke et al., 2021). This is due in part to a lack of adequate numbers of expert faculty and clinical instructors who can deliver gerontological nursing education and ensure that students meet entry-to-practice gerontological competencies (Canadian Association of Schools of Nursing [CASN], 2017).
Further, practising nurses experience challenges to obtain continuing education because of shift work and competing care priorities, leading many to favour asynchronous and/or e-learning activities (Dahlke et al., 2020).
Modules enhance nurses’ perceptions and skills
Taken together, nurses are often ill prepared to care for the demographic they are most likely to encounter in care settings that are institutionally ageist, and where they have little opportunity to obtain continuing education about this population.
Enhancing nurses’ perceptions and skills in working with older adults cannot be overstated. It is essential to create a shared goal and vision that strengthen the integrality of the nursing profession, rooted in health across the lifespan and sustained by a collaborative and supportive team culture.
To fill the current theory-to-practice gap in the nursing care of older adults, gerontological experts developed educational content that was grounded in theory. These asynchronous e-learning modules, offered by the Alberta Gerontological Nurses Association (AGNA), provide round-the-clock accessibility and a practical and effective way of knowledge transfer.
Access to educational modules can create well-rounded geriatric nurses who practise in complex, contemporary health care with finite resources by enhancing their evidence-based practice and gerontological competencies.
Learning modules summary
| Title of module |
Content and gerontological competencies |
Time to complete |
| Understanding and communicating with older people |
Information about ageism and how to communicate with older people, including those with dementia |
90 min |
| Cognitive impairment |
Includes delirium, dementia, depression, and responsive behaviours with videos of practical ways to deal with them |
3 h |
| Continence and mobility |
Information on assessing for a range of lower urinary tract symptoms and a review of mobilization, including the link between continence and mobility |
90 min |
| Health promotion |
Information about aspects related to health promotion with older people |
30 min |
| Comfort and continence |
Information about comfort rounds, with particular attention to the importance of toileting during these rounds |
30 min |
| Responsive behaviours |
Advanced information about how to manage responsive behaviours and explanations of how these communicate unmet needs |
20 min |
| Equity and diversity |
Ageism and the heterogeneity of older people; information about cultural diversity |
30 min |
| Pain assessment |
Information about pain assessment and management, with a special focus on older adults |
30 min |
| Palliative care |
Information about the palliative care model that can be started early in a chronic condition and progress as a person ages, through to death |
30 min |
| Leadership and ageism |
Information about clinical leadership, with practical strategies for diminishing ageist practices |
30 min |
Development of the learning modules
Enhancing nurses’ knowledge about how to care for the population they are most likely to encounter — older adults — began when two faculty members (Dr. Sherry Dahlke and Dr. Kathleen Hunter) were asked by a hospital manager to provide education about working with older people.
Nurses in this hospital had been asking their manager for education, but none of the nurse educators in the institution had the expertise to provide gerontological education (Dahlke et al., 2019). This experience, providing education for practising nurses, led Dr. Dahlke to think about ensuring that nursing students received this education before they graduated. Thus, she developed three e-learning modules (Understanding and Communicating with Older People; Cognitive Impairment; and Continence and Mobility) for nursing students, based on content that she and Dr. Hunter had earlier developed for practising nurses.
The board at the Canadian Gerontological Nurses Association and the College of Licenced Practical Nurses of Alberta believed these modules could be helpful to practising nurses as well as nursing students. They were tested with practising nurses, who reported them as helpful knowledge and an enjoyable learning experience (Dahlke et al., 2023).
In 2022 the modules were tested in several nursing programs across Canada as part of an Awakening Canadians to Ageism research grant (Devkota et al., 2023). This grant mandated the development of an advisory group that included gerontological experts and older Canadians.
The advisory group said ensuring nurses have accurate knowledge about ageing and older people was a priority, as it would diminish ageist perspectives. The group acknowledged the power of nurses — as well as other health-care professionals and institutional systems — to influence individual care experiences.
Thus, as part of knowledge mobilization, Dr. Dahlke and her research team of gerontological experts developed seven more modules based on the Canadian Association of Schools of Nursing (CASN)’s gerontological competencies. Nursing students have trialled these seven modules to determine their acceptability, and have reported that the modules increased their knowledge about older people through an enjoyable method of learning. All of the modules were developed based on evidence, including game elements, videos, knowledge quizzes, and interactive case studies.
Goal: to reach as many nurses as possible
Our desire is to ensure that these modules are available to the broadest possible number of Canadian nurses. Because the modules are asynchronous, they provide flexible delivery at no cost, as well as unbiased information. In addition, they reflect national standards:
The research team seeks to broadly distribute all 10 of the e-modules to practising nurses. They are available for no cost from AGNA. In addition, these modules can support nurses and nursing associations in leveraging accurate information about older people, diminishing ageism in nursing practice and advocating for change in health care and social culture (Chiu et al., 2021).
We invite you to visit AGNA’s website to learn more, or access the modules as part of your own professional development. Our ultimate goal is to improve nurses’ perceptions of and ability to work with older people. As a platform for these modules, AGNA is supporting the opportunity for Canadian nurses to obtain evidence informed practice and to engage in discussion and reflections after completing the modules.
References
Alberta Gerontological Nurses Association (AGNA). (2023). Mission and Objectives. https://agna.ca/about/mission-and-objectives/
Canadian Association of Schools of Nursing. (2017). Entry-to-Practice Gerontological Care Competencies for Baccalaureate Programs in Nursing. Ottawa: author. https://www.casn.ca/2018/01/entry-practice-gerontological-care-competencies-baccalaureate-programs-nursing/
Canadian Gerontological Nursing Association. (2020). Gerontological Nursing Standards of Practice and Competencies 2020 (4th ed.). Toronto: author.
Chiu, P., Cummings, G.G., Thorne, S., & Schick-Makaroff, K. (2021). Policy advocacy and nursing organizations: A scoping review. Policy, Politics & Nursing Practice, 22(4), 271–291. https://doi.org/10.1177/15271544211050611
Dahlke, S., Butler, J., Hunter, K.F., Law, J., Schindel Martin, L., & Pietrosanu, M. (2023). Improving practicing nurses’ knowledge of the cognitive impairment, continence, and mobility needs of older people. International Journal of Nursing Education Scholarship. https://doi.org/10.1515/ijnes-2022-0130
Dahlke, S., Hunter, K.F., & Amodu, O. (2020). Innovation in education with acute care nurses. Journal of Continuing Nursing Education, 51(9), 420–424. https//doi:10.3928/00220124-20200812-07
Dahlke, S., Hunter, K., Negrin, K., Kalogirou, M.R., Fox, M., & Wagg, A. (2019). The educational needs of nursing staff when working with hospitalised older people. Journal of Clinical Nursing, 28, 221–234. doi:10.1111/jocn.14631
Dahlke, S., Kalogirou, M.R., & Swoboda, N. L. (2021). Registered nurses’ reflections on their educational preparation to work with older people. International Journal of Older People Nursing, 16(2). doi:10.1111/opn.12363
Devkota, R., Dahlke, S., Butler, J.I., & Shrestha, S., Fox, .M., Davidson, S., Hunter, K.F., Law, J., Pietrosanu, M., (2023). Evaluating three e-learning modules to enhance student nurses’ perceptions of older people. International Journal of Nursing Education Scholarship, 20(1), 1-12. https://doi-org.login.ezproxy.library.ualberta.ca/10.1515/ijnes-2023-0059
Kojima, G. (2018). Frailty as a predictor of nursing home placement among community-dwelling older adults: A systematic review and meta-analysis. Journal of Geriatric Physical Therapy, 41(1), 42–48. https://doi.org/10.1519/JPT.0000000000000097
McAllister, M., Ryan, C., Dodd, L., Goldenberg, M., & Brien, D. L. (2020). A thematic literature review of innovative strategies to prepare nursing students for aged-care. Nurse Education Today. 87:104355. doi:10.1016/j.nedt.2020.104355
United Nations. (2023). World Social Report 2023: Leaving No One Behind in an Ageing World. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesa_pd_2023_wsr-fullreport.pdf
Sherry Dahlke, PhD, RN, GNC(C), is an associate professor in the Faculty of Nursing at the University of Alberta.
Kelly Baskerville, RN, BN, GNC(C), is a master of nursing student and research assistant in the Faculty of Nursing at the University of Alberta and president of the Alberta Gerontological Nurses Association.
Cherryll de la Cruz, RN, GNC(C), CPPS, obtained a master of science in health-care quality and safety at Harvard Medical School and is a senior provincial patient safety specialist at Alberta Health Services and education lead with the Alberta Gerontological Nurses Association.
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