In September, Elizabeth Downes, DNP, RN, FAANP, will join an exclusive group of 169 nurse educators, as she is inducted as a Fellow into the National League for Nursing’s Academy of Nursing Education. Fellows are nurse educators who have made sustained and significant contributions to nursing education and provided visionary leadership.
Downes is an associate clinical professor at the Nell Hodgson Woodruff School of Nursing at Emory University; a part-time family nurse practitioner at a Minute Clinic; and is an international nursing consultant with the Carter Center.
How does a nurse become an exceptional educator? In Downes’ case, it comes from a strong desire and a lot of experience.
What led you to choose nursing?
I was a Peace Corps volunteer in Africa after college. It was there I encountered the role of nurse practitioner. Nurses are the primary care providers in so many places around the world. I loved community health and wanted to follow that model. I completed a nursing program that was a direct entry into the nurse practitioner role. I didn’t work on a hospital floor for very long.
So what did you do?
I spent seven years in Africa, working as a clinical instructor for the Ministry of Health in Mozambique and as the clinic director for the United States Embassy there. I also volunteered with a program that helped victims of land mines to have better outcomes. That was heart-stopping, hard work emotionally and physically, but I loved working with the nurses. They had very few resources and were so hungry for knowledge. In Africa is where I got involved in teaching. American nurses have so much more formal training than nurses in other parts of the world. I realized that I could make a bigger impact than directly caring for patients by educating the nurses.
When did you start teaching in the US?
Teaching has always been a part of nursing. We all teach our patients. In 1994, I was working in a nurse-led Emory clinic and was asked to become a clinical instructor for Emory nursing students. I did, but then I went to Fiji and started a regional training program for nurse practitioners in 1998. It’s still going on today. I think that’s where I made a real shift to educating the educators.
How long have you taught at Emory?
I’ve been at Emory’s nursing school for about 15 years and currently serve as Co-Coordinator of Emory’s Family Nurse Practitioner program. I’m also a consultant to the Carter Center Mental Health Program in Liberia, and I keep my clinical skills sharp by working at a Minute Clinic about 40-50 hours a month.
You have been recognized for your innovative teaching and learning strategies. How did you learn those?
Some things you learn by experience or out of need. We have been in the midst of an educational revolution the last 10 to 20 years. We always taught nurses through lecture, demonstration and practical experiences. Now with electronics, we can do so much more.
This year, I completed my courses to become a Certified Nurse Educator through the National League for Nursing. That’s where I learned different methodologies. We all learn differently, so I try to incorporate different teaching methods into my classes. At the start of class, I’ll ask my students what they expect to learn and how they learn best. They don’t always know, but I can help them identify their learning strengths. For instance, an audio learner would benefit from taping lectures for repeated listening. Knowing expectations and how people learn, I try and align the course to meet expectations.
What are some of the strategies that you use, and why?
Threaded through all my teaching is my desire to improve the health of vulnerable populations, so I include a service learning project in every class. When students actually work with migrant workers in Moultrie or refugees in Clarkston, they see their patients ’lives and get to know them differently.
Genuine education grows from meaningful experiences and it’s our job to provide those experiences. I live for those ah-hah moments. Our biggest challenge is not having enough clinical sites for our undergraduate and graduate nursing students.
How do you compensate?
Simulation is a very common method now, but I also like to use Observed Structured Clinical Exams. Live models pretend to have heart failure or an injury, so that we can observe student competencies to assess and treat them. With OSCE we can control the learning. A nurse doing a clinical rotation might never be presented with a heart failure patient.
We have also developed a computer-based teaching model for dermatology. Lectures are online, but we observe students with a live patient to make sure they know how to examine, report and devise a treatment plan. They have to show they can apply what they know. It takes more time, money and work to teach that way, but when clinical sites are scarce, you have to be creative.
What makes for a good teaching day?
I love being a clinical instructor, and seeing patients along with my students. That’s when my nursing and teaching are totally intertwined.
What advice would you give other nurses considering the educator role?
Volunteer to be a preceptor at your clinical facility. That’s the first step to being an educator. Also learn about education theory and different learning styles, so you can mix it up in the classroom.
