Nursing Instructor: Interview with Mary Canobbio, RN, MS, FAAN, FAHA
Teaching graduate students in a traditional campus environment
Where are you employed?
I am a lecturer in the advanced practice nursing (APN) program at the UCLA School of Nursing.
How long have you been a nurse and a nurse educator?
I’ve been a nurse for almost 40 years and I’ve worked as a nurse educator for 27 years, beginning my teaching career at UCLA in 1981.
What experiences led you to a career in education?
While with Kaiser Permanente in Los Angeles, I served as a nurse teacher practitioner in the area of critical care, providing education for patients, families and nurses. My responsibilities were in both patient/family education and staff development.
Tell us about your work at UCLA.
I specifically teach graduate students in advance practice who are becoming nurse practitioners or clinical specialists in acute care. As graduates, they go on to work in specialties such as emergency, trauma, neurology, cardiac surgery or cardiology, my personal area of expertise and specialization.
How did you gain personal expertise in cardiology and cardiac surgery?
As part of my graduate work at UCLA, I focused on cardiology, and I’m a clinical nurse specialist in that field. I started teaching just out of graduate school. At the time, I hadn’t found a job, so I was asked to help teach some clinical courses.While I was waiting to see how things would develop in my career, I went to the medical center and asked the chief of cardiology to allow me to see patients in the clinic in order to maintain my clinical skills. He referred me to a cardiologist who was working with a new population of patients, his new specialty being adult congenital heart disease. This physician was trying to organize a program in this very specialized area. This fascinated me, so I volunteered to work with him and he in turn taught me about congenital heart disease. That was a complete change in my career trajectory and became the focus of my research program and clinical practice.
So, you still work in the clinical setting?
Yes, I see patients with congenital heart disease and my research revolves around the reproductive outcomes of women who have complex congenital heart disease. I’m also now working in a program that offers transitional care for adolescents with congenital heart disease, preparing them to manage their condition as they transfer to the adult setting. Historically, these patients weren’t expected to survive childhood, but because of advances in healthcare, there are more adults than children with congenital heart disease. These young patients need education and care in terms of their reproductive life planning and other important lifestyle issues.
What changes in technology have you seen in nursing education?
I’ve seen tremendous changes. When I started out, we didn’t have computers, copy machines or email! We relied on textbooks, lectures and the slides and transparencies that we made ourselves. There was no PowerPoint or Internet. All of our communication came from the lecture hall.
We still lecture, but now we’re able to supplement our students’ education with information from the Internet, including videos and other electronic media, which have really brought a great deal of sophistication to the experience of teaching and learning.
When it comes to clinical instruction, simulation dummies offer a life-like experience where students can practice skills like central line insertion or intubation. Using these very responsive dummies, we can actually simulate scenarios where the patient is experiencing stridor or other abnormal symptoms, and the student must decide what to do in that specific situation.
Because this simulation technology is new, we don’t yet know what the educational outcomes will be. However, the preliminary data looks good and we’re optimistic that these technologies will help us educate and prepare our students to be even better clinicians.
How have the demographics of the student body changed?
Students are definitely more ethnically and racially diverse, of course. In terms of age, we now have an increasing number of younger nurses in their early- to mid-20s pursuing graduate degrees. Many new nurses now seem to work as staff nurses for only one or two years before deciding to earn an advanced degree. Perhaps the stress of bedside nursing now seems greater. Or perhaps the desire for more autonomy in the care of patients makes nurses want to move on to advanced practice nursing sooner. And while salaries differ in every region of the country, the earning potential does increase with a graduate degree.
Do you foresee more changes coming in terms of nursing education?
When I started in the acute care program at UCLA, our students were graduating as acute care nurse practitioners. Now, the certifying bodies have changed the requirements so that graduates are now population-based rather than specialty-based. So, our program is now focused on adult/gero, with a subspecialty in acute care. This results in new NPs having a broader base of knowledge, rather than being more specialized.
Following graduation, they can then choose to seek specialized training. As educators, we have had to be mindful of what is going on in practice and adjust to those changes accordingly. Due to the aging of the general population, we’ve also had to introduce gerontology into our curriculum. Instead of just teaching the diseases of aging, we teach our students how to approach and respond to the concerns and needs of patients and their loved ones. Using simulation with student actors is a wonderful way for students to become aware of the needs and problems of the elderly.
What has surprised you during your teaching career?
I had an “a-ha” moment about 15 years ago, when I was in a particular class with a very bright group of students who asked a lot of questions and showed great curiosity. It was one of their last clinical conferences before graduation and we were discussing medications. I realized that I didn’t know most of the drugs my students were talking about, and I was reminded of how important it is to stay in clinical practice rather than just do research. So, I returned to the clinical setting.
It’s easy to step away from practice into a complacent ivory tower, but teachers must remain in clinical practice in order to remain clinically relevant.
Keith Carlson, RN, BSN, has worked as a nurse since 1996 and maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.