Enhancing the Capacity to Teach Gerontological

Nursing: A Faculty Development Project

Lois L. Miller, PhD, RN, FGSA, FAAN, Catherine R. Van Son, PhD, RN, Juliana C. Cartwright,
PhD, RN, and Tiffany L. Allen, BS

abstract
This article describes a faculty development initiative implemented by baccalaureate school of nursing faculty to address the urgent need for education and development in gerontological nursing. The Gerontological Nursing Education
Curriculum (G-NEC) project was implemented in five states
between 2006 and 2009 to (a) increase faculty knowledge
of gerontological nursing, and (b) increase gerontological
content in participating schools of nursing. A 4-hour workshop presented at 11 schools introduced key concepts and
instructional activities related to care of older adults. Participants rated content and format highly; follow-up reports indicated that many made curriculum changes to incorporate
gerontological content. The authors describe workshop content and teaching strategies, curriculum changes participants
made to incorporate gerontological content, and implications
for faculty development.
J Contin Educ Nurs 2010;41(5):211-216.

2006; Grabb, Jeffers, & Campbell, 2004; Lange, Wallace,

Grossman, Lippman, & Novotny, 2006). Some of these
projects have identified faculty development in gerontological nursing as a prerequisite to curricular change
(Blais, Mikolaj, Jedlicka, Strayer, & Stanek, 2006; Latimer & Thornlow, 2006). This article presents an example
of how one regional group of baccalaureate school of
nursing faculty addressed the pressing need for faculty
education and development in the area of gerontological
nursing.
The faculty development project, Gerontological
Nursing Education Curriculum (G-NEC), funded by
the Health Resources and Services Administration, was
implemented in five states in the Northwestern United

he unprecedented demands of an aging population,

coupled with the shortage of registered nursesespecially in care settings that serve older adultsand
gaps in gerontological nursing content in undergraduate
curricula, pose a crisis for health care services. This projected crisis has been well documented (Bednash, Fagin,
& Mezey, 2003; Grocki & Fox, 2004; Institute of Medicine, 2008; Kovner, Mezey, & Harrington, 2002; Wetle,
Wallace, Fortinsky, & Salsberg, 2004). Led by the John
A. Hartford Foundation (Fagin, Franklin, Regenstreif,
& Huba, 2006), there has been a substantial increase in
projects and programs aimed at increasing the gerontological nursing content in baccalaureate schools of
nursing during the past 15 years (e.g., Barba & Gendler,

Dr. Miller is Professor, Oregon Health & Science University, Portland, Oregon. Dr. Van Son is Assistant Professor, Washington State
University, College of Nursing, Spokane, Washington. Dr. Cartwright
is Associate Professor, Oregon Health & Science University, School of
Nursing, Portland, Oregon. Ms. Allen is Senior Research Assistant, Oregon Health & Science University, School of Nursing, Ashland, Oregon.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly
in this activity. This project was supported by a grant from the Health
Resources and Services Administration Comprehensive Geriatric Education Program (Grant Number D62HP06855). The statements and
conclusions presented are those of the authors and do not necessarily
reflect the views or policies of the sponsoring agency.
The authors acknowledge the participation of the member schools of
nursing and faculty in the Northwest Coalition for Geriatric Nursing
Education in this project, and the John A. Hartford Foundation Center
of Geriatric Nursing Excellence at Oregon Health & Science University
for its support of the NW Coalition and its programs.
Presented at Connecting the Dots: Geriatric Nursing, Education,
and Clinical Simulation International Conference, April 2-3, 2009,
Chapel Hill, North Carolina.
Address correspondence to Lois L. Miller, PhD, RN, FGSA, FAAN,
Professor, Oregon Health & Science University, 3455 SW US Veterans
Hospital Road, Portland, OR 97239.
doi:10.3928/00220124-20100423-04

The Journal of Continuing Education in Nursing Vol 41, No 5, 2010

211

States (Alaska, Idaho, Montana, Oregon, and Washington) between 2006 and 2009. The goal of the project
was twofold: to increase faculty knowledge of gerontological nursing, and to increase gerontological content
in participating schools of nursing. A 4-hour workshop,
Threads for the Tapestry: Weaving Care of Older Adults
into the Curriculum, was presented at 11 schools to provide a mechanism for introducing nursing faculty to key
concepts and instructional activities related to caring for
older adults across settings. It was taught by the second author, a skilled educator with more than 25 years
of experience in both geriatric clinical work and teaching gerontological nursing. She is one of the authors of
the CD-ROM that was used in the project and is discussed below. This article (a) describes the content and
the teaching strategies of the projects workshop, (b)
describes how participants incorporated gerontological
nursing content into their curricula, and (c) discusses the
implications for faculty development.
WORKSHOP DESCRIPTION
The primary teaching resource for the workshop was
the CD-ROM entitled A Focus on Older Adults: Competency Development and Demonstration for Health
Professionals (Older Adult CD-ROM) (Felver & Van
Son, 2006). Developed, tested, and modified over several years by gerontological nursing experts, this innovative CD-ROM contains a comprehensive set of specific
teaching strategies, learning activities, and competency
demonstrations focused on the care of older adults.
It is organized around a set of nine competencies that
comprehensively address all aspects of health and aging,
from health promotion and communication skills, to
complex geriatric syndromes (e.g., delirium, dementia,
polypharmacy, pain, and falls), to ethical, organizational,
and health policy issues (Felver & Van Son, 2007). The
Older Adult CD-ROM was used to (a) orient the participating faculty to the breadth of gerontological nursing content that is available, (b) expose participants to
specific teaching strategies that will engage students in
learning about gerontological nursing, and (c) solve the
challenges of infusing gerontological content and learning activities into existing nursing courses throughout
the curriculum.
The workshop was presented using a train-thetrainer methodology in which gerontological content
in the Older Adult CD-ROM was reviewed and teaching methods were actively demonstrated. The challenge of teaching gerontological content when the majority of students are not interested in working with
older adults was acknowledged at the beginning, and
significant emphasis was placed on using creative, ex212

periential, and interactive teaching methods to engage

students.
The workshop facilitator briefly reviewed each competency in the Older Adult CD-ROM and then demonstrated methods to teach the content. For example,
components of the first competency, awareness, included issues related to ageism, the demographics related to
aging in the United States, and normal aging as it relates
to sensory changes. Teaching about sensory changes included distributing a sensory kit, which participants used
to experience various challenges faced by older adults
related to normal changes in vision, taste, and touch.
At the same time, participants learned from the Older
Adult CD-ROM how to make their own sensory kits
with common, inexpensive items. Following this exercise, participants took the Unfair Hearing Test, a free
online digital recording of a list of 10 words that mimic
various hearing deficits.
Emphasis was placed on exposing participants to free
or inexpensive gerontological teaching resources. Free
resources included Internet sites such as YouTube, gerontological nursing websites, and organizations devoted to aging issues. Two YouTube videos were shown: a
music video by Avril Lavigne, When Youre Gone (Lavigne & Walker, 2007), and a 40-second video about ageism, Say No to Ageism (2007). These brief videos can be
used as icebreakers, as lecture transitions, or to stimulate
dialogue related to attitudes about aging. Although YouTube videos require prescreening by faculty, remaining
current with technology is important for communicating
with todays students. Examples of inexpensive and easy
to obtain resources that address gerontological content
included the CD-ROM Toolkit for Nursing Excellence
at End of Life Transition (Wilkie and TNEEL Investigators, 2001) and Bathing Without a Battle (Barrick, Rader,
& Sloane, 2003). Both cost less than $50 and address critical issues facing all nurses.
Key websites included AJN/Try This and How To
Try This Series, and ConsultGeriRN.com. These websites provide the latest in evidence-based nursing care
for older adults in a variety of settings. They are quick
and easy to navigate, and can entice additional perusal
of gerontological websites by both faculty and students.
Affective learning activities were presented as a way to
give voice to the older adults. Examples included Maya
Angelous poem On Aging (1996), poignant excerpts
from Lustbaders book Counting on Kindness (1991),
and Tolstoys The Death of Ivan Ilych (1886/2003) as an
end-of-life case study. Thus, participants were exposed
to a wide variety of resources that engaged them experientially in content they can readily use to teach gerontological nursing.
Copyright SLACK Incorporated

Table 1

Table 2

Quality of Workshop Content and

Format

Ratings of Knowledge About Teaching

Gerontological Nursing

Workshop Content and Format

M (Range)a

Quality of content

3.8 (2 to 4)

Knowledge

Relevance of content

3.8 (0 to 4)

Quality of format

3.7 (1 to 4)

Usefulness of resources

3.9 (2 to 4)

Note. aScale: 0 = poor to 4 = excellent.

EVALUATION METHODS
Both formative and summative data were collected to
evaluate participants satisfaction with the workshop and
its impact on curricula, course content, and instructional
activities. Formative postworkshop evaluations provided ongoing feedback. Participants rated the workshop
content and format on a scale from poor (0) to excellent
(4), and rated their knowledge of gerontological nursing
before and after the workshop from none (0) to great
deal (4). Numeric postworkshop evaluation data were
analyzed using means and ranges. Summative evaluation
was accomplished by e-mailing surveys to participants
12 months after the workshop. Participants were asked
to describe changes they made in instructional activities
and course content after attending the workshop. Responses to the e-mail surveys were qualitative in nature
and were analyzed for common themes and unique responses.
FINDINGS
The workshop was presented at 11 baccalaureate
schools of nursing, with 235 faculty participating. Several sites invited faculty from other schools of nursing
and community colleges, as well as nurse educators
from clinical agencies. Results are reported for both the
formative evaluation of participants satisfaction with
the workshop and gains in knowledge and the summative evaluation of changes made in participants curricula.
Formative Evaluation
The quality of workshop content and format were
highly rated (Table 1). Mean scores for the four items
ranged from 3.7 to 3.9. In written comments, participants indicated that they particularly liked the quick
pace, the facilitators role modeling for using teaching
strategies, and discussion of specific ways to integrate gerontological content into general courses, such as health
assessment, pharmacology, and community nursing.
The Journal of Continuing Education in Nursing Vol 41, No 5, 2010

Preworkshopa

Postworkshopa

SD

SD

Knowledge about
strategies to
infuse gerontological content into
nursing education

2.3

1.0
(N = 233)

3.7

0.52*
(N = 233)

Knowledge about
innovative learning activities for
infusing gerontological content
into nursing
education

2.2

1.1
(N = 233)

3.7

0.51*
(N = 232)

Note. aScale: 0 = poor to 4 = excellent. *p = .00.

Participants ratings of their knowledge of gerontological nursing and how to teach it improved considerably
from before the workshop to after the workshop (Table
2). Knowledge about strategies to infuse gerontological
content into nursing education improved from a mean
of 2.2 prior to the workshop to 3.7 after the workshop.
Knowledge about innovative learning activities in gerontological nursing education improved from a mean of 2.3
prior to the workshop to 3.7 after the workshop.
Summative Evaluation
E-mail surveys were sent to 214 participants 12 months
after the workshop asking whether they had made any
changes in their courses or curriculum and to describe
such changes. Reasons for not including all 235 workshop participants were a lack of contact information,
incorrect contact information, and requests not to be
contacted. Sixty (28%) of the 214 participants responded
at 12 months. Of these, 37 (62%) reported either making
changes or planning to make changes, or were already
teaching gerontological content. An additional 11 (18%)
were either no longer teaching or teaching in a non-clinical course that did not lend itself to gerontology content.
Only 11 participants (18%) reported making no changes. One participant (2%) did not indicate whether any
changes had been made.
Examples of Curriculum Changes to Integrate
Gerontological Content
Faculty reported that they had made a wide variety
of course changes after attending the workshop. The
Sidebar contains selected examples from the 12-month
survey primarily representing specific learning activities
213

Sidebar

Examples of Curriculum Changes to Integrate Gerontological Content

Added readings about older adults to augment textbook content on asthma, diabetes, heart disease, and other health conditions.
Included a class on the complexities of aging and distinguishing normal physiological consequences of aging from pathology.
Added a quiz to physical assessment content that focused on physical assessment findings for the elderly individual.
Used the PowerPoint presentation on falls prevention from the Older Adult CD-ROM.
Created student participation in the Enhance Fitness Program at a senior center; students interviewed older adults about exercise and
nutrition and were invited to eat lunch at the meal site.
Required student observation of an interdisciplinary team evaluation meeting at a Program of All-Inclusive Care of the Elderly (PACE)
site, followed by debriefing and discussion.
Required student observation of a class of the Living Well Program, an evidence-based program led by members of the general public
that promotes health among individuals with chronic illnesses, followed by debriefing and discussion.
Used the Older Adult CD-ROM as a resource in long-term care to complete concept-based assignments, obtain gerontological information, and develop a teaching project for the staff and residents.
Assigned readings related to gerontology that focused on families and community health issues.
Selected research articles with a gerontological focus for critique in the research course.
Added gerontology to an acute care course by basing at least one of the case studies on an older adult patient.
Revised a maternity nursing course by adding the health care needs of women during the climacteric, including sexuality.
Used one 3-hour class to conduct interactive activities that included practicing older adult-specific assessments, using the sensory kits
to learn about age-related sensory changes, and exploring attitudes related to the older adult population.
Revised the entire senior public health course.
Loaded the Older Adult CD-ROM on computer laboratory computers so students could easily access that information.

that were integrated into existing courses as well as some

major revisions of entire courses.
Responses From Students and Clinical Sites
Participants reported positive responses from students and clinical sites, but also expressed ongoing difficulty with sparking an interest in older adults among
students.
We broke down the assessments into chunks, and once
the students got over the shock of the number of assessments, they did great. They have to do a mini-assessment
every day. The students liked it, and I can see the difference in their approach to older adults. The long-term
care nurses were thrilled that we added this specific information.
The students are really surprised (about experiencing
sensory changes), especially those who have not worked
with the elderly.
A challenge still remains to interest students about this
population. So many times when speaking of potential
clinical sites they still say, I dont want a site with old
people.

IMPLICATIONS AND RECOMMENDATIONS

The response rate of 28% for the 12-month survey
and the corresponding 62% of those who actually made
changes in their curriculum may seem low. However,
214

the authors view the curricular changes as very positive, especially given their many years of experience with
faculty resistance to teaching gerontological content. Although 72% of attendees did not return the completed
survey, the authors goal is to highlight the changes that
were made to encourage others to make similar changes.
Ongoing Need for Faculty Development
Faculty are beginning to recognize the importance of
addressing aging-specific content in their courses. Overwhelmingly, participants rated the workshop as an effective mechanism to increase their knowledge and teach
strategies to infuse gerontological content in their courses. This brief workshop is one of many models of faculty
development that can be used to address this issue, and
it appears to be effective in motivating faculty to make at
least one modification to their courses. Longer term, as
these faculty retire and new faculty are hired, there will
be an ongoing need for faculty development and education in gerontological nursing.
Several factors may have facilitated faculty motivation to integrate gerontological content into courses.
Throughout the workshop, the facilitator modeled active and experiential application of gerontological content. For example, age-related sensory changes were
simulated with the sensory kit and participants took
the Unfair Hearing Test. In addition, the Older Adult
CD-ROM provided a menu of ready to use instrucCopyright SLACK Incorporated

tional materials that could be easily integrated into existing courses, depending on faculty teaching style, student learning goals, and course focus. These materials
included case studies with instructor guidelines, puzzles,
quizzes, PowerPoint presentations, websites, articles,
video clips, and other interactive resources focused on
the care of older adults regardless of their health condition or setting. The workshop facilitator used these resources as opportunities to discuss how specific content
can be readily included in existing courses. Combined,
the workshop and the Older Adult CD-ROM provide
and demonstrate a range of resources and strategies that
can be adapted by faculty with limited expertise in or
knowledge of gerontological nursing practice.
Address Gerontology Content in Entire Curricula
Although this and other programs have reported
some success in increasing the gerontology content by
individual faculty, the next steps should address gerontology content in entire curricula. The American Association of Colleges of Nursing (AACN) recommends
that curriculum include a freestanding, required course
on gerontological nursing that has both a didactic and
a clinical component, as well as gerontological content
integrated throughout (AACN, 2000). Data regarding
the curricular content of gerontological nursing are
extremely limited and rely on self-report of schools as
opposed to a more rigorous curricular mapping. Two
national surveys of baccalaureate schools (one with a
response rate of 90% [N = 556] and the other with a
response rate of 36% [N = 202]) report that 34% and
51% of programs, respectively, have a standalone gerontological nursing course (Berman et al., 2005; Gilje,
Lacey, & Moore, 2007). Although 92% of schools in
one study reported integrating content into one or
more individual courses, only 22% of schools have
both a standalone course and courses with integrated
content (Berman et al., 2005). This means that to fully
integrate gerontology content throughout the curriculum as recommended by the AACN, most faculty will
need additional knowledge to teach it. Faculty development projects, such as the one described in this article,
are a step in the right direction. However, to meet the
nursing needs of older adults, more emphasis must be
placed on systematic and comprehensive curricular revisions to meet the AACNs recommendations.

key points
Teaching Gerontological Nursing
Miller, L. L., Van Son, C. R., Cartwright, J. C., Allen, T. L. (2010).
Enhancing the Capacity to Teach Gerontological Nursing: A
Faculty Development Project. The Journal of Continuing Education in Nursing, 41(5), 211-216.

Faculty development in gerontological nursing is a prerequisite

to the curricular change required to meet the unprecedented
health care demands of an aging population.

A 4-hour workshop presented at 11 schools of nursing in

five states focused on (a) gerontological nursing content, (b)
exposing participants to specific teaching strategies, and (c)
solving the challenges of infusing gerontological content and
learning activities into existing courses.

The brief workshop described in this article is one of many

models that can be used to address the need for faculty development in gerontological nursing and motivate faculty to make
aging-related modifications to their courses.

Ongoing faculty development in gerontological nursing will be

needed as current faculty retire and new faculty are hired.

more U.S. faculty than ever before possess additional

education in gerontology. To assist faculty to increase
gerontological content in their courses, their expertise
can be better used through partnering. Although this
project involved partnering with faculty across multiple
states, some projects reported in the literature have organized gerontology interest groups within schools and
between two or more schools (Barba & Gendler, 2006;
Hertz et al., 2005). Others have developed partnerships
with clinical sites; in these cases, both faculty and clinical nurses learn more about the needs of older adults
(Barba & Gendler, 2006; Schildwachter, Lekan, Hebert,
& Leatherwood, 2007; Specht & Mobily, 2005).

Partner With Other Faculty and Schools of

Nursing
One reason often given for not integrating more gerontology content is the lack of nurses expert in the field
(Gilje et al., 2007; Jeffers & Campbell, 2005). However,

Use the Available Teaching Resources

Over the course of the project, it became clear that
faculty needed creative, effective, and inexpensive teaching resources centrally located to reduce the barriers
they often confront when trying to infuse gerontological
content into their courses. To meet this need, the website
www.GeroNursingEd.org was created. GeroNursingEd.
org is a developing repository of ready to use teaching
resources, many of them created by the faculty participants. The website includes complete standalone gerontological nursing courses, as well as individual learning
activities that can be incorporated into existing courses.

The Journal of Continuing Education in Nursing Vol 41, No 5, 2010

215

It provides media and links to other websites that focus

on older adults.
Summary
The demand for faculty with skills to teach gerontological nursing is clearly critical. The half-day workshop
for nursing faculty reported in this article resulted in
important changes to participants curricula. The Older
Adult CD-ROM used in this workshop is an excellent
teaching resource that can be used by both faculty and
students to increase their knowledge of gerontological
nursing. Ongoing efforts to develop future faculty in gerontological nursing will be required as current faculty
retire and new faculty take their place.
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permission.