Putting Wheels on Tradition: Reimagining Innovation in Clinical Education

In this episode of Nursing EDge Unscripted, host Steven Palazzo speaks with Donna Badowski about her guest editorial, “Putting Wheels on the Tradition: Reimagining Innovation in Clinical Education,” published in Nursing Education Perspectives. Badowski argues that while simulation, community-based learning, and other innovative approaches are valuable, traditional hospital-based clinical experiences remain essential and should be reimagined rather than replaced. She discusses challenges facing clinical education, including limited student access to patient care activities, increasing reliance on preceptor-led models, and the need for faculty to remain actively engaged in coaching, questioning, and developing students’ clinical judgment. The conversation explores practical strategies for enhancing clinical learning, such as faculty-led huddles, guided clinical reasoning activities, and better integration of simulation and practice experiences. Badowski also reflects on the potential role of artificial intelligence as a tool to support faculty creativity and student learning while emphasizing the continued importance of human mentorship and intentional teaching in clinical settings.

Badowski, Donna. Putting Wheels on Tradition: Reimagining Innovation in Clinical Education. Nursing Education Perspectives 47(1):p 3-4, 1/2 2026. | DOI: 10.1097/01.NEP.0000000000001496 

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Transcript

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Welcome to this episode of NLN Nursing Edge Unscripted. I'm your host, Dr. Steven Palazzo, a member of the editorial board for Nursing Education Perspectives. In this episode, we will examine the guest editorial, Putting Wheels on the Tradition Reimagining Innovation in Clinical Education. This work is authored by Dr. Donna Badowski, founding director of nursing and vice dean of the School of Science, Engineering, and Technology at St. Mary's University in San Antonio. Dr. Badowski also serves as Innovation Center editor for Nursing Education Perspectives. This guest editorial appears in the January February 2026 edition of Nursing Education Perspectives. The editorial emphasizes the need to innovate clinical education while preserving the value of traditional clinical experiences. Dr. Badowski notes that simulation, community- based learning, and other non-traditional models have advanced nursing education, but hospital-based clinical practice remains essential because many new nurses enter acute care. Rather than retiring traditional clinical education, she positions it should be re-imagined. Well, welcome Dr. Baldowski. We're very excited to have you. Thank you, Dr. Palazzo. So, let's just get off on some of the questions here right away. So, you discussed that traditional clinical experiences should be re-imagined rather than retired. What wheels could nursing programs add to strengthen faculty-led clinical education while preserving the value of the bedside education? So first of all I just want to say that bedside learning does remain the foundation of clinical learning. And the impetus for me writing this article was I belong to a consortium here in San Antonio and the issues with not having access to electronic health records or some hospitals not even allowing nurses to even administer medication. and some hospitals where you have oh you can only have two students here and two students there and that leaves faculty and that really leads to a more of a preceptor-led model which might not be the case for an early nursing student. So we need to kind of present ourselves as you know programs of nursing to these hospitals and so that we can remain as a unit like you know 8 to 10 students on a unit where faculty take the lead so to say so that they're actively coaching and questioning the students instead of placing them with a nurse to follow them along throughout the day. So, some types of wheels that, you know, might be considered and that, you know, I haven't really seen because a lot of the articles written are about community- based learning or simulation and those are all great, but we need to really reinvent what's happening in the clinical setting. So, perhaps maybe a midday huddle where you know the faculty will pull the students and do a midday huddle. We always start with a pre-brief in the morning and we end with the post-conference but maybe we need maybe we need to meet in the middle sometimes of the day. Or you know faculty rounding with the students are other options or if it's a facility that doesn't allow students to administer medication maybe there could be some sort of guided medication reasoning that is done during the clinical day. They observe the nurse administer the medication since the faculty is not there. But then the faculty can pull that student aside and do some sort of guided medication reasoning either before or after the medication administration or ask the student what type of patient education would you provide if you were administering this medication. mock administration when access is limited. You know, we can we don't need the simulation suites for to provide simulation. We can bring those simulation tools to clinical and maybe do some sort of mock simulated medication administration in the clinical setting. All good points you raised there. You also mentioned in the editorial that preceptor-led models may shift teaching responsibilities to already overtax nurses who are working in the units. So, how can nursing programs balance that preceptorship partnership with the need for direct faculty coaching, questioning and assessment of clinical judgment? Yeah, that's a great question and I am not anti-preceptor as I mentioned earlier. I really believe the novice nurse nursing student requires the mentorship of their faculty. Our bedside nurses are we know that they're overwhelmed in the clinical setting. They have high patient loads. They have a lot of things on their plate. And now to take the time to coach and guide a novice nursing student might not be the best learning experience for these students. So, I'm not anti-preceptor, but maybe that's should be safe for our senior level nursing students. Could be because you know nursing staff exposure is valuable. I mean these are experienced nurses working at the bedside and you know students can actually follow by observing but to me a precept model is that staff nurse actually watching a student do these types of skills. And again when and we know when students are doing skills things are a lot slower. So that kind of will put that staff nurse behind and start creating anxiety and them feeling overwhelmed. So again this is why I really believe it would behoove nursing faculty to think about rethink and put wheels on that clinical day in the clinical setting. I love all the different articles out in community- based settings as well as simulation. But now let's focus more in the clinical setting. And there really isn't a lot out there about innovations of clinical teaching itself. in in the traditional environment. There's not and not a lot of data either. No, you know, there was that empty Yeah. How long we've been doing clinical education and just not having good data to I mean, there's not even data to correlate with, you know, the amount of time or hours spent in direct patient care, you know, at the bedside and outcomes, right? A lot of boards of nursing don't even define the number clinical. It's whatever hours you think is going to help the students meet the competencies. And if we're not really studying that, how do we even know as faculty? Yeah, I suspect because it's hard variables to measure. You're right that it probably dissuades a lot of people from looking at that as a research endeavor. But it boy, it definitely seems necessary. Well, maybe a scaffolded approach. You know, thinking about a scaffolded approach from reliance on more clinical faculty cognitive development of students early on transitioning over to a preceptorship model when they get to their internship, you know, semester, right? And because remember faculty have the educational expertise, right? And the preceptor has more of the practice expertise. So, and that those novice nurses really need the guidance and coaching. So, how yeah, how do we bring the three together? Like I think of it as the practice piece, right, that the nurses at the bedside have that psychomotor piece that's at in simulation and then that you know experience cognitive clinical reasoning piece that our faculty bring and marrying those three together into some kind of scaffolded approach, you know, is one way that I got out of reading your editorial. Yeah. You know, simulation provides a great opportunity for the deliberate practice of skills, right? And even in my role as a director and doing our advisory council meetings, I so often hear from our clinical partners is we can teach them the technical skills. We need you to teach them those softer skills such as communication and clinical judgment and clinical reasoning. And I, you know, it is challenging. But that's why I'm kind of created this article to push our colleagues to be, you know, be innovative and they probably are, but they're not sharing that innovation. So this is a great opportunity to write up a nice article to share among their colleagues and then maybe you know either the originators of the innovation or someone else could take it and start studying it to see if it really is making a difference. We touched on simulation a little bit but as I was reading through the editorial and got towards the end there you know you brought in which is kind of on everybody's mind right now right technology especially artificial intelligence you know what is that going to do and how may that help focus faculty focus on intentionality of reasoning judgment and patient advocacy like what safeguards are needed to ensure that these tools like these AI tools that are developing rather rapidly rather than replace the human experience of nursing education and the dimensions of nursing education, how can they enhance it and we probably don't know yet necessarily it's going to look like. Right. Right. Well, we have to really understand that AI is not going away. You know, we know that there's already AI robots in some facilities. Moxi is what I'm thinking of. And I know there's some companies that are working on actual nurse robots. But again that you, as you mentioned, they can't replace the human side. So, we need to teach our students how to work with and know that it's not going to take over the human touch, the human connection that we have with our patients. And it might take over some of those technical skills. So more better place for us to really work on those softer skills to you know have our students become stronger in those skills. Clinical judgment, advocacy, empathy, they all require human interaction, not robotic interaction. Now AI can you know I again because it's so new it's something I know that I will use for example when I'm creating an escape room. I teach healthcare informatics. I'm not even in the clinical setting right now, but if I want to create an escape room related to some sort of informatics competency, I will use AI because it can help me create an escape room a lot quicker than I can. But I know that it makes mistakes. So, I have to keep working with it and say, "This doesn't seem right. There seems like a missing piece." And I feel that the same thing can be done in clinical education if you know there's a lot there's a lot of downtime in in in the clinical setting and maybe nurse faculty can turn to AI and reach out and say I've got this clinical day and let's say OB I know that there's a lot of downtime sometimes I remember doing clinical one time when there were two mother baby couplets and I had 10 students. Wow. And it was a 12-hour clinical day. Oh, so a lot of downtime. So that's where, you know, maybe AI can actually, you know, come in handy to give that nursing faculty ideas for clinical learning in that environ in in the actual traditional clinical environment. Well, you know, your editorial brings up some very important points that will get us all thinking. I want to thank you for joining us today, Dr. Badowski. I want to remind the listeners that the article is putting wheels on tradition reimagining innovation in clinical education and I want to thank also Dr. Badowski for her work as an editor on the Innovation Center of Nursing Education Perspectives. There's a lot of work that goes into that. So we appreciate the time and effort you put into that. And again and I want to thank you for inviting me to this podcast. Oh absolutely. It was a pleasure to have you. It's a great topic and it's you know something we need to think about. Thank you.