Nursing Expertise in Adaptability

The NExA Model

Nursing Expertise in Adaptability (NExA) Model

The Nursing Expertise in Adaptability (NExA) Model is a holistic theoretical framework in nursing education that interconnects student-centric learning, technology integration, and situational learning opportunities. It strengthens critical thinking skills and fosters adaptability in a rapidly evolving technological healthcare landscape.

By promoting learner equity and accelerating competency development through seamless incorporation of modern technologies, the NExA Model mitigates burnout and enhances preparedness across all stages of the nursing profession.

Imagine as a nursing student (or even an experienced nurse), being able to learn about anything nursing related that’s engaging, exciting, and most importantly…

unique to you.

Now, imagine having that system (whether it’s your annual training modules or your first semester nursing class) take into account your knowledge, your strengths, weaknesses, and teaching you in a way that you want to learn.

And what’s more…it automatically adapts.

It changes after every test, every quiz, or every interaction. It takes into account that you only want to watch 2-3 minute videos, you want to swipe up, you want to find the most important information quickly, and you want immediate feedback that tells you what you need to work on, based on what you need to learn.

That’s the beauty of the Nursing Expertise in Adaptability Theoretical Model (NExA).

A set of interconnected learning principles that enhance and synergize each other, in a way that leverage your unique needs with the rapidly changing tech and healthcare systems.

The Current State of Nursing and Education

The NExA model was designed to address a significant gap in nursing education: many nursing students, new nurses, and even experienced nurses are being exposed to fragmented teaching methods. Traditional models like Knowles’ adult learning theory or Benner’s novice-to-expert framework don't adequately account for the modern realities that today’s nursing students and nurses face, particularly the rapid advancement of technology in healthcare.

Many students come from backgrounds where they are digital natives but lack formal digital literacy, or they are struggling to adapt to new tools. The NExA model was built to bridge this gap by offering a comprehensive framework that integrates personalized learning with the tools needed for today’s tech-driven clinical environments.

The NExA model adapts to individual learning preferences and supports critical thinking and clinical decision-making by using a flexible, dynamic approach. It combines the best of traditional learning theories with the technological advancements necessary for modern nursing practice, creating an expedited process for developing key skills that can be applied in a fast-paced, technology-driven healthcare world.

The Objectives of the NExA Model

While Benner and Knowles were landmark educational theorists, their theories didn’t account for the digital native. That is, someone who was brought into the educational continuum with a piece of technology in their hand.

Additionally, the challenges of The New Nurse Paradox highlight the complexities of the transition to practice.

As a result, there was a need for a new framework. This framework focuses on the following:

  • The Student’s Needs: Tailoring educational experiences to each nurse’s unique strengths, prior knowledge, and areas for growth ensures that learning is targeted and relevant. This approach enhances skill acquisition and retention by focusing on what each learner needs to master, rather than relying on a one-size-fits-all curriculum. By centering education around the individual, the focus is to keep learners engaged and motivated, accelerating competency development and removing barriers to understanding.

  • Evolving Technologies: Embracing widely available and advancing technologies, such as automation, digital learning platforms, and the use of generative aritificial intelligence enriches the learning experience, making it more engaging and accessible. Technological support helps to ease challenges in the educational system, by leveraging data analysis to support changes in scalability and to provide a learner-centric approach.

  • Workforce Preparation: Providing real-world learning opportunities strengthens and develops the critical thinking skills essential for today's rapidly evolving healthcare landscape. By utilizing problem-based learning, nurses are better prepared to apply their knowledge in real-life situations. This situational approach enhances their ability to make swift, informed decisions, which is crucial in the fast-paced medical environment, effectively preparing them for the workforce.

The Nursing Expertise in Adaptability Model: What’s Changed From Benner

Benner’s model aimed to provide nurses a framework and guidance to get from a novice level to that of an expert. The challenge is that the framework is just unreleastic today, given the rapid changes in technology and the workforce. Waiting 2-3 years in a high demand, high turnover profession to be considered “competent,” is just not a feasible task anymore.

There’s a great need to implement a framework that allows educators and trainers the ability to support nurses through the continuum of nursing practice.

  • Nursing Students - Nursing students should tangentially be trained in an effort to improve mastery, with a focus on competency. This will better prepare them for the expectation of practice, as they transition to a new role.

  • New Nurses - The most susceptible group, they lack the support and resources outside of residency programs to develop clinical decision making and critical thinking skills to support their transition to practice.

  • Experienced Nurses - Often jaded by the nursing process, organizational regulations and rules, and the overwhelm of patient care, they are left to be forced to train on changes in practice and technology, without taking into account their current knowledge base.

The NExA Model Framework

The NExA model is designed to function as a comprehensive, interconnected system where every core element and sub-element works together to create a synergistic learning environment. Each component enhances the others, building a cohesive framework that adapts to the evolving needs of today’s nurses and nursing students.

Student-Centric Learning

The Student-Centric Learning element of the NExA model emphasizes the individual learner’s needs, focusing on personalized learning pathways that promote competency-based education and self-directed learning. It ensures that each nurse develops the skills they need most while fostering a sense of ownership over their professional development.

  • Competency-Based Learning

    This component ensures that nurses focus on mastering key competencies that are directly relevant to their practice, eliminating redundant information. By emphasizing essential skills, the learning process is streamlined, allowing for more efficient knowledge acquisition and better retention.

  • Individual Learning Paths

    This component creates personalized learning journeys for each student, allowing them to learn at their own pace and focus on areas that are most critical for their development. It ensures that the learning experience is tailored to the individual, enhancing their professional growth.

  • Learning Autonomy

    This component promotes self-directed learning, enabling nurses to choose how and what they focus on in their education. By fostering autonomy, NExA increases engagement and motivation, encouraging nurses to take ownership of their lifelong learning process.

Integrated Adaptability (IA)

Integrated Adaptability ensures that the NExA model can evolve alongside technological advancements and educational innovations. It leverages modern tools and data-driven methods to keep learning relevant, adaptable, and scalable.

  • Technology-Enhanced Learning

    The integration of varying means of technology encourages support and innovation in a rapidly advancing landscape. The utilization of simplistic tools such as virtual meeting rooms and whiteboards, to usinng advanced tools such as AI-driven platforms, virtual simulations, and interactive technologies, this component ensures that the learning experience remains dynamic, engaging, and aligned with the latest digital advancements in healthcare.

  • Data-Driven Iteration

    With this integration, educators, students, and systems can continuously refine the learning process through data analysis, enabling the NExA model to adapt based on student performance and feedback. It ensures that the model evolves in real-time, remaining responsive to learners’ needs, and optimizing the critical thinking development process.

  • Scalable Efficiencies

    Implementing the idea of scalability, users of the NExA theoretical model can continue to grow and scale without sacrificing the quality of education. By utilizing automation and adaptive learning technologies, the model supports large groups of students while maintaining a personalized learning experience for each, depending on the design, resource allocation, and implementation.

Situational-Based Learning

Situational-Based Learning prepares nurses and nursing students for the complexities of real-world clinical practice (or changes in healthcare and healthcare IT) by using real-world elements and utilizing practical scenarios that require critical thinking and decision-making. It bridges the gap between theoretical knowledge and real-life application.

  • Contextual Decision-Making

    Immersing students in realistic scenarios where they must make decisions based on the context of the situation, helps them to develop the ability to adapt and make informed choices in clinical settings.

  • Critical Thinking Skills

    By focusing on ability to analyze complex situations and respond appropriately, this enhances critical thinking. As a result, this process ensures that nurses are equipped to navigate challenging clinical environments.

  • Dynamic Outcome Exploration

    This component enables learners to explore multiple possible outcomes based on the decisions they make in various clinical scenarios. It helps learners understand the implications of their actions, refining their decision-making abilities over time.

Case Study - New Nurse Residents & Digital Nursing Solutions

Over the course of a year, a study was conducted to examine the effects of the NExA model and implementation of Generative AI in new nurses and their transition to practice. The intent of this study was to determine how effective a competency-based, asychronous model would affect the retention of digital software solution education for nurses.

This study examined the integration of Generative AI tools and emulated generative AI chatbot support in nursing residency training programs, comparing their impact on class efficiency, knowledge retention, and task performance with traditional methods.

Across three cohorts—Non-Generative AI, Generative AI, and Generative AI with emulated chatbot support—133 participants were assessed.

Here are the general findings:

  • Generative AI-enhanced training reduced class time by 24.73%, with a 7.18% improvement in knowledge retention and application.

  • The cohort with emulated generative AI chatbot support showed an 8.56% improvement in final test scores with more consistent performance.

  • In the baseline cohort compared to the cohort using generative AI in an asynchronous model, daily task efficiency increased, with AI-supported cohorts spending less time on digital tools (166.53 minutes/day) compared to the Non-AI cohort (188.89 minutes/day).

This study is based on the Nursing Expertise in Adaptability Model, which promotes individualized, competency-focused learning. The findings demonstrate how integrating AI tools can improve learner engagement, test scores, and the application of knowledge in real-world settings.

These findings support that nursing education designed utilizing the NExA model supports the hypothesis that competency-based, learner-centric methods that integrate technology support long-term and short-term retention when it comes to the application of nursing education.

The NExA Model provides a holistic and learner-centric approach to nursing education, building on the foundational research of Benner and Knowles. By eliminating educational redundancies and embracing adult learning principles, it accelerates the transition from novice to expert through engaging and technological solutions. This framework addresses individual learning gaps, reinforces knowledge, and applies skills in real-world settings, enhancing competency and mastery.

Ultimately, the NExA Model reduces burnout and increases preparedness, fostering a more effective and resilient nursing workforce.