By Tiffany Goralczyk, MSN, RN, CNL, Director of Clinical Solutions, Elemeno Health
LinkedIn: Tiffany Goralczyk, MSN, RN, CNL
LinkedIn: Elemeno Health
While the nursing shortage has long challenged the U.S. healthcare system, the COVID-19 pandemic intensified its visibility as demand and costs surged. The U.S. Bureau of Labor Statistics forecasts approximately 190,000 gross new job openings annually for registered nurses (RNs) between 2024 and 2034. Employment of RNs is projected to grow 5% each year on average—faster than the average for all occupations. Much of this demand reflects the need to replace nurses retiring or leaving the profession for other fields. The shortage places a significant strain on those who are still working. A survey by the American Society of Registered Nurses shows the majority of CNOs (61 percent) believe that shortages have a considerable or significant negative impact on nurse morale, which is linked to patient satisfaction and patient care quality, and 34% of CNOs believe staffing shortages harm patient care.
There is an under-recognized root cause of the nation’s inability to supply enough new nurses to meet rising demand: a critical shortage of nurse educators.
The challenges of nursing education
In 2024, a total of 80,162 qualified applications were rejected by nursing schools nationwide, according to the American Association of Colleges of Nursing (AACN). The primary reason these applications were turned away was a “persistent shortage of nurse faculty,” according to the AACN.
Indeed, classroom nursing education programs face faculty shortages that directly limit their ability to meet growing demand. Many programs struggle to fill open teaching positions because qualified faculty must hold advanced degrees, yet clinical roles often offer higher pay and more flexible schedules.
Compounding the issue, much of the existing faculty workforce is approaching retirement age, creating a shrinking pipeline of experienced educators at the very time when the need for them is expanding.
In addition to staffing challenges, educators must constantly update curricula to keep pace with rapid changes in healthcare delivery. Advances in telehealth, electronic health records, and artificial intelligence in patient care necessitate that programs adapt quickly, ensuring students are prepared for modern practice. This shift toward competency-based education requires faculty to redesign courses, integrate new teaching technologies, and strike a balance between theoretical instruction and practical skill development.
Educators also navigate wide variation in student preparedness and the pressures of heavy workloads. Incoming nursing students often have varying levels of readiness in science and math, necessitating tailored support. At the same time, faculty must also adjust their teaching strategies to accommodate a generation of learners who expect technology-driven, interactive instruction.
These combined pressures contribute to stress and burnout, exacerbating the difficulty of retaining, let alone recruiting, skilled educators in the classroom.
Borrowing a page from hospital-based counterparts
While foundational nursing education starts in the classroom, it continues on through clinical rotations in the hospital, where both nursing students and new hires receive on-the-job training. Although classroom and hospital-based educators operate in different settings, they together oversee the nursing education continuum — and both are feeling the strain of staffing shortages.
To relieve pressure associated with staffing shortages, many leading hospitals have invested in overhauling and modernizing their training programs. Often, this new approach leans heavily on “microlearning.”
In nurse training, microlearning refers to delivering very short, focused learning modules — such as quick videos, images, and interactive job aids — that provide actionable, location-specific information exactly when and where nurses need it. This “just-in-time” approach enables training to be repeatedly accessed by learners at the moment of need, regardless of the educator’s presence. Repetition helps learners build confidence and achieve competency more quickly. At the same time, this automation of training frees time for the educators, reducing teaching fatigue and increasing bandwidth to ensure consistent access to up-to-date information.
A study published in Nursing Management examined an initiative by one hospital to implement microlearning in the emergency department. The hospital utilized microlearning to enhance its Tiered Skills Acquisition Model (TSAM), a training method where new nurses learn by managing full patient assignments while observing and practicing alongside experienced staff.
The hospital launched a microlearning app to deliver key, just-in-time job aids to support each tier within TSAM. With the microlearning approach, educators could orient new staff in context, sharing specific “bite-sized” content with the orientee on mobile devices or workstations on wheels, while concurrently teaching a procedure or workflow in real-time.
Orientees could then review the same just-in-time training modules whenever needed, reinforcing their skills and accelerating their independence. Nursing educators documented the orientee’s achievement of competency at each tier before approving progression to the next. Orientation formally concluded when the orientee had mastered all tiered skills and demonstrated competency at each level.
During the 16-month study observation period following the implementation of the microlearning app, the team onboarded 95 new staff members and created 124 unique microlearning content items, which received over 1,000 views per month from both new and existing staff members.
Following the microlearning implementation, orientation time to competency decreased 50% from 144 hours to 72 hours for experienced RNs, resulting in savings of $6,200 per experienced RN. For new graduate RNs, orientation time decreased 42% from 1,092 to 630 hours, translating to savings of $40,000 per RN.
Overall, annualizing the total number of new RNs with salary and benefits, and including costs of backfill coverage ($244,000), the fiscal savings totaled $822,000 per year, according to the study. The hospital has since scaled the microlearning app across all hospital nursing units.
Investment in the future
The nursing shortage is not just about too few bedside nurses. It’s deeply rooted in a parallel crisis in education. Schools of nursing are unable to meet demand primarily due to a shortage of faculty, an aging educator workforce, and the allure of better pay or flexibility in clinical roles. Without urgent changes to the nursing educator pipeline, the demand for nurses will soon outpace our capacity to train them. Microlearning offers a way to bridge that gap — extending the reach of every educator, easing pressure, modernizing instruction, and accelerating the preparation of the workforce patients urgently need.
