Dignity and respect in midwifery education in the UK: A survey of Lead Midwives of Education

In the UK respect, dignity and compassion are the underpinning values which must determine service user care in the National Health Service (NHS). In midwifery education it is unclear how students are being taught these values. We created a study that aimed to explore how learning about dignity and respect is facilitated and assessed within pre-registration midwifery curricula. An online survey was devised and distributed to all Lead Midwives for Education in the UK. The findings are presented under the three main themes of understanding the meaning of dignity and respect, teaching and assessment and experiences. The study concludes that, though there are some good areas of education practice there is inconsistency in how Nursing and Midwifery Council (NMC) guidelines are transferred into curricula. This leads to students receiving differing emphasis of education on the values of dignity and respect.     

Liberating new talents: an innovative pre-registration community-focused adult nursing programme

The drive for a more community-focused approach to pre-registration nursing education as identified in Modernising Nursing Careers, (Department of Health, 2006a) has continued to gather momentum. The research literature identifies that the community context impacts significantly on care delivery, with student nurses often missing the underlying complexities of working in this context; focusing on the task in hand rather than the broader landscape of care (Carr, 2004). In 2008, a community focused pre-registration adult nursing degree pathway was started at Canterbury Christ Church University (CCCU), to prepare a cohort of 16 nursing students to work in the community and general practice setting at the point of registration. Placement learning has been focused within general practice and community through a hub and spoke approach to enable students to develop a deep understanding of the complexities of care in this setting with particular reference to the management of risk and unpredictability. The pilot is being formally evaluated with a particular emphasis on the meaning and relevance of practice learning within these settings. The emerging data will not only provide evidence to promote the community and general practice agenda within pre-registration curricula, but help to clarify the essential skills and knowledge required to prepare students nurses for working in these settings.     

“A stressful and frightening experience”? Children's nurses' perceived readiness to care for children with cancer following pre-registration nurse education: A qualitative study

BackgroundIn the UK children with cancer are cared for by children's nurses in a variety of settings, specialist and non-specialist. Whilst post-registration specialist education is available to some nurses, many nurses rely solely on pre-registration education to competently care for these children. This study explores whether nurses perceive that this adequately prepares them.ObjectivesTo explore the extent to which qualified nurses perceive that pre-registration nurse education prepares them to care for children with cancer; to consider the implications for children's nursing pre-registration curricula.DesignA small-scale qualitative study was undertaken using an interpretivist approach.MethodsSemi-structured interviews were conducted with six qualified children's nurses in two clinical areas - a specialist children's cancer inpatient ward, and a general children's ward where inpatients included children with cancer.ResultsFindings are discussed in relation to three emergent themes: Learning in Theory and Practice, Care of the Child and Family, and Resilience. Participants attached significance to the quantity and quality of practice experience. They reflected on barriers to specific and transferable theoretical learning and stressed the importance of integrating theory and practice. Understanding of family-centred care formed a significant part of their preparation. Preconceptions, communication with families and the emotional impact of this speciality were stressful. Improved pre-registration preparation may have developed participants' resilience.ConclusionThe complexities of caring for children with cancer and their families require well-prepared nurses. Participants' perceptions of preparedness were influenced by aspects of pre-registration education. Their experiences suggest that curricula should be practice-focused and include a range of placements. Specialist theoretical content must be integrated with practice and transferability of knowledge and skills made explicit. Reflection and problem-based learning may foster coping mechanisms and resilience that will equip them to care for children with cancer.     

Problem based learning in mental health nursing: the students' experience

Problem based learning (PBL) is well established within the field of health-care education for professionals worldwide, although little has been done to explore the experiences of students undertaking a PBL course in mental health nursing. Without firm evidence of the benefits of PBL, educationalists in mental health might be reluctant to view it as an option in curricula design. This U.K. study examined the experiences of pre-registration post-graduate mental health student nurses undertaking a 2-year educational course in which all teaching and assessment followed a PBL philosophy. Focus groups were used throughout the course to elicit in-depth qualitative data that was analysed by applying a constant comparative method. The analysis of the data uncovered the following broad themes: 'moves to autonomy, 'surviving the groups' and 'the impact of PBL'. The findings show that participants had mainly positive experiences and gained a range of study and interpersonal skills central to mental health nursing. Participants described initial anxieties resulting from engagement in PBL. However, they increasingly gained confidence in this approach, exercising increasing control over the PBL process. Despite this increased autonomy, participants continued to value the input of skilled facilitators. A recurring issue centred on the potential for interpersonal conflict within the student group and its impact on their learning. It is suggested that more research is needed examining the use of PBL in mental health nursing.     

Patient safety in an English pre-registration nursing curriculum

This study explored patient safety in an English pre-registration nursing curriculum. The need to improve patient safety has been recognised as a key priority, both nationally and internationally. Education has a crucial role in developing the knowledge, skills and attitudes that promote patient safety. However, evidence about how patient safety is addressed in healthcare professional curricula and how organisations develop safe practitioners is limited.An organisational case study identified factors affecting patient safety educational provision. Content analysis revealed what aspects of patient safety featured in the formal pre-registration nursing curriculum. Interviews were conducted with students, lecturers and key education stakeholders from various levels of the educational organisation, to explore their perceptions of patient safety and its location in the curriculum and practice.Patient safety was not explicit in the formal curriculum, but was included in teaching. Students reported gaining most knowledge and experience from clinical practice. The organisational culture of both education and practice was characterised as defensive and closed, and as having an individual versus a systems approach. Findings suggest the need for clarification of the concept of patient safety, as well as revision of curricula and teaching, learning and assessment strategies in order to address patient safety explicitly.     

What are pre-registration nurses taught about caring for children?

Nurse education curricula have to be continually reviewed to ensure that content remains applicable to contemporary healthcare developments. In this article, the authors report the findings of a research study that investigated the children's nursing component taught in all non-children's BSc Nursing degree programmes in Irish colleges. The aim of the study was to identify how European Union directives and national curriculum guidelines are interpreted in colleges, and to clarify the preparation that non-children's pre-registration nursing students receive with respect to caring for children. The authors explored aspects related to children's nursing in all non-children's undergraduate pre-registration programmes, including curriculum content and its delivery, assessments and practice experiences. Data were collected by a specifically designed questionnaire based on the Requirements and Standards for Nurse Education Programmes (An Bord Altranais, 2005a; b). A university ethics committee provided ethical approval. The response rate was 54%?(n=7), and data were analysed using SPSS 16 and content analysis. The authors' findings illustrated that the requirements and standards of all nursing programmes are interpreted in a variety of ways regarding children's nursing. Nationally, nursing content related to children needs to be reviewed in all nursing programmes to ensure consistency among providers. Healthcare requirements for children and families need to be heightened within curricula for all disciplines.     

Use of experiential methods to teach research in a pre-registration nursing curriculum

For nursing to become firmly established as a research-based profession, it is essential that all nurses are equipped with the skills to critique research literature. This demands the integration of research application into nursing curricula at all levels. In order for nursing problems to be effectively illuminated, it is important that a range of quantitative and qualitative approaches are utilised. This necessitates teaching material from across the range of relevant research paradigms. Many students commencing pre-registration courses have a limited knowledge of either nursing or research. Others have had a variety of previous experiences of research as a subject, some of which have generated negative stereotypes and disinterest. This paper will explore the challenges encountered when teaching research to students on a pre-registration advanced diploma course. The authors have developed a range of experiential exercises which attempt to explore research concepts in a meaningful way. The presentation of research principles is followed up by formative work linked to clinical placements. Discussion during feedback sessions allows for sharing of ideas and experiences within the group and facilitates critical reflection. The evaluation from this initiative has been positive and encouraging. A selection of the methods used and evaluation material will be presented.     

Thai nursing students' adaption to problem-based learning: a qualitative study

Student-centred forms of learning have gained favour internationally over the last few decades including problem based learning, an approach now incorporated in medicine, nursing and other disciplines’ education in many countries. However, it is still new in Thailand and being piloted to try to offset traditional forms of didactic, teacher-centred forms of teaching. In this qualitative study, 25 undergraduate nursing students in northern Thailand were interviewed about their experiences with problem-based learning in a health promotion subject. Content analysis was used to interrogate interview data, which revealed four categories: adapting, seeking assistance, self-development, and thinking process development. Initially participants had mixed emotions of confusion, negativity or boredom in the adaption process, but expressed satisfaction with creativity in learning, group work, and leadership development. They described increased abilities to problem solve and think critically, but struggled to develop questioning behaviours in learning. Socio-culturally in Thai education, students have great respect for teachers, but rarely question or challenge them or their learning. We conclude that problem-based learning has great potential in Thai nursing education, but educators and systems need to systematically prepare appropriate learning environments, their staff and students, to incorporate this within curricula.     

Skills for safe practice – A qualitative study to evaluate the use of simulation in safeguarding children teaching for pre-registration children’s nurses

Safeguarding children teaching is a required component in all pre-registration nursing curricula. A structured approach to this teaching as part of preparation for registration as a children's nurse was developed jointly by the Course Leader and the Designated Nurse for Safeguarding Children. This approach aims to equip children's nurses with the necessary theoretical knowledge and practical skills needed for safe practice. A key element in this curriculum is simulation, where students must assess injuries on manikins, select and complete appropriate documentation, and perform a nursing handover. Simulation has recognised value in nurse education but its use in safeguarding children teaching for student children's nurses has not previously been widely reported.This small-scale qualitative study explored the student experience and the impact of simulation teaching in the development of relevant knowledge and the core safeguarding skill set of observation, interpretation, documentation and communication.The methodology for this small, qualitative study was triangulated, comprising observation of the simulation teaching and two sets of semi-structured interviews. The resultant data was investigated using thematic analysis.The outcome of the study suggested that students were able to transfer learning from the simulation into clinical practice, and that simulation as an approach to safeguarding children teaching resonated with the students' preferred learning style and merits further consideration and evaluation.     

Effectiveness and value of massage skills training during pre-registration nurse education

BACKGROUND: The integration of Complementary and alternative medicine (CAM) interventions into healthcare practices is becoming more popular and frequently accessed by patients. Various disciplines have integrated CAM techniques education into the preparation of their practitioners in response to this, but this varies widely, as does its success. Students'experiences of such education in pre-registration is largely unknown in the UK, and methods by which to successful achieve effective learning within this arena are largely unreported within the literature. AIMS AND OBJECTIVES: This study highlighted three specifics aims; to examine the perspectives of pre-registration nursing students on being taught massage skills during pre-registration nurse education; to identify the learning and development that occurs during massage skills training; and to identify methods of enhancing the provision of such skills training and its experience. CONCLUSION: This paper demonstrates the value of integrating complementary therapies into nurse education, developing the holistic approach of student nurses and their concept of caring. In addition it contributes significantly to the knowledge base of the effectiveness of the value of CAM education in nurse preparation, highlighting the high value students place on CAM education and demonstrating notable development in the preparation of holistic practitioners. The method utilised also yielded ways to improve the delivery of such education, and demonstrates how creative teaching methods can motivate and enhance effective learning.     

The use of team-based learning in a second year undergraduate pre-registration nursing course on evidence-informed decision making

More engaging teaching and learning strategies are needed to teach research-related courses to pre-registration nursing students. Team-based learning was implemented within a second year pre-registration nursing evidence-informed decision making course. Results from a questionnaire survey indicated that 70% believed team-based learning was appropriate for the course, 60% that it was an effective and motivating learning strategy, and 54% recommended using team-based learning in other courses. The results from ten student interviews illustrated the positive way in which team-based learning was perceived, and how the students thought it contributed to their learning. Test results were improved with an increase in the numbers of students achieving 70% or higher; and higher scores for students in the lowest quartile. Team-based learning was shown to be an effective strategy that preserved the benefits of small group teaching with large student groups.     

Supporting pre-registration nursing students in their exploration of death and dying

Student nurses will be exposed to dying patients from the very start of their education. The authors believe that nurse lecturers have a duty of care towards both the student and the patient in preparing them to cope with this experience. End of life care deserves further emphasis within the forum of nurse education. Within this article the authors outline their introduction of a new teaching session at the beginning of the pre-registration nursing curriculum at Birmingham City University to help prepare student nurses from all four fields of nursing to participate in end of life care. This flexible session entitled ‘perceptions of dying’ allows the students to explore their fears, anxieties and expectations of caring for a patient at the end of their life and discusses the mechanisms available for seeking support. The purpose of this article is to raise debate about the teaching of the subject of death and dying within pre-registration nurse education and to show case the lesson concept that the authors believe could be disseminated further to address this student need.     

Incomplete holism in pre-registration nurse education: the position of the biological sciences

There is an ongoing debate in nurse education concerning the role and delivery of the biological sciences in the nursing curriculum. One of the fundamental questions raised by this debate asks how best can teachers impart biological knowledge in a manner that can be readily applied by students and qualified nurses to inform their clinical practice. This paper will include a discussion of some of the features of pre-registration education that may have influenced the manner in which biological sciences are perceived, taught and used by nurses. It will be argued that nursing may have developed a form of incomplete holism and that this may be in part responsible for the challenges that remain to be met within this area of the nursing curriculum. As a response to incomplete holism an innovative approach within pre-registration education will be introduced. This development involves the use of linked teaching sessions which aim to develop the analytical skills necessary to apply physiological knowledge to nursing practice.     

Nurse prescribing: implications for the life sciences in nursing curricula

The development of new roles, over recent years, for health care professionals, has meant that the boundaries between the different occupations are no longer as clear as they were in the past. For example, the reduction in junior doctors' hours in the United Kingdom (UK), has meant that nurses have had the opportunity to expand their practice into a variety of areas which were once exclusively the responsibility of doctors. One area in which nurses (in the UK) have expanded their practice is prescribing. This paper commences with an overview of the development of nurse prescribing and highlights the important role of the life sciences in the education and training of nurse prescribers. The major findings from studies examining the teaching and learning of these sciences in nursing curricula are presented, and the implications for post-qualifying courses enabling nurses to prescribe, and pre-registration nurse education programmes are discussed.     

Nursing education in China: past, present and future

wong f.k.y. & zhao y. (2012) Journal of Nursing Management 20, 38–44
Nursing education in China: past, present and future Aim To describe the development of nursing education in the past, present and future in China. Background The development of nursing education in China is closely tied with the country’s wider context, including the social, political and economic environment. Evaluation The source of information includes published materials accessible to the public and the authors’ knowledge as content experts of the nursing situation in China. Key issues Nursing in China is developing rapidly particularly in the last decade in quantity and quality terms. The education development of nursing is in line with the service development which aims at client-centred care adopting a holistic approach caring for clients at the preventive, curative and rehabilitative levels. Conclusions Nursing education in China, both at the pre-registration and post-registration level, plays a key role in building a strong team of nurses to fulfil the health mission of the country. Implications for nursing management Managers in nursing education need to continuously revise the curriculum to produce nurses who meet societal needs at present and for the future. At the same time, nurse managers in the service need to make best use of these nursing talents according to the nurses’ competence and educational levels.     

The debate in favour of using simulation education in pre-registration adult nursing

The purpose of this paper is to have a fresh look at the literature on the advantages and disadvantages of simulation education as a teaching, learning and assessment methodology within pre-registration nurse education. It will highlight the reasons why simulation education has been re-introduced into nurse education within many Higher Education Institutions (HEI) in the United Kingdom (UK). This is in an attempt to enable the student nurse to develop competence in the clinical skills required for fitness for award, practice and purpose. This comes at a time when the Nursing and Midwifery Council (NMC) are conducting further research on simulation education and whether it can replace practice hours.     

The nature and purpose of the role of the nurse lecturer in practice settings

This paper examines the role of lecturers in nursing in pre-registration education. It focuses on the nature and purpose of the nurse lecturer's contribution in the practice setting, with particular emphasis on the issues surrounding clinical credibility. This is particularly pertinent in the light of current recommendations, which emphasise the importance of clinical learning in pre-registration education programmes. The purpose of the lecturer's role in clinical practice settings is ill defined. This lack of clear consensus regarding the expected outcomes for lecturers (in practice), leads to difficulty outlining what they should do in practice settings. Although lecturers accept that they have an important part to play in maximizing the learning opportunities for students in both university and practice settings, they are less clear about how this should be achieved in the latter. This paper argues that: It is opportune to examine and realign the lecturers contribution in practice settings given that there has been a shift in the responsibility for clinical learning; nurse education is now embedded in the higher education sector and there is a need for a greater emphasis on practice development. Clinical credibility for lecturers is about the development of nursing practice through education which is not always achieved by 'hands on' care. For example, assisting nurses in a ward area to develop expertise in evidence based practice may not involve 'hands on' care giving but does involve being conversant with current research and practice issues. The lecturer's expertise in practice settings is in teaching and facilitating learning, rather than direct care giving. No one common model for practice may be either feasible or desirable. However, it is important that nurse lecturers do not follow a particular approach because the debate about the nurse lecturer's role in practice settings fails to acknowledge the strengths and weaknesses of each model. It is important that the approach is based on sound rationale.     

An investigation into students' performance of invasive and non-invasive procedures on each other in classroom settings

A belief that pre-registration nursing programmes in the United Kingdom were not adequately equipping students with fundamental clinical skills has led to increasing interest in alternative methods for developing students' practical skills, as an adjunct to their placement experiences. Whilst recent literature offers insight into the operational aspects of developing and running clinical skills facilities in higher education institutions, there is limited evidence regarding the types of procedures taught, or the risks and benefits to students practising these procedures on each other. This study therefore sought to identify the current status of peer-practised learning within pre-registration nurse education. A survey approach was adopted and questionnaires were sent to all Higher Education Institutes delivering pre registration nursing and midwifery programmes in the United Kingdom (n=72). Ethical approval was acquired and principles of strict confidentiality were adhered to throughout. Both quantitative and qualitative data were obtained. Quantitative data were analysed using SPSS (version 11.5), and qualitative data were systematically scrutinised for emerging themes. The findings support the notion that peer-practised learning in the classroom setting is a desirable method of teaching and learning core clinical skills from a teacher perspective. However, notable inconsistencies in the range of procedures students are allowed to perform on each other were found. The mechanisms of risk assessment and concept of consent were also found to be decidedly variable.     

Undergraduate psychiatric nursing education at the crossroads in Ireland. The generalist vs. specialist approach: towards a common foundation

This paper provides a critical overview of undergraduate educational preparation for psychiatric nursing and proposes the use of a model, which may equip psychiatric nurses to adapt to current and future directions in psychiatric nursing practice. It contends that mental health nursing is a distinct scope of practice and as such requires specialty undergraduate education. A major difference between educational preparation for psychiatric nursing in the Republic of Ireland and the UK, and distinct from most other developed countries, is the existence of separate, specialized pre-registration programmes that, upon graduation, allow the nurse to register as a psychiatric nurse. In other countries such as, Australia, the integration of pre-registration nurse education into the university sector resulted in the wide-scale adoption of a generalist approach to nurse education. In light of the recent changes in pre-registration nursing education in Ireland, and the integration of nursing into higher-level education, this paper examines the generalist vs. specialist approach to nurse education. It contends that neither the generalist nor the specialist model best serve the nursing profession in preparing safe and competent practitioners. Rather, it argues that the use of a model which incorporates both generalist and specialist perspectives will help to redress the imbalance inherent in both of the existing approaches and promote a sense of unity in the profession without sacrificing the real strengths of specialization. Such a model will also facilitate psychiatric nurses to adapt to current and future directions in psychiatric nursing practice.