Nursing education: a descriptive examination of the effects of moving from hospitals to colleges

Twenty years of change. That has been the experience of nurse educators in Ontario. Those years saw programmes shortened by a third, curricula revised significantly, bases moved from hospitals to colleges, faculty unionised and organisational relationshops altered. In Ontario the changes climaxed in the move, in 1973, of the diploma schools of nursing from their hospital bases to post-secondary education system, specifically to the Colleges of Applied Arts and Technology (CAAT). This article examines the developments leading to this move and some of its effects on nursing education and nurse educators. In general the findings indicate that the move brought major pressures on the nursing curriculum, the faculty themselves and the department chairmen.     

The perception of Swedish nurses and nurse teachers of the integration of theory with nursing practice. An explorative qualitative study

Nursing education in Sweden has undergone quite a few changes during the last decade. The aim has been to make nursing more holistic, individualised and health-oriented. Social competence, systematic problem solving and research have also been emphasised. These changes in nursing education have led to new demands on nurse teachers. Nurse teachers, directors of nursing education at three nursing schools and a few nurses were interviewed about the problems they experienced in relation to the new demands. The main problems reported were: 1) students inadequately prepared for nursing education, 2) students' attitudes to the social and health-oriented content of the first course at nursing school, 3) integration of research and nursing, 4) resistance to a more theory-based and nurse teacher-dominated nursing education, 5) integration of nursing theory and nursing practice and 6) incompatible demands on the clinical nurse teacher.     

The ENB pilot schemes. How plans have become reality

After inviting schools of nursing to submit proposals for innovative nurse education programmes incorporating some of the elements of Project 2000, the English National board approved six as pilot schemes. This paper reports on a three-year research project which looked at how the schools tackled the brief and introduced changes to their curriculums. Two of the courses enable students to gain registration and a diploma in nursing studies or nursing science, and one offers a certificate from a university granting exemption from one year of an undergraduate course. Further developments on accreditation, and course units, together with the possible reduction of multiple student intakes to once annually, are issues to be explored further in Project 2000 courses.     

Trends in nursing education since 1976

Since the first issue of MCN was published, many changes have transpired in nursing education on all levels. These trends in nursing education since 1976 are addressed for diploma, associate, baccalaureate, master's, and doctoral programs. Examples of such trends focus on enrollments, graduations, and minority students. Trends to watch for in nursing education over the next quarter century are forecasted along with recommendations for nurse educators.     

中国护理教育规模结构与护理人力需求的研究与思考

目的:了解我国护理起始教育规模结构与社会对护理人力的需求。方法:采用文件查阅和问卷调查法收集护理教育办学信息,全国护士数量和护士执业资格考试等信息,采用咨询法征集有关专家的意见。结果:近年来我国护理起始教育招生规模巨大;教育的层次结构有所改善,大专和本科所占比例明显提高,但中专所占比例仍然过大;医疗单位对护士的需求总量增加,其中对中专生的需求量减少,对大专和本科生的需求量增加;护士人力资源有所改善但仍然短缺;通过执业资格考试的人数远远超过执业护士的增长人数。结论:近年来我国护理教育规模发展迅速,但教育的层次结构与用人单位的需求差距较大,有待改善;各种因素导致护理人力短缺,应予以关注。     

Facilitating transformation through collaboration

The philosophical underpinnings of transformative education were utilized to redesign a course taught to special education majors and nursing students at a rural southeastern university. The main goal when restructuring the class was to develop a course that would encourage communication and collaboration between education and nursing majors within the school community. The current course, "Health Care Perspectives of Exceptional Students," focuses on specific health care topics, with nurse faculty presenting the health care aspects and education faculty discussing educational implications for the classroom teacher. Every class includes dialogue and activities that require interaction. The last two classes are devoted to first-aid training and CPR certification. During the evaluation phase of the course, both education and nursing majors responded positively to the question of whether or not medically fragile children belong in the classroom. Furthermore, they saw the need for communication and collaboration between the classroom teacher and the school nurse as essential for effectively serving the medically fragile child in the school setting.     

The relevance of associate degree nursing education: past,present, future

Associate degree nursing education remains a relevant choice for students entering the nursing profession. Since its introduction fifty years ago, associate degree nursing education has had a significant impact on the registered nursing population in the United States. The climate for a new type of nurse was created by a nursing shortage, the growth of community and junior colleges, and government and consumer interest. Evaluation of initial programs revealed that desired outcomes were met. A proliferation of associate degree nursing programs followed with there currently being more than 800 associate degree nursing programs in the nation. Controversy regarding associate degree nursing as an entry level for registered nurses has been evolving since its inception. Issues related to technical nursing versus professional nursing titles and roles, and differentiated roles have been divisive for the nursing profession. Current demographics reveal that associate degree nursing continues to make a positive impact on the registered nurse population, providing almost 60% of entry level graduates each year, and attracting a greater percentage of minority groups and males. Associate degree nursing representatives should be involved in defining the future of nursing. Societal needs for health care and individual rights for access to education should be considered. Collaborative efforts among the nursing organizations are essential to promoting recruitment and retention efforts.     

Postdiploma nursing education: after the year 2000

The emergence of new health care needs related to changing demographics, financial restraints on health care, and increased rates of chronic illness has contributed to the need for nurses with a range of highly specialized skills. Yet traditional education programs for nurses have focused on diploma level preparation for bedside staff positions. This study explores the assessments of 714 clinical nurses with diploma level preparation and 56 nurse managers about the need for postdiploma nursing education. The results reveal a preference for clinically focused university education over noncredit coursework or a generic degree program. Nurses and their managers agree on the necessity for opportunities for more preparation in gerontology and palliative care, as well as the need for all practicing nurses to learn many skills cutting across clinical areas including clinical decision-making, communication, and leadership. Strategies for assisting nurses to access university education including innovative distance education methods are discussed.     

The change from general nurse education to a nursing diploma in Papua New Guinea

Papua New Guinea has started to change from a hospital based general nurse training to a competency based, university linked, diploma of nursing training program. This paper looks at the development of nurse education in Papua New Guinea. It also briefly outlines the present and proposed courses. The expected benefits and anticipated problems are then discussed and the paper ends with challenges being faced by those involved in nurse education.     

Impact of debt on nursing students in higher education

This article examines some of the financial problems faced by nursing students in higher education and outlines current debates among politicians and educational institutions. It includes a discussion of nurse education in the four countries of the U.K., the effects of offering diploma and degree courses, attrition rates, bursaries, job security, potential problems caused by an ongoing crisis of funding in the NHS and its effects on the future of nursing.     

Irish diploma in nursing students' first clinical allocation: the views of nurse managers

AIM OF THE STUDY: To ascertain the views held by some Irish general nurse managers of the Diploma in Nursing students' first clinical allocation. RATIONALE: Until 1994, nurses in Ireland were trained under a 3-year apprenticeship system and were employed throughout their clinical experience. In March 1997, the first intake of Diploma in Nursing students into one Dublin university were scheduled to commence their clinical placements. As this was the first time that supernumerary students were to be placed in the clinical areas, it was important to discover how effective the whole process was in terms of nurse managers' experiences. RESEARCH METHODS: A grounded-theory approach, using unstructured interviews, explored Irish nurse managers' views of the impact of supernumerary students in the workplace. Ethical approval was granted. All available nurse managers in three general teaching hospitals linked with the university agreed to take part (n = 10). RESULTS: Three themes emerged from the data, entitled 'Structure', 'Students' and 'Support'. In general, the managers believed that staff had had sufficient preparation for this change and that the whole process had been well handled. The respondents were pleasantly surprised by the students' abilities and interest in nursing. Minor problems were dealt with successfully at the local level and the support received by the students was found to be excellent. DISCUSSION: Preconceptions of the students as more intellectual and less able for practical nursing were found to be untenable. The students' presence was welcomed and their questioning attitude, enthusiasm and application of knowledge was praised. Strong clinical support was required and students benefited from giving care, rather than just observing care given. CONCLUSION: It is recommended that supernumerary students should be encouraged to give full care under supervision, in order to learn and to become proficient in all clinical skills. The next phase of change, transition to degree status for students from 2002, will benefit from lessons learned in the past 7 years since transition from certificate to diploma education.     

Does the baccalaureate make a difference?: Differentiating nurse performance by education and experience

The nursing profession continues to debate the question of whether level of education matters in performance once the nurse is oriented to a particular setting, or whether the assumed advantages of baccalaureate education can be substituted by on-the-job experience. In this study, nurses with a baccalaureate degree demonstrated more nursing competencies when compared with their associate degree or diploma colleagues. Results also suggest that education promotes a broader range of abilities than does experience.     

Education of children's nurses in Ireland: an update

The first teaching hospital for sick children in Great Britain and Ireland opened in Dublin in 1821. From then, the development of sick children's nursing in Ireland followed a similar path to that in many other countries until a national report in 2000 recognised that post-registration pathways alone were unlikely to meet future health service needs for suitably qualified and flexible children's nurses. In 2006, a four-and-a-half-year integrated children's and general nursing pre-registration degree programme started on four sites. At the same time, the existing 18-month post-registration course was replaced with an accelerated one-year diploma programme. The full integration of children's nursing into third level at both pre- and post-registration level was a welcome development in Ireland. Further work is under way to address the remaining educational challenges: post-graduate and doctoral programmes, preparation of advanced nurse practitioners and continuing professional education for qualified children's nurses.     

Integrating Informatics into the Graduate Community Health Nursing Curriculum

Abstract Advanced practice of community health nursing is enhanced if the nurse is able to identify, create, and use databases to support nursing assessments of communities and to manage and evaluate community health programs. The College of Nursing, Rutgers, The State University of New Jersey, has revised its curriculum for community health nursing graduate students to include a strong focus on nursing informatics. This paper summarizes the integration of theoretical content and practice exercises into a pre-course workshop and four-course sequence. A focal point of this effort has been the "Healthy People 2000 Nursing Informatics Project," in which students develop an automated community-assessment tool and database related to the Year 2000 objectives. The use of this database and related national, state, and local databases to document community needs is emphasized. Students also evaluate nursing information systems and use information technologies to design and evaluate community health grant proposals. Curriculum development, evaluation, and modification are detailed in relation to student learning needs, faculty preparation, and equipment and consultation requirements.     

‘Levels’ of attainment in nursing practice: reality or illusion?

In earlier research based on an analysis of course documentation, it had been found that there was little consensus among nurse educators concerning the parameters which distinguish levels of practice skills, particularly those which differentiate diploma and degree qualifications in the United Kingdom. This result was confirmed and strengthened in the current study. Lecturers in nursing, when presented with a sorting task using 40 statements derived from course documentation selected from the earlier study, were unable to distinguish statements describing diploma level from those describing degree level practice. Possible reasons for the difficulty are discussed. It is concluded that the attempt to represent practice skill in a hierarchy of assessment for degree or diploma qualifications is premature since the parameters of practice remain unreliably specified.     

The technical competence of registered nurses in the administration of oral medications

An individual who desires to become a registered nurse (RN) may choose from three types of education: associate degree, diploma, and baccalaureate degree programs. The dilemma of this decision is heightened by the strong disagreement within the nursing profession regarding which of the three modes best prepares a nurse to become a competent practitioner. The purpose of this study was to examine variables which might explain variance in the technical competence of RNs as evidenced by skill in administering oral medications. Six variables were investigated as possible predictors of the variance in oral medication administration procedure, i.e., basic nursing education, drug knowledge, age, previous RN experience, previous nursing experience, and highest nursing education completed. Sixty volunteer RNs in a Baltimore community hospital (252 beds) were observed twice each as they administered two oral medications to a patient. A Technical Competence Tool (TCT) was used to record performance of the 16 critical behaviors deemed essential for safe and accurate drug administration. The total scores from observation one and two were summed to obtain a total competence score. Each nurse also completed a 14-item Drug Knowledge Profile (DKP) and Demographic Data Sheet (DDS). Although there was a wide range of total competence scores, only three percent of the variance was explained by the six predictor variables. It was concluded that the selected variables were not significant predictors of the technical competence of RNs in the administration of oral medications.(ABSTRACT TRUNCATED AT 250 WORDS)     

Incorporating a service improvement project into an undergraduate nursing programme: A pilot study

Although service improvement projects have been incorporated into some postregistration nurse education modules in the UK, they have not been generally available to pre‐registration students. This paper reports on the implementation and evaluation of a pilot project in pre‐registration nurse education at one university in eastern England. It concludes that the nursing students found the project to be a useful addition to their course. Supportive reactions were obtained from nurse managers, mentors and academics. A need to improve communication with clinical areas through the use of web‐based materials was highlighted.     

The integration of nursing and midwifery education within higher education: implications for teachers — a qualitative research study

This study was a qualitative narrative that reviewed the historical developments that led to the integration of nursing and midwifery education with higher education in the United Kingdom (UK). A sample of teachers was investigated with particular reference to role conflicts they may have experienced as a result of integration. In addition to this the views of established academic university staff were assessed. The methodology adopted for the research was an eclectic qualitative one, drawing on several approaches, and sought to enquire into individuals personal perception of these events. In this paper the progression of events, nationally and locally, that led to the educational reforms in nursing and midwifery in the 1990s are examined. This narration includes a brief history of the creation of a new university department. Following this there is detail of how data were collected and analysed from a teacher population within this new department. The findings, whilst difficult to generalize to the wider population of nurse and midwife teachers, demonstrate that the sample of teachers examined, all of whom have been involved in the process of integration, have been exposed to stress that has resulted in role conflict. Established university staff, however, were more objective, expressing some broad anxieties regarding the resource demands and research capability of the new department.     

A path model of factors influencing the academic performance of nursing students

AIMS: The aim of this study was to build and test a model describing some of the psychological processes underlying nursing students' academic performance. The model hypothesized that age and entry qualifications influence students' academic motivation (locus of control, academic worries, self-efficacy, and expectations), and that this in turn affects their decisions to seek support, which subsequently influences their academic performance. RATIONALE AND BACKGROUND: A literature search showed that previous academic motivation research is piecemeal. The present work sought to integrate previous findings into a coherent framework as a way of advancing our understanding of the complex interactive nature of the factors influencing student performance. METHOD: Path analysis was performed on data obtained from questionnaires and university records for 315 students undertaking a preregistration diploma course in nursing at a university in the Northwest of England. RESULTS: Support-seeking was more predictive of student performance than entry qualifications. Support-seeking also mediated the age-performance relationship: greater willingness to seek support led to the better academic performance of older students. Other features of the accepted model suggested that students who judged their self-efficacy to be higher expected higher grades and that these highly optimistic expectations led to less support-seeking. Academic worries and internal control beliefs were also found to have positive influences on support-seeking. The model developed accounted for 24% of the variance in students' academic performance. DISCUSSION: Implications for nurse education, and interventions that focus on improving students' academic motivation are discussed in the context of the 'personal teacher' support framework.