An interpersonal-epistemological curriculum model for nurse education

This paper proposes a curriculum model for nurse education which holds forms of knowledge and interpersonal relationships as key issues if nurse education is to develop autonomous, reflective, critical practitioners. By adopting areas of cognitive interest, principles of andragogy and the concept of reflection-in-action, the model provides a heuristic tool which attempts to enable the provision of a nurse education which is devoted to adult learning processes and relevant to the development of education in the practice setting. The technical, practical and emancipatory areas of cognitive interest provide an understanding of learning domains which require different knowledge bases, methods of learning and forms of assessment to each other. The pedagogy/andragogy dichotomy is presented to reflect two teaching paradigms. The former approach is derived from the activity of teaching children and provides for passive dependence. The latter is more appropriate to adult learning and student self-direction. The model attempts to promote the transitional dynamic which moves the student nurse toward a state of greater self-direction. Finally, the concept of reflection-in-action is discussed in an attempt to ensure that the areas of cognitive interest and the learning strategies are inextricably linked to the practice component of a professional nurse education. All three dimensions are combined to show how each should develop in unison as the professional education of the nurse proceeds along a chronological dimension.     

Prilocaine 3% is superior to a mixture of bupivacaine and lignocaine for peribulbar anaesthesia

We have compared motor block of the extraocular muscles produced by injections of 3% prilocaine and a mixture of equal parts of 2% lignocaine and 0.75% bupivacaine into the medial compartment of the orbit. A volume of 8 ml was used initially, and a vasoconstrictor and hyaluronidase were added to both solutions. Ninety patients undergoing cataract surgery were allocated randomly to one of two groups in double- blind study. Eight minutes after block insertion, the median ocular movement score in the prilocaine group was 1 and in the lignocaine- bupivacaine group 3. This difference was statistically significant (P = 0.016). Twenty of the patients who received prilocaine and 29 of the patients who received the lignocaine-bupivacaine mixture required an additional inferotemporal injection. This difference was not statistically significant (P = 0.094).      

Issues and challenges of curriculum reform to competency‐based curricula in Africa: A meta‐synthesis

Although in recent decades reforms to undergraduate nursing and midwifery education have increasingly been guided by the concept of competency‐based curriculum in a drive to produce competent graduates in the African context, the topic remains poorly researched in‐depth. The related issues and challenges need to be explored in the interest of evidence‐based practice. This article stems from a systematic review of qualitative literature on the design and implementation of competency‐based curriculum. Data was inductively analyzed using constant comparison. The two categories that emerged were: (i) the need for a paradigm shift to competency‐based curriculum; and (ii) the associated issues and challenges, such as a shift from informative to transformative learning, lack or limited of involvement of key stakeholders in curriculum development, focus on hospital‐oriented education, lack of preparation of educators, and inappropriate resources. While ongoing reform of nursing and midwifery education continues, much still needs to be done – in particular, extensive financial investment to increase the capacity of educators, mentors and infrastructure, and the development of collaborative frameworks between nursing and midwifery and higher educational councils.