Impact of the Bologna process in Bachelor nursing programmes: The Swedish case

Comparison of the Iranian and Scandinavian bachelor of nursing curriculum (Sweden): A scoping review

BACKGROUND

The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care.

MATERIALS AND METHODS

The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive-comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases.

RESULTS

The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation.

CONCLUSION

It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.

Self-efficacy beliefs among baccalaureate nursing students - A cross-sectional, comparative study

The aim of this study is to explore baccalaureate nursing students' self-efficacy beliefs related to theoretical coursework. Self-efficacy, i.e., the perception of one's ability to successfully complete a task, has been shown to correlate positively with academic performance and persistence. Nursing students from a large Norwegian university participated (n=132). Data were collected through a digital questionnaire and analyzed using SPSS statistics. Descriptive analysis was performed. Student groups were compared according to gender, age, and year of study using one-way analyses of variance and independent sample t-tests. The findings suggest that the students' self-efficacy beliefs related to theoretical coursework are quite high, with few significant differences between the groups. While the students have confidence in their ability to reach academic goals, self-efficacy when facing stress and distraction is lower. The findings may be of interest to educators striving to optimize learning in baccalaureate nursing programs.

Self-Perceived Competence of Ambulance Nurses in the Care of Patients with Mental Illness: A Questionnaire Survey

Ambulance nurses in prehospital emergency care must assess, treat, and triage patients with mental health issues. This study aimed to investigate the self-perceived competence of ambulance nurses in prehospital emergency care of patients with mental illness. A cross-sectional questionnaire survey was done, a question-index value (Q-IV; range: 0–1.0) was defined as a summary of the proportion of positive responses (%). Correlations of self-perceived competence with education and professional experience were also examined. Overall self-perceived competence was good (mean Q-IV, 0.80). For six of the nine questions, women rated their abilities slightly lower than men. Women rated themselves as fairly good in providing “information about types of effective help available” (Q-IV, 0.55) and in “suggesting tactics for helping a person with mental illness feel better” (Q-IV, 0.56). Men rated their competence as fairly good in “directing patients to appropriate sources of help” (Q-IV, 0.58). Self-perceived competence did not correlate with education level or professional experience. In conclusion, these results indicate that in encounters with patients who have mental illness, ambulance nurses perceive their overall competencies as good, with some sex-based differences in self-perception for specific knowledge areas. Education level and professional experience did not correlate with self-perceived competence.

Complexities in Studying and Practicing Nursing-A Theoretical Elaboration Based on Reflections by Nurses and Nursing Students

The aim of this study was to explore nursing students' and clinically active nurses' experiential ideas about nursing to provide a foundation for a critical reflection on the complexities involved in studying and practicing nursing. Using a participatory approach, 9 experiential ideas about nursing as a subject, nursing practice, and being a nurse were identified and reflected upon with a total of 238 participants. This was followed by a theoretical analysis in relation to the clinical gaze in nursing and epistemology, which ends in an argument for a rediscovery of the broader Aristotelian view of knowledge in nursing education and practice.

Specialist Ambulance Nurses' Perceptions of Nursing: A Phenomenographic Study

Although nursing is the main area of interest in the curriculum of the specialist ambulance nursing program in the advanced level of education, there has been reported a lack of knowledge about nursing in within the ambulance service. The aim was to explore specialist ambulance nurses' perceptions of nursing, which were explored by employing a phenomenographic approach. The study comprises individual interviews with 19 strategically selected specialist ambulance nurses. The results showed seven descriptive categories emerged detailing the variations in how the specialist ambulance nurses perceive, understand, and conceptualize the phenomenon of nursing in the Swedish Ambulance Service. Four categories revealed the specialist ambulance nurses' qualitatively different perceptions of nursing, i.e., their role and responsibility, while three showed perceived barriers to assuming their role and responsibility, comprising culture and leadership, conditions, and framework. The seven categories are outlined in the outcome space. In conclusion, there is a very wide variety of perceptions of ambulance nursing within the Swedish Ambulance Service. There is a need for implement the nursing process both in the Specialist Nursing Pre-hospital Emergency Care education curriculum and within clinical practice. Further, there is a necessity to develop and implement nursing guidelines in the ambulance.

Assessing nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters: A multicentre cross-sectional study

BACKGROUND

Inserting Peripheral Venous Catheters (PVCs) is one of the most routinely performed invasive procedures in nursing care and, if not well managed, it could expose patients to bloodstream-related infections. Knowledge of guidelines for the management of PVCs is fundamental to arise nurses and nursing students (NSs)' awareness on the importance of recommendations' adherence for clinical practice improvement.

OBJECTIVE

To determine NSs' theoretical knowledge of evidence-based guidelines for management of PVCs and investigate potential predictive factors associated to recommendations' adherence.

DESIGN

Cross-sectional.

SETTINGS

The study was carried out (March-September 2015) in seven Universities of three Regions of Italy (Marche, Abruzzo, Emilia Romagna).

PARTICIPANTS

A convenience sample of NSs (n = 1056) was involved.

METHODS

We collected data using a 10-items validated questionnaire assessing: knowledge of NSs' PVC guidelines and socio-demographic characteristics of the sample.

RESULTS

Most participants were female (74.8%), mean age: 22.4 years (DS = 3.9); attending the first, second and third year of Bachelor in Nursing (34.8%; 32.9%; 32.3%, respectively); with at least one year of training experience (32.1%). Most of incorrect answers given by NSs concerned the right way to wash hands before CVPs insertion (33.5%); the replacement of administration set <24 h when neither lipid emulsions nor blood products have been infused (79.7%); the choice of dressing to cover insertion site (59.3%); the use of steel needles to administer drugs (60.9%); the use of antibiotic ointment (68.7%); the correct concentration of chlorhexidine before PVCs' insertion (70.7%). In multivariate analysis, a higher level of education and an increased number of years of training experience and wards attended, were associated with better test scores. "Infusionset removal after 24 h when lipids or blood products are administered" (75.4%).

CONCLUSIONS

NSs' overall level of knowledge to some recommendations is inadequate. Nurse educators should emphasize on the importance of Evidence-based guidelines' knowledge in order to promote the translation of theory into practice of NSs.

Analysis of University Postgraduate Nursing Education in Spain

BACKGROUND

The nursing education program framework in Spain has recently been adapted and modified. This study aimed to analyze university postgraduate master'slevel nursing education during the past 21 years in Spain in terms of educational supply and demand.

METHOD

A retrospective, longitudinal, descriptive, and observational design was used. The educational offerings at 15 university nursing schools in Spain were examined. The target population was 7,871 registered and licensed nurses who had completed postgraduate education.

RESULTS

Among the 211 programs offered, public universities' educational offerings focused on two areas-public health and emergency care-whereas most courses in private universities were in surgery. Regarding demand, 1,235 nurses were enrolled. The most frequently requested educational areas were surgery, emergency and urgent care, and public health.

CONCLUSION

Although the postgraduate nursing education situation has changed, supply and demand for this type of education in Spain are well balanced at both public and private universities. [J Nurs Educ. 2016;55(11):615-622.].

A Comparison of Patient-Centered Care in Pharmacy Curricula in the United States and Europe

Objective. To compare United States and European Higher Education Area (EHEA) undergraduate pharmacy curricula in terms of patient-centered care courses. Methods. Websites from all pharmacy colleges or schools in the United States and the 41 countries in the EHEA were retrieved from the FIP Official World List of Pharmacy Schools and investigated. A random sample of schools was selected and, based on analyses of course descriptions from syllabi, each course was classified into the following categories: social/behavioral/administrative pharmacy sciences, clinical sciences, experiential, or other/basic sciences. Results. Of 147 schools of pharmacy, 59 were included (23 in US and 36 in the EHEA). Differences existed in the percentages of credits/hours in all of the four subject area categories. Conclusion. Institutions in EHEA countries maintain a greater focus on basic sciences and a lower load of clinical sciences in pharmacy curricula compared to the United States. These differences may not be in accordance with international recommendations to educate future pharmacists focused on patient care.

Assessing progression of clinical reasoning through virtual patients: An exploratory study

To avoid test-driven learning, there have been discussions regarding the use of more formative assessments in health care education to promote students' deep learning. Feedback is important in formative assessment, but many students ignore it; therefore, interventions should be introduced which stimulate them to reflect on the new knowledge. The aim for this study was to explore if Virtual Patient (VP)-based formative assessments, in connection with self-evaluations, had an impact on postgraduate pediatric nursing students' development of clinical reasoning abilities. Students' self-evaluations served as the basis for measuring progress. Data was analysed using deductive content analysis. The findings showed a clear progression of the clinical reasoning ability of the students. After the first assessment, the students described feelings of uncertainty and that their knowledge gaps were exposed. At the mid-course assessment the awareness of improved clinical reasoning was obvious and the students were more certain of knowing how to solve the VP cases. In the final assessment, self-efficacy was expressed. VP-based assessments, in connection with self-evaluations, early in the education resulted in a gain of students' own identification of the concept of clinical reasoning, awareness of what to focus on during clinical practice and visualised expected clinical competence.

Nursing education in the European higher education area - variations in implementation

BACKGROUND

The European Higher Education Area (EHEA) aims to ensure comparable, compatible and coherent systems of higher education.

OBJECTIVES

The purpose of this study was to statistically analyze nursing education in Europe. Analysis was based on the quantitative determinants essential in describing the implementation of nursing education. First, nursing education in the 45 member countries of the EHEA was analyzed. Second, nursing education in the 29 original member countries was analyzed in more detail. Both analyses focused on the similarities and differences between nations.

METHODS

A systematic literary review design was used. Data collection was conducted based on key quantitative determinants used to describe the implementation of nursing education. These determinants were based on the European Union standards and recommendations by the EHEA. Data were collected from three sources: research articles, internet databases and emails. The literature was analyzed using deductive content analysis. The data were quantified, studied and compared and the results were described based on frequencies and percentages and presented in tables.

RESULTS

More similarities than differences in nursing education were noted between the different EHEA member countries. A full academic pathway of studying for a bachelor's degree, a master's degree and a doctorate in nursing was offered in 60% of the countries. Nevertheless, there are still countries offering education only on the diploma level, demonstrating that the differences between countries are at points rather significant.

CONCLUSIONS

Based on the analyses, it is evident that there are still rather significant differences between countries and that support for aligning national practices and mobility is needed. A common ground in terminology and evidence-based recommendations published in English would be beneficial for countries currently developing nursing education programs. We also suggest creating an online database containing information on nursing education for all 45 member countries to support the mobility of nursing students, nurses and researchers.

Clinical reasoning in nursing, a think-aloud study using virtual patients - a base for an innovative assessment

In health-care education, it is important to assess the competencies that are essential for the professional role. To develop clinical reasoning skills is crucial for nursing practice and therefore an important learning outcome in nursing education programmes. Virtual patients (VPs) are interactive computer simulations of real-life clinical scenarios and have been suggested for use not only for learning, but also for assessment of clinical reasoning. The aim of this study was to investigate how experienced paediatric nurses reason regarding complex VP cases and how they make clinical decisions. The study was also aimed to give information about possible issues that should be assessed in clinical reasoning exams for post-graduate students in diploma specialist paediatric nursing education. The information from this study is believed to be of high value when developing scoring and grading models for a VP-based examination for the specialist diploma in paediatric nursing education. Using the think-aloud method, data were collected from 30 RNs working in Swedish paediatric departments, and child or school health-care centres. Content analysis was used to analyse the data. The results indicate that experienced nurses try to consolidate their hypotheses by seeing a pattern and judging the value of signs, symptoms, physical examinations, laboratory tests and radiology. They show high specific competence but earlier experience of similar cases was also of importance for the decision making. The nurses thought it was an innovative assessment focusing on clinical reasoning and clinical decision making. They thought it was an enjoyable way to be assessed and that all three main issues could be assessed using VPs. In conclusion, VPs seem to be a possible model for assessing the clinical reasoning process and clinical decision making, but how to score and grade such exams needs further research.

Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: a questionnaire survey

AIM

The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized.

BACKGROUND

The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models.

METHOD

A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire.

RESULTS

In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p<0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship.

CONCLUSION

The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

Bologna Process, More or Less: Nursing Education in the European Economic Area: A Discussion Paper

The Bologna Declaration and the subsequent processes is the single most important reform of higher education taking place in Europe in the last 30 years. Signed in 1999, it includes 46 European Union countries and aimed to create, a more coherent, compatible, comparable and competitive European Higher Education Area. The purpose of this paper is to discuss the Bologna Declaration achievements in nursing education at 2010 within eight countries that first signed the Declaration on 1999. Researchers primarily identified national laws, policy statements, guidelines and grey literature; then, a literature review on Bologna Declaration implementation in nursing was conducted on the Medline and CINAHL databases. Critical analyses of these documents were performed by expert nurse educators. Structural, organizational, functional and cultural obstacles are hindering full Bologna Process implementation in nursing education within European Economic Area. A call for action is offered in order to achieve a functionally unified system within nursing.

Development of Instruments for Assessment of Knowledge and Skills in Performing Venepuncture and Inserting Peripheral Venous Catheters

Purpose

Performing venepuncture is one of the most routinely performed invasive procedures in nursing care. The aim of this study was to develop instruments for the assessment of nursing students' knowledge and skills when performing venepuncture and inserting a peripheral venous catheter.

Methods

Two instruments were developed using the following steps. 1) Assessment items of importance for the procedures (venepuncture 48 items and peripheral venous catheter 51 items) were collected from focus groups including nurses, lecturers and patients. 2) The number of items was reduced using a method based on the Delphi method. Experts (n=51) reviewed the instruments in two rounds. The revised versions included 31 items for venepuncture and 33 items for peripheral venous catheter insertion. 3) Usability tests were conducted by nurses who tested the instruments to confirm that items were possible to assess. 4) Inter-rater reliability was assessed by twelve lecturers who in pairs, but independently of each other, used the instruments to assess 50 nursing students.

Results

Proportion of agreement and Cohen's kappa coefficient were calculated for each item to determine inter-rater reliability. Among the tested items for both instruments, the median proportion of agreement was 1 (range 0.66-1) and the median kappa was 0.52 (range 0.22-1).

Conclusions

The instruments developed for assessing nursing students' knowledge and skills of venepuncture and peripheral venous catheter insertion showed satisfactory inter-rater reliability.

The evolution of midwifery education at the master's level: a study of Swedish midwifery education programmes after the implementation of the Bologna process

In Europe, midwifery education has undergone a number of reforms in the past few decades. In several countries, it has shifted from vocational training to academic education. The higher education reform, known as the "Bologna process" aimed to create convergence in higher education among a number of European countries and enhance opportunities for mobility, employment and collaborative research. It also indicated a transparent and easily compared system of academic degrees, generating a new educational system in three cycles. This study explores the implementation of the process in Sweden when the midwifery education was transferred from diploma to postgraduate or master's level. The aim of this study was to analyse how the implementation of the Bologna process in the Swedish higher education system has impacted midwifery education programmes in the country. Descriptive statistics and content analysis were employed to analyse 32 questionnaire responses from teachers and the 2009-2010 curricula and syllabi of 11 postgraduate midwifery education programmes at Swedish universities and university colleges. The results revealed variations among the universities at the major subject into the three disciplines; midwifery, nursing and caring with different conceptualisations, even when the content was identical in the curricula to that of the midwifery professional knowledge base. Implementation of the new reform not only has accelerated the academisation process, but also puts higher demand on the students and requires higher competencies among teachers to involve more evidence-based knowledge, seminars, independent studies and a postgraduate degree project in the major subject. Thus the students earn not only a diploma in midwifery, but also a master's degree in the major subject, which affords the opportunity for an academic career. But still there is a tension between professional and academic education.

Mastering the professional role as a newly graduated registered nurse

Professional development is a process starting during undergraduate education and continuing throughout working life. A new nurse's transition from school to work has been described as difficult. This study aims to develop a model describing the professional development of new nurses during their first years of work. To develop this model, constant comparative analyses were performed. The method was a qualitative study of survey data on 330 registered nurses. The results showed that mastering the professional role was the result of an ongoing process building on the nurse's experiences and interactions with the surrounding environment. The professional developmental process involves the following interrelated sub-processes: evaluating and re-evaluating educational experiences, developing professional self-efficacy and developing clinical competence. These sub-processes are influenced by the following factors: social values and norms, healthcare organization, management of new nurses, co-workers, patients and significant others and the nurse's own family and friends. These factors affect professional development directly, indirectly or as mediating influences and can lead to possible outcomes, as new nurses choose to remain in or leave the profession. The results underscore the importance of developing a professional nursing role within the new working context. To facilitate this professional development, new nurses need support from their nursing-school educators and their healthcare employers. The model described here will be the subject of further measurement and testing.

Nursing students' experiences of assessment by the Swedish National Clinical Final Examination

The Swedish National Clinical Final Examination (NCFE) was established in 2007 in order to examine nursing students' clinical competence upon completing their Bachelor's degree in nursing. The NCFE constitutes an innovative method of examination, divided into two parts: a written and bedside test. The aim of this study was to evaluate nursing students' experiences of being assessed by means of the NCFE, in order to obtain information that could be used to improve the examination. A survey was conducted using a questionnaire with open-ended questions concerning the written and the bedside part of the NCFE. The answers from 577 third-year nursing students were analysed using content analysis. The nursing students regarded the NCFE as promoting further learning and as an important means of quality assurance. Its comprehensive nature was perceived to tie the education together and contributed to the students' awareness of their own clinical competence. The strengths of the NCFE especially highlighted were its high degree of objectivity and the fact that it took place in a natural setting. However, the students felt that the NCFE did not cover the entire nursing programme and that it caused stress. It thus appears to be important to reconsider the written theoretical part of the examination and to standardise the bedside part.

Nurses' experiences of participation in a research and development programme

AIMS AND OBJECTIVES

To describe clinical nurses' experience of participating in a Research and Development (R&D) programme and its influence on their research interest and ability to conduct and apply nursing research.

BACKGROUND

To stimulate nurses' research interest and to overcome barriers for building research capacity in nursing, there is a need for sustainable research programmes. A two-year programme was designed for nurses, to take part in both an academic education for master and research seminars and workshops to conduct a research project from idea to publication.

DESIGN

A qualitative approach using using focus group interviews.

METHODS

Registered nurses (n=12) with a bachelor's degree in nursing, participated. Data were collected in focus group interviews, after one year and when the programme ended. Content analysis was used to analyse the data.

RESULTS

The findings consist of two themes: being a traveller in the world of nursing research, which included three categories, and experiencing professional growth as a result of nursing research training, in both cases focusing on the experience of students involved in a cohesive programme which included four categories: discovering new dimensions of clinical nursing practice; selected and confirmed; supported by professional others; development of professional self-concept.

CONCLUSIONS

To support early career researchers, there is a need for strong leadership, an organisational and supportive infrastructure underpinning research capability building in nurses. In this context, research strategies, programmes and collaboration between leaders of academia and clinical institutions appear to be essential.

RELEVANCE TO CLINICAL PRACTICE

The R&D programme illustrates an effective way of stimulating nurses' lifelong learning by building the capacity to conduct and apply nursing research in clinical practice. The structure of the programme can be used as a model in other contexts.

The convergence process in European Higher Education and its historical cultural impact on Spanish clinical nursing training

The objective of this study was to promote student reflection on the historical and cultural impact of the implementation of the European Higher Education Area (EHEA) on the nursing practicum course in Spain. The objective was to demonstrate the relevance of a clinical practice diary as a facilitative tool for reflection, metacognition and self-evaluation during the practicum. The theoretical framework for this study was based on the socio-critical and critical thinking and comparative education paradigms. Methodologically, we used reflection and educational, ethnography-based resources.

RESULTS

Theoretical and methodological competencies were perceived as requiring more time and effort (records, nursing process: 29%/35% respectively), whereas the technical skills that related to community work are perceived as involving the least amount of time and effort requiring (13%/10% respectively). The conclusion we have reached is that the primary difficulties in implementing the EHEA are in the cultural transformations that result from the new system of student-centred learning. A clinical practice diary is an effective tool with which to contextualise the nursing practicum and its impact on cultural characteristics, ways of thinking and the reflections of the students. This clinical practice diary facilitates the achievement of competences through the processes of reflection and metacognition.