Reforms in nursing education across Western Europe: from agenda to practice

Cross-sectional evaluation of pharmaceutical care competences in nurse education: how well do curricula prepare students of different educational levels?

BACKGROUND

Nurses play an important role in interprofessional pharmaceutical care. Curricula related to pharmaceutical care, however, vary a lot. Mapping the presence of pharmaceutical care related domains and competences in nurse educational programs can lead to a better understanding of the extent to which curricula fit expectations of the labour market. The aim of this study was to describe 1) the presence of pharmaceutical care oriented content in nursing curricula at different educational levels and 2) nursing students' perceived readiness to provide nurse pharmaceutical care in practice.

METHODS

A quantitative cross-sectional survey design was used. Nursing schools in 14 European countries offering educational programs for levels 4-7 students were approached between January and April 2021. Through an online survey final year students had to indicate to what extent pharmaceutical care topics were present in their curriculum.

RESULTS

A total of 1807 students participated, of whom 8% had level 4-5, 80% level 6, 12% level 7. Up to 84% of the students indicated that pharmaceutical care content was insufficiently addressed in their curriculum. On average 14% [range 0-30] felt sufficiently prepared to achieve the required pharmaceutical care competences in practice. In level 5 curricula more pharmaceutical care domains were absent compared with other levels.

CONCLUSIONS

Although several pharmaceutical care related courses are present in current curricula of level 4-7 nurses, its embedding should be extended. Too many students perceive an insufficient preparation to achieve pharmaceutical care competences required in practice. Existing gaps in pharmaceutical care should be addressed to offer more thoroughly prepared nurses to the labour market.

Nurse educator education in six European countries: a descriptive study / Ausbildung von Pflegepädagog/-innen in sechs europäischen Ländern – eine deskriptive Studie

Objectives

Information on nurse educator education is scarce. The present study thus aims to provide an overview of the requirements for and standards of nurse educator education in six European countries in order to enable further reflection and promote discourse on the topic. Methods: A descriptive international cross-sectional comparative study was conducted across six European countries. Data were collected via an online questionnaire completed by experts in nurse educator education or in organisations with specialist knowledge about nurse educator preparation (n = 11). The data were analysed, compared, and condensed.

Results

The participating countries differ in terms of their educational requirements and the working environments they provide for nurse educators. Formal nurse educator education is available in three of the six countries. Furthermore, in the countries with formal education for nurse educators, differences exist in terms of the regulation and implementation of the education. The educational requirements of nurse educators in higher education are mostly not specific to nursing and are instead general requirements for professional (tertiary) or higher education.

Conclusions

The analysis reveals heterogeneous regulations, standards, and pathways in the education of nurse educators in the six different counties included in the study. Despite some formal and content-related similarities, no uniform picture of the educational requirements, programmes, or standards was identified. The results of this international comparative research confirm the need for further research that examines whether the education of nurse educators meets the global need both for skilled nurses and for more Europe-wide collaboration in nurse educator education.

Continuing professional development among social- and health-care educators

Future social- and health-care educators will be required to have versatile competence in educating professionals that reflects both the constantly changing health-care environment and delivery of high-quality patient care. Continuing professional development can be defined as a process that aims to increase educators' competence and well-being, along with the effectiveness of an organisation. This study aimed to describe educators' continuing professional development and clarify the contribution of continuing education. The research applied a qualitative approach as only limited information about social- and health-care educators' professional development currently exists.' Data were collected by group interviews of 35 experienced social- and health-care educators from six institutions of higher education and two vocational schools across Finland. An inductive content analysis yielded 39 subcategories, 11 categories and three main categories, namely, educators' approaches for developing professional competence, barriers to continuing education, and educators' continuing education needs. The educators reported that they maintain and develop their competence in versatile ways; for example, continuing professional development takes place through both formal continuing education and informal collaboration at daily work. Regarding barriers to continuing education, the educators most often cited the lack of planning and a lack of resources, for example, scheduling and financial factors. The continuing education needs of social- and health-care educators are highly individual and should not only reflect organisational goals. The fact that this study only included experienced educators can be considered a limitation, as a sample that also included novice educators may have yielded different perceptions of continuing education and professional development. The results of the research can be utilised when designing the continuing professional development of educators at the individual, group or organisational level.

First-year nursing students' collaboration using peer learning during clinical practice education: An observational study

The purpose of this observational study was to describe the collaboration between first-year nursing students using peer learning during their first clinical practice education. In earlier, predominantly interview studies, peer learning has been described as a model with several positive outcomes. However, no studies on how students act in collaboration in a real-life context have been found. The present study observed sixteen arbitrarily paired nursing students (eight pairs) on three to five occasions per pair, in total 164 h from September 2015 to March 2016. Repeated unstructured observations including informal conversations were used. Using qualitative content analysis, one theme 'Involuntary collaboration leads to growth in different competencies' emerged and three categories 'Practising nursing skills and abilities when working together', 'Establishing knowledge by helping each other to understand' and 'Sharing thoughts, feelings, and knowledge and put them into words'. In conclusion, nursing students using peer learning were observed practising several competencies, some of them not so easily elicited according to earlier research as organization, nursing leadership, teaching, and supervision.

Public health nursing education viewed through the lens of superdiversity: a resource for global health

BACKGROUND

Nurses are increasingly confronted with the challenge of globalization and the acceleration of migratory flows. This reality affects the notion of culture and its influence on health-related behaviors. The state of health of the population in the Canton of Geneva, where there is a wide diversity of origins, is characterized by significant differences. The term "superdiversity" is used to describe the increasing complexity in ethnic diversity due to migration and social stratification. Nursing education in Geneva, influenced by the Bologna Process, appears appropriate for superdiverse contexts of care, with the development of dedicated competencies.

AIM

This discussion paper aims to examine the academic curricula implemented in Geneva in the light of the concept of superdiversity.

MAIN TEXT

In Geneva, nursing education and curricula in public health are based on a competence framework for nursing care divided into 7 roles and educational tracks. Bachelor's-level nurses know how to assess a care problem quickly and solve it effectively by setting relevant priorities, and do so based on evidence. The curricula aim to teach nurses to design population and individual interventions in their superdiverse context.

DISCUSSION

Education should enable students to develop their role as health promoters for the well-being of patients and communities, taking into account cultural complexity.

CONCLUSIONS

Superdiverse contexts highlight the role of nurse educators in preparing future generations of public health nurses.

Positioning public nursing colleges in South African higher education: Stakeholders' perspectives

BACKGROUND

 Public nursing colleges (PNCs) are currently redeploying from provincial departments of health to higher education to become part of a unified higher education system in South Africa. As primary producers of nurses, this migration process needs to be managed carefully, with stakeholders having a common understanding of this process.

OBJECTIVES

 This study aimed to explore the stakeholders' perspectives on the positioning of PNCs in higher education.

METHOD

 The study followed a qualitative grounded theory design. Purposive and theoretical sampling were utilised to achieve a sample size of 40 participants, including representatives from the Department of Higher Education and Training; professional associates; nursing educators; student leaders; nursing leaders; and nurses from the healthcare setting. Data were collected through observations, interviews and document analysis.

RESULTS

 It emerged from the study that the integration of PNCs into higher education is a result of the country's political and legal context. A number of policy and legal frameworks emerged as contextual conditions that provided a basis for the change. The integration of PNCs into higher education was conceptualised as a functional shift in the governance of colleges; a political tool to transform nursing education; a means to enhance the quality of college-based nursing programmes, and a vehicle for the greater professionalisation of nursing. Conflicting legislation and funding emerged as two issues of concern.

CONCLUSION

 Integrating PNCs with higher education came about because of political changes and the resolution of the ruling party to improve the quality of graduates produced, who will in turn improve the quality of healthcare service delivery offered.

Nurse professional competence (NPC) assessed among newly graduated nurses in higher educational institutions in Europe

Nursing education will play an important role in further advancing healthcare transformation in the future. The aim of this study was to assess and compare nursing education and self-reported professional competence among nursing students graduating with a bachelor's degree from higher education institutions in Europe. Data were collected using the Nurse Professional Competence Scale including 88 items and eight competence areas. In total, 752 nursing students at 11 higher education institutions in Europe participated in the study, with a response rate of 88.7%. The highest measured mean scores were found in the competence areas ‘Value-based nursing care’ and ‘Medical technical care’ and the lowest were found in ‘Legislation in nursing and safety planning’ and ‘Education and supervision of staff and students’. Nursing students in central Europe scored significantly higher on seven out of the eight competence areas than nursing students in northern and southern Europe. In order to standardize and further develop nursing education in Europe, the assessment of nursing-related competences is of crucial importance.

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.

Experiences and perceptions of the theory-practice gap in nursing in a resource-constrained setting: A qualitative description study

AIM

To describe experiences and perceptions of theory-practice gap in nursing in a resource-constrained setting. Theory-practice gap is extensively discussed and studied in some parts of the world. Interventions to bridge the theory-practice gap have been varied and depend on an understanding of the contextual healthcare environment. Experiences and perceptions of the theory-practice gap in a resource-constrained setting have not been comprehensively described.

DESIGN

A qualitative description methodology was used.

METHODS

Maximum variation sampling based on role in the events of theory-practice gap was used to recruit student nurses, nurse faculty and clinicians from two study sites for focus group discussions. Data were analysed using conventional content analysis.

RESULTS

Five themes were identified: system inadequacies; resource constraints; challenges of the clinical learning environment; clinical placement and supervision; and nurse faculty factors. Systems inadequacy and resource constraints formed the spine of the challenges contributing to the theory-practice gap in the research setting.

Competence areas of health science teachers - A systematic review of quantitative studies

BACKGROUND

In the face of rapid digitalisation and ever-higher educational requirements for healthcare professionals, it is important that health science teachers possess the relevant core competences. The education of health science teachers varies internationally and there is no consensus about the minimum qualifications and experience they require.

OBJECTIVE

The aim of this systematic review was to describe the health science teachers' competences and the factors related to it.

DESIGN

Systematic review of original quantitative studies.

DATA SOURCES

Four databases were selected from which to retrieve original studies: Cinahl (Ebsco), PubMed, Medic, Eri (ProQuest).

REVIEW METHODS

The systematic review used PICOS inclusion criteria. Original peer-reviewed quantitative studies published between 1/2007 and 1/2018 were identified. Screening was conducted by two researchers separately reading the 1885 titles, 600 abstracts, and 63 full-texts that were identified, and then agreed between them. Critical appraisal was performed using the JBI MAStARI evaluation tool. The data was extracted and then analysed narratively.

RESULTS

The core competences of health science teachers include areas of knowledge, skills and attitudes. Health science teachers evaluate their own competence as high. Only in relation to entrepreneurship and leadership knowledge was evaluated to be average. The most common factors influencing competence were teachers' title/position, healthcare experience, research activities, age, academic degree and for which type of organisation they work.

CONCLUSION

It is important to identify the core competencies required by health science teachers in order to train highly competent healthcare professionals. Based on the findings of this systematic review we suggest that teachers should be encouraged to gain university education and actively participate in research, and that younger teachers should have opportunities to practice the relevant teaching skills to build competence.

A systematic review of online learning programs for nurse preceptors

BACKGROUND

Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competency, and enhance problem solving skills. Managing the dual roles of a registered nurse and preceptor poses tremendous challenges to many preceptors. Online learning is recognized as an effective learning approach for enhancing nursing knowledge and skills.

OBJECTIVE

The systematic review aims to review and synthesise the online learning programs for preceptors.

DESIGN

A systematic review was designed based on the Cochrane Handbook for Systematic Reviews of Programs.

DATA SOURCES

Articles published between January 2000 and June 2016 were sought from six electronic databases: CINAHL, Medline OVID, PubMed, Science Direct, Scopus, and Web of Science.

METHODS

All papers were reviewed and quality assessment was performed. Nine studies were finally selected. Data were extracted, organized and analysed using a narrative synthesis.

RESULTS

The review identified five overarching themes: development of the online learning programs for nurse preceptors, major contents of the programs, uniqueness of each program, modes of delivery, and outcomes of the programs.

CONCLUSION

The systematic review provides insightful information on educational programs for preceptors. At this information age, online learning offers accessibility, convenience, flexibility, which could of great advantage for the working adults. In addition, the online platform provides an alternative for preceptors who face challenges of workload, time, and support system. Therefore, it is paramount that continuing education courses need to be integrated with technology, increase the flexibility and responsiveness of the nursing workforce, and offer alternative means to take up courses.

The perspectives of preceptors regarding clinical assessment for undergraduate nursing students

AIM

To explore the perspectives of preceptors about clinical assessment for undergraduate nursing students in transition to practice.

BACKGROUND

The assessment of clinical competence is a complex process due to the diverse nature of nursing practice. As such, nurse preceptors play a crucial role in clinical assessment for nursing students. Although preceptors may enjoy the process of clinical teaching and assessment, they face challenges that need to be addressed to facilitate students' clinical learning and assessment.

METHODS

An exploratory qualitative approach was adopted. A purposive sample of 17 preceptors from two tertiary hospitals in Singapore was recruited to participate in three focus group discussions from March to July 2014.

FINDINGS

Five themes emerged from the data analysis: the need for a valid and reliable clinical assessment tool; meaningful reflection and feedback; varied methods in clinical assessment; high level of commitment and struggles with dual roles and the need to enhance the support system for preceptors.

CONCLUSIONS

There is no doubt that a valid and reliable clinical assessment tool can serve as a guide for preceptors to enhance their clarity in assessment and feedback. It is essential for all stakeholders to be involved in the development of the clinical assessment tool. Workload, time, support system and formal educational programmes for preceptors influenced their preparation and self-confidence.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

The themes that emerged from the focus group discussions could assist in the development of a more reliable and valid clinical assessment tool to evaluate the clinical competence of nursing students in transition to practice. Clinical and educational institutions could collaborate closely to develop an educational programme and a preceptorship handbook, focusing on pedagogical contents for clinical education and assessment.

Tuning Nursing Educational in an Italian academic context

BACKGROUND

The European Union Bologna Process has laid the foundation for a common European competence-based educational framework. In many countries, nursing education is in transition from vocational to higher education, with many diverse systems. The competence-based approach provided by the project Tuning Educational Structures offers a common and coherent framework able to facilitate the implementation of the principles underpinning the Bologna Process reform.

OBJECTIVES

This study aimed to ascertain the relevance that Italian nursing university lecturers attributed to the 40 competences of the Italian version of the nursing Bachelor's and Master's Degrees. These competences were developed through adoption of the Tuning Methodology in the nursing context.

SETTING

The study was conducted in the 4 universities of one region of Italy which offer nursing Bachelor's and Master's Degrees.

PARTICIPANTS

A total of 164 Italian university nursing lecturers.

METHODS

Using a four point scale, a cross sectional survey was conducted from March 2011 to April 2012. Participants evaluated each competence according to its relevance for Bachelor's or Master's Education. Frequency analysis was conducted.

RESULTS

The significance for each competence of Tuning was rated very high by Italian lecturers and appeared to overlap partially with the original European study. In Italy, the most relevant competences for Bachelor's Degree were the skills associated with the use of appropriate interventions, activities and skills in nursing and the skills associated with nursing practice and clinical decision-making. For Master's Degree, leadership, management and team competences were the most important.

CONCLUSIONS

The Tuning Nursing Project was accepted by the Italian lecturers. The competence-based approach was considered by Italian lectures as a support enabling to reflect on the current Italian nursing education cycles of study and to ensure shared visions and common approaches between Italian and European lecturers.

Clinical supervision in primary health care; experiences of district nurses as clinical supervisors - a qualitative study

BACKGROUND

Learning in the clinical environment is an important part of nursing education. Several recent studies focusing on clinical learning have been based on hospital settings. Little is known about primary health care (PHC) as clinical environment where district nurses (DNs) or nurses supervise students. It is important to understand more about opportunities and difficulties in supervising in this area in order to develop PHC as an optimal learning environment for nursing students. The main objective of this study was to gain an understanding of supervisors' experiences of supervising undergraduate students at PHC units.

METHODS

A qualitative research approach was used to collect data and analyse supervisors' experiences. Six focus groups were carried out with 24 supervisors. Focus group data were audio-taped. The data were analysed using an inductive content analysis.

RESULTS

Three themes illustrated supervisors' experiences: abandonment, ambivalence and sharing the holistic approach. Supervisors felt abandoned by their managers, colleagues and nurse teachers from universities. They experienced ambivalence due to simultaneously being supervisors for students and carrying out their daily work with patients. At the same time, they were proud to be DNs and willing to share their unique role to apply a holistic approach and continuity in patient care with students.

CONCLUSION

When supervising students in PHC, social support and communication between supervisors and their colleagues and management as well as nurse teachers need to be taken into consideration both at universities and at primary health care units.

Social accountability and nursing education in South Africa

BACKGROUND

There is global emphasis on transforming health workforce education in support of universal health coverage.

OBJECTIVE

This paper uses a social accountability framework, specifically the World Health Organization's six building blocks for transformative education, to explore key informants' perspectives on nursing education in South Africa.

METHODS

Using a snowballing sampling technique, 44 key informants were selected purposively on the basis of their expertise or knowledge of the research area. Semi-structured interviews were conducted with the key informants after informed consent had been obtained. The interviews were analysed using template analysis.

RESULTS

South Africa has strategic plans on human resources for health and nursing education, training, and practice and has a well-established system of regulation and accreditation of nursing education through the South African Nursing Council (SANC). Key informants criticised the following: the lack of national staffing norms; sub-optimal governance by both the SANC and the Department of Health; outdated curricula that are unresponsive to population and health system needs; lack of preparedness of nurse educators; and the unsuitability of the majority of nursing students. These problems are exacerbated by a perceived lack of prioritisation of nursing, resource constraints in both the nursing education institutions and the health training facilities, and general implementation inertia.

CONCLUSION

Social accountability, which is an essential component of transformative education, necessitates that attention be paid to the issues of governance, responsive curricula, educator preparedness, and appropriate student recruitment and selection.

Identification of nursing competency assessment tools as possibility of their use in nursing education in Slovenia---a systematic literature review

AIMS

The aim of this study was to identify existing tools that purport to measure clinical nursing competence through the use of a systematic literature review to consider the possibilities of using them in nursing education in Slovenia.

DESIGN

A systematic literature review following PRISMA guidelines.

METHODS

The databases that were searched included MEDLINE, Cinahl, Cochrane Library and Science Direct. The search was limited to available full text articles in English, published between 2003 and 2013.

RESULTS

After applying the inclusion and exclusion criteria, seven papers were included. The review indicated the availability of some highly reliable tools that enable assessment of clinical competences in nursing education. At the same time, however, it is still not clear as to what competences nursing students must achieve during their education.

CONCLUSIONS

Our review showed that various tools exist for assessing clinical nursing competences. In addition, for each country it is important to compose an assessment tool, which measures actual clinical nursing competences, and means customized for their needs and based on their national guidelines. Slovenia has three academic faculties and five colleges with a nursing education program. Common standards regarding assessment of nursing competences among them would definitely lead to better practices and success of graduates and subsequently for the professionals in nursing field. What emerges from the literature is the need to move forward, to foster creativity, freedom of thought and originality and for these reasons we have to consider the possibility of developing a model for obtaining universal clinical competencies.

Developing preceptorship through action research: Part 1

Clinical preception in practice plays a significant role in both registered and practical nurse studies. As such, the cooperation between the faculty and working life is important to narrow the theory-practice gap, with emphasis being placed on a student-oriented approach promoting self-direction and lifelong learning. The aim of this project was to develop the preceptorship at five different units within the health-care sector in western Finland by implementing an action research (AR) approach. This article is the first of a two-part article on the project, focusing on a cultural analysis and the development of preception models conducted within the project. The five units participating in the study were the following: a long-term care ward in the community, a ward for people with dementia, a geriatric ward, a medical ward and a surgical ward representing specialised care. The starting point of the study was a cultural analysis, which was made in all the five units to obtain a 'bottom-up' perspective. In each of the five units 3-5 nurses were appointed to become members of the core groups. This meant that all the units would start from the perspective of their own working environment when creating a preception model that would fit into their particular workplace. During this process, the participants received continuous support from the researchers. Several workshops and seminars were also arranged to further support the core groups and staff. The models were implemented and tested during the academic year 2010-2011 followed by an evaluation of the project. The evaluation results will be presented in the second part of the two-part article. The project showed that reflective practice and critical thinking can be improved through an AR approach.

Nursing education reform in South Africa--lessons from a policy analysis study

BACKGROUND

Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013.

OBJECTIVE

We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa.

DESIGN

We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software.

RESULTS

The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa.

CONCLUSIONS

The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which will need to be addressed if important nursing education reforms are to be realised.

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.

The working lives of nurse teachers in mainland China and the United Kingdom: a questionnaire survey

BACKGROUND

Nurse education has undergone considerable changes creating new opportunities and challenges for nurse teachers. Limited comparative research of the working lives of nurse teachers has been reported, thus similarities and differences that may exist are unidentified.

AIM

This paper reports a study of the working lives of nurse teachers in mainland China and the United Kingdom.

DESIGN

A cross-sectional questionnaire survey.

PARTICIPANTS

Census sample of nurse teachers working in four nursing schools in mainland China (n=3) and the United Kingdom (n=1). The overall response rate was 56.8% (China=61, 61.0%, UK=60, 53.1%).

METHODS

Completion of questionnaire specifically developed for the study but comprising six validated tools to collecting data on: job satisfaction, sense of coherence, role conflict and role ambiguity, work empowerment and professional identification. Data on self-reported roles and personal details were also collected. Data were collected between September 2008 and January 2009.

RESULTS

Both samples were satisfied with their jobs overall but reported low levels of satisfaction with promotion. Chinese nurse teachers working full-time reported the lowest level for sense of coherence and professional identification. Nurse teachers working full-time in the United Kingdom reported the highest role conflict score. Sense of coherence and work empowerment were significantly and positively correlated to job satisfaction. Role conflict and role ambiguity were negatively correlated (but not always significantly) to job satisfaction and its facets. For respondents in mainland China, professional identification was significantly and positively correlated with overall job satisfaction and its facets.

CONCLUSIONS

Strategies to improve job satisfaction with promotion opportunities for both samples are indicated. Respondents working full-time in both mainland China and the United Kingdom experienced greater challenges at work than their part-time colleagues.

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.

Stressors of dual-qualification nursing teachers in the ChengDu-ChongQing economic zone of China--a qualitative study

Nursing and teaching are considered risk professions with high levels of stress and burnout. Dual-qualification nursing teachers (DQNT) are nurses who both teach and practise. These nurses face additional stress. This study explored the stressors of DQNT in the Chengdu-Chongqing Economic Zone of China. This qualitative study used in-depth, open-ended interviews. The interview responses were analysed using a grounded theory approach. The participants in this study included 21 DQNT from 5 teaching hospitals in the Chengdu-Chongqing Economic Zone of China. The results indicated that heavy workload, personal safety, inadequate pay, role overload, and poor working environment are stressors of DQNT. Furthermore, Chinese DQNT face violence from patients and students. The study provides a theoretical basis to help DQNT to cope with stress.

The competence and the cooperation of nurse educators

BACKGROUND

The competence of nurse educators and cooperation between nurse educators and nurse leaders and mentors are important in terms of producing high-quality and evidence-based nursing education.

OBJECTIVES

The purpose of this study was to assess the competence of nurse educators based on their own evaluations as well as those of nursing students, educational administrators, nurse leaders and nurse mentors and to describe the cooperation between educators and educational administrators, nurse leaders and nurse mentors.

DESIGN

A descriptive, cross-sectional survey design was used.

SETTING

The research was conducted in educational and clinical nursing settings.

PARTICIPANTS

The nurse educators, students and educational administrators were from polytechnics offering degree programs in nursing, public health nursing, emergency nursing and midwifery. The nurse leaders represented special health care and primary health care. The nurse mentors were nurses working in the medical wards of the university hospitals.

METHODS

The data were collected via email using a structured questionnaire (A Tool for Evaluation of Requirements of Nurse Teacher).

RESULTS

In total 689 responses were received from nurse educators (n=342), nursing students (n=202), educational administrators (n=17), nurse leaders (n=64) and nurse mentors (n=64). The results show that nurse educators rated their competence as being very good. Nursing students and nurse mentors were the most critical in their evaluations. The cooperation between nurse educators and educational administrators and nurse leaders was rated as good but nurse mentors were quite critical.

CONCLUSIONS

To maintain and improve the competence and cooperation of nurse educators, interventions are needed.

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.

Competence areas of nursing students in Europe

The focus of this study is on European nursing education, where there have been several reforms over the last two decades attempting to harmonise curricula and degree structures. One of the most powerful reforms was started by the Bologna Declaration in 1999; since then, significant progress has been made towards achieving the European Higher Education Area (EHEA) and the implementation of the European Qualifications Framework (EQF) in education practice. The Directive of recognition of professional qualifications (2005/36/EC) regulates nursing education. All these strategies aim to harmonise nursing education, but specific competence areas in nursing are still missing within the European Union (EU). The purpose of this review was to seek competence areas for nursing students within the EU as identified in previous studies and other documents. Altogether, 67 competence areas were identified and classified into eight main categories: (1) professional and ethical values and practice, (2) nursing skills and intervention, (3) communication and interpersonal skills, (4) knowledge and cognitive ability, (5) assessment and improving quality in nursing, (6) professional development, (7) leadership, management and teamwork, and (8) research utilisation. In order to obtain a comprehensive concept of competence, more research is needed on nursing students' competence areas across the EU due to the fact that the EU is a common labour market and nurses are educated for the EU as a whole. Nursing is a global profession and nurse competence is central to patient care outcomes, so it is also internationally important that nurses have good competence.

Teaching nursing psychomotor skills in a fundamentals laboratory: a literature review

AIM

The aim of this article is to determine the most effective methods of teaching psychomotor skills.

BACKGROUND

Research has pointed to a gap between nursing practice and nursing education. Due to a number of conditions, nursing students are learning basic skills in laboratories, rather than clinical settings.

METHOD

A literature review was conducted to evaluate studies published since 1995 that compared alternative and traditional methods of teaching skills to novice nursing students.

RESULTS

Of the 13 studies found, most assessed computer-related methods. A few examined alternatives, such as the use of standardized patients, high-fidelity manikins, and a mental-imaging technique.

CONCLUSION

Based on this limited evidence, it appears that teaching methods providing access to online interactive materials were significantly more effective than others.Three studies found that a combination of traditional lecture and demonstration methods plus computer use was more effective than either method alone.

Nurses' research utilization two years after graduation--a national survey of associated individual, organizational, and educational factors

Background

Nurses’ research utilization (RU) as part of evidence-based practice is strongly emphasized in today’s nursing education and clinical practice. The primary aim of RU is to provide high-quality nursing care to patients. Data on newly graduated nurses’ RU are scarce, but a predominance of low use has been reported in recent studies. Factors associated with nurses’ RU have previously been identified among individual and organizational/contextual factors, but there is a lack of knowledge about how these factors, including educational ones, interact with each other and with RU, particularly in nurses during the first years after graduation. The purpose of this study was therefore to identify factors that predict the probability for low RU among registered nurses two years after graduation.

Methods

Data were collected as part of the LANE study (Longitudinal Analysis of Nursing Education), a Swedish national survey of nursing students and registered nurses. Data on nurses’ instrumental, conceptual, and persuasive RU were collected two years after graduation (2007, n = 845), together with data on work contextual factors. Data on individual and educational factors were collected in the first year (2002) and last term of education (2004). Guided by an analytic schedule, bivariate analyses, followed by logistic regression modeling, were applied.

Results

Of the variables associated with RU in the bivariate analyses, six were found to be significantly related to low RU in the final logistic regression model: work in the psychiatric setting, role ambiguity, sufficient staffing, low work challenge, being male, and low student activity.

Conclusions

A number of factors associated with nurses’ low extent of RU two years postgraduation were found, most of them potentially modifiable. These findings illustrate the multitude of factors related to low RU extent and take their interrelationships into account. This knowledge might serve as useful input in planning future studies aiming to improve nurses’, specifically newly graduated nurses’, RU.

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

The higher education reform in Europe known as the "Bologna Process" implies further harmonisation and integration of nursing programmes into the higher education system. This study explores this process in Sweden, where the development of nursing education into an undergraduate programme started in 1977. The aim of this study was to analyse characteristics of the major subject and its relationship to other subject areas, such as medical sciences and social sciences, in Bachelor level nursing programmes in Sweden following initial implementation of the Bologna process. A constructivist approach and descriptive content analysis were employed to analyse the 2008 nursing curricula and syllabi of 27 undergraduate programmes at 26 Swedish universities and university colleges. The results revealed variation in terms and concepts used for the major subject as well as its scientific foundation, demarcation between the major subject and other subjects included in the study programmes and its relationship to the profession. These variations are linked to the variety of research orientations under debate in the Scandinavian countries: Nursing Science and Caring Science; representing different knowledge domains, focus, challenges and visions for the discipline. Potential implications of basing curricula on a major subject other than Nursing Science in a Bachelor level nursing programme are highlighted.

An exploration of the clinical learning experience of nursing students in nine European countries

The overall aim of the study was to develop a composite and comparative view of what factors enhance the learning experiences of student nurses whilst they are in clinical practice. The study involved students undertaking general nurse training programmes in nine Western European countries. The study focused on: (1) student nurse experiences of clinical learning environments, (2) the supervision provided by qualified nurses in clinical placements, and (3) the level of interaction between student and nurse teachers. The study utilised a validated theoretical model: the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale. The evaluation scale has a number of sub-dimensions: Pedagogical atmosphere on the ward; Supervisory Relationships; the Leadership Style of Ward Managers; Premises of Nursing; and the Role of the Nurse Teacher. Data (N=1903) was collected from Cyprus, Belgium, England, Finland, Ireland, Italy, Netherlands, Spain and Sweden using web-based questionnaire 2007-2008. The findings revealed that respondents were generally satisfied with their clinical placements. There was clear support for the mentorship approach; 57% of respondents had a successful mentorship experience although some 18% of respondents experienced unsuccessful supervision. The most satisfied students studied at a university college, and had at least a seven week clinical placement supported by individualised mentorship relationships. Learning to become a nurse is a multidimensional process that requires both significant time being spent working with patients and a supportive supervisory relationship.

Nursing education in Denmark, Finland, Norway and Sweden - from Bachelor's degree to PhD

AIM

This paper is a discussion of the similarities and differences in baccalaureate nursing education programme structures, content and pathways to postbaccalaureate education in the Scandinavian countries.

BACKGROUND

For the last three decades nursing education internationally, as well as in the Scandinavian countries, has experienced ongoing reforms. The driving forces behind these reforms have been efforts for professional development within nursing and to harmonize higher education in several European countries.

DATA SOURCES

The data were collected by a critical review of the guiding principles, national directives and educational structures and content of Bachelor's degree programmes from 1990 to 2008 and of further educational levels in the four Scandinavian countries.

DISCUSSION

There are similarities as well as substantial differences in the educational structures, contents and lengths in the different nursing programmes. Nursing education is organized in the three cycles described in the Bologna Process, but there are differences regarding names and terms for degrees and allocation of European Credit Transfer System credits.

IMPLICATIONS FOR NURSING

Policymakers need to consider more carefully the directives in the Bologna Declaration when planning and implementing nursing programmes at Bachelor's and postgraduate levels. Knowledge of the content and structure of nursing education in these countries may enhance development and cooperation between institutions.

CONCLUSION

A challenge for the ministries of education in the Scandinavian countries is to compare and coordinate nursing educational programmes in order to enable nursing students, educators, researchers and nurses to study and work in Scandinavia, Europe or even globally.

Master's level in primary health care education - students' and preceptors' perceptions and experiences of the alteration in the clinical areas

BACKGROUND

Many Western European countries are undergoing reforms with changes in higher education according to the Bologna declaration for Higher European Education Area. In accordance with these changes, the Master's degree was introduced in specialist nurse education in Sweden in 2007, and as a result changed the curriculum and modified theoretical and clinical areas. The aim of this study was to investigate students' and preceptors' perceptions and experiences of Master's level education in primary health care with a focus on the clinical area.

METHODS

A descriptive design and qualitative approach was used. Interviews with ten students and ten preceptors were performed twice, before and after the clinical practice period. Interviews were audio-recorded, transcribed verbatim and themes formulated.

RESULTS

Students perceived alteration in the content of the education at the Master's level such as more independence and additional assignments. The preceptors perceived benefits with the Master's level but were unsure of how to transform theoretical and abstract knowledge into practice. Writing the Master's thesis was seen by students to take time away from clinical practice. For some students and preceptors the content of the Master's level clinical practice area was experienced as vague and indistinct. The students had not expected supervision to be different from earlier experiences, while preceptors felt higher demands and requested more knowledge. Both students and preceptors perceived that education at the Master's level might lead to a higher status for the nurses' profession in primary health care.

CONCLUSIONS

Students and preceptors experienced both advantages and disadvantages concerning the change in specialist nurse education in primary health care at the Master's level. The altered educational content was experienced as a step forward, but they also questioned how the new knowledge could be used in practice. The relevance of the Master's thesis was questioned. Supervision was seen by students as an introduction to the work of the district nurses' work. Preceptors perceived high demands and did not feel enough qualified for student supervision. Both groups considered it an advantage with the change in education that could result in higher status for nurses working in primary health care.

'They don't know much about us': educational reform impacts on students' learning in the clinical environment

Placements are an integral component of the medical, nursing, and allied health curriculum. Literature on problem-based learning indicates that curriculum change can impact student experience. However, outside of the nursing literature, there is little research on the impact of education reform on students' experiences of placements. This paper reports on medical, midwifery and paramedic students' perception of the impact of education reform they experienced in the clinical setting. A qualitative study using a semi-structured schedule was conducted. Data was collected using focus groups (17), individual interviews (48) and written responses (2) from undergraduate students (103) and graduates (27) from a tertiary institution in Victoria, Australia. Recorded interviews were analysed, coded and categorised into themes. Whilst students indicated they were prepared for the impact of educational reform on their placement experience, they perceived that clinical educators responsible for teaching them were less prepared. Three themes were identified from the data: clinical educator's lack of familiarity with new curriculum, clinical educator's negative attitudes to curricular change and looking to the future. Our study advances the understanding of the implications of education reform during the clinical placement of medical, midwifery, and paramedic students. Whilst important lessons can be learned from the medical and nursing literature this study highlights that staff responsible for curriculum change need to action change management process to ensure that the clinical educators are able to deliver the revised program.

Job satisfaction of nurse teachers: a literature review. Part I: Measurement, levels and components

Job satisfaction among nurses is of concern throughout the world but the satisfaction of nurse teachers has received less attention and no review of global research on the topic has been published. A comprehensive literature review (1976-2007) was undertaken from an international perspective (n=26 papers and 4 doctoral abstracts) to examine the state of knowledge about nurse teachers' job satisfaction over time. Coverage over the last 30 years was selected to examine if the level and contributing factors to nurse teachers' job satisfaction have changed during a time which has seen considerable developments and reorganization of nurse education as well as the role of nurse teachers. The purpose of this Part I paper is to: (i) review the different measurements of job satisfaction, (ii) report the job satisfaction levels of nurse teachers and, (iii) identify the components of job satisfaction of nurse teachers. This paper provides the foundation for the Part II paper which reviews the literature regarding the effects and related factors of nurse teachers' job satisfaction.

Nurses' shop stewards and their collaboration with management

PURPOSE

This study investigates the collaboration between Danish nurses' shop stewai-ds and workplace management. The aim of the study is to track changes in workplace climate after a major structural reform of the health sector.

DESIGN/METHODOLOGY/APPROACH

The data source for the study is a comprehensive survey among union representatives in the health and care sectors.

FINDINGS

Generally, and not surprisingly, shops stewards maintain closer relations and a higher degree of loyalty to the nearest managers rather than management at higher levels in the hierarchy. It can also be demonstrated that more experienced shop stewards, those who have been employed in this position and in the workplace for the longest terms have more affirmative relations to management than less experienced shop stewards with shorter tenure. Those shop stewards who spend much time on the entitled duties are rewarded with positive collaboration with management. Hard times at the workplace and dissatisfied colleagues, who do not support their union representative, often result in less rewarding relations with management. Quite unexpectedly, the intensity of relations with management is not significantly related to structural or other changes that the workplace has experienced over the past two years. Changes are therefore accepted as inevitable and regular occurrences in the health sector.

RESEARCH LIMITATIONS/IMPLICATIONS

The response rate is very high in the survey. Further qualitative research may reveal details about the background and implications. PRACTICAL IMPLICATION: The study suggests that many shop stewards may suffer from a competence gap in terms of more advanced new public management strategies and tools. This gap has not yet been successfully filled by the services and training activities offered by the Danish Nurses Union.

ORIGINALITY/VALUE

Results from the study are being taken on board in the union's strategies. The evidence is also helpful for the managers in the health sector, as they are seeking to develop a constructive the collaboration with the unions.

Online multimedia delivery of the European Union directive within adult nursing education

The use of online multimedia content in nurse education is still in its infancy with limited research about its role and acceptance by students and staff within nursing courses. This paper describes the development of interactive web-based delivery for the European Union directive (77/453/EEC) for maternity, child care and mental health within adult nursing education. An evaluative study carried out by an online questionnaire with students, using both structured questions and free text, and a focus group with staff whilst identifying areas for further development found general acceptance of this approach. The study has provided important insights into both the content and delivery of the packs, and the format of the material. The use of IT, with multimedia elements, was seen as being beneficial by both students and staff. The findings will be useful in improving and developing the packs for future cohorts.

A review of nurse educator career pathways; a European perspective

Abstract

In 1999, the Bologna declaration was established to increase standardisation of higher education including nursing education across Europe. This process encourages improved workforce mobility within the European Union as qualifications become increasingly recognised across a number of European countries. This article identifies current intelligence around a specific discipline in nursing: regarding the nurse educator, what is written and known about career pathways, the underlying influences within nurse training and further opportunities for study at the higher academic levels. A study of the literature across European countries together with a focus group workshop of nurse educators held in Udine, Italy, in November 2007 has enabled the authors to review the position and status of nurse educators across a number of European countries and identify factors affecting nurse educator mobility. Common themes and shared concerns have been identified as has recommendations for future research.

The changing face of European healthcare education: the Hungarian experience

Throughout Europe, higher education is undergoing great changes in order to establish what is being called the European Higher Education Area (EHEA) based on the Bologna process. The goal being the establishment of a uniform, transparent and efficient development of professionals in a higher education system that can react in a flexible way to the changes in the labor market, and to the challenges presented by increasing globalization. The aim of this article is to provide an overview of the Bologna process and to give a summary of the implemented initial stages in the health care higher education of Hungary. As a consequence, the Hungarian higher education in healthcare has undergone considerable reforms to facilitate transition into this new system. The results indicate that the new structure in health sciences is not compatible with other way of European countries of introducing Bologna reforms, although the content of the former BSc curriculum still remained the same. MSc programs are still being discussed.

The Bologna process: the quiet revolution in nursing higher education

This paper will trace the history and continuing development of the 'Bologna Process' whose aim is to create convergence of higher education across the European Union by 2010. It will identify how this will have profound implications for graduate nurse education and present opportunities for students, graduate nurses, teachers and researchers in terms of mobility and employment as well as collaborative research. Although supportive, the paper questions whether these reforms will provide the much-needed impetus to raise the educational status of the vast majority of European nurses from diploma to graduate level. Barriers to achieving the ideal of an all-graduate EU nursing workforce are discussed in an economic and political context. The main thrust of the paper is that, if this were achieved, it would have a positive impact on the health care systems and populations of participating countries as well as their economies.

Partnership--success factors of interorganizational relationships

AIM

Key factors of successful interorganizational partnerships are applied to the context of nursing and midwifery education.

BACKGROUND

Reports in nursing education emphasize the need for more collaborative partnerships between the education and healthcare sectors of nursing and midwifery education.

EVALUATION

There is little research examining the implementation of interorganizational relationships particularly in nursing.

KEY ISSUES

Key success factors are grouped into seven areas of trust and valuing the partner, leadership and managing change, a partnership framework, communication and interaction, equity and involvement in decision making, power and the role of partnership coordinator.

CONCLUSION

There is a need for contextual research in relation to implementing partnership in nursing and midwifery.

IMPLICATIONS FOR NURSING MANAGEMENT

Partnership arrangements are essential for quality nursing and midwifery education. This article adds knowledge by way of application of these factors to organizations that provide nursing and midwifery education. Nurse managers have an important role in determining the quality of learning experience within the health service. It is essential, therefore that both nurse managers and nurse educationalist know the key factors which promote successful interoganizational relationships to ensure these factors are manifest in practice.