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Fit for whose purpose? The contextual forces underpinning the provision of nurse education in the UK.

This paper explores the implications of the contextual forces currently underpinning nurse education. It challenges the notion of a model of education which is principally founded on the concept of 'fitness for purpose'. Open acknowledgement is made that the driving forces impacting on the purchasers and providers of nurse education are different, and may be in conflict. The central tenet of this debate is based upon a growing awareness that the notion of practitioners being fit for purpose is increasingly being dictated and articulated by local purchasers. Their views may reflect financial expedience and short-term goals, arguably to the detriment of a longer term vision. Tensions also exist between purchasers' locally driven agendas and the reality that practitioners receive a nationally and internationally recognized qualification. The importance of manpower planning is also central to the debate. Solutions are offered which consider guidelines offered by a range of recent policy documents. Their contribution to the debate is assessed. Recommendations are made which recognize the need to equip practitioners with skills that have currency at point of registration, but argue that dominance must be given to the longer term goals of the educational enterprise.

Curriculum↗

Monkey see, monkey do: a critique of the competency model in graduate medical education.

BACKGROUND: Graduate medical education in the UK is in danger of being subsumed in a minimalist discourse of competency. ARGUMENT: While accepting that competence in a doctor is a sine qua non, the author criticises the construction of a graduate and specialist medical education based solely upon a competency model. Many competency models follow the concepts of either academic competence or operational competence, both of which have lately been subject to criticism. CONCLUSION: The author discusses the need for replacing such criterion-referenced models in favour of a model that engages the higher order competence, performance and understanding which represent professional practice at its best.

Clinical Competence↗

Transformational partnership for delivery of R.N. baccalaureate education: a service/education leadership model.

A transformational partnership model between a consortium of rural community hospitals and a private Christian university reflects a shared vision for R.N. baccalaureate degree completion. The model includes a community-wide system to promote and sustain accessible, high-quality education for the place-bound R.N. who desires to achieve a B.S.N. Stakeholders, experiencing the current climate of change in health care, benefit from this innovative service/education leadership model. The collaboration built on a commitment to common goals and shared resources seeks to prepare individuals who apply critical thinking to practice settings along with the continuum of care.

Christianity↗

Developing internet-based eHealth promotion programs: the Spiral Technology Action Research (STAR) model.

Health education and health promotion have a tradition of using information and communication technology (ICT). In recent years, the rapid growth of the Internet has created innovative opportunities for Web-based health education and behavior change applications-termed eHealth promotion. However, many eHealth promotion applications are developed without an explicit model to guide the design, evaluation, and ongoing improvement of the program. The spiral technology action research (STAR) model was developed to address this need. The model comprises five cycles (listen, plan, do, study, act) that weave together technological development, community involvement, and continuous improvement. The model is illustrated by a case study describing the development of the Smoking Zine (www.SmokingZine.org), a youth smoking prevention and cessation Web site.

Adolescent↗

A model for facilitation in nursing education.

A key step in the development of a model for learning is to identify the needs of both the facilitators and the learners. The purpose of this study was to develop a model for facilitation in nursing education based on the identified needs of facilitators and learners and a confirmation by the literature. A qualitative research design was used and the population of the study was the facilitators and the learners of departments/schools of nursing in four universities in South Africa. Focus group interviews were conducted with facilitators and learners. The sample was purposively selected. The results underline the needs as well as the perceptions of both facilitators and learners with regard to facilitation. Concepts were identified and analyzed from the identified needs which led to the development of the model for facilitation. The complete visual model was described and presented to experts for evaluation. Feedback from the evaluators was used to adapt and finalize the model, after which the model was again presented to evaluators who approved and accepted it. The model is a unique contribution to nursing education as it sets guidelines for a new field of learning in nursing education.

Attitude of Health Personnel↗

Improving dietetics education with interactive communication technology.

Changes occurring in health care, education, and technology are altering dietetics education. A model of learnercentered, cooperative, distance education based on interactive online technology is described for use in a dietetic internship. Evaluation of this model includes review of key-feature exams, results of computer attitudes surveys, use of the technology by interns, exit interviews, and performance on the examination for registered dietitians. In a pilot study of the model with 8 subjects, comfort using the Internet improved significantly. Use of interactive communication technology in dietetics education has the potential to improve competency, technological aptitude, professional partnering skills, and lifelong learning skills.

CD-I↗

New directions in palliative care education.

In the past, palliative care education in the United Kingdom has tended to be patchy and ad hoc, rather that systematic and comprehensive. Recently the picture has begun to change, and this paper identifies and discusses three areas where developments are occurring. Firstly, educational provision has become more comprehensive and systematic, so that the needs of staff in all care settings and at all levels of practice and experience are now being addressed. Secondly, palliative nursing curricula that draw on research into the problems of nurses working with dying patients and the dimensions of the supportive role are now being developed. Thirdly, a number of initiatives are underway to assure the quality of palliative care education. Two of those initiatives concern the preparation, support and evaluation of educational roles and the development of educational research programmes.

Clinical Competence↗

Open learning: the state of the art in nursing and midwifery.

In this paper the authors examine the differences between open and distance learning and describe a framework based on the two dimensions of contiguity and openness to identify four 'ideal type' teaching situations. In the second part of the paper, recent developments in higher education are summarised and the shift towards increased flexibility of education provision is highlighted. Finally, it is argued that alongside the debate about definitions and educational philosophies, there is an urgent need to evaluate the effectiveness of open and distance learning systems. Personal beliefs and assertions about the benefits of open/distance learning need to be replaced by sound evidence.

Education, Nursing↗

In defence of andragogy. Part 2: An educational process consistent with modern nursing's aims.

In 1987 the English National Board (1987) made it clear that it supported a move towards an andragogical approach to nurse education. Recently such moves have been questioned as has the validity of andragogy (Darbyshire 1993). In response to such challenges this paper extends some of the arguments made in the article 'In defence of andragogy' (Milligan 1995). It is argued that andragogy provides a framework within which care and other crucial aspects of the nurse-patient/client relationship can be mirrored and thereby facilitated in future practitioners. In the socialization processes inherent in nurse education, care is surely difficult to teach or facilitate unless the philosophy and methods are consistent with such ends. Furthermore, it is frequently argued that as educationalists we need to be consistent in our approach to students with that which we hope to see in their future practice (Bevis & Murray 1990). Andragogy offers a medium through which this can be facilitated. It is essentially a humanistic educational process that values the individual. The power relationship between the educator and student is much more horizontal than is found in the historically common hierarchical educational relationship. An educational process based upon andragogy therefore mirrors important parts of the nurse-patient/client relationship. It offers a theory of education consistent with the aims of modern day nursing practice. We should seek to improve our understanding of andragogy and no longer conceptualize it as one end of a false dichotomy with pedagogy.

Education, Nursing, Baccalaureate↗

The role of nurse educators in the development of reflective practitioners: a selective case study of the Australian and UK experience.

The potential to improve patient/client care, stimulate the personal and professional growth of the practitioner and help close the theory practice gap has provoked much discussion in the nursing literature on the benefits of reflection on practice. In order to examine recent developments in this area, a study tour, supported by the Florence Nightingale Foundation, was conducted in Australia and the UK during the spring and summer of 1995. Using an illuminative case study approach, data collected demonstrated that although reflective practice was fully endorsed by the nursing profession in Australia, and there were excellent examples of reflective practice in use, the continued growth of the reflective practice movement appeared to be threatened by the rationalization of both clinical and theoretical education in the universities. Issues around methods of encouraging reflection in students focused on ethical use of journals, the levels of reflection developed and the outcome effectiveness of reflective learning. Although it is recommended that the nursing profession continue to endorse developments in reflective practice in the UK, it is also necessary to encourage both process and outcome evaluations of its effects on the development of the individual nurse and on the ensuing quality of health care delivery.

Australia↗

Teaching social justice.

Social justice is a core nursing value and the foundation of public health nursing. Social justice ideology requires nursing students to uphold moral, legal, and humanistic principles related to health. As such, teaching social justice requires a basis in moral developmental theory. In addition, teaching social justice demands action beyond classroom pedagogy. The author describes how social justice is taught within a baccalaureate program. A social justice project is described and examples are provided.

Community Health Planning↗

Critical thinking and learning styles of students in conventional and accelerated programmes.

AIM AND PURPOSE: To assess the difference between the predominant critical thinking disposition(s) and learning styles of nursing students in the conventional (Stream I) and the accelerated (Stream II) baccalaureate nursing education programmes. This study will be beneficial to students, faculty and institutions as it will help them to acquire better understanding of critical thinking potentials and learning styles of nurses, as well as the relationship between learning styles and critical thinking dispositions. METHOD: This was a descriptive correlational study. The convenience sample consisted of 80 Stream I and 50 Stream II students. The following instruments were used for data collection: The Learning Styles Inventory of Kolb and the California Critical Thinking Dispositions Inventory of Facione and Facione. Descriptive and inferential statistics were used to analyse the data. RESULTS: Overall, Stream II students were significantly more critical thinkers (P=0.000), inquisitive (P=0.000) and self-confident (P=0.002). The predominant learning styles of Streams I and II were the diverger and the converger, respectively, with no difference except in relation to their learning abilities, namely, concrete experience (P=0.017), in favour of Stream I. Further, the findings indicate a weak (range of r=0.209-0.328) though significant (range of P=0.017-0.000) correlation between learning abilities and various critical thinking dispositions.

Age Factors↗

[Philosophy of nursing education. Various considerations].

The study has objective to promote a reflection about the importance of philosophy for nurse's formation. For this purpose, we search of questions in the literature that could give foundations about the theme, focusing on the importance for scientific nursing research.

Education, Nursing↗