perspective of nursing education

Perspective of Nursing

educationBy:- firoz qureshiDept. psychiatric

nursing

Perspective of Nursing education

• It is our prime responsibility to upgrade our profession, education is an important tool which is needed for the up gradation of our profession.

• It deals with education, nursing education, history of development of nursing education at national level & global level.

Introduction cont..

• Education ;• “Education is the all -round drawing the best

in child & man – body – mind and spirit”.(M.K. Gandhi)

Nursing Education

• Nursing education is the professional education for the preparation of nurses to enable them to render professional nursing care to people of all ages, in all phases of health & illnesses, in a variety of settings

A brief history of Nursing education

• Nursing education world wide (global)• European schools of nursing;• -Early nurses did not receive formal training

specifically designed to prepare them to care for the sick.

• -The school of kaiserwerth was one of the programs which was established to train women to care for the sick and poor.

European schools of nursing cont..

• -The La source program was founded in 1859 to prepare lay women to care for sick in their homes. The theory consisted of one hour class held daily for five months. For a total of 120 hrs. The students studied anatomy, Physiology, hygiene, pathology, and nursing procedures.

European schools of nursing cont..

• -At the completion of program the student was given an oral exam. The students wore no uniforms & were not called nurses.

• -The La source program later develops into 3 year program.

• Students became regular students and completed the three year program.

The Nightingale School For Nurses

• Advocated nursing as both an art and science.• Strongly believed that the focus of the training

school should be nursing education rather than nursing service.

• Nightingale firmly believed that nursing was a profession based on fundamental principles.

• She wanted nurse to be educated in a program of systematic instruction., which included both theory & practical.

The Nightingale School For Nurses cont..

• Curriculum should be flexible and stress compassion & empathy for the patient.

• St. Thomas hospital was selected for the clinical learning experiences.

• The Nightingale school is considered the first ”modern” school of nursing and the beginning of nursing as an organized profession.

• The program was one year in length.• Evaluation & testing was done by school matron.

The Nightingale School For Nurses cont..

• Graduate of the nightingale school were later head nurses in Scotland, Germany, Norway, Sweden, Canada, the united states, south Africa, India and Australia.

Early Nursing Education In United States

• During the first part of 19th century, the only organized preparation of nurses was in catholic sisterhoods.

• In 1839 the nurse society of Philadelphia under the direction of Dr. Joseph, organized a school of nursing which was patent after the work of Elizabeth fry in Ingland.

• Dr. Mary Zakrzewska, a obstetrician attempted to establish a training school at the new inland hospital for women & children in Boston, Massachussetts, in 1861.

Early programs

• Three schools- • Bellevue hospital training school in new york,• Massachusetts hospital training school in Boston,• and the connecticut training school in new

heaven were opened in America during 1873.• The school greatly influenced the development

of nursing education.

The Development of Nursing

• In 1879 there were 11 training schools in united states

• The rapid expansion of scientific medicine necessitated more hospitals and thus more nurses.

Early Trends: In 1895 the American society of superintendents of training school of nurses was organized.

Early Trends cont..

• This group was concerned with improvement of curricula and standard of admission.

• In 1912 the association changed its name to the national league of nursing education.

• In 1917 a standard curriculum for schools of nursing was published which outlined the curriculum for a three year course.

• In 1907 the American hospital association determined there were three classification of nurses-

Early Trends cont..

• 1) administrators & educators.• 2) bed side nurses• 3) attendant of subsidiary nurse

The Winslow Goldmark Report

• When world war began more nurses were needed. Many schools of nursing waived their admission in order to recruit as many students as possible.

• The Rockefeller foundation became interested in health care & decided to fund the committee.

•

The Winslow Goldmark Report cont..

• For the study of nursing education Dr. C.A. Winslow an expert in public health was the chairman of committee, but his secretary Josephine gold mark was responsible for study.

• In 1923 a committee made a number of recommendations which had great influence on the development of nursing education.

The Winslow Goldmark Report cont..

• The committee recommended that nursing school affiliate with a college or university and that schools should be funded.

The committee on the grading of schools of nursing

• In 1925 another committee was developed to continue the study done by Winslow and gold mark.

• Representatives of the national league of nursing education, the American Nurses association the national organization for public health nursing, the American medical association and American hospital Association comprised the committee on the grading of schools of nursing.

The committee on the grading of schools of nursing cont..

• The committee was given the tasks of studying the supply and demand of nurses, analyzing nursing practice & education & grading the nursing schools. The study took over 7 years.

• The findings of the committee was indicated that nursing education was inadequate to prepare nurses.

• The study led to reform in nursing education.

The Brown Report• In 1944 a postwar planning group, the national planning

committee was established to develop professional objectives and determine the areas which required study & research.

• In 1947 Dr. Ester Lucile brown social scientist undertook a study of schools of nursing.

• The study recommended that all existing schools of nursing in the country form affiliations with universities & the schools of nursing should have their own budgets.

The Brown Report cont..

• It focuses on educational preparation for nurses, periodic reexamination of nursing schools to ensure quality education

Federal Funding

• Florescence Nightingale had stated that nursing school should be responsible to the public for the quality of work of their graduates. The standards of nursing education were greatly improved across the country, because in order to obtain federal moneies, schools had to meet the requirements developed by the national league of education. .

Federal Funding cont..

• In 1964, another nurse Training Act was passed is provided federal assistance to schools of nursing & nursing students.

• In 1971 the Nurse Training Act was expanded to include student aid, research grants, funding for new schools of nursing, capitation, & preparation of nurse specialist.

Federal Funding cont..

• In 1975 appropriations were made for construction grants, project grants, institutional support, financial distress, nurse practitioner preparation, traineeships, & student loans.

Nursing Education In India

• In the past progress of nursing in India has been hindered by many difficulties such as low status of women, the system of pardah among Muslim women, cast system among Hindus, illiteracy, poverty etc.

• Since independence in 1947, many changes have taken place & attitude toward nursing is still changing.

Nursing Education In India cont..

• Modern nursing education started on the basis of Florence Nightingale work & training plan developed in hospital school of Nursing in London.

• It is hard to realized that recognized preparation for modern nursing education began with the establishment of Nightingale school of nursing in London.


• Miss nightingale also believed that the nursing school should be separate financially & administered from hospitals where the students trained.

• Nurses were educated under an apprenticeship model of education characterized as a training program in which students could learn by working with & being directed by nurses on a clinical unit.


• Early apprentice nursing program had no formal classes or textbooks.

• This model of nursing training questions as early 1500s with recommendation from curriculum committee proposed guidelines by establishing norms for nursing education. Thus it signaled an expectation by the nursing communities than preparation of nurses should be an educational rather than apprentice.

Military Nursing

• It is the earliest type & 1664 the East India company helped to start a hospital for soldiers at St. George Madras.

• In 1797 a lying hospital was built and 1854 government sanctioned training school for midwives.

• In 1861, Military hospital led to reform in civilian hospitals. This laid foundation for public health nursing.

Civilian Hospitals

• Nursing in the Military hospital was of poor quality carried on by male orderliness and the menial staff

• In 1871 the government general hospital, Madras undertook a plan to train nurses.

• Nurses were brought from England to be in charge & the first 6 students were those who had previously received their diploma in midwifery.

Civilian Hospitals cont..

• In 1878 the government invited the sister of the community of all saints to come from England & taken over the work of nursing. Their work was appreciated & the need for training nurses was felt.

• At this time it was difficult to get nurses. There were only a few Anglo- Indians & Indian Christian girls working on Mission hospital.

Civilian Hospitals cont..

• The sisters of all saints were the first to establish a training school for nurses in the hospital. In 1891 Bai Kashibat Ganapat, was the first Indian nurse to come for training.

Mission Hospitals

• Mission hospitals were the first to begin the training of Indian as nurses. In the beginning there was no uniformity of course or educational requirements.

• About 1907- 1910 the north India united Board of Examiners for Mission Hospital was organized & set up rules for admissions and standards of training and conducted a public examination.

•

Mission Hospitals cont..

• On 24th may 1909 the Indian Medical Mission Association granted the nursing Diploma after examining student by Central Board of nurses training schools in south India.

Dufferin Fund

• Until the late 19th century there was no women Doctors and therefore no care for women except in mission hospitals.

• In 1885 Lady Dufferin was responsible for starting the “ National Association for Supplying Medical Aid by women of India”. This is commonly called the “ Dufferin Fund” and continues to provide education for women to train nurses & midwives for hospitals and private work.

Text -book

• One of the handicaps in the development of nursing schools was the lack of text-books.

• A beginning has been made in this book and the first text-book for nurses in India was put out by the south India examining Board of the nurse's league of Christian medical association of India in 1941.

Nursing Education

• Nursing Education in India began with very brief periods of training. The basic program for combined general nursing & midwifery developed rapidly after 1871 .

• The training for general was extended to two years & then for three years before they enter midwifery training.

• The first 4 year basic bachelor degree programs were established in 1946 at the colleges of nursing in Delhi & vellore.

Nursing Education cont..

• In 1963 the school of nursing in Trivandrum institute the first two year post certificate Bachelor degree program. The first Master, s degree course, a two year post graduate program was begun in 1960 at the college of nursing in Delhi.

Auxillary Nursing

• A two year program for the auxiliary nurse midwife was first established in 1951 at St. Mary,s Hospital.

• The practice of the Auxiliary Nurse Midwife has helped to improve the amount of care given to the patient as well as the health teaching given to the public.

Registration for Nurses

• As training for nurses, midwives & health visitors progresses, the need for legislation was felt.

• In 1926, Madras state formed the first registration council.

The Indian Nursing Council

• The Indian Nursing Council Act was introduced in the constituent Assembly of India in November 1947. it was passed & came into force on December 31, 1947.

• The purpose of council is to coordinate the activities of the various state registration councils, to set up standards for nursing education & to make sure these standards are carried out.

Nursing Organizations

• In the early 20th century many countries established national nursing associations. One of such association for nurses & auxiliary nurses in India is trained nurses association of India.

Trained Nurses Association of India

• The head office is located in New Delhi. The official organ of trained nurses association of India is the nursing journal of India which was first published in 1909.

Call for Change in Nursing Education

• One of natural responses to the changes in health care, new technologies, and calls for a better educated workforce has been to expand current educational requirements.

Excellence In Nursing Education Model

• New ways of educating health professionals, including inter- professional education and practice & new practice models must be developed.

Hallmarks of Excellence in Nursing Education

• Students: -Students are excited about learning, exhibit a spirit of inquiry and a sense of wonderment.- Students are committed to innovation, continuous

quality/ performance improvement, and excellence.- Students are committed to a carrier in nursing.

Hallmarks of Excellence in Nursing Education cont..

• Faculty: • expertise as educators, clinicians, &

researchers.• accountable for promoting excellence &

providing leadership in their area(s) of expertise.• all faculty have structured preparation for the

faculty role, as well as competence in their area(s) of teaching responsibility.

Hallmarks of Excellence in Nursing Education

• Continuous Quality Improvement:• The program engages in a variety of activities

that promote excellence, including accreditation from national nursing accreditation bodies.

• The program design, implementation & evaluation are continuously reviewed & revised to achieve and maintain excellence.


• Curriculum:• Flexible, & reflects current societal and health

care trends and issues, research findings & innovative practices, as well as local and global practices.

• Emphasizes student, s values development, socialization to the new role, commitment to life long learning, & creativity.


• Resources:• Enhance the profession, benefit the community &

expand service/ learning opportunities.• Technology is used effectively to support teaching/

learning evaluation processes.• Financial resources of the program are used to support

curriculum innovation, visionary long range planning, faculty development, an empowering learning environment, creative initiatives, continuous quality improvement of the program.


• Innovation:• The design & implementation of the program is

innovative.• The innovativeness of the program helps to

create a preferred future for nursing.• Educational Research: Faculty & students

contribute to the development of the science of nursing education through the critique, utilization, dissemination or conduct of research.


• Environment:• The educational environment empowers students &

faculty and promotes collegial dialogue, innovation change, creativity, values development, and ethical behavior.

• Leadership: Faculty, students, and alumni are prepared for & assume leadership roles that advance quality nursing care; promote positive change, innovation, & excellence; & enhance the power and influence of the nursing profession.

Role of the Nurse Educator in The 21st Century

• A new Health System for 21st century, the Institute of Medicine acknowledges that the education of health professionals in need of major change & asserts that the clinical education of health professionals is outdated and not responsive to the present or future needs in health care.

Role of the Nurse Educator in The 21st Century cont..

• As its guiding vision, the Institute of Medicine makes the recommendation that health professionals should be educated to deliver patient- centered care within an interdisciplinary team that emphasizes evidence based practice, quality improvement approaches, and informatics

Emphasis On Student Learning

• Over the past decade, education has shifted from a teacher- centered to a student centered approach.

• Understanding & facilitating student learning must be a priority for the nurse educator of the 21st century.

Emphasis On Student Learning cont..

• Greater focus on outcomes of learning, rather than on understanding the processes involved in learning.

• Skillful assessment of student learning outcomes is also needed in order to evaluate how students learn & the degree to which teaching strategies encourage meaningful learning.

Promotion of Evidence-Based Practice

• The primary focus of health care institutions today is on the provision of quality care within a cost effective framework. This emphasis on outcomes has led to a national movement requiring evidence based care.

• The movement toward evidence based practice requires that educators & practitioners engage in collaborative research.

Emphasis on Authentic Student- Teacher Relationships

• There is mounting evidence to suggest that a thoughtful student-teacher relationship is essential for students to develop & grow.

• The humanistic approach recognizes that students have their own experiences that enrich learning while also viewing the student as a participant in learning.

Confidence

• Several authors suggested that nurse educators develop confidence in student-centered teaching as they develop a “firm grounding in the pedagogy of the teaching/ learning experience”

Focusing on Student's Needs

• Student-centered teaching as focusing on students needs, rather than imposing what the teacher believes is essential to learn, as letting “learn”

Learning Partnerships

• Many authors referred to student-centered teaching occurring within a community of partnership of learners.

• Although content is important in establishing learning partnerships, these authors emphasized that the processes of learning within partnership transcends more content knowledge.

The Learning Setting

• Different learning settings pose challenges to nurse educators, intention to use student- centered teaching approaches.

Challenges For the nurse educator in 21st century

• the need to establish an independent evidence base in nursing education

• Innovative studies that are conducted often consist of small samples & narrow settings, & often are not replicated. As a result of there is little development of the science of nursing education.

•

Challenges For the nurse educator in 21st century

• Compounding the funding issues, some doctoral programs in nursing have not officially recognized nursing education as a developing science, and limit doctoral dissertations to clinical practice areas. This prevent students from engaging in scholarly investigations in nursing education & limit the growth of the science of nursing education

• -

Challenges For the nurse educator in 21st century cont..

• -Many challenges in nursing education in recent years. Changes in student population, educational delivery methods, diversity in practice settings, technological advances in health care & new modes of curriculum delivery have altered the landscape of nursing education

• The challenge for nurse educator is to engage in research aimed at determining the effectiveness of nursing education.

Thank you