A common core curriculum for nurses, midwives and health visitors

0260 6917189/0009-0082~510.00

NurscEdwatron T&y (1989) $82-92 0 Longman Group UK Ltd 1989

A common core curriculum for nurses, midwives and health visitor3 C M Gilling

This article puts forward an argument for the content of a Common Foundation Programme, as described in the United Kingdom Central Council for Nursing Midwifery and Health Visiting (UKCC) document ‘Project 2000 - A New Preparation for Practice’, published in May 1986. By using Lawton’s (1983) Cultural Analysis approach to curriculum design, the content suggested would meet the competencies for a first level nurse as laid down in the Nurses, Midwives and Health Visitors Act of 1979 and the changing health needs of our society.

The issue of a common core curriculum has generated much debate in both general and nursing education. Whilst in general education this debate has been associated with central control, in nursing it has been seen as aspects of the curriculum which are ‘common’ to all the specialised apparent

branches

in nursing.

in a number

from Government

This has been

of reports

on nursing

and professional

bodies (The

Committee

On Nursing

1972; ENB 1985; RCN,

1985). Skilbeck

(1982) argues that core learnings

Such concepts Common

goes on to describe

a common

outline,

is common

defined in partnership bodies and interpreted

common

‘common

and meet local needs.

leaves the interpretation

Curriculum

studies

Nurse Education, The Royal Free Hospital and Friern School of Nursing, Pond Street, London NW3 2QG (Requests for offprints to CMG) Manuscript accepted 27 September 1988

82

Boards

and implementation

and to

of nursing

to innovate

as a subject

in nursing

education in the UK has developed as a sequel to that in general education, but curriculum models have been adapted

C M Gilling MA BEd(Hons) RGN SCM RNT Director of

midwifery

in partnership

and the National

sequent

may be built -

schools,

can be read as

of nursing,

It is defined

schools and departments

learnings

which, in all

by central and local by schools’. (Skilbeck

to all schools’

to all branches

with the UKCC

and related

to

1982)

‘They are basic in that they are intended to provide a foundation or base on which suband this should provide learners with conceptual and methodological tools to continue their own learning’. (Skilbeck 1982)

Skilbeck

core curriculum

‘that part of the whole curriculum broad

and health visiting.

basic and essential:

the UKCC’s suggested Programme.

as:

The are

underlie

Foundation

with difficulty.

Law-

ton’s (1983) cultural analysis model is based on a reconstructuralist or society centred ideology (Fig 1). The essence of reconstructionalism is that education is seen as a way of improving society. It stresses social values in a democratic

NURSE EDUCATION

TODAY

83

1. PHILOSOPHICAL CRITERIA aims, worthwhileness the structure of knowledge

3. SELECTION

&“RE

jr

5. CURRICULUM ORGANISED stages sequences

Fig 1 Cultural analysis model (Lawton 1978)

society.

Such

nursing

education,

an ideology

health of society. Skilbeck and Hargreaves structionist

(1982)

framework

for

analysis

of the culture

secondary

(1984),

schools,

through

nurses,

so that schools can

greater meeting

strength

porate

social cohesion.

and

core curriculum health

a

and unity could be achieved

in

could be developed other

health

physiotherapists,

Lawton’s

model

and elaborated

further

including

and social workers.

was first developed

further

core

to incor-

professionals,

in 1978

in 1983. His model gives

a sound base from which to develop

a common

foundation programme and could be adapted thus (Fig 2). In taking this model it provides a more flexible base for curriculum design and therefore more adaptable to changing needs in nursing and health. This model could also be used by degree courses in nursing, and the common

core elements

could

suggestions

to take

but the following

puts

for interpretation.

be retained

PHILOSOPHICAL Ideologies

CRITERIA

of nursing

Bevis (1982) argues from the historical

visitors,

future health needs. This common

approach doctors,

a common

forward

the scope of this article in depth,

an

could apply to health and,

midwives

section

allows,

within society’s value systems

The same argument for

This

and post basic

courses. each

core curri-

through

‘built on’ in specialist programmes It is beyond

Lawton (1973)

of society.

and would bring about greater therefore,

to

of the

argue within the recon-

for rapid change

adapt to variables

be applied

for a common

culum

they argue,

could

and the improvement

and

ment

of

illustrates

nursing’s under

value

system

four progressive

develop-

which

she

themes:

1. Asceticism 2. Romanticism 3. Pragmatism 4. Human Each nursing

Existentialism

of these, values

she believes

at different

has dominated

times

during

the

development of nursing. None of them seem to have completely disappeared. Such values are part of the culture

of nursing

from one generation From Asceticism,

to another. nursing has inherited

and passed

on the

image of nursing as a ‘calling’ with an emphasis on devotion to duty, to the exclusion of self.

84

NURSE EDUCATION

TODAl

1. PHILOSOPHICAL CRITERIA a. Ideologies of Nursing b. Ideologies of Education c. Structure of Nursing Knowledae

t-

4 3. SELECTION FROM CULTURE

I

Fig 2 A cultural analysis model for a nursing curriculum

Romanticism doctor’s nomy,

has projected

handmaiden, independence

or

maticism has fostered where

patients

rather

than

organised

as the

any auto-

assertiveness.

become

sees

nurse

lacking

Prag-

the medical model of care cases

individuals,

around

ties. Bevis

the

hence

and

and

medical Human

diagnoses

hospitals

diagnostic

are

speciali-

Existentialism

as the

The

move

to a more

philosophical

nursing helps to unite the profession ing role and practices power.

A more

fession

will have

and thus heightens

articulate more

base

and

assertive

control

to

in identify-

over

its pro-

its own

future and affairs. The search for the nature and characteristics of nursing

began in the USA and Henderson’s

natural maturation of the philosophy of nursing. Humanism places importance and high priority

(1966)

on

(1982) offer an alternative which illustrates the move to human existentialism and is broad

caring

nursing

about

infers

patient/client

people.

a freedom regarding

Existentialism

for

of choice

the

the care

for

offered

and

definition

known.

enough

However,

is perhaps

the

most

McFarlane

and

Castledine

for a common

foundation

that the patient is central and the basic priority of

and yet more

all nursing

care in the UK. For instance,

care.

The

nurse

too

must

have

applicable

freedom to make choices as to the area of his/her expertise, limitations in knowledge and the

of professional

ability

health professionals’.

to make

sound judgements.

This

also

programme

to methods

of health

it states ‘the practice

nursing is in a colleague

ship with the practice

well

of medicine

relationand other

means that the nurse must be more accountable for his/her actions

and not just

responding

to

doctors’ demands. This will be particularly relevant as the profession develops the specialist practitioner role. These modern models of nursing will place different demands on nurses in the moral sense, asking for ‘ultra obligation’ and the ethical question is whether nurses wish to accept this aspect of their role (Inglesby 1985).

Educational ideologies These

can be placed along a continuum

ranging

from classical humanism, associated with pure subjects, high attainment in examinations and pre-defined views about what is fitting to do, feel and

think

thought

to of

as

progressivism. a

student

This

is usually

centred

ideology

A’URSE EDUCATION

drawing on ideas of Rousseau, others. These ideologies are product

Carl Rogers and reflected in the

versus process curriculum

has, naturally,

affected

nursing

debate which

depends

and immigration.

on birthrate,

Despite

higher

The structure of nursing knowledge

ciplines

structure from

of nursing knowledge

myths

and

and, until recently,

the medical

curriculum.

at curriculum

rituals,

has

other

in essence

dis-

reflected

In the 1970’s attempts

planning

were

made

and

such

aspects as integration of theory and practice, the use of problem solving and the move to total patient care are recounted The introduction 1977 appeared these

in the nursing

of behavioural

to hamper

initiatives

and

the

to identify

curriculum

nursing’s

in

than develop moved

firmly to a product model, remaining bound and medically orientated. Recent attempting

press.

objectives

rather

subject papers

own body of

knowledge, acknowledge the reliance on other disciplines in the Biological and Behaviourial Sciences,

but stress the need for the application

of research nursing

to develop

(McFarlane

deathrate

standards

of

living, recent reports show that the UK has some

education.

Faculty

The present

85

Population structure and change This, of course,

of the worst health problems.

developed

‘TODAY

the art and science

of

1975; Cox 1982).

of Community

mortality countries

has fallen in Europe,

affected

1986; The

1986).

Infant

less than in most other and the figures are still

by regional,

differences.

(Smith

Medicine

ethnic

Expectation

and

of further

social

class

life at the age

of 45 years is one of the worst of any developed country.

Diseases

such

as measles,

whooping

cough and congenital rubella, all preventable, which have been eliminated in other developed countries, Britain. trends

still cause All nurses

in order

preventative Migration belonged

death

need

and

disability

to be aware

to develop

their

in

of such

role towards

medicine. has increased

from countries

to the Old Commonwealth,

in large multicultural

groups,

which

resulting

particularly

in the

cities. Mares. Henley and Baxter (1985) illustrate well how basic in-service training is failing to prepare

health professionals

in multicultural

adequately

communities.

to work

The difference

in

the setting of health care for those in inner cities where

unemployment,

immigrant

populations

and poor housing predominate, are in contrast to that in rural towns and villages. These changes

SOCIOLOGICAL

in population

CONSIDERATIONS

In relating

this aspect of Lawton’s model to the sociological consideraeducation,

nursing

tions will be particularly respect

social,

change

related to health.

technological

and

In this

ideological

are all inter-related.

aspects

nursing

of

the changing need

social

change

that

These

changes

influence greatly

in

also illustrate

setting of health care and hence the

to change

have impli-

Nursing

Care.

Family and kinship More mobility and the fact that families occupy houses

have often

left the older gener-

ation behind; breaking up the ‘extended family’ results in no support for the young and old. The

are many and have changed

the last 25 years.

lar Community

smaller

Social change The

density and structure

cations for health care in the UK and in particu-

the

setting

of

the

increase

of

women

repercussions

in employment

for the family. There

in roles for both husband

and wife, often result-

learning

Cox (1983) particularly

Social class and social stratification Despite

the

relevant visiting.

and

Health

Service

nursing,

midwifery

has

ing in conflict.

environment of nursing education. identifies those issues which are to

also

is a change

health

equality

original

claims

of

the

National

in 1948, 40 years on there is no

of health

care

(Black

Report

1982).

86

NURSE EDUCATION

There

TODAY

is an obvious and persistent

difference

patterns of disease and death between economic

classes in the UK, e.g. perinatal

lity. Mortality and morbidity

in

the sociomorta-

trends are all signi-

ficantly higher in social classes IV and V. These results may be due not only to inequalities

in the

provision of health care, but to wider sociological differences

of standard

employment.

of livinglife

It has been suggested

styles and that some of

the inequalities are due to members of socio-economic groups IV and V being unable to identify or articulate

their needs for health care. It may

be that there is a need for the nurse to become patient/client advocate. Health does not exist in isolation; enced

by environmental,

a

it is influ-

social and economic

factors which are all related to each other. Such issues are closely linked

Changes

of which all nurses need to be

aware.

in social

The powerful

dominance

following

and

the

made

from

that of pragmatism

move

to a more

incorporates and

health

studies

research Barnett

(1983)

The

of

of

infectious

lists

approach,

10 to

can

20%

of

culture

than in

Nursing

the need for nurses This

(Wilson,

will require

a

applied

sees two approaches

nursing

of one

therefore,

in women

are increasing

from

lung

and fatalities

from cervical cancer are almost as high as they were 15 years ago, although other European have halved the rate. Cigarettes a year from

cause

heart

and

lung disease and deaths due to alcohol and drugs are rising rapidly (Faculty of Community cine 1986).

Medi-

the way for change

in

attitudes, health care, power and resources. Many of these diseases have no cure but are and much can be done to tackle the

cause. With reference to World Health Organisation’s (WHO) Campaign for ‘Health For All By The Year 2000’ (1981), Dr Mahler sees nurses as an essential part of the health education

strategy.

takes the form

his

suggested

Both

of

‘systems’

the interpretative

looks

at

will be used here

in

and society and the relation-

to the

attempts

cancer

Deaths

as

to cultural

and the interpretative.

approach

such whereas

not meeting

preventable

research.

1983).

as a whole.

together,

disease.

point

advances

FROM CULTURE

classificatory

from

statistics

recent

analysis

world

Such

on the

and nursing

SELECTION

check

between

deaths

rather

radical change in nursing ideology and a change in the philosophy underpinning the curriculum.

diseases. Britain has the highest death rate in the

100000

to nursing

health

& Osborne

ship

at least

approach

of

has demonstrated

analysing

countries

existentiaof role. The

to develop their role as health educators

of medical technology

this with the fact that hospitals

heart

draws

already

ideologies

to human

holistic

concepts

illness

of the development

elimination

probably

has

to the move in nursing

lism and the search for a definition

illustrates cure

are

Reference

change.

been

diseases has created a disease orientated society, which demands ‘miracle cures.’ O’Neill (1983) only

ideologies

technological

analysis, the classificatory

in the footsteps

antibiotics

nursing

with those of social and

Lawton change

and

very much inter-related

Cultural

Technological

change

to those of education

and both are seen as political and raise moral and ethical questions,

Ideological

other.

Cultural

to draw these

in order to illustrate

analysis,

two aspects

where nursing

is

the health needs of our society.

Lawton uses anthropological and cultural reasons for sub-dividing the culture of societies into eight sub-systems

or structures:

1. Social structure/social

system

2. Economic system 3. Communication system 4. Rationality system 5. Technological system 6. Morality system 7. Belief system 8. Aesthetic

system

These eight sub-systems interact and influence one another, and are closely related to health care in our society in which nursing is a subculture.

NURSE EDUCATION

Social structure/social Nurses

lack of knowledge

system of social and health

issues and how people respond due to the confinement hospital

setting.

to these is partly

of nursing education

Nursing

itself

to a

has to operate

within the bureaucratic

system and the central

control

Health

Thus,

of the National

Service

the social system is inter-related

years

later,

using

the

which

a similar nursing

demands

strategy

process greater

communication.

Nurses

TODAY

surfaced

approach patient

87 when

to care,

contact

have focussed

and

on the

‘paper work’ involved rather than the concept underlying this approach to care (Nicklin 1984).

(NHS). with the

political system.

Rationality system This includes

technology

and the scientific

to medical and nursing education.

base

Specialisation

The economic system

is inevitable

Similar to education,

aspects of nursing, such as renal or cardiothoratic nursing will follow that of medicine. A

understand the NHS,

there is a need for nurses to

how resources

are allocated

within

judgements

can be

so that informed

made over the use of resources. may arise between

Contradictions

the philosophies

behind

NHS and the ‘right’ to buy private within a democratic

society.

need to be discussed, ledgeable

the

health

care

Such health

so that nurses

issues

are know-

about all the facts and so that they can

advise clients

and clarify

their own beliefs

and

values. The economic political

system

present.

Health

resources,

system is closely related which

dominates

care obviously

but the allocation

Government. policy. The Griffith proposes within tightening

control

make

savings

Nurses

is determined

therefore

the

NHS

and improve

of

aims

resources

Managers

at and

role has developed

example,

care

To the patient,

base in order

to

the quality of the service.

base, and this will include the biological (Akinsanya nurse

1984;

system

practitioners

much of

that the lack of communication was due to their and problems the

patients might pose. It is interesting

in their

and judgements

on being

able to recognise

the normal,

sciences

own

right,

then

will need to be based the abnormal

from

to be aware of the patient’s physical,

psychological, understand

social and spiritual their

needs and to

role as promoters

None

of this can be achieved

basic

knowledge

from

various skills required

of health.

without

which

a broad

to develop

the

by any nurse in whatever

caring situation.

Technological

that so many

system

This has increased rapidly as part of the nurse’s role in the last 20 years, and is inter-related with

and resulted

in medicine. The need to to patients is essential and

between nurses and patients inability to cope with anxieties

ill or

1986). If nurses are to become

decisions

sometimes

both doctors and nurses are beginning to realise this important aspect of their roles. Menzies (1960) suggested

mentally

care.

the standard

nursing is full ofjargon,

which has its roots explain terminology

for the nurse in, for

elderly,

mentally handicapped. In any specialisation there is the need to have a sound knowledge

the rationality

Communications

of the

field, and some

may try to

of patient

monitor

of care from a sound research maintain

by

implementation

at the expense

should

at

needs monetary

of monetary

looks for value for money.

to the

nursing

different

in this ever changing

Recent

system.

Unfortunately,

been at the expense in the hierarchy

nursing

research

this has

of patient

of nursing

has brought

care

‘tasks’.

into ques-

tion long standing nursing procedures and made nurses see these lines of enquiry towards an improvement of nursing care, as the essence of nursing, rather than in invasion of the doctor’s role. Technical skills also call for the need for continuing

education

in keeping

up to

date and to have a sound knowledge of scientific principles and anatomy and physiology.

88

NURSE EDUCATION

Morality This

system

includes

nurses

TODAI

the ethical

to clarify

system

and requires

their roles. Both

Societies

ethics or attitudes

have unwritten

towards morality,

codes of

whilst pro-

fessionals make these explicit and legal (UKCC Code of Professional Conduct 1984). Nurses need

to question

beliefs

constantly

their

in the very different

values

health

which they find themselves

(Hide

and

settings

in

1986). Under

moral and ethical systems, there are also the legal aspects of nursing,

Core area of knowledge and experience

systems have

been present in nursing but often not recognised or developed.

Table 1 Match of systems and society to core areas of knowledge and experience

which concern

patient safety

Systems Society

Behavioural Sciences Concepts of Health Communication and Interpersonal Skills Biological Sciences Nursing Theory and Practice Moral and Ethical Reasoning Professional Studies Individual Drives/Needs

Social System Economic/Political Communications System Rationality System Technological System Morality System Belief System Aesthetic Svstem

and the nurse’s responsibility.

Belief system This

is also linked

to the morality

involves value clarification, of nursing underpin

system and

and the development

ideologies.

The

philosophies

of

belief

system

nursing,

with certain

needs.

will

attitudes

nursing

cannot

be value

clarified

and incorporated

Philosophies

free.

They

for nurses to become

common

foundation

programme,

for

midwifery,

particularly

Lawton

(1983)

is good

be

match

these

prac-

titioners.

makes from

A move

centred

approach

greater

recognition

career

pattern

encourage

to individual

towards

a more

in nurse education and

students

to these. help

would give

A more

and

to remain

needs student flexible

guidance

may

in nursing.

This

system is linked to the morality and belief system and the nurse’s drive/need to search for excellence

in what counts

standards’

of nursing

for ‘good’ and ‘high

care.

The use of Lawton’s sub-systems can be linked to core areas of knowledge and experience for a

J-year

direct

a plea to retain

that

the old curriculum

and In this

10 and 11 of courses

Register

and

District Nursing

details

of

and School

Also considered

a BSc

Carpenter

the

Nursing

(new curricu-

Studies

course,

on Nurse Education

Zealand (1970) and the suggestions in the papers mentioned Many covered

of

these

rationality.

The

in New

put forward

previously.

reports

by the core

for

have been

were the course con-

in Nursing

in Nursing

Report

areas

suggested

aspects

but again

without

It is also evident that there is a need

to demonstrate

more

equal

weighting

in the

curriculum to the different core areas. How then do the new suggested core areas of knowledge and experience

meet the statutory

requirements

to practice? The 1979 Nurses Act defined a list of competencies

COMMON FOUNDATION PROGRAMME

the

the

lum),

This system can be related and drives.

core

respect the syllabi for Parts 1,3,5,8,

analysed.

system

these

1). the

to preparation

to the new requirements.

tent of the Diploma

Aesthetic

(Table out’ of

entry programme. which

issues such as

professional

programme have ‘opted

of

into the curriculum.

The belief system will incorporate support

must

foundation midwives

areas would be equally applicable

towards giving care and the belief in Man as an individual

common Although

to be achieved

by the students

in

their training rules. These have been enlarged by the UKCC and provide a better guide for curricula planners. By using the suggested core areas of knowledge and experience for the these foundation programme, common competencies

could be achieved (Table 2). These

NURSE EDUCATION

Table 2 Matching

are

of core areas to UKCC competencies

particularly

research

Core areas of knowledge & experience

UKCC suggested competencies

cation

Behaviour Sciences Concepts of Health Communication/Interpersonal Skills Biological Sciences Nursing Theory & Practice Moral & Ethical Reasoning Professional Studies

1,2,3,4 1.3.7.11 1,lO

existing

matches

strate the degree required

knowledge. has particular

Teaching

and in no way demon-

areas of knowledge

core

area.

Some

and experience

suggested

which could

be covered by each core area are presented Appendix.

in the

These are not in any order of priority

and the term ‘nursing’

applies to any of the four

branches.

these

sub-headings related

have

for

been

and one cannot

isolation

they

into are

Social

and

higher

changes

education

affect

and

in

ways

the of

teaching and learning. If nursing education is to gain academic credibility, then it must offer

to have a variety students’

design can be

adapted

to encourage

in a nursing

discovery/problem When

solving learning.

students

become

have full student

It

curriculum

status,

between teacher

teaching calls

supernumery this should

strategies

for

more

the teacher

strategies

in order

to create

ences to meet students’ It is beyond this

in much

education teachers

but

to embrace

it

experi-

learning

the remit of this article detail,

but

demonstrates

research the

to look carefully

cesses and their teaching ning the curriculum.

also

new teaching

meaningful

differing

need

styles. to cover

in higher for

at adult learning strategies

CURRICULUM

Recent

‘contract’

(1975),

by

Pask

ORGANISED

can be adapted exiciting

stances.

Many

based on a health orientated

However,

produced

and

innovating

by Schools

pro-

model are of Nursing.

none of these can be put into practice in the clinical

areas. It is evident that if Schools of Nursing are to have more control over the learning environment, then there

must be greater

emphasis

on

in-service education and the professional development of all the qualified nursing staff.

pro-

when plan-

Entwistle

Entwistle et al (1979) and Brumby

curriculum

to local circum-

grammes

CONCLUSION cover

(1976),

learning

nurse

processes

research

and student to individual

In taking the core areas suggested, organisation

Preliminary

Learning

and

allow for

and the student.

without the assistance of colleagues

programme,

to

students come from a mixed ability background.

more

the pedagogy

of teaching

in nursing where

now being

educational

examin-

approaches

courses of equal status to those of higher education and universities. This includes not only a changes

and

two

really be considered

technological

of

and Salsjo

to how students

closely

from the other.

pattern

edusolved

The process model of curriculum

needs.

divided

emphasis,

they

new material with

This is also necessary

between Although

how

relevance

in meeting

more collaboration

THEORIES

Their

in higher

to assessments

is a need

in tailoring

PSYCHOLOGICAL

89

strategies

strategies learning.

nursing.

Work of Marton

learn in relation ations.

of input into the curriculum

for each

problems,

them and how they integrated (1976)

1,4, 14 1,5,13, 14, 15 8,8 6,8,12

to

at how students

perceived

There are subjective

relevant

looked

TODAY

(1982)

many

papers of

from the UKCC

these

areas

and

(1987)

the

do

content

illustrated here comes as no surprise. This article has attempted to explain the arguments behind this and emphasises

areas that are being debated

90

NURSE EDUCATION

‘TODAE

by the statutory bodies. It also demonstrates a cultural

analysis

education of our

cationalists introduced

The

which has now been

dation programme on

nursing

problem

for

how

nursing

health needs nurse

edu-

will be to determine how much can be in a common foundation pro-

years to 18 months built

enables

to adapt to the changing

society.

gramme

approach

in the

reduced

from

and how the common can be followed through four

suggested

2

foun-

branches

and of

the adult, the child, the mentally ill and

the mentally

handicapped.

References Akinsanya J 1984 Development of a nursing knowledge base in the life sciences: problems and prospects. International Journal of Nursing 2 1: 22 l-222 Akinsanya J 1986 Teaching the teachers. Senior Nurse 4: 27-28 Bevis 0 1982 Curriculum building in nursing, 3rd Ed. Mosby, USA Black D, Morris J N, Smith C, Townsend P 1982 Inequalities in Health: The Black Report. Eds. P Townsend and N Davidson. Harmondsworth, Penguin, London Bridge W, Macleod Clarke J 1981 Communication in nursing care. HM and M Publishers, London Brumbv M N 1982 Consistent differences in cognitive styles shown for qualitative biological problem solving. British Journal of Educational Psychology 5: 224-257 Cox C 1982 Frontiers of nursing in the “1st century: lessons from the past and present for future directions in nursing education. International Journal of Nursing Studies 19: l-9 Cox C 1983 Sociology. An introduction for nurses. midwives and health visitors. Butterworths, London Department of Health, New Zealand 1971 An improved system of nursing education for New Zealand (Carpenter Report). Department of Health, New Zealand DHSS 1983 National Health Service management enquiry (The Griffith Report). HMSO, London Dodd A P 1974 Towards an understanding of nursing. Unpublished PhD thesis, London English National Board for Nursing. Midwiferv and fiealth Visiting 1985 Professionayeducationitraining: a consultative paper. ENB, London

This article is adapted from a dissertation for an MA in Curriculum studies - a copy of which is available at the RCN Library (Steinberg Collection). It was also the basis of a paper delivered at the Royal College of Nursing Association of Nurse Education Annual Conference in April 1987.

Entwistle N 1975 How students learn: information processing, intellectual development and confronta
NURSE EDUCATION

Royal College of Nursing 1985 The education of nurses: a new dispensation. Commission on Nursing Education (Chairman: Sir Harry Judge). RCN, London Skilbeck M 1982 Three educational ideologies in T Horton, and P Raggart. Challenge and Change in the Curriculum. Hodder and Stoughton, London Skilbeck M 1982 A core curriculum for the common school. Quotations: pp 21 & 25. Institute of Education, University of London Skilbeck M 1984 School based curriculum development. Harper and Row, London Smith J P 1986 Nursing and health care in the twentieth century: myth, reality and dichotomy. Journal of Advanced Nursing 11: 127-132

TODAY

9 1

The Council for the Education and Training of Health Visitors 1977 An investigation into the principles of health visiting. CETHV, London United Kingdom Central Council for Nurses, Midwives and Health Visitors 1984 Code of professional conduct, 2nd Ed. UKCC, London United Kingdom Central Council for Nurses, Midwives and Health Visitors 1986 Project 2000 - a new preparation for practice. UKCC, London Wilson Barnett J, Osborne J 1983 Studies evaluating patient teaching: implications for practice. International Journal of Nursing Studies 20: 33-34.

APPENDIX 1. BEHAVIOURAL

SCIENCES (Social Systems)

Concepts of General Psychology Human growth & development Development Psychology Theories of Personality Social Psychology of the Family and other primary groups Human sexuality Individual differences Deprivation and Loss Individual/Deviant Behaviour

Concepts of Sociology relate to life cycle

Relevance and importance of Sociology to nursing practice. Sociology of professions and the professional role. Social structures related to behaviour. Social influence on health/illness Ethnic & cultural needs.

role.

Labelling Theory Social Systems Sociology of institutions and institutionalisation.

2. CONCEPTS OF HEALTH (Economic/Political Systems) Models of Health. Social, cultural and ethnic factors affecting health. Health Service provision in the U.K. (Social Administration) Health Issues: e.g. economic, environmental, political, occupational. The ‘sick’ role and maintenance of health. Health Education - nurses’ role. Resources and Services. Epidemeology/Demographic changes. Multi-cultural Issues (Ethnomedicine). Changing patterns of disease and health care. Concepts of primary health care. Professional responsibility for personal health. World Health - Nurses’ role. 3. COMMUNICATIONS AND INTERPERSONAL SKILLS (Communication System) Developing self-awareness to enhance communication and interpersonal skills. Communication skills as a vital part of patient care. Effective and ineffective communication. Establishing rapport. Verbal/Non verbal skills. Good listening skills (receptive, non-judgemental). Written and oral communications within the professional context. 4. BIOLOGICAL SCIENCES (Rationality System) Life sciences integrated with life cycle. Biological sciences related to nursing and clinical experience. Physiological and biochemical principles underlying human functions, e.g. cytology, genetic, embryology, and nutrition.

growth

92

NURSE EDUCATION

TODAY

Concept of Homeostasis. Nature and Causation of Disease (Pathology). Applied Pharmacology. 5. NURSING THEORY AND PRACTICE (Technological System) Philosophy of Nursing. Models of Nursing Care. Concept of Individual Care. Meeting fundamental needs through nursing care. Introduction to common disorders (treatment and related nursing care) linked to clinical experience. Teaching patients to accommodate change in health status. Teaching principles that promote health generally and in relation to specific disorders and their prevention. Helping individuals and families to recognise health needs and when to take preventive action. Research awareness, the need for nursing research and its application. Appraisal of research findings to specific areas of practice, application of research to nursing practice. Information retrieval. 6. MORAL AND ETHICAL REASONING (Morality System) Concepts of Morality. Morality within social/nursing context. Values and beliefs (value clarification). Decision making (patient’s choice/telling truth/priorities of care. Confidentiality/Disclosing information (patient’s rights). Code of Ethics. Ethics related to research. Moral dilemmas related to specific groups of patients/clients (mentally ill/handicapped/life Power of the professional/patient’s advocacy. Conflict between professional duties and political responsibilities of the nurse. 7. PROFESSIONAL STUDIES (Belief System) Nursing as a professional (related to history of nursing and nursing education). Concepts of professionalism/Concepts of the role of the nurse. Professional awareness. Changing role of the nurse. Responsibility/Accountability/Autonomy. Code of Professional Conduct. Development of nursing in relation to the development of health care. Role of the statutory bodies. Professional Organisations and Trade Unions (Labour Relations). The rights of professional practitioners. Relevant aspects of Law/politics of nursing. Feminism and its role in nursing. Introduction to teaching and management. Emergence of specialised roles/Career development. Interdependence of professional groups and interdisciplinary work. Nursing within the International context (ICN). 6. INDIVIDUAL NEEDS/DRIVES (Aesthetic System) Developing self awareness. Self assessment/Peer assessment. Learning contracts. Study Skills. Identifying individual learning strategies. Use of Learning Resources. Use of Tutorial SupporUCounselling. Developing coping mechanisms through interpersonal Career counselling/development.

support.

support machine)