Project 2000: the higher education context

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individual

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needs within the course.

Responding to existing students and practitioners Change of this magnitude cannot be undertaken without some impact on existing students and practitioners. We have tried to be especially sensitive in this area. Information and discussion sessions have been made available. We are developing an accreditation system for current RN qualification, post-registration programmes and a number of major initiatives for post registration development at diplomate, graduate and Master’s degree level. Keeping existing curricula ‘alive’ has been a challenge which we have tried to address. Implementation of continuous assessment of theory for existing courses has been maintained. The calibre of work submitted by students (undertaking courses leading to RNMH/RMN/ RCN awards) is impressive and this is being recognised through the accreditation programme.

Developing intellectual tension in nursing In order to move nursing education forward we have to start developng a body of knowledge which truly reflects the analytical and synthesis skills demanded by graduate education. We have to develop ‘intellectual tension’, academic rigour

and a sound research base into the development programmes for staff. Teachers in Portsmouth are seen to be committed to this direction and will be supported by considerable investment in staff development over the next year. There needs to be time and space to achieve this sort of development and thus will require careful long-term planning to ensure that people are able to make decisions in relations to the commitments of the workload.

CONCLUSION This course is just beginning and we are getting to grips with the reality of the course. We are taking our 2nd intake into the programme in April. Teachers are excited and want to participate. The challenge has been to cope with the demands we make ourselves. As you venture into your own intitiatives it may be helpful to recall what a personal student said to me last week: ‘This is the most scary course I have ever done. It makes you think about yourself and other people in a way which means I have to find ways of doing nursing that helps the client to be involved as much as I am. I go home and just have to read and find out because when I meet clients I have to understand how it is for them. I’m living this course, sorry I meant loving this course (she paused) or perhaps 1 was right the first time’ Taken from ‘From Novice to Expert’ by P. Benner (1986, Addison-Wesley).

Project 2000: the higher education context Mark Mitchell The purpose of this paper is to outline some of the factors that have facilitated the successful launch of a large, multi-branch Project 2000 scheme linked to the award of a Diploma of Higher Education at Portsmouth Polytechnic. The paper will argue that it was combined effect

of a range of national enabled a polytechnic experience of nursing cation to undertake innovation.

and local factors that with little traditional and paramedical eduthis major academic

NL’RSE EDUCATION

NATIONAL CHANGES EDUCATION

IN HIGHER

The 1980s have witnessed a period of unprecedented change in British higher education. Although there can be little doubt that the overall effect of these changes has been damaging, one of the few positive consequences has been to make the HE sector in general more responsive to the opportunities offered by nursing and paramedical education. Three national developments are particularly worthy of note, each of which has encouraged individual institutions to take advantage of the opportunities provided by the reorganisation of nurse education. Firstly, polytechnics and colleges of higher education have, at the end of the decade, found themselves with a degree of autonomy and control over their own affairs that would scarcely have seemed possible 10 years earlier. The 1988 Education Reform Act, which removed the polytechnics and major colleges from Local Authority control, has enabled HE to respond much more quickly to the education and training needs of institutions in the statutory, voluntary and private sectors. Further, the devolution of responsibility’ for the validation of courses to accredited polytechnics and colleges has freed them from a ‘top-down’ system of quality assurance that in the past tended to stifle the kind of innovatory curriculum development that must be an essential feature of any attempt to make Project 2000 a reality. Secondly, the impact of national planning in the non-university sector has had the effect of encouraging polytechnics and colleges to pay much more attention to the vocational relevance of their courses and to the career destinations of their students. In the mid-1980s. the National Advisory Body attempted to change the sector by switching funds away from more traditional ‘academic’ areas. Although this strategy was ultimately unsuccessful in that it failed to produce any significant changes in the academic profiles by Polytechnics and Colleges, it has underlined the need for all academic disciplines to re-think their priorites in the light of the

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growing emphasis on professional and vocational relevance. In view of this it is not surprising that the attempts by Schools of Nursing up and down the country to forge closer links with their local Institutions of Higher Education have received such a warm response! More recently, the demise of the NAB and its replacement by the Polytechnic and colleges Funding Council has produced a radically different system for the funding of institutions. However the council remains committed to the idea that the PCFC sector has a distinctive mission, one major element of which is the provision of professionally and vocationally relevant courses. In addition, by enouraging polytechnics and colleges to seek alternative sources of income to supplement the ever-diminishing unit of resource in HE, the new funding regime is likely to reinforce rather than undermine the new relationships that have been established between schools of nursing and HE institutions up and down the country. Thirdly, the last few years have seen a transformation in the attitudes of academics towards the idea of ‘practice learning’. There is now a much wider acceptance by polytechnics and colleges that students learn in a variety of ways and that introducing elements of ‘learning by doing’ into the HE curriculum can acutally enrich and complement more traditional academic approaches. The national debates over credit accumulation and transfer and the accreditation of prior learning and experience have reinforced this process. As a result, the incorporation of components of practice learning within the academic curriculum has become far more acceptable. The traditional 4-year sandwich course found in engineering, science and business studies departments has normally comprised 3 years of academic study and one year of industrial placement. The degree of integration between the college-based and industrial-based elements of the course has been minimal and, in reality, the academic qualification has been achieved on the basis of the 3 years in college. However it is now possible, given a proper degree of integration between the college-based and the practice-based curriculum. to treat these as the mutually supportive

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parts of a single

TODAl

course.

This

has encouraged

group

of

individuals

polytechnics and colleges to link Project 2000 Nursing courses to the award of a Diploma of

The existence

of ajoint

Higher

management

group

Education.

The thorough

way in which

responsibilities

nurse and clinical tutors assess clinical skills and

bility of negotiating

financial arrangements

the reser-

vations expressed by some of the more traditionally-minded members of the academic community

over

these

have in turn provided innovation

developments,

which

a source of much-needed

within HE, where the detailed assess-

ment of practice

learning

has been sadly neg-

lected. Thus nursing

Secondly,

the growing and

HE

opportunities

rapprochement

has been

provided

can only be realised establishment

encouraged

developments.

both organisations

structure

and content

planned.

A joint

HE institutions,

collaborative

schools of nursing

District Health Authorities

involving

Project

provided structure,

the

management

Thirdly,

and

arrangements

staff at all

it

Group,

is

launched

result of the close collaboration

between

mouth District School of Nursing

in recent years,

it is clear that a crucial prerequisite

Ports-

of this success

has been the existence of a formalised and clearly defined set of inter-locking committees and working

groups,

together

system of accountability

between

particularly

important

of schemes

like the Project

involve large

numbers

with a proper them.

had been

for the successful 2000

DipHE

of students

launch

following

a

the Steering

technic

of

staff’

responsibility

collaborative

arrangements

are there-

launch of any Project

agreed

to the

Foundation

by the Steering

curriculum

development of curriculum

who

were

charged

with

the

specific syllabuses for

of the CFP. From the outset

who

of Nursing. would

for the delivery

that each of

programmes

in the

In this way

ultimately

have

of the individual classroom

were

brought together and encouraged to form close working relationships at an early stage in the

of any nursing

Proper

collaborative

to a number

and the School

to the award of a separately fore vital to the successful 2000 scheme.

that

these curriculum planning teams should be composed of members of staff from the Poly-

development

Diploma.

and and

Group were unanimous

Common Foundation Programme and up to four separate branches, each of which may lead named

content

be discussed

of the course and the

of preparing

each of the elements

teaching

which

teams

responsibility

groups

This is

course

of the Common

the detailed

planning

as a

a forum in which the

essential

work was delegated of new nursing-related

by

2000 consul-

management and planning of Project 2000 but also at the level of curriculum development.

Programme

the range

Group,

exist not only in relation

key components

In reviewing

Steering

Project

could

Once the broad structure

COLLABORATIVE ARRANGEMENTS

that the

resolved.

links

levels in these organisations.

courses that has been successfully

to ensure

2000

tative document, course

of the new

shortly after the initial publication

issues of course

at a local level through

of a set of

launch

of the course is effectively

the

by these developments

and

must be close collaboration

between

by a

However

contractual

involved was a key factor

the UKCC of their original

between

senior

with the responsi-

the complex

there

executive

organisations.

DHA/Polytechnic

the successful

established

variety of national

between

in enabling Diploma.

have

charged

competencies

has helped to overcome

who

in their respective

Fourthly,

of the course. planning

award requires

for the conjoint

course

linked

validation

to an academic

the closest collaboration

between

In the first place, it is absolutely essential that innovative ventures which involve new forms of collaboration between an HE institution and a

key individuals who are both experienced in the preparation of validation documents and familiar with the different requirements of the professional and academic validating agencies. In the case of the Portsmouth Project 2000 scheme.

local DHA

it was only possible to achieve this by seconding

should

be properly

managed

by a

NURSE EDU<:ATlON

two individuals, one from the polytechnic and one from the school of nursing, virtually fulltime to prepare and edit the validation documents and, most crucially, to liaise with the ENB officers and members of the Polytechnic Validation Committee. The importance of this form of collaboration in preparing documentation and planning for the validation meetings cannot be over emphasised. Finally, these various forms of cross+rganisational collaboration have themselves to be properly coordinated within an overall structure in which clear lines of accountability are established. This is particularly important given the numbers of staff who are likely to be involved in the management, planning and delivery of Project 2000 schemes. Without a proper stystem of acountability, individual tutors are likely to lose the sense of ‘ownership’ and ‘belongingness’ that is so important to the successful operation of any course.

HE INSTITUTIONS AND PROJECT 2000: INTERNAL REQUIREMENTS In large and diverse HE institutions, major new academic developments often present a challenge to established institutional structures and procedures. This is particularly true of the development of new nursing courses such as Project 2000. Nursing does not fit easily into the conventional discipline-based departments and faculties commonly found within HE institutions. Even where successful departments of nursing or faculties of health studies are already in existence, complex inter-departmental servicing arrangements are often needed to sustain the broad disciplinary base of nursing studies courses. Major new academic initiatives such as the Project 2000 nursing courses thus require a proper planned response by HE institutions rather than a series of ad hoc arrangements. In the first place, following a full debate at the institution’s academic board, the academic development plan and, if appropriate, the institutional mission statement should be amended to take account of this major new growth area.

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Secondly, it is essential to establish proper systems of financial and budgetary control so that individual budget holders are clearly aware of the resource parameters within which they are working. In reality, there is always likely to be a tension between what is desirable from the curriculum development and course delivery point of view and what is achievable within the envelope of resources available. Thirdly, it is important to establish clear and unambiguous lines of responsibility for the provision of adequate library, audio-visual and other learning resources that are essential for meeting the learning objectives of the course. In a multi-disciplinary area such as nursing, it is all too easy to allow the responsibility for the provision of learning support to be shuffled off onto another department or faculty. Finally, HE institutions, particularly those with little traditional experience of nurse education, must pay particular attention to the staff development needs of the individual members of the lecturing staff involved in the planning of Project 2000 courses. This is particularly important if academic staff are to understand that collaboration in nurse education involves a partnership between equals in which each side has much to learn from the other. A positive staff development policy that encourages HE staff to familiarise themselves with the complexitities of nurse education is crucially important in making Project 2000 a reality.

CONCLUSION I will conclude this paper by commenting briefly on some specific factors which, if they are not addressed, will hamper the future development of Project 2000 schemes around the country. the system of conjoint Most importantly, academic and professional validation could, in my view, be very considerably streamlined without damaging the effective quality assurance mechanisms that the system is designed to underpin. At one level, difficulties arise simply because of the lack of familiarity with the different ‘cultures’ of validation that have developed within the two spheres. There is a real

3%

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need for the ENB and the CNAA together to sponsor a series of workshops around the country designed to familiarise college lecturers and nurse tutors with the different procedural requirements and expectations entailed in academic and professional validation. However, the complexities and difficulties experienced in conjoint validation are also an expression of more profound divergences in philosophy and approach between the two sectors. The recent decision by the ENB to embrace the idea of peer review as an integral part of the validation process and to establish a register of specialist visitors has been widely welcomed in HE. However, I believe that the board will need to modify further its highly centralised approval procedures, particularly if Schools of Nursing are to be linked ever more closely to accredited HE institutions that may well be awarding their own degrees and diplomas within the next few years. Secondly, we must recognise that the impact of the proposals contained in the NHS White Paper ‘Working For Patients’, together with the consequences of the ideas expressed in Working Paper 10, are likely to make HE institutions more hesitant in becoming involved in new collaborative ventures with DHAs. HE institutions are rightly concerned at the proposed

transfer of responsibilities for the funding of nursing and paramedical education to regional health authorities. On the one hand, it is not clear that the close relationships that have developed between colleges, Schools of Nursing and DHAs will be able to be recreated at the level of the RHA. On the other, the majority of HE institutions will be extremely reluctant to participate in yet another system of competitive tendering in an attempt to secure education and training contracts from regions. Finally, we have to recognise that the plans to create an internal market within the NHS are also likely to undermine the enthusiasm of HE institutions for participating in major new initiatives in nursing education, at least during the transitionary period. At the present time, many of the costs of expensive clinical and community placements, together with the associated costs of teaching and supervision in these placements, are ‘lost’ within the system. Whether these hidden educational subsidies will continue in the future is uncertain. The thought that, in a few years time, independent hospital trusts could be insisting that higher education corporations cover the full costs of clinical and community placements is likely to deter rather than encourage future collaborative ventures in the field of nurse education.

District general manager’s perspective Chris West You will all know the real tragedy is that a number of us have known for something like 12 years about the projected decline in the number of school leavers taking place now and on through the early part of this decade. I can remember as an Area Administrator in Wiltshire being dumbfounded when we looked at the demographic trends on school leavers and then looked at the manpowerlwomenpower retirement rates particularly in community nursing

and we saw with the graph of one going down, the graph of the other going up at the same period of time. There was a real anxiety, about how we can maintain adequate Community Nursing Services particularly with this underlying demographic problem. Then overlying that demographic trend was the greater shift of care into the community in a number of areas and I could not see how we were going to cope. The real tragedy was that almost 12 years passed