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The role of the assistant director of nursing education (basic training)
NURSE EDUCATION TODAY
The role of the assistant director of nursing education (basic training) Cynthia M Gilling Director of Nursing Education, School of Nursing, The Royal Free Hospital, London
ON INVESTIGATION, little has been published on the role of the assistant director of nursing education and perhaps the reason for this is that it can differ widely from school to school. Historically, the role developed from the 1974-75 reorganisation of the National Health Service. With the reduction of many schools of nursing and the formation of larger more complex schools, the Department of Health and Social Security established the new grade of assistant director of nursing education. The' then General Nursing Council for England and Wales issued guidelines indicating a role specification and suggesting that this post could carry responsibility for basic nursing or post-basic nursing education. The following are some of the principal responsibilities that were seen.
1. Education and organisation (a) Controls and co-ordinates the work of the department within the agreed policies of the school. (b) Discusses the planning and the organisation of the curricula with the senior tutors. (c) Draws up criteria for the evaluation of courses with the senior tutors. (d) Monitors the progress of learners and the success of the course. (e) Supervises the work of tutor and clinical teacher students gaining teaching practice in the school. 2. Communications (a) Promotes positive interaction between the school of nursing and the heads of nursing service. (b) Advises the director on matters of curriculum planning related to the practice areas. (c) Enables the movement of learners in the hospitals and other practice areas to be balanced, so that students and pupils know and understand their progression of experience and the practice areas have the number of learners required to provide for good care to be given and guod standards of ward teaching and supervision to be achieved. D
198\ Lo ngma n Group Ltd.
(d) Advises the senior tutors on the implementation of agreed policy regarding internal ward assessments and examinations.
3. Educational activities (a) Maintains close links with educational institutions, including those involved in training nurse teachers. (b) Encourages the use and evaluation of new teaching/learning methods. (c) Explores the possibilities of forming local centres for nurse teachers, ' with special reference to sharing technological provision. (d) Implements clinical and educational research findings where opportunity and policy permits. (e) Initiates with appropriate expert advice, and/or participates in, research in nursing education. 4. Personnel . (a) Advises the senior tutors about the personnel care of the learners. (b) Provides for the counselling of the teaching staff of her department and encourages their development. (c) Ensures that adequate and accurate records are kept for learners and staff and that personnel files are maintained according to the personnel policy for the district. effective conferences between (d) Fosters teachers and between the learners and teachers (eg Set Representatives Council). 5. Policy formation and financial control (a) Participates with the director in the drawing up of estimation of expenditure. (b) Monitors the budgets provided. (c) Participates in planning for future developments and the implementation of agreed plans, regarding .particularly. the effect upon learners and staff. Later, the actual size of a school of nursing to warrant the appointment of an assistant director for basic education was established at 500-600 learners. On looking at these activities some would say that 87
NURSE EDUCATION TODAY the post is not really intermediate between the senior tutor and the director but just takes more of the responsibility in management away from the senior tutors. The role could also appear to be unnecessary in a school with only 500-600 learners following just one or two courses leading to registration. If the role is to be recognised as a training post for those wishing to proceed to being a director of nursing education, then the assistant must work closely with the director. Opportunities to act for the director in attending meetings with directors of nursing/midwifery service, or in manpower planning and with the EAG (previously RNTC) provide valuable experiences. As well as being involved in all policy relating to the nurse learners, their clinical placements and the teaching and support staff, the assistant director of nursing education must know or have access to the appropriate information to enable her to make decisions about problems which arise. In discussing the role of the director, Quinn (1980) noted the importance of good leadership and how it can dramatically affect the morale of the whole school. In my experience this is true, and therefore it is important that the assistant director of nursing education works with the director and senior nursing staff in developing the philosophy of the educational division and in introducing change. Little is available for the preparation of directors of nursing education and much has to be learnt 'on the job' by the successful applicant if he/she has not held an assistant director post. Similarly, senior tutors should be given every opportunity of acting for the assistant director, to learn about the managerial responsibilities of the role and gain insight into the much wider aspects of the director's role. Another aspect of the role is that of co-ordinator, especially important in a large and complex school of over 900 learners offering eight different schemes of training leading to registration. Quinn (1980) is one of the few writers on nursing education to have even mentioned the assistant director's role. He emphasised the need for integrated teams. This integration is particularly necessary when there are a variety of courses being undertaken, so that the teams of teachers do not become isolated and unaware of the demands on the rest of the staff and the learners. The assistant director of nursing education should have an overall view of the school so that he/she is aware of any constraints and can help senior tutors in their role and encourage innovation. The assistant director must be seen to be available to all tutorial staff and learners. This is most important in any school but even more so where the staff number over 50. Smith (1975) supported this when he said, 'Colleges are employers of large numbers of people. Good organisation depends on good people, people must matter to the organisation and one of the prime responsibilities of management is to devise a personnel policy for all staff members.' It is not so easy to identify problems in a large school but much can be achieved by discussion at regular
88
formal and informal meetings, by good communication practices, and by ready offer of help and advice if required. Having a specific educational role such as responsibility for curriculum development gives the assistant director an opportunity to act as a change agent. In some aspects perhaps the role can be equated to that of the deputy heads in general education. Stenhouse (1975) quoted Musgrove (1971) in how he saw their role: 'They see their job as requiring first and foremost skills in dealing with school staff, listening to their problems, suggesting solutions and interceding with the head on their behalf. They do not see themselves primarily as organisers, they consider that "concern for teachers" is the most important part of their job.' Stenhouse later went on to talk also about the changing roles of deputy heads and how heads are deploying deputies as 'change agents' with responsibilities for curriculum development or staff development. The liaison role of the assistant director of nursing education is illustrated diagrammatically in Figure 1. In this respect the assistant director is much involved in the day-to-day running of the school. In many respects the role is similar to that of a director in a small school of nursing. It is essential that there is regular communication between the assistant director and the senior tutors. Here, staff appraisal can be a useful tool for discussion and for showing the assistant director how both roles can be adapted to the best advantage of all concerned. The role of the· assistant director could be interpreted as being a job that involves much paper work. Normally a certain amount is to be expected. In the book A guide for teachers of nursing Smith (1975) suggested the establishment of the post of a registrar, or bursar. This would be a welcome addition to many schools of nursing since much precious time is spent in keeping learners' records, indexing and entry forms for examinations-time which could be used for teaching and counselling purposes. The assistant director's role can be a challenge and a worthwhile experience. While the loss of one's 'own' students is .inevitable, there need not be a loss of learner contact; an assistant director can be involved in teaching certain aspects of the curriculum. If an assistant director of nursing education-post basic education is also in post, then links can be developed and another teaching input maintained: for example, helping in the preparation of newly qualified staff, meetings with clinical teachers, orientation programmes for new staff and the selection of assessors for the clinical areas. In the Rcn document 'To teach or not to teach', again little reference to the role is made. However, under the heading of assistant director of nursing education is stated: D 198·1Longman Group Lld.
NURSE EDUCATION TODAY Director
Assistant Director of N ursing Educat ion
(Pos t Ba. ic)
t I 0 ,;"N"";~
Allo cation
Senior
Service Coll eag ues
TU10"~ \
-----.
A ssistant Director of Nurs ing Educ at ion
AVA~ Administralion / (Gene ral)
ow
l - - - - r Clinical Teach er
~Tutor/CT St udents
/
I
DePt of Furt her and Hig her Educat ion
the school of nursing and could in volve research and development of nursing education .' This last sentence emphasises the point that was orig inally made in this article. The role of the assistant director of nursing education may well differ according to local needs, but if th e post is to be seen as a preparatory stage to a director appointment, then some of the aspects of the role that have been m entioned in this article should be included in the specification. NOTE
Secr etarial Staff
Library
. .- -..... « frequent communication ____ r
regarding school. policies. cha nges etc.
Fig 1: Tbeliaison role of the assistant director of nursing education
'These appointments are made according to local needs of the school of nursing to assist the Director of Nursing Education... As a staff post this enables flexibility of responsibility and function, eg curriculum design, recruitment and selection, eoordinating aspects of nurse training in a multiregister training school. These responsibilities and functions would be tailored to the local needs of
This paper originated from a pro ject submitted for the degree of BEd(Hons) at The Polytechnic of th e South Bank and while the author was the Assistant Director at The Princess Alexandra School of Nursing, The London Ho spital, Whitechapel, London.
REFERENCES G eneral Nursing Council 1975 The specification for intermediate post between director of nursing ed ucation and senior tutor. GNC Guidance Paper May 1975. Hoy R, Robbin J 1973 Nurse edu cation . In: The profession of nursing. McGraw-HilI, M aidenh ead, eh . 23, p . 127. Qu inn F M 1980 Aspects of educational management. In: The principles and practice of nurse educa tion . Croom Helm, London, eh . 9, p . 315. Royal College of Nursing. Asso ciation of Nursing Ed ucation. To teach or not to teach? That is the que stion. Rcn, London. Smith JP 1975 College org ani sation, management and curriculum. In: Reybould E (ed) A guide for teachers of nurses. Blackwell , Scientific, Oxford, eh, 8, p . 117. St enhouse L 1975 An introduction to cu rriculum, research and d evelopm ent. Open University. H einemann, London.
Student nurse wastage and attitudes to treatment B D Davis Deputy Director, Nursing Research Unit, University of Edinburgh STUDIES of nurse training show a continuing dilemma caused by the twin problems of numbers and standards; increase in the former leading to "fears of decrease in th e latter. This paper describes a study concerned with the problem of maintaining an adequate supply of students through the training school. It is the first in a series of three articles looking at the relationships between attitudes and student nurse training. Within a psychiatric hospital the problem of numbers was affected by the levels set for entry requirements and also by the numbers available. A th ird factor was that of attrition, or wastage. The problem of entry requirements was solved by using the minimum standards set by the General Nursing Council, and that of numbers available was tackled by seeking recruits from overseas. However, the problem of wastage was not so easy to solve, and a local survey of rates was undertaken to establish the size of the problem.
HI STORICAL
l' 1984 Longman Gr oup Lt d.
The national rates for wastage seem to be rem arkably constant at around 33 per cent (GNC 1966). This figure was confirmed by the Report of the Committee on Nursing (1972) . However, the reg ional and hospital rates may vary substantially about this figure. For example, Srivastava (1959) found a figure of 50 pe r cent, and McGuire ( 196 1, 1966) a figure of 26 per cent.
Nurse wastage 'su r ve y In the present study two periods were re trospectively considered: the late 1960s and the early 1970s. During the second of these periods recruitment policy was extended to include a larger group from overseas. Table 1 shows wastage and examination pass rates from the two periods, and Table 2 shows proportions of overs eas students recruited for the two periods. One possible explanation of the varying wastage
89
The role of the assistant director of nursing education (basic training) Cynthia M Gilling Director of Nursing Education, School of Nursing, The Royal Free Hospital, London
ON INVESTIGATION, little has been published on the role of the assistant director of nursing education and perhaps the reason for this is that it can differ widely from school to school. Historically, the role developed from the 1974-75 reorganisation of the National Health Service. With the reduction of many schools of nursing and the formation of larger more complex schools, the Department of Health and Social Security established the new grade of assistant director of nursing education. The' then General Nursing Council for England and Wales issued guidelines indicating a role specification and suggesting that this post could carry responsibility for basic nursing or post-basic nursing education. The following are some of the principal responsibilities that were seen.
1. Education and organisation (a) Controls and co-ordinates the work of the department within the agreed policies of the school. (b) Discusses the planning and the organisation of the curricula with the senior tutors. (c) Draws up criteria for the evaluation of courses with the senior tutors. (d) Monitors the progress of learners and the success of the course. (e) Supervises the work of tutor and clinical teacher students gaining teaching practice in the school. 2. Communications (a) Promotes positive interaction between the school of nursing and the heads of nursing service. (b) Advises the director on matters of curriculum planning related to the practice areas. (c) Enables the movement of learners in the hospitals and other practice areas to be balanced, so that students and pupils know and understand their progression of experience and the practice areas have the number of learners required to provide for good care to be given and guod standards of ward teaching and supervision to be achieved. D
198\ Lo ngma n Group Ltd.
(d) Advises the senior tutors on the implementation of agreed policy regarding internal ward assessments and examinations.
3. Educational activities (a) Maintains close links with educational institutions, including those involved in training nurse teachers. (b) Encourages the use and evaluation of new teaching/learning methods. (c) Explores the possibilities of forming local centres for nurse teachers, ' with special reference to sharing technological provision. (d) Implements clinical and educational research findings where opportunity and policy permits. (e) Initiates with appropriate expert advice, and/or participates in, research in nursing education. 4. Personnel . (a) Advises the senior tutors about the personnel care of the learners. (b) Provides for the counselling of the teaching staff of her department and encourages their development. (c) Ensures that adequate and accurate records are kept for learners and staff and that personnel files are maintained according to the personnel policy for the district. effective conferences between (d) Fosters teachers and between the learners and teachers (eg Set Representatives Council). 5. Policy formation and financial control (a) Participates with the director in the drawing up of estimation of expenditure. (b) Monitors the budgets provided. (c) Participates in planning for future developments and the implementation of agreed plans, regarding .particularly. the effect upon learners and staff. Later, the actual size of a school of nursing to warrant the appointment of an assistant director for basic education was established at 500-600 learners. On looking at these activities some would say that 87
NURSE EDUCATION TODAY the post is not really intermediate between the senior tutor and the director but just takes more of the responsibility in management away from the senior tutors. The role could also appear to be unnecessary in a school with only 500-600 learners following just one or two courses leading to registration. If the role is to be recognised as a training post for those wishing to proceed to being a director of nursing education, then the assistant must work closely with the director. Opportunities to act for the director in attending meetings with directors of nursing/midwifery service, or in manpower planning and with the EAG (previously RNTC) provide valuable experiences. As well as being involved in all policy relating to the nurse learners, their clinical placements and the teaching and support staff, the assistant director of nursing education must know or have access to the appropriate information to enable her to make decisions about problems which arise. In discussing the role of the director, Quinn (1980) noted the importance of good leadership and how it can dramatically affect the morale of the whole school. In my experience this is true, and therefore it is important that the assistant director of nursing education works with the director and senior nursing staff in developing the philosophy of the educational division and in introducing change. Little is available for the preparation of directors of nursing education and much has to be learnt 'on the job' by the successful applicant if he/she has not held an assistant director post. Similarly, senior tutors should be given every opportunity of acting for the assistant director, to learn about the managerial responsibilities of the role and gain insight into the much wider aspects of the director's role. Another aspect of the role is that of co-ordinator, especially important in a large and complex school of over 900 learners offering eight different schemes of training leading to registration. Quinn (1980) is one of the few writers on nursing education to have even mentioned the assistant director's role. He emphasised the need for integrated teams. This integration is particularly necessary when there are a variety of courses being undertaken, so that the teams of teachers do not become isolated and unaware of the demands on the rest of the staff and the learners. The assistant director of nursing education should have an overall view of the school so that he/she is aware of any constraints and can help senior tutors in their role and encourage innovation. The assistant director must be seen to be available to all tutorial staff and learners. This is most important in any school but even more so where the staff number over 50. Smith (1975) supported this when he said, 'Colleges are employers of large numbers of people. Good organisation depends on good people, people must matter to the organisation and one of the prime responsibilities of management is to devise a personnel policy for all staff members.' It is not so easy to identify problems in a large school but much can be achieved by discussion at regular
88
formal and informal meetings, by good communication practices, and by ready offer of help and advice if required. Having a specific educational role such as responsibility for curriculum development gives the assistant director an opportunity to act as a change agent. In some aspects perhaps the role can be equated to that of the deputy heads in general education. Stenhouse (1975) quoted Musgrove (1971) in how he saw their role: 'They see their job as requiring first and foremost skills in dealing with school staff, listening to their problems, suggesting solutions and interceding with the head on their behalf. They do not see themselves primarily as organisers, they consider that "concern for teachers" is the most important part of their job.' Stenhouse later went on to talk also about the changing roles of deputy heads and how heads are deploying deputies as 'change agents' with responsibilities for curriculum development or staff development. The liaison role of the assistant director of nursing education is illustrated diagrammatically in Figure 1. In this respect the assistant director is much involved in the day-to-day running of the school. In many respects the role is similar to that of a director in a small school of nursing. It is essential that there is regular communication between the assistant director and the senior tutors. Here, staff appraisal can be a useful tool for discussion and for showing the assistant director how both roles can be adapted to the best advantage of all concerned. The role of the· assistant director could be interpreted as being a job that involves much paper work. Normally a certain amount is to be expected. In the book A guide for teachers of nursing Smith (1975) suggested the establishment of the post of a registrar, or bursar. This would be a welcome addition to many schools of nursing since much precious time is spent in keeping learners' records, indexing and entry forms for examinations-time which could be used for teaching and counselling purposes. The assistant director's role can be a challenge and a worthwhile experience. While the loss of one's 'own' students is .inevitable, there need not be a loss of learner contact; an assistant director can be involved in teaching certain aspects of the curriculum. If an assistant director of nursing education-post basic education is also in post, then links can be developed and another teaching input maintained: for example, helping in the preparation of newly qualified staff, meetings with clinical teachers, orientation programmes for new staff and the selection of assessors for the clinical areas. In the Rcn document 'To teach or not to teach', again little reference to the role is made. However, under the heading of assistant director of nursing education is stated: D 198·1Longman Group Lld.
NURSE EDUCATION TODAY Director
Assistant Director of N ursing Educat ion
(Pos t Ba. ic)
t I 0 ,;"N"";~
Allo cation
Senior
Service Coll eag ues
TU10"~ \
-----.
A ssistant Director of Nurs ing Educ at ion
AVA~ Administralion / (Gene ral)
ow
l - - - - r Clinical Teach er
~Tutor/CT St udents
/
I
DePt of Furt her and Hig her Educat ion
the school of nursing and could in volve research and development of nursing education .' This last sentence emphasises the point that was orig inally made in this article. The role of the assistant director of nursing education may well differ according to local needs, but if th e post is to be seen as a preparatory stage to a director appointment, then some of the aspects of the role that have been m entioned in this article should be included in the specification. NOTE
Secr etarial Staff
Library
. .- -..... « frequent communication ____ r
regarding school. policies. cha nges etc.
Fig 1: Tbeliaison role of the assistant director of nursing education
'These appointments are made according to local needs of the school of nursing to assist the Director of Nursing Education... As a staff post this enables flexibility of responsibility and function, eg curriculum design, recruitment and selection, eoordinating aspects of nurse training in a multiregister training school. These responsibilities and functions would be tailored to the local needs of
This paper originated from a pro ject submitted for the degree of BEd(Hons) at The Polytechnic of th e South Bank and while the author was the Assistant Director at The Princess Alexandra School of Nursing, The London Ho spital, Whitechapel, London.
REFERENCES G eneral Nursing Council 1975 The specification for intermediate post between director of nursing ed ucation and senior tutor. GNC Guidance Paper May 1975. Hoy R, Robbin J 1973 Nurse edu cation . In: The profession of nursing. McGraw-HilI, M aidenh ead, eh . 23, p . 127. Qu inn F M 1980 Aspects of educational management. In: The principles and practice of nurse educa tion . Croom Helm, London, eh . 9, p . 315. Royal College of Nursing. Asso ciation of Nursing Ed ucation. To teach or not to teach? That is the que stion. Rcn, London. Smith JP 1975 College org ani sation, management and curriculum. In: Reybould E (ed) A guide for teachers of nurses. Blackwell , Scientific, Oxford, eh, 8, p . 117. St enhouse L 1975 An introduction to cu rriculum, research and d evelopm ent. Open University. H einemann, London.
Student nurse wastage and attitudes to treatment B D Davis Deputy Director, Nursing Research Unit, University of Edinburgh STUDIES of nurse training show a continuing dilemma caused by the twin problems of numbers and standards; increase in the former leading to "fears of decrease in th e latter. This paper describes a study concerned with the problem of maintaining an adequate supply of students through the training school. It is the first in a series of three articles looking at the relationships between attitudes and student nurse training. Within a psychiatric hospital the problem of numbers was affected by the levels set for entry requirements and also by the numbers available. A th ird factor was that of attrition, or wastage. The problem of entry requirements was solved by using the minimum standards set by the General Nursing Council, and that of numbers available was tackled by seeking recruits from overseas. However, the problem of wastage was not so easy to solve, and a local survey of rates was undertaken to establish the size of the problem.
HI STORICAL
l' 1984 Longman Gr oup Lt d.
The national rates for wastage seem to be rem arkably constant at around 33 per cent (GNC 1966). This figure was confirmed by the Report of the Committee on Nursing (1972) . However, the reg ional and hospital rates may vary substantially about this figure. For example, Srivastava (1959) found a figure of 50 pe r cent, and McGuire ( 196 1, 1966) a figure of 26 per cent.
Nurse wastage 'su r ve y In the present study two periods were re trospectively considered: the late 1960s and the early 1970s. During the second of these periods recruitment policy was extended to include a larger group from overseas. Table 1 shows wastage and examination pass rates from the two periods, and Table 2 shows proportions of overs eas students recruited for the two periods. One possible explanation of the varying wastage
89