Pre-registration Courses Research Articles

Learning About Patient Safety: Organizational Context and Culture in the Education of Health Care Professionals

This study investigated the formal and informal ways pre-registration students from medicine, nursing, physiotherapy and pharmacy learn about keeping patients safe. This paper gives an overview of the study and explores findings in relation to organizational context and culture. The study employed a phased design using multiple qualitative methods. The overall approach drew on 'illuminative evaluation'. Ethical approval was obtained. Phase 1 employed a convenience sample of 13 pre-registration courses across the UK. Curriculum documents were gathered, and course directors interviewed. Phase 2 used eight case studies, two for each professional group, to develop an in-depth investigation of learning across university and practice by students and newly-qualified practitioners in relation to patient safety, and to examine the organizational culture that students and newly-qualified staff are exposed to. Analysis was iterative and ongoing throughout the study, using frameworks agreed by all researchers. Patient safety was felt to have become a higher priority for the health care system in recent years. Incident reporting was a key feature of the patient safety agenda within the organizations examined. Staff were often unclear or too busy to report. On the whole, students were not engaged and may not be aware of incident reporting schemes. They may not have access to existing systems in their organization. Most did not access employers' induction programmes. Some training sessions occasionally included students but this did not appear to be routine. Action is needed to develop an efficient interface between employers and education providers to develop up-to-date curricula for patient safety.

Voices - Mentors and managers must be ready for changes to pre-registration courses

Voices - Mentors and managers must be ready for changes to pre-registration courses

How to apply for nurse training

There has been a significant rise in the number of applicants to nursing pre-registration courses at British universities. A large proportion of these will be healthcare assistants. This article aims to guide them through the process of applying for nurse training and preparing for a successful outcome at interview.

A Pharmacy Preregistration Course Using Online Teaching and Learning Methods

To design and evaluate a preregistration course utilizing asynchronous online learning as the primary distance education delivery method. Online course components including tutorials, quizzes, and moderated small-group asynchronous case-based discussions were implemented. Online delivery was supplemented with self-directed and face-to-face learning. Pharmacy graduates who had completed the course in 2004 and 2005 were surveyed. The majority felt they had benefited from all components of the course, and that online delivery provided benefits including increased peer support, shared learning, and immediate feedback on performance. A majority of the first cohort reported that the workload associated with asynchronous online discussions was too great. The course was altered in 2005 to reduce the online component. Participant satisfaction improved, and most felt that the balance of online to face-to-face delivery was appropriate. A new pharmacy preregistration course was successfully implemented. Online teaching and learning was well accepted and appeared to deliver benefits over traditional distance education methods once workload issues were addressed.

Use of book borrowing statistics as a means to establish library use by pre-registration nursing students: a case study at the University of Northumbria

This paper examines the book borrowing by pre-registration students at the University of Northumbria over a three-year period. Nursing education was transferred into higher education in the early 1990s resulting in large numbers of extra students in many higher education institutions. Little work has been done to establish the impact this move has had in library and information services. This work analyses book borrowing by two nursing pre-registration courses from three perspectives: quantity of books borrowed, book borrowing dispersed over an academic year and the subject material borrowed. Analysis of borrowing is completed using the TALIS Library software. The findings of this study are related to some of the major issues facing those providing library and information services to health students

The learning divide

Jane Ryan argues for single-sex groups when discussing learning styles in pre-registration courses

Diagnosing the problem: Using a tool to identify pre-registration nursing students’ mathematical ability

Mathematical ability is a skill nurses need to safely administer medicines and fluids to patients (Elliott, M., Joyce, J., 2005. Mapping drug calculation skills in an undergraduate nursing curriculum. Nurse Education in Practice 5, 225–229). However some nurses and nursing students lack mathematical proficiency (Hilton, D.E., 1999. Considering academic qualification in mathematics as an entry requirement for a diploma in nursing programme. Nurse Education Today 19, 543–547). A tool was devised to assess the mathematical abilities of nursing students. This was administered to 304 nursing students in one Higher Education Institution (HEI) in Wales, United Kingdom (UK) on entry to a pre-registration undergraduate nursing course. The students completed a diagnostic mathematics test comprising of 25 non-clinical General Certificate of Secondary Education (GCSE) level multiple choice questions with a pass mark set at 72%. The key findings were that only 19% ( n = 53) of students passed the test. Students appeared to have difficulties with questions involving decimals, SI units, formulae and fractions. The key demographic variable that influenced test scores was previous mathematical qualifications on entry to the course. The tool proved useful in two ways. First, in identifying those students who needed extra tutorial support in mathematics. Second, in identifying those areas of mathematics that presented difficulties for students.

The Australian nurse and midwifery workforce: Issues, developments and the future

The paper is concerned with data, concepts and analyses necessary for understanding the nurse and midwifery workforces at a macro-level, and for developing policies and plans that can best assure the quality and sufficiency of those workforces in the future. The size, composition and age profile of the nurse workforce are set out first. This is followed by an outline of the notions of 'attachment' to and 'separation' from a profession. Data on the population with professional nurse qualifications, whether working in the profession, in another occupation, or not working illustrates the patterns of 'attachment' and 'separation' over the working age range. Historical developments since the 1960s are then considered, including the workforce size and age profile, the nurse labour market, pre-registration course completions, and movement in and out of Australian of nursing professionals. The nature and impact of the 'oversupply' of nurses in the early- to mid-1990s is discussed. Six matters are outlined that need to be taken into account when estimating future requirements. A discussion of the potential for quantitative impact on the overall nurse labour market from work redesign and role extension concludes that there is no easy solution for macro-level nurse workforce shortages, and that some otherwise very positive initiatives may exacerbate shortages. It is clear that further increases in pre-registration (and pre-enrolment) intakes and completions will be necessary, as least for a further 8-12 years. Some of the barriers to such increases are noted and suggestions for the future made.

An exploratory Delphi study on the integration of disabled students into physiotherapy education

Objectives The introduction of the Disability Discrimination Act (DDA) IV (1995) in the UK requires universities to ensure that they do not discriminate against disabled students. The objectives of this study were to achieve consensus on the attributes required for a competent physiotherapist, and to explore implementation of the DDA into physiotherapy education. Design An exploratory study was performed using the Delphi technique. Respondents were asked to comment on the skills required to be a physiotherapist, and the implementation of the DDA during the admission process. Setting and participants Participation was invited from all physiotherapy admission tutors working on pre-registration physiotherapy courses in England ( n = 43). Twenty of these consented to be involved, and 13 completed the whole study. Method The Delphi study consisted of three questionnaires administered sequentially; the results from one questionnaire forming the basis of the next. On analysis of the third questionnaire, consensus and saturation had been achieved. Results The admission tutors showed strong consensus (92%) on the skills necessary to be a physiotherapist, although there was some debate about sensory and physical abilities. Participants were uneasy about the level of support for staff and their knowledge of support systems for disabled students. Respondents also expressed concern over the level of support for disabled students. The possibility of conditional qualification for disabled students was discussed. Conclusion Standards set out by the professional bodies could be used to enable disabled students to self-assess their abilities prior to application for courses. Disability support systems within universities need to include physiotherapy tutors.

Involving students in the challenges of caring for older people

Students acquire nursing knowledge and values through occupational socialisation during varied work-based placements. Such experiences not only influence their career paths but, crucially, their orientation towards older people in practice. This paper draws on research exploring nursing students' experiences of working with older people during a pre-registration course. It aims to show how understanding their perceptions might assist in meeting the future challenges of elder care. The author reveals that reformed nurse education, service modernisation and changing roles have modified traditional views of nursing older people but not overturned them. Nurses in age-specific and non-acute areas were more likely to practise and encourage a person-centred approach, this being consistent with students' ideals.

Coverage of dementia is patchy in pre-reg courses report shows.

This study reports on the results of a questionnaire about the coverage of dementia in pre-registration courses for health and social care professionals. Results showed that coverage within the mental health branch of nursing is highly variable while coverage in the adult branch is limited and sometimes non-existent, despite reported deficits in the ability of general nurses to work effectively with people with dementia. The questionnaire was based around a curriculum developed by the Higher Education for Dementia Network. This sets out key areas that should be covered including: ■ Models of dementia ■ Ethics and dementia ■ The law and dementia ■ Therapeutic intervention ■ Pharmacology ■ Holistic health ■ Partnership with carers ■ Cultural issues and diversity ■ Research.

Higher education provision for professionals working with people with dementia: A scoping exercise

This paper reports on the first national UK survey of higher education provision related to dementia care. A questionnaire was distributed to lecturers in Higher Education Institutions (HEIs) in England and Wales seeking information about the amount of coverage of dementia within their pre-registration and pre-qualifying courses for health and social care professionals, and continuing professional development (CPD) courses on dementia care. Information was sought regarding the content of courses, and their relation to a published "dementia curriculum" [Pulsford et al., The contribution of higher education to dementia care, Journal of Dementia Care 11(4) (2003) 27-29]. Results show that coverage of dementia within the mental health branch of pre-registration nursing programmes is very variable, and may be related to the presence of an experienced and committed lecturer within the HEI. Coverage of dementia on adult branch programmes is limited, and sometimes non-existent, despite reported deficits in the ability of general nurses to work effectively with people with dementia. Occupational Therapists and Social Workers receive similar input to adult branch nurses. CPD courses are provided by around 70% of HEIs overall, but there is a shortage of specialised diploma and degree level courses on dementia care. Most areas of the dementia curriculum are covered in both pre-registration and CPD courses, but culture and diversity, young onset dementia, and physical health care may be less well addressed. Recommendations are made for developing higher education provision for professionals working with this group of people.

Wound care education needs a boost

This morning I had the pleasure of discussing the assessment and treatment of leg ulcers with 300 undergraduate students. When I asked how many of them had encountered leg ulcers in practice, every student raised their hand. The same happened last year when I covered chronic wounds. Most (if not all) students will see – and possibly treat – chronic, complex wounds and leg ulcers during many parts of their course. My worry is not this, but the lack of wound and leg ulcer care in the curriculum. There appear to be only 6 hours spent on some preregistration courses studying wounds. Some nurses report 70% of their workload involving wound and leg ulcer management. So why is it that so little time is spent teaching these subjects at undergraduate level?

Critical Care Nursing: science and practice, 2nd edition

There are many critical care books that encompass knowledge, skills and expertise in critical care nursing. As a nurse who is very hands-on and spends most of her time in the clinical area, I value a textbook that combines clinical practice and knowledge. This textbook is ideal for nurses who want to understand practical issues that may be experienced while caring for the critically ill at the bedside. The authors obviously have great knowledge and experience in this arena, and have ensured that they have updated topics from the first edition such as sepsis and neurointensive care. All chapters have sections on trouble shooting, such as resolving outflow problems in peritoneal dialysis and problems associated with electrocardiogram monitoring. These are the sorts of clinical problem that inexperienced nurses have concerns about and want to be able to remedy systematically at the bed space. This book will also appeal to experienced critical care nurses, especially as a reminder if they have not made use of certain skills or experienced certain illnesses for a long time. It will also appeal to pre-registration and post-registration courses in intensive care nursing, especially as it has a 'test yourself' section at the end of each chapter – but it is very easy to cheat because the answers are just under the questions! The book is in a logical order, and highlights the need for critical care skills to be expanded outside the geographical area, improving early recognition of critical illness and improving ward care of the critically ill. As a critical care outreach Clinical Nurse Specialist, this is music to my ears. All critical care nurses need to be aware of the bigger picture, and not isolate themselves from the rest of the hospital. Each chapter discusses care of the critical care patient but further reading would be needed to have in-depth knowledge. It will definitely give all readers a good foundation in critical care nursing. You will need to have a great love of pink and red, as there really is a lack of colour and pictures in the text. I felt the book was easy to read and kept me interested, and I would recommend it to my colleagues.

An investigation to find strategies to improve student nurses' maths skills

Being able to perform drug calculations accurately is an essential skill for nurses. Many studies, however, have demonstrated that nurses need to improve this area of their practice and in particular their mathematical skills. Several strategies have been implemented to develop the drug calculation skills of nurses, with mixed success. This article reports on a study that was carried out to investigate whether strategies implemented within a second-year pre-registration course were perceived by students to be helpful in improving their mathematical skills for drug calculations. The results demonstrated that students felt their mathematics and confidence improved as a result of these strategies. The students' evaluation of the learning strategy that they found most helpful in learning drug calculation gave a mixed result, indicating that students have differing learning styles and needs. The study also indicates that student nurses were able to integrate the mathematical skills into their nursing practice by having different strategies that allowed them to develop conceptual, mathematical and practical skills concurrently. The study recommends the implementation of integrated strategies to address drug calculation skills in student nurses, although further research is still required.

Undergraduate pre-registration nursing education in Australia: a longitudinal examination of enrolment and completion numbers with a focus on students from rural and remote campus locations

There is much evidence to indicate a shortage of Registered Nurses (RNs) in Australia and to suggest that the shortage may be more pronounced in rural and remote locations. Attracting RNs to work in rural and remote areas may not be as simple as increasing the intake of students into university undergraduate pre-registration nursing courses. There is some evidence indicating that student nurses may be more likely to enter the nursing workforce in rural and remote locations if they have existing associations with rural and remote areas and/or their undergraduate education provides opportunities to undertake supported placements in rural and remote settings. Two important difficulties have been associated with measuring outcomes in relation to rural and remote pre-registration nursing students. One is defining what constitutes a rural or remote location and the other is suspect data on the number of nursing students enrolled in, and completing, nursing courses. The aims of this study were to provide a longitudinal profile of the number of domestic students studying and completing undergraduate pre-registration nursing courses in Australia, with a particular emphasis on identifying those at rural and remote university campuses, and to compare results across States and Territories. This study presents the combined findings from two investigative reports. Data on undergraduate pre-registration nursing student numbers were collected via electronic survey instruments completed by staff at all Australian educational institutions offering undergraduate pre-registration nursing education programs in 2001 and 2002. Australian domestic students were the focus of this study. Data included the total number of domestic students enrolled in undergraduate pre-registration nursing courses in 2001 and 2002, the number of domestic students who successfully completed courses in 1999, 2000 and 2001, and estimates for the number expected to complete in 2002. Surveys were sent to course coordinators or other staff nominated by heads of divisions of nursing at each institution. There was a 100% response rate. Twenty-four rural and remote campus locations were identified using an adjusted form of the Rural, Remote and Metropolitan Areas (RRMA) classification system. The Australian Capital Territory and the Northern Territory did not have any rural or remote campus locations. In contrast, undergraduate pre-registration nursing in Tasmania was offered at a rural campus only (for the first 2 years). From 2001 to 2002, there was an increase of just over 5% in the total number of domestic students enrolled in undergraduate pre-registration nursing courses in Australia (2002 total = 22,811 students). Rural and remote location students accounted for slightly more than 25% of these students in 2001, and almost 27% in 2002. The States Victoria, New South Wales and Queensland had the highest percentage of students enrolled at rural and remote campus locations, greater than the Australian average for both years. In contrast, South Australia and Western Australia had less than 11% of students enrolled at rural and remote campus locations for each year. Total undergraduate pre-registration course completions increased by approximately 16% across Australia between 1999 (n = 4868) and 2002 (n = 5667), although for 2002, the figure was projected. Of these total course completions, the percentage of students completing at rural and remote campus locations increased from almost 23% to nearly 28% during the same period. Of the States/Territories with both metropolitan and rural/remote campus locations, only Victoria and Queensland had more than 25% of their total student completions consisting of students enrolled at rural and remote campus locations for each year. In contrast, South Australia and Western Australia had approximately 6% of student completions consisting of students enrolled at rural and remote campus locations in 1999, increasing to approximately 12% projected for 2002. In this study, the authors attempted to improve the accuracy of data collection in relation to the number of domestic undergraduate pre-registration nursing students in Australia, which is representative of the potentially new Australian domestic RN workforce. There was a trend towards an increasing number of students being enrolled in undergraduate pre-registration nursing courses, and also toward an increasing number of course completions. From the perspective of the rural and remote RN workforce, the percentage of students enrolled and completing courses at rural and remote campus locations was found to be increasing. However, there may be some areas of concern for education and workforce planners in States and Territories that are providing a smaller percentage of their undergraduate pre-registration nursing courses in rural and remote areas. Several study limitations are discussed and suggestions made for future research.

RCN council sticks with all-graduate profession

Wide entry gate will remain despite insistence on degree-level pre-registration courses

NVQs and practice assessment in a pre-registration course.

In response to the government's strategic intentions for nursing outlined in Making a Difference (DoH 1999), the University of Brighton has used national vocational qualification (NVQ) standards to facilitate assessment of practice during the common foundation year of the pre-registration diploma in nursing. The aim of this initiative is to provide 'step on' and 'step off' points using a nationally recognised qualification to meet government requirements for a more flexible approach to nurse education.

Creating diversity in the healthcare workforce. The role of pre-registration nurse education in the UK.

It has been suggested that the introduction of first the diploma pre-registration course and then the three-year degree pre-registration course are likely to have an impact upon the diversity of the future nursing workforce in the UK. Using findings from three large-scale projects, this paper assesses the nature of these changes by comparing the diversity within recently qualified cohorts of graduate, diplomate and certificate-qualified nurses. Findings indicate little difference between the three groups in terms of gender and ethnic origin. A higher proportion of graduates had academic qualifications, which were generally higher than the qualifications held by the other groups of nurses. However, diplomates were the most diverse group overall, being older and more likely to have children, and also having greater previous working experiences. The overall conclusion is that, despite qualification differences, the level of diversity amongst degree-qualifiers was a return to the lower levels associated with qualifiers from certificate courses. Thus the introduction of degree courses may dilute the relative success of the diploma course in terms of the recruitment of a more diverse workforce. The findings are considered in the context of current debates about the future shape of nurse education in the UK.

The brave new university world: factors affecting quality assurance of nursing graduates in australian undergraduate programs

Over the past 10 to 17 years following the transition of undergraduate nurse education to the tertiary system, Australian nurse educators have adapted resourcefully to many challenges in a system which is being continuously re-modelled. Some of these challenges were anticipated whilst others are covert and insidious. The goal of tertiary based education for nurses was to ensure competent and professionally prepared graduates (Nurse Education Review Secretariat 1994 pxviii). The ideology of economic-rationalism and its various faces is now endemic and flourishing in Australian universities and is inevitably affecting this goal for tertiary nursing education. This paper considers some of the implications of broader ideological changes arising from government policy and the micro-ramifications of these for the ability of the discipline to ensure quality assurance of graduates from pre-registration courses. In particular the pervasive impact of these policies on the quality of formative and summative assessment in both clinical and theoretical contexts is considered with specific reference to the highly problematic and little explored nature of social discourse which occurs when formative, and ultimately, summative pass/fail decisions are negotiated. Increasing commercialisation of universities is changing the way the student-teacher relationship is perceived with the role of the student moving from that of consumer with rights, to that of customer in the market-place of the university. It is imperative for the integrity of the discipline that the dynamics and discourse emanating from changing relationships in the 'brave new university world' are researched and that the issues are confronted in open and honest debate.