Pre-registration Nursing Programmes Research Articles

Commentary: Embedding clinical research in pre-registration nursing and midwifery programmes.

Commentary: Embedding clinical research in pre-registration nursing and midwifery programmes.

Embedding clinical research in pre-registration nursing and midwifery programmes.

Within the UK, there is a goal that research is embedded into everyday healthcare practice. Currently education provided to students at pre-registration level is theoretical, with little focus on clinical research delivery. The paper's aim is to report on the development and evaluation of a pre-registration clinical research resource for nursing and midwifery students with direct application to clinical settings and patient care outcomes. An initial survey assessed whether the learning resource was useful for nursing pre-registration students. Based on the findings, alongside expert stakeholder input, adaptations were made to the learning resources and a second survey re-evaluated the learning resources. Survey findings were analysed using descriptive statistics. Free text responses were thematically grouped. Ninety-seven pre-registration nursing students responded. Most students agreed that they had enjoyed using the resources, had improved understanding of clinical research, anticipated being actively involved in research and would consider a future clinical research role. The learning resources can help overcome barriers to research engagement by nurses and midwives. The results demonstrate that research can be incorporated into clinical, educational and academic roles, highlighting their worth in supporting the clinical research workforce.

Students’ evaluation of professional experience placement quality in a pre-registration nursing programme: A cross-sectional survey

AimTo evaluate the quality of student nurses' experiences and overall satisfaction with professional experience placements at a regional Australian University. BackgroundProfessional experience placements are a crucial component of pre-registration nursing programs. However, the absence of standardised approaches to assess placement quality has created uncertainty on what constitutes a high-quality placement from a student’s perspective. DesignCross-sectional survey. MethodsA descriptive cross-sectional survey was administered online to 800 second and third year undergraduate nursing students at an Australian university. The survey contains demographic questions (e.g., year of study, placement specialty, duration, setting and geographic location), a validated Placement Evaluation Tool and free-text comments. The Placement Evaluation Tool is a 20-item questionnaire that measures two key factors: clinical environment (factor 1), learning support (factor 2) and overall satisfaction of students’ learning experiences during a professional experience placement. A descriptive analysis was conducted to evaluate the student’s overall experience and satisfaction. Multivariate linear regression was used to assess the relationship between the quality of the student experience and demographics and presented as beta coefficient (β) and confidence interval (CI). Free-text comments were thematically analysed. ResultsA total of 1104 survey responses were received (as students may rate more than one placement), with an estimated 71% response rate. Most responses (60.3%) were third-year students. Most students experienced high-quality placements, reflected in the overall positive placement experience (PET item 1–19 score: mean 85.9 out of 95) and high student satisfaction (PET item 20: mean 8.53 out of 10). Multiple linear regression analyses revealed that the third year of study and public facilities were independent predictors of positive student experiences (β: 2.61, 95% CI: 0.75, 4.47 and β: 3.72, CI: 0.90, 6.55, respectively). Further analysis of PET items related to factor 1 and factor 2 revealed that high positive experiences in public facilities may be due to the higher learning support (β: 2.54, CI: 0.80, 4.27). Three main themes were perceived to be important to students' professional experience: (i) staff and facilitator attitudes, (ii) learning opportunities and (iii) a team-based learning environment. ConclusionsMost students reported high-quality placement experience and high satisfaction; however, a lack of learning support may contribute to less positive student experiences. This finding emphasises the importance of collaboration between clinical facilities and educational institutions to enhance the student’s placement experience.

A cross-sectional study of resilience and well-being among nursing students in Saudi Arabia.

Promoting resilience and embracing healthy coping strategies can effectively assist nursing students in managing stress and enhancing their welfare. Nonetheless, a comprehensive understanding of the factors influencing their well-being and resilience, pivotal for both academic accomplishments and future career longevity, remains incomplete. A cross-sectional descriptive correlational design was adopted for this study. Participants comprised students enrolled in pre-registration nursing programs at both undergraduate and graduate levels. The World Health Organization-5 Well-Being Index and the 10-item Connor-Davidson Resilience Scale were utilized to assess psychological well-being and resilience, respectively. The study involved 175 university nursing students selected through convenience sampling. On the 10-item Connor-Davidson Resilience Scale, the average score was 25.5, with undergraduate and graduate students scoring an average of 25.4 and 26.3, respectively. Nevertheless, the two groups had no statistically significant difference (p = 0.526). Regarding perceived well-being, the average World Health Organization-5 score was 16.1, with no noticeable distinction between undergraduates and postgraduates (p = 0.858). Notably, bivariate analysis revealed a moderate positive correlation between self-reported resilience and perceived well-being (rp = 0.281, p = 0.001). Moreover, senior students exhibited significantly higher scores on the perceived well-being scale than junior students (17.0 vs 15.1, p = 0.010). Multivariable regression analysis also identified that self-reported resilience represents a consistent means of predicting perceived well-being (regression coefficient B = 0.22, p < 0.001). The outcomes indicate that university-based nursing students who exhibit higher levels of resilience have more positive perceptions of their well-being. Moreover, postgraduate students exhibit more significant resilience levels than undergraduate students.

Dementia: A call for a paradigm shift in pre-registration nurse education.

Dementia is a progressive brain disorder that affects memory, thinking and behaviour. It is a major global public health concern, with an estimated 55million people worldwide living with the condition. In the UK, there is an estimated 944,000 people with dementia. This number is expected to double by 2050. Dementia is a major cause of disability and dependency, and it places a significant burden on families and carers. The current level of dementia education in pre-registration nursing programmes in the UK is inadequate. There are no pre-registration nursing educational programmes that offer dementia as a speciality. This is a major concern, as nurses are the primary providers of care to people with dementia. This article argues that dementia should be established as a branch of pre-registration nursing education that leads to a Registered Nurse (RN) - Dementia. This could help to address the shortage of specialist dementia nurses in the country. This article provides an important suggestion for countries with a shortage of specialist dementia nurses to consider establishing a stand-alone pre-registration branch of dementia nurse education. This would result in a more specialised workforce with the skills and knowledge to provide high-quality care to people with dementia.

Development of a simulation placement in a pre-registration nursing programme.

A 4-week simulation placement for first-year student nurses using an innovative blended approach was developed and delivered in one university. This was the first tariff-funded simulation placement in the UK for student nurses. To describe how this flexible simulation placement was developed, operated and adapted due to COVID-19 while exploring the student nurses' experiences and preparedness for practice. An anonymous online survey was undertaken and a placement evaluation was completed and compared with traditional clinical placement evaluations by previous students at the same point in their studies. Students were as satisfied with the simulation placement as students who had attended real practice placements: 92% of students were satisfied with their simulated placement experience and 92% felt prepared for practice. This simulated placement has been an acceptable replacement for traditional practice placements, particularly during the COVID-19 pandemic.

Patient privacy protection among university nursing students: A cross-sectional study.

Protecting a person's right to privacy and confidentiality is important in healthcare services. As future health professionals, nursing students should bear the same responsibility as qualified health professionals in protecting patient privacy. To investigate nursing students' practices of patient privacy protection and to identify factors associated with their practices. A cross-sectional study design was adopted. A two-part survey was used to collect two types of data on nursing students: (1) personal characteristics, including demographics, clinical experience and use of information and communication technology and social media and (2) practice of patient privacy protection, collected using the Patient Privacy Scale. A total of 319 nursing students aged 18 or above, studying pre-registration nursing programmes and who had attended at least one block of clinical placement, were recruited from a university in Hong Kong. The study received ethical approval from the Survey and Behavioural Research Ethics Committee of the Chinese University of Hong Kong. The participants were informed of the study aim and written consent was obtained before completing the survey. The mean total score on the Patient Privacy Scale was 119.7 out of 135. Nursing students who were regular users of Instagram and those who had never taken photographs with patients and hence did not need to obtain patient consent were associated with better practices of patient privacy protection (higher total scores on the Patient Privacy Scale). The findings improve our understanding of nursing students' practice of patient privacy protection and the associated factors. This will inform the development and revision of current strategies to enhance nursing students' practice of patient privacy protection, especially their use of social media.

Pre-registration nursing students' perceptions of their baseline digital literacy and what it means for education: A prospective COHORT survey study

BackgroundTo build complex digital skills and capability required by digitally-driven work environments, we must first understand nursing students' baseline digital literacy if educators are to develop a fit for purpose curriculum underpinned by digital health technologies. ObjectiveTo determine first-year pre-registration nursing students' perceived baseline digital literacy before their first clinical placement. DesignProspective cohort study. SettingsTwo universities in Australia in 2020. ParticipantsStudents enrolled in pre-registration nursing programs at Bachelor's and Master's level. MethodsParticipants (N = 205) completed an online 27-item survey composed of a Likert-type scale, forced-choice items, and open-ended questions. Data were analyzed with descriptive statistics. ResultsParticipants engaged with digital technology early in life, with 49.75% students using some form of digital technology before ten years of age. Students reported the highest daily use of technology to search the internet for information (92%), online social networking (68.3%) and watching videos (67%). Most students expressed the least confidence in identifying different types of portable storage devices (24.1% Master's students; 41.7% Bachelor's students), describing the advantages of a digital camera (39.3% Master's students; 48.3% Bachelor's students), and totaling numbers in spreadsheets (22.8% Masters students; 48.3% Bachelor's students). No statistical differences were observed between the two universities or the two cohorts in terms of perceived confidence in using technology and software applications to support their learning. Interestingly, 24.7% of participants expressed high confidence in using electronic medical records without prior training, which may reflect positive attitude towards engaging with unknown digital technologies. ConclusionsNursing students are frequent internet and social media users. However, despite positive attitudes to digital technology and widespread presence of digital technology in students' lives, deficits in students' confidence in using digital technology and software required for learning persist. Targeted digital literacy education interventions are needed as part of foundational nursing studies to improve nursing students' baseline digital literacy before commencing clinical placement. These should be scaffolded across the program to ensure an effective transition to nursing practice in evolving digitally-driven healthcare environments.

The Theory of Human Relatedness as a Potential Underlying Causative Mechanism in Nursing Student Placement Experiences: A UK-Based Critical Realist Study

Context: This study, underpinned by Critical Realism, re-analysed interview data acquired to examine the views and experiences of four stakeholder groups involved in the delivery of employer-sponsored pre-registration nursing programmes offered by a UK university in which all students already held an appointment as a non-registrant carer and who completed their placements within a block or integrated practicum framework. The re-analysis focused on the extent to which this interview data aligned with the key propositions of the Theory of Human Relatedness and therefore whether this theory, congruent with assertions based on the results of an earlier realist synthesis, might provide a causative explanation of factors affecting nursing student placement experiences. Methods: Semi-structured, digitally recorded and professionally transcribed interviews, each lasting approximately 30 minutes, were held with a purposive sample of 37, predominantly female, respondents in 4 stakeholder groups involved in employer-sponsored pre-registration nursing programmes. These stakeholder groups were students, employers, mentors, and practice tutors and were associated with programme provision within twelve healthcare organisations in northern England. Results: Although more modest in some areas, data provides support for every key proposition identified within the Theory of Human Relatedness; suggesting this theory may closely reflect the criteria that stakeholders implicitly employ to evaluate placement models. More respondents in all groups described the block practicum model in ways that suggest it is best able to promote a sense of connectedness, belonging and synchrony for learners. In contrast, an integrated placement design was portrayed in terms that implied it may increase the risk of disconnectedness but might also be more likely to promote reciprocity. Insufficient data was available to identify the perceived effect of either practicum design in respect of enmeshment, parallelism, and mutuality. Conclusion: The results of this research suggest that a block placement may foster more positive relatedness experiences for students and other stakeholders within nursing programmes. Moreover, the extent to which a practicum framework is perceived to promote connectedness, belonging, reciprocity and mutuality, to minimise disconnectedness and enmeshment and to reduce the need for parallelism may underpin stakeholder appraisal of the two practicum frameworks. Little research regarding the effect of placement duration and intensity on student learning within pre-registration healthcare programmes or the application of the Theory of Human Relatedness to practicum experiences, however, has been undertaken to date and such investigation is complicated by inconsistent terminology to describe practicum designs. It is argued that further academic enquiry within both fields should be a priority for healthcare educators; not least because it may provide further insights into curriculum designs capable of reducing student attrition.

The impact of COVID-19 on practice learning in nurse education.

The COVID-19 pandemic has impacted healthcare education and delivery, including both theory and practice learning. Academic staff responded rapidly to move teaching online during the first lockdown, with many returning to practice to deliver care or upskill practice staff to work in critical care. Many pre-registration students responded by becoming paid NHS employees, contributing to care delivery while remaining on their programme of study. Practice learning partners, despite the challenges of the pandemic, continued to support students to achieve their registration status. This occurred within the context of the Emergency and Recovery Standards, published by the Nursing and Midwifery Council between March 2020 and September 2021. This paper sets out the response of students, practice learning partners and higher education institutions involved in pre-registration nursing and midwifery programmes.

Promoting community engagement in a pre-registration nursing programme: a qualitative study of student experiences.

To offer child health student nurses a broader learning experience in practice with an autonomous choice of a volunteer placement area. To reflect the changing nature of health care and the move of care closer to home in the placement experience. To evaluate participants' experiences. This study used descriptive and interpretative methods of qualitative data collection. This successive cross-sectional data collection ran from 2017 to 2020. All data were thematically analysed using Braun and Clarke's model. Data collection strategies included two focus groups (n=14) and written reflections (n=19). Students identified their increased confidence, development as a professional, wider learning and community engagement. They also appreciated the relief from formal assessment of practice and the chance to focus on the experience. Students positively evaluated this experience, reporting a wider understanding of health and wellbeing in the community. Consideration needs to be given to risk assessments in the areas students undertake the placements and the embedding of the experience into the overall curriculum.

The use of block and integrated practicum structures within employer-sponsored pre-registration nursing programmes: A Critical Realist study

This study, underpinned by Critical Realism, explores the use of block and integrated placement frameworks within employer-sponsored pre-registration nursing programmes at a United Kingdom university. Digitally recorded, commercially transcribed semi-structured interviews involving four stakeholder groups (employers, students, mentors, and practice tutors), were exposed to qualitative content analysis, and yielded four common themes; connectedness, role transition, carer work and difference. Most respondents perceived the block model as being more effective in promoting connectedness, facilitating role transition, and mitigating against perceived difference; although use of the integrated model was considered more desirable for services having to release these students from carer work. Results also highlight various factors which may influence the most appropriate choice of practicum model, including individual student characteristics, the service in which learners undertake their non-registrant care work, the nature of the placement and mentor autonomy within their clinical role. Congruent with the principles of Critical Realism, efforts to establish potential underlying causative mechanisms associated with practicum experiences are underway and currently involves scrutiny of these results against key features of the Theory of Human Relatedness. Furthermore, a regression analysis to identify the statistical relationship between the placement model completed by two national cohorts and retention rates/degree classifications is in progress. This combined work contributes to the extremely limited body of knowledge in an important area of curriculum design within nurse education.

Informing future nursing: An exploration of respiratory teaching in the pre-registration nurse curriculum

Aim/objectiveThe aim is to examine and map the respiratory skills taught in the pre-registration nursing curriculum (2010). BackgroundRespiratory assessment and care are fundamental clinical skills enabling nurses to treat and care for people with acute and chronic respiratory diseases. The incidence of respiratory disease is rising, globally and most nurses will care for respiratory patients during their career.The extent of pre-registration respiratory specific education delivered in UK NMC (Nursing and Midwifery Council) approved education institutions (AEIs) is currently unknown. The move to the 2018 revised NMC standards for pre-registration nursing offers AEIs the opportunity to review provision of respiratory education. This study describes respiratory education delivered to pre-registration nurses in UK AEIs prior to implementation of the new NMC standards. Curriculum re-design can be adapted for the global nursing community. DesignThis is a freedom of information survey; to gather, examine and map curriculum content. MethodsA survey of UK AEIs was conducted to initially scope provision of respiratory education for pre-registration nursing programmes. AEIs were emailed a freedom of information (FOI) request and provided information about the curriculum between April-June 2019. ResultsSeventy-five UK AEIs providing pre-registration nursing programmes responded. Over half of AEIs dedicated over 4 h of teaching respiratory anatomy and physiology (60.8%), respiratory pathophysiology (75.3%) and long- term respiratory conditions (60.3%). Less than half (44.4%) spent over 4 h teaching respiratory health and prevention of respiratory disease. Just over a third spent over 4 h on respiratory pharmacology (33.8%), local and national respiratory guidelines (33.3%) and information on pulmonary rehabilitation and other interventions for the management of respiratory conditions (35.2%). In most AEIs, skills laboratories were used to teach respiratory skills. Student competence was not always assessed. Respiratory learning was reported to take place during practice placements, but this was variable. ConclusionsVariation exists in provision of respiratory education in pre-registration nursing programmes across the UK. Whilst some respiratory topics appear to be covered adequately, others have limited time on knowledge and skills teaching. New standards and curricula offer AEIs the opportunity to enhance this provision. Adaptations can be made and the curriculum transferred to the global nursing workforce. Tweetable abstractGaps have been identified in respiratory teaching pre-registration nurse education. Curriculum redesign to focus on respiratory care.

Enhancing Flexibility in Learning Processes: Simulation Training as an Alternative Mode to Substitute Clinical Practicum during COVID-19

The pre-registration nursing training programmes were facing practical difficulties in arranging clinical practicum to students due to COVID-19 pandemic. In order to ensure clinical competencies of nursing students before their graduation, academics have been exploring strategies to overcome the challenges by enhancing flexibility in the learning processes. Simulation, as a kind of educational technology, with computerized software programmes can replicate real clinical situations in a non-threatening environment for training. It has been supported to enhance nursing students’ clinical competencies. This paper illustrates the development of simulation training curriculum based on the ADDIE model. It was supported that the application of ADDIE model in the instruction development resulted in meeting the learning needs of students and allowed flexibility of learning processes during the pandemic.

Pre-registration nursing students’ experiences of stress

This research study aimed to explore stress among pre-registration nursing students in the United Kingdom. The specific objectives of the study were: To explore the experience of stress among pre-registration nursing students; to determine the type of stress and sources of stress in pre-registration nursing field; to investigate the perceptions of pre-registration nursing students on stress and anxiety in pre-registration nursing programme; and to identify suitable measures that can be implemented to help the pre-registration nursing students to cope with stress. Qualitative research method and phenomenological approach was used in this study and the data was collected with the help of face-to-face semi-structured interviews. The setting for the current study was a higher education institution (HEI) that delivers pre-registration nurse education in the UK. The study sample was six pre-registration nursing students from the East Midlands who were in the first, second, and in final year of the study program leading to BSc (Hons) Nursing with NMC Registration. A thematic analysis of the data was conducted which led to four emergent themes: Pre-registration nursing students’ experiences of stress; re-registration nursing students’ perceptions of stress and anxiety; sources of stress in the nursing field; and measures for coping with stress. The findings revealed that the pre-registration nursing students in this study perceived stress as a problem associated with human health that basically is caused by academic pressure presented by either theoretical assignments, projects, and examinations and placement demands such as while caring for patients. Moreover, stress among pre-registration nursing students was found to be a problem embedded in their lifestyle that impacts their wellbeing. Further findings showed that the study participants perceived that stress and anxiety are interrelated; anxiety takes place in response to stress resulting from academic and clinical placement pressure; and anxiety has a strong relationship with stress and is a contributor to depression too. The study participants also perceived that the major causes of stress include social distress, financial problems, academic pressure, demands of clinical placement, and family expectations. Academic pressure was found to be the most common cause of stress among the pre-registration nursing students in this study. Lastly, the findings revealed that the coping strategies that can help pre-registration nursing students to manage stress are adopting social support mechanisms, encouraging physical activities, and spiritual support. Keywords : Pre-registration nursing students, Stress, Coping. DOI: 10.7176/JHMN/85-14 Publication date: January 31 st 2021

A broken triangle: Students’ perceptions regarding the learning of nursing administration in a low-resource setting

Background. Nursing education institutions (NEIs) must ensure that their graduates are competent in nursing administration. The adoption of nursing administration-related learning outcomes in pre-registration nursing programmes in Africa has created a platform for the teaching and assessment of nursing administration. Challenges aligned with low-resource NEIs, such as rigid content-based vocational programmes, limit the value and utility of the teaching of nursing administration, resulting in graduates who are not able to manage healthcare units effectively. Therefore, this study explored students’ experiences of a nursing administration module with the hope that alignment of the outcomes, content and assessments would be pivotal in the module review to improve nurses’ efficiency in managing health units. Objectives . To describe student nurses’ perceptions regarding the alignment of learning outcomes, content and assessment of a nursing administration module in an NEI in a low-resource setting. Methods. A sequential mixed methods design was executed in three phases. Data were collected through documents, self-administered questionnaires and focus group discussions with students enrolled in a 3-year pre-registration programme at an NEI in a low-resource setting. The gathered documents were enumerated and mapped against the specific elements of a curriculum as described by Harden and Dent. The quantitative data were analysed through descriptive statistics, focusing on frequencies. The data generated from the focus groups were transcribed verbatim, and thematic analysis through an inductive reasoning approach was used. Results. The study revealed a non-alignment among learning outcomes, content and assessment of the administration module, causing students to struggle in meeting the expected learning outcomes of the module. In as much as the curriculum documents specified the learning outcomes, the classroom teaching seemed only to be aligned with the described curriculum. In addition to other challenges, the contextual characteristics of the related clinical environment did not support application of what was learnt in the classroom. The assessment practices mirrored the expectations of the curriculum, but were not aligned with contextual realities. Conclusion. Nursing students struggle to meet expected learning outcomes related to nursing administration due to the non-alignment among learning outcomes, content and assessment of the module. NEIs in low-resource settings must radically transform their pre-registration nursing curricula to incorporate contemporary issues and clinical contextual realities to enhance the utility of nursing administration learning outcomes.

Patient safety education in pre-registration nursing programmes in South Korea.

This study investigated how patient safety is currently taught in pre-registration nursing programmes across South Korea and explored nurse educators' perspectives on curriculum change. Pre-graduate education plays a critical role in preparing nurses with the requisite patient safety competencies. However, little is known about how patient safety education is addressed in South Korean nursing schools or the perspectives of nurse educators regarding patient safety education and a need for change. This descriptive study used data collected during a 2019 accreditation workshop provided by the Korean Accreditation Board of Nursing Education. A paper-and-pencil survey was completed by 80 nurse educators working in 16 regions throughout Korea. A little consistency was found in approaches to teaching patient safety. Patient safety topics are addressed throughout various nursing courses, and patient safety education is limited in hours of instruction and breadth of content. A majority of respondents indicated that additional supports are needed, including a national standardized curriculum for patient safety education. A new approach to teaching patient safety is needed in Korean pre-registration nursing education. Overall, patient safety education is limited and provided through a fragmented approach with little attention to systems, workplace design or human issues that are necessary for developing the critical reasoning and skills to support patient safety. The accrediting and regulatory bodies in South Korea should work together to develop and implement explicit standards of patient safety education and patient safety competencies for nursing students. Development of a standardized national curriculum is essential for providing a consistent, systematic and comprehensive approach to patient safety education in nursing programmes.

The Value and Development of Postgraduate Pre-registration Children and Young People’s Nursing Using Co-production

This commentary introduces the reader to the realism and value of using co-production to develop pre-registration nursing programs for undergraduate and postgraduate nurses – its primary focus is o...

“Yes, the type of student supervision matters, but what about the placement structure?” - A critical realist review of block and integrated practice learning models within pre-registration nursing programmes

This paper highlights the importance of effective clinical experiences for pre-registration nursing students and the wealth of published work associated with practice learning, particularly regarding approaches to student supervision during a practicum. It draws attention to frequent calls within nursing literature for longer placements; many of which fail to either identify the perceived benefits of such change or state whether a longer practicum should involve increased practice learning hours or redistribute existing hours over an extended period; key omissions given the resource-intensive nature of providing these educational opportunities. It also highlights a paucity of research regarding the effect of placement duration and intensity on clinical learning and that practicum design is commonly shaped by custom, practice, operational and financial considerations rather than a sound educational rationale. A Critical Realist review of studies associated with two fundamental placement structures, the block, and integrated models, is offered to consider their strengths and limitations. Moreover, work that evaluates initiatives offering students paid employment in caring roles undertaken alongside a pre-registration programme and therefore displaying similarities to the integrated practice learning model are examined. The review concludes that, as yet, there is insufficient empirical evidence to recommend the targeted application of either a block or integrated placement model within any specific part of a pre-registration nursing programme, calls for greater consistency in the language of placement structure and outlines the author’s own current work contributing to the extremely limited body of knowledge available regarding this aspect of curriculum design within nurse education.

The future of nurse education: imagining the art of the possible.

Thinking about the pipeline for registered nurses and the transition of students to registered nurse: what if we were to create a perfect nurse education curriculum- something that we feel is currently elusive!? What if HEI’s and their healthcare partners were not constrained by student fees and capped numbers; securing practice learning opportunities for first- and second-year students, what could we do with nurse education? Yes, we would have to take risks, let’s just think about what might be possible if we were able to be bold and brave with our curriculum design. We are clear that we are advocates of graduate nurses of whom are critical thinkers and that during their pre-registration nursing programme, students are provided with the quality nursing curriculum and practice learning experience. In this paper, we will not be debating the issue of work contracts, paid learning experiences, student rights or the debate around if low paid on the job nursing students training will take the profession backwards. Others such as Leary (2020) provide this discussion. Instead we offer our thoughts around the future curriculum possibilities, and we welcome further discussion on the issues and recommendations that we make, for example have a clear vision for nursing -be bold about the role of the nurse and be clear about the future of nursing.