Article

The development of a conceptually based nursing curriculum: an international experiment

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Abstract

Nursing programmes in the United States of America are based on a conceptual framework. Not only do faculty and students ascribe to the necessity of such programmes but the national accreditation agency also provides its accreditation approval for the institution only after all criteria are met, including the requirement of a well-defined, operationalized and implemented framework. Can a nursing programme be developed in other nations utilizing the esoteric, American-based idea of the necessity for a conceptually based curriculum? The author answers this question. The manuscript presents both the process utilized in selecting a conceptual framwork for a new junior college programme in Kuwait and discusses the selected framework. The idea of a conceptual framework to guide the curriculum was as foreign in Kuwait as it was to nursing curricula in the United States 15 years ago. Though initially rejected by the faculty in Kuwait, the idea of a conceptual framework was reintroduced after much faculty discussion and questions related to nursing knowledge vis-a-vis medical knowledge, and what should be included in and excluded from the programme. By the end of the second year, a definite framework had been operationalized into courses and content. The selection of the framework evolved from faculty participation in the operationalization of the framework. This point is quite significant particularly in an international assignment, as it is the faculty who are left with the monumental task of supporting and continuing the work which has been done. Strategies used to develop and implement a conceptual framework included confrontation of faculty of the existing situation, lectures, seminars, workshops, and the identification of a critical review board.

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... 12 Two other papers excluded from this review on the basis of review objectives examined the development of a new curriculum in Kuwait, and suggested that the social, health and nursing properties in a country should be considered carefully in order to develop a new curriculum that best fits the needs of the country. 18,19 It can be concluded that the cultural and economic relevancy of the borrowed curriculum model should be assessed even when the two countries are within the same region. ...
... 12 Two other papers excluded from this review on the basis of review objectives examined the development of a new curriculum in Kuwait, and suggested that the social, health and nursing properties in a country should be considered carefully in order to develop a new curriculum that best fits the needs of the country. 18,19 It can be concluded that the cultural and economic relevancy of the borrowed curriculum model should be assessed even when the two countries are within the same region. ...
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Objectives: The objective of this review was to appraise and synthesise the best available evidence on the feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries. Inclusion criteria: This review considered quantitative and qualitative research papers that addressed the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries. Papers of the highest level of evidence rating were given priority. Participants of interest were all levels of nursing staff, nursing students, healthcare consumers and healthcare administrators. Outcomes of interest that are relevant to the evaluation of undergraduate nursing curricula were considered in the review including cost-effectiveness, cultural relevancy, adaptability, consumer satisfaction and student satisfaction. Search strategy: The search strategy sought to find both published and unpublished studies and papers, limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Finally, the reference list of all identified reports and articles was searched, the contents pages of a few relevant journals were hand searched and experts in the field were contacted to find any relevant studies missed from the first two searches. Methodological quality: Each paper was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. Results: A total of four papers, including one descriptive study and three textual papers, were included in the review. Because of the diverse nature of these papers, meta-synthesis of the results was not possible. For this reason, this section of the review is presented in narrative form. In this review, a descriptive study and a textual opinion paper examined the cultural relevancy of borrowed curriculum models, and the global influence of American nursing. Another two opinion papers evaluated the adaptability of another country curriculum models in their countries. Conclusion: The evidence regarding the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries is weak because of the paucity of high-quality studies. However, some lower-level evidence suggesting that direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. Second, the approach of considering international, regional and local experiences more feasible and presumably a more effective strategy for adapting of a country's curriculum into a culturally or economically different country.
... 12 Two other papers excluded from this review on the basis of review objectives examined the development of a new curriculum in Kuwait, and suggested that the social, health and nursing properties in a country should be considered carefully in order to develop a new curriculum that best fits the needs of the country. 18,19 It can be concluded that the cultural and economic relevancy of the borrowed curriculum model should be assessed even when the two countries are within the same region. ...
Article
Objectives  The objective of this review was to appraise and synthesise the best available evidence on the feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries. Inclusion criteria  This review considered quantitative and qualitative research papers that addressed the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries. Papers of the highest level of evidence rating were given priority. Participants of interest were all levels of nursing staff, nursing students, healthcare consumers and healthcare administrators. Outcomes of interest that are relevant to the evaluation of undergraduate nursing curricula were considered in the review including cost-effectiveness, cultural relevancy, adaptability, consumer satisfaction and student satisfaction. Search strategy  The search strategy sought to find both published and unpublished studies and papers, limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Finally, the reference list of all identified reports and articles was searched, the contents pages of a few relevant journals were hand searched and experts in the field were contacted to find any relevant studies missed from the first two searches. Methodological quality  Each paper was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management, Assessment and Review of Information (SUMARI) package. Results  A total of four papers, including one descriptive study and three textual papers, were included in the review. Because of the diverse nature of these papers, meta-synthesis of the results was not possible. For this reason, this section of the review is presented in narrative form. In this review, a descriptive study and a textual opinion paper examined the cultural relevancy of borrowed curriculum models, and the global influence of American nursing. Another two opinion papers evaluated the adaptability of another country curriculum models in their countries. Conclusion  The evidence regarding the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries is weak because of the paucity of high-quality studies. However, some lower-level evidence suggesting that direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. Second, the approach of considering international, regional and local experiences more feasible and presumably a more effective strategy for adapting of a country's curriculum into a culturally or economically different country.
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Nursing education in Sweden has undergone quite a few changes during the last decade. The aim has been to make nursing more holistic, individualised and health-oriented. Social competence, systematic problem solving and research have also been emphasised. These changes in nursing education have led to new demands on nurse teachers. Nurse teachers, directors of nursing education at three nursing schools and a few nurses were interviewed about the problems they experienced in relation to the new demands. The main problems reported were: 1) students inadequately prepared for nursing education, 2) students' attitudes to the social and health-oriented content of the first course at nursing school, 3) integration of research and nursing, 4) resistance to a more theory-based and nurse teacher-dominated nursing education, 5) integration of nursing theory and nursing practice and 6) incompatible demands on the clinical nurse teacher.
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In this article the author discusses the meaning of a conceptual framework in the curriculum, the advantages of a conceptual framework, the relationship of curriculum design to the conceptual framework and some types of conceptual framework used in nursing curricula. The conceptual framework in the curriculum process and the relationship of nursing theory to the conceptual framework are also discussed. This article presents some results of a survey of Australian post-basic clinical nursing courses and a content analysis of curricula for these courses. Such curricula are often perceived as based on nursing theory but in reality most appear to be heavily orientated to the medical model.
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Because of a dearth of material in the literature regarding the process of teaching transcultural nursing, it was necessary to do an analysis of processes, or feasibility study while at the same time engaging in the process of teaching transcultural nursing. Findings from this analysis indicate that a number of strategies can be used to help nurses integrate culturally sensitive material, but that the most important of these may be experiential learning.
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While American nursing attempts to deal with the multitude of dilemmas that have been plaguing it for decades, many developing countries look to the USA for a nursing model to emulate, and then become lost in this confusion of its nursing profession. However, these countries continue to reach out and seek consultants with educational and practical experience in nursing in the USA, as well as in other developed countries. A paradigm is proposed for use by educators and consultants to help delineate the major issues a developing country has to confront in establishing a stable nursing service. This paradigm is explicated by applying it to the situation in Kuwait, a Fourth World country with many social paradoxes (e.g., rich in economic resources but poor in human resources). Four major paradoxes in nursing are identified by using the proposed paradigm. They are: 1 educational needs vs. educational reality; 2 locals vs. cosmopolitans; 3 role congruency vs. role incongruency; and finally 4 medical vs. nursing conceptual models. Although these paradoxes became manifest through work done by the author in Kuwait, any international health care professional will quickly realize that the prardoxes are not unique to Kuwait but have parallels in many other countries which are at different stages of development.
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International nursing, as well as the entire nursing profession, has committed itself to a change paradigm. An alternative to the change paradigm has been proposed to account for elements of stability and persistence. This alternative, therapeutic syncretism, is defined and described, emphasizing an individual's effect on the syncretic process. Finally, the Kingdom of Swaziland illustrates therapeutic syncretism in action as the nation, nurses, and indigenous healers reflect qualities of persistence and change.
Article
A conceptual framework provides boundaries within which facts, concepts, theories, and propositions from three theoretical sources interact with clarity, coherence, and consistency. From the framework objectives are derived. The framework gives direction to the curriculum design. Finally, the conceptual framework serves as a background against which objectives can be tested. A conceptual framework for curriculum encourages systematic curriculum evaluation that will eventually allow us to more accurately describe, explain, predict, and control the work of curriculum.
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The utility of systems models and development models for practitioners
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MASLOW A.H. (1970) Motivation and Personality. 2nd ed. Harper and Row, New York.
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