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Articlesmj-20180921

MEFANET Journal 2019; 6(1): xx-xx

ORIGINAL ARTICLE

Cooperation between European countries and Western Balkan at the modification of nursing study program

Anna Hudáková1*, Gabriela Kuriplachová1, Dagmar Magurová1, Štefánia Andraščíková2, Ľubica Rybárová1

1 Department of Nursing, Faculty of Health Care, University of Presov in Presov, Slovak Republic
2 Department of Midwifery, Faculty of Health Care, University of Presov in Presov, Slovak Republic
* Corresponding author: anna.hudakova@unipo.sk

Abstract

Article history:

Received 21 September 2019
Revised 22 July 2019
Accepted 24 July 2019
Available online 15 August 2019

Peer review:

Daniel Schwarz, Martin Komenda


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Introduction: Project TEMPUS IV – CCNURCA (Competency Based Curriculum Reform in Nursing and Caring in Western Balkan Universities) is currently under way in the international cooperation, which initiates European standards in order to innovation the content of training in nursing. The main objective of this paper is presentation of transforming education in European countries and supporting the modernization of higher education. It also focuses on the cooperation and modernization of higher education in partner countries in the wider neighborhood.

Methods: Methodology for theoretical education in study program nursing includes working groups were created and questionnaire was implemented a survey in order to fulfill the objectives of the project.

Results: The evaluation of a curriculum and the schedule of a study program of nursing were running in the theoretical level. The activity to support the education of teachers themselves, so-called program TOT (Training of Trainers), where the participating specialists from the ranks of teachers were giving trainings in new techniques within the theoretical and practical training to each other, was deemed inspirational.

Discussion: The new program in nursing was verified in this way and monitored the suitability of students, self-evaluation and teacher satisfaction. Results of the project consortia CCNURCA represent innovative changes for the countries of Western Balkan. Educational institutions, health care institutions and government organizations shall unite their efforts for the sake of reforming the curriculum.

Keywords

Nursing; curriculum; train-the-trainers courses, ECTS credits; knowledge-skills-competences


Introduction

The transformation of education in the European Union has led to many changes in the modification of teaching, curriculum and the allocation of hours within courses, the introduction of new teaching methods into studies [1].

The project TEMPUS IV - CCNURCA (Competency Based Curriculum Reform in Nursing and Healthcare in Western Balkan Univer­sities, No. 544169-TEMPUS-1-2013-1-BE-TEMPUS-JPCR) was implemented within the framework of international cooperation, the main aim of which was to use methods, and activities to modernize the curriculum in nursing.

The profile of the study program in Slovakia (at the Faculty of Health Care of Presov, University of Presov and other faculties) meets the criteria recommended by the standards of the European Union, the recommendations of the Munich Declaration (2000) and the criteria of the Bologna Declaration (1999). The key competencies for nursing as recommended by the European Union are: communication skills and competences, critical thinking skills and effective problem solving skills, ability to use modern information technologies, ability to adapt to the role of teacher, consultant, lawyer, patient lawyer, and personal and interpersonal skills [2].

The range of time allocation for the nursing study department is total 4,600 hours, where half of it is practical education (2,300 hours). The student's workload is the ratio between contact and non-contact hours in accordance with the EU directives [3]. Reforming the curriculum for adapting, upgrading and restructuring existing curricula focuses on developing, testing, creating / accrediting new curricula, and disseminating results. The curriculum reform will also focus on the content, structure, teaching methods and use of new learning materials in the context of the program, and the modernization of European higher education (Europe 2020 Strategy, Strategic Framework for European Cooperation in Education and Training (ET 2020) and Bologna Process).

The aim of the transformation of education is to develop and introduce study programs and recognition agreements between higher education institutions in the European Union and in partner countries. The newly opened courses must be structured according to the three-cycle system and must use the European Credit Transfer System (ECTS) and mechanisms for recognizing different levels of education.

Methods

The aim of transforming education in European countries is to support the modernization of higher education. It also focuses on the cooperation and modernization of higher education in partner countries in the wider neighborhood. In particular, the program supports voluntary convergence with developments in higher education in the European Union, stemming from the Europe 2020 strategy, the Strategic framework for European Cooperation in education and training and the Bologna process.

This paper deals with TEMPUS IV – CCNURCA, the specific aim of which was to implement current European requirements in nursing education and to analyze curriculum at nursing institutions in the countries of the Western Balkans (WB). Another objective of the project was to propose a framework for nursing education that would be in according with the Bologna Declaration and European standards that would include ECTS credits in the curriculum of the nursing study program.

The implementation of the pilot phase of the new curriculum in accordance with good educational standards, the introduction of new methods in nursing education and the attempt to outline proposals for new legislation corresponding to changes in nursing education programs within the trans-European network is essential.   

The aim of the project is to ensure successful evaluation and accreditation of the new study program of nursing and the subsequent changes in legislative standards of the countries involved in the project [4]. Strengthening networking between higher education institutions and research institutions in partner countries and European Member States is also essential.

As part of the planned activities of the international project TEMPUS IV – CCNURCA, consortiums were conducted on the territory of participating countries, during which seminars, workshops, and working meetings were held.

Working groups, whose task was to jointly develop modifications to the content of the curriculum in accordance with the partner countries, were created in the initiation phase of the project. In the next phase of the project, questionnaires focusing on research itself, teaching and teaching methods were distributed in order to fulfil the objectives of the project. Training courses for teachers were being carried out in order to innovate the technical education in the study program of nursing.

The leader of the project is educational institution Odisee in Belgium (older name is HUB-KAHO) and co-operative in­stitutions are Department of Nursing, Faculty of Health Care University of Presov in Presov (Slovak Republic) and other 15 participating partners from Albania, Bosnia and Herzegovina, Switzerland, Nether­lands, Serbia and Montenegro [5].

Results

The outcome of the solution for the studied issues in nursing education in the WB countries was the international profile of the nurses training within selected European countries (see Table 1) [6].

Table 1. Higher education of nursing in selected European countries [4]/em>

Country

1st degree of nursing study

2nd degree of nursing study

 

Sector

 

Length of study in years

Qual

General/specialist

Title

Length of study  in years

Belgium

HE

SN in UC sector

3

Degree

General

Diploma

3

Denmark

HE

SN in UC sector

3.5

Degree

General

 

 

Finland

HE

Polytechnics

3.5

Degree

General

Practical

3

France

FE

SN

3

Diploma

General

 

 

Germany

FE

SN

3

Diploma

DE

Nurse assistant

1

Ireland

HE

University

4

Degree

DE

 

 

Italy

HE

University

3

Degree

General (some DE)

 

 

Netherlands

HE

SN

4

Degree

General

MBOV

4

Norway

HE

University/UC

3

Degree

General

 

 

Spain

HE

University

3

Degree

General

 

 

Sweden

HE

University

3

Diploma

General

Licensed

3

Switzerland

Voc
HE

SN
University

3

Diploma

General

 

 

UK

HE

University

3

Diploma and degree

Branch

 

 

HE: higher education; SN: school of nursing; UC: university college; DE: direct entry; FE: further education; Voc: vocational.

From the data collected, it is evident that five of the thirteen EU countries (Belgium, Finland, Germany, Netherlands and Sweden) provide two-degree nursing education. United Kingdom among other countries of the European Union is characterized by the fact that the education of nurses moved to the university degree. France, Germany and Switzerland offer the training of nurses in nursing schools and in France, a campaign for nurses is running in order to transfer the nursing education to a higher education [7,8].

Nursing education in the WB countries is in the transition period: implementation of new methods, development of new methods based on existing competences, creation of joint programs with other institutions. There are differences in the basic training of nurses (bachelor studies). Impact on nursing education is represented the establishment of private universities offering education programs in nursing with a different standard than the public universities. This creates a room for improvement in theoretical and practical fields. The current study programs are oriented towards biomedical way and not holistically. Most systems do not cover the required allocation - 4600 hours of education (including half of them in the clinical conditions). Methods for theoretical and practical training required innovation [9].

Despite these deficiencies, there are also positive trends in nursing education, such as the ongoing reforms in the context of European criteria for the higher education, implementation of new strategies and cooperation with the concerned organizations, cooperation within individual faculties, investments in the material equipment of educational institutions, and, finally, national projects in the interest of the innovation of nursing education. CCNURCA project represents a dominant basis for resolving these issues [5].

Inspired by the knowledge and insights gathered during the former meetings and supported by the strategic document on competences, goals and outcomes for new nursing curriculum on the WB universities, each WB partner sent a proposal with the competences to their mentoring European partners. Following core competences were identified and agreed upon: Management of patients health; Quality of care; Management competences; Educational and legal issues; Ethics; Research; Administration of documentation; Communication skills; Teamwork competences. In general it can be stated that the curriculum reform for the WB needs to focus on: practical skills; communication skills, nursing concepts (e.g. nursing diagnoses), problem based critical thinking, integrated learning (integration of theory and practice) and Evidence Based Practice [10].

The staff of the WB partners involved in the training have active roles in teaching in nursing education and are closely involved in the modification of the existing curriculum. There was presence of hierarchical officers to ensure and support dissemination of the experience gained at department and faculty level upon their return. The evaluation of a curriculum and the schedule of a study program of nursing were running in the theoretical level. The activity to support the education of teachers themselves, so-called program TOT (Training of Trainers), where the participating specialists from the ranks of teachers were giving trainings in new techniques within the theoretical and practical training to each other, was deemed inspirational [4].

Questionnaires (Figure 1) evaluated mittings and workshops they were implemented in partner countries and focused on:

  • progress of project in general,
  • program Training of Trainers,
  • relevance of the project contents for your own work,
  • organization the overall project management,
  • feedback in general and recommendations.

Demonstrations, discussions and mutual exchange of knowledge were highly appreciated by all participating partners.

Trainings and training sessions focused on the content of the practical training in nursing among the partners of the EU and WB were held, likewise, the very management of capabilities and skills within the practical training, its organization and the possibilities of e-learning in the education of students. It was necessary to monitor the feedback of a practical training and training evaluation in the clinical environment. The evaluation of a curriculum and the schedule of a study program of nursing were running in the theoretical level. The activity to support the education of teachers themselves, so-called program TOT (training of trainers), where the participating specialists from the ranks of teachers were giving trainings in new techniques within the theoretical and practical training to each other, was deemed inspirational [4].

During consortium, theoretical methodology of teaching in nursing, the use of traditional and innovative methods, such as: lecture, group instruction strategies: snowball, learning based on problems, role playing methods, simulations, etc., were presented. The evolution of evaluating the capabilities and skills of students in the clinical environment was presented from the historical perspective (a detailed description of the schedule for the study program of nursing) [11].

The comparison of individual study programs in terms of allocated hours, the ratio of theoretical and practical training, qualifications of mentors of the practical training, a description of ECTS credits, defining competencies and learning outcomes, and others, were required. The action plan shall be designed to be able to implement new teaching methods and evaluation procedures in the study program [15].

In the future we will prepare bilateral agreements regarding the placement of students and teachers and participation in joint international projects.

Discussion

The evolution of evaluating the capabilities and skills of students in the clinical environment was presented from the historical perspective (a detailed description of the schedule for the study program of nursing) [11].

Representatives from WB countries formed working groups with the project co-workers from European countries, where each group worked on the creation of the matrix of students´ competences and skills, time allocation for the course, creation of adequate workload for a student and analysis of study program schedule. The comparison of individual study programs in terms of allocated hours, the ratio of theoretical and practical training, qualifications of mentors of the practical training a description of ECTS credits, defining competencies and learning outcomes and others, were required. Studied curriculum proposals, information sheets and study plans were discussed with experts from European countries and then modified according to the recommendations [12].

The meetings of representatives of the countries involved in the project supported the presentation of alternative teaching methods with regard to the learning process. At the same time, thought maps were presented that promote critical thinking, the ability to see problems and improve the patient's capacity for creativity among students. Simulation methods have been presented in order to innovate technical skills [13].

Presented suggestions within the pilot program, such as learning objectives, learning outcomes, theoretical and practical competences, teaching methods, the methodology of evaluation, and ECTS credits (program guide, curriculum handouts), were implemented in the new curriculum and were offered in the study programs of nursing and midwifery in the countries of the Western Balkan.

CCNURCA project leaders recommended to implement a curriculum reform in the education of the health care as a national priority for the three partner countries - Montenegro, Bosnia and Herzegovina and Albania, whereas the main objective of the project is to reform the curriculum in nursing, which is also in line with the Bologna Declaration [14]. The validation of the curriculum as a pilot project and the translation of materials into English and German were carried out. A pilot project aimed at testing new curriculum was planned for the academic year 2015-2016.

The new program in nursing was verified in this way and monitored the suitability of students, self-evaluation and teacher satisfaction. All stakeholders - teachers, coordinators, representatives of ministries worked closely together to implement of the project. In the last phase of the project, the partial results of a questionnaire survey focused on the innovation of the teaching itself were evaluated. The action plan is designed for pedagogical practice to be able to implement new study methods and assessment procedures in the study program [15].

The implementation of learning outcomes at the level of study courses is clearly linked to their definition within the content of information sheets of the particular courses in the study programs. The full content of learning outcomes in the curriculum is primarily based on revised Bloom's taxonomy [16].   

The education of nurses in Slovakia shall be compatible with European criteria, the curriculum shall be oriented to the whole personality of the patient, not just the process of a disease treatment. Basic principles of nursing training in European countries are based on the principles of the European Federation of Associations of Nursing (EFAN), International Council of Nursing (ICN) and the World Health Organization (WHO) (Regulation (EC) No. 1638/2006, Regulation (EC) No. 1905 / 2006) [17,18,19,20].

In the future, the intention of the current cooperation between the countries within the consortium is to prepare bilateral agreements regarding the placement of students and teachers and participation in joint international projects.

Conclusions

The project TEMPUS IV – CCNURCA promotes institutional cooperation and focuses on the reform and modernization of higher education systems in the partner countries. It contributes to an area of cooperation in the field of higher education involving the European Union and partner countries in the surrounding area.

Project is implemented in close coordination with the program Erasmus Mundus which provides scholarships to third country students allowing them to participate in top level master courses and doctorate programs inside the European Union. With regards to the Western Balkans, project TEMPUS contributes to preparing the candidate countries and potential candidates for a participation in the integrated Lifelong Learning Program.

As project TEMPUS IV is designed to support the modernization of higher education systems in the partner countries, its themes are structured around the main policy areas governing the current trends of higher education worldwide. The themes for cooperation are structured in the following three building blocks:

  1. Curricular Reform - modernization of curricula in academic disciplines identified as priorities by the partner countries, using the European Credit Transfer System , the three cycle system and the recognition of degrees.
  2. Governance Reform - university management and services for students, introduction of quality assurance, institutional and financial autonomy and accountability, equal and transparent access to higher education, development of international relations.

Higher education and society include: training of non-university teachers; development of partnerships with enterprises; knowledge triangle: education-research-innovation;  training courses for public services (ministries, regional/local authorities); development of lifelong learning in society at large and qualifications frameworks [8].

Dissemination of the project tasks results and publication of created and modified teaching materials is scheduled in the specified time period. Establishment of a network among the participating countries of the European Union and WB assumes the planning of modifications in legislative standards [10]. The results and ongoing information are exchanged by the participating countries on various meetings and consortia, which are simultaneously a prerequisite to stimulating proposals and planned changes. The domain of education shall be the evidence-based practice, taking into account the specification of each individual and creating professional nursing standards in nursing.

Results of the project consortia CCNURCA represent innovative changes for the countries of the Western Balkan. Educational institutions, health care institutions and government organizations shall unite their efforts for the sake of reforming the curriculum. European partner countries represent a supervisor role and support participating countries in the innovation of study programs.

Conflict of interest

Neither author has any financial or personal relationship with people or organizations that could inappropriately influence their work.


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Please cite as:
Hudáková A, Kuriplachová G, Magurová D, Andraščíková Š, Rybárová Ľ. Cooperation between European countries and Western Balkan at the modification of nursing study program. MEFANET Journal 2019; 6(1): xx-xx. Available at WWW: http://mj.mefanet.cz/mj-20180921.

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