Nurse educator knowledge, attitude and skills towards using high-fidelity simulation : a study in the vocational education sector
- Authors: Akhter, Zainab , Malik, Gulzar , Plummer, Virginia
- Date: 2021
- Type: Text , Journal article
- Relation: Nurse Education in Practice Vol. 53, no. (2021), p.
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- Description: High-fidelity simulation has become an essential educational approach in nurse education globally. Several studies have explored the experience of undergraduate nursing students and educators with high-fidelity simulation; however, none have explored the experience of students in the vocational educational sector. The aim of the study was to explore nurse educators’ knowledge, attitude and skills toward using high-fidelity simulation in the setting of vocational education. An anonymous on-line survey design was conducted at three campuses of a major Australian Technical and Further Education vocational education setting. Forty-eight nurse educators teaching into Diploma of Nursing program for at least six months were invited to participate, 29 participated in the study, a response rate of 60%. Participants expressed lack of knowledge in managing technological issues, simulation facilitation procedures and conducting scenarios. Most participants had positive attitude towards high-fidelity simulation and rated their skills as ‘novice’. An urgent need for nurse educator training was identified to enhance knowledge and skills in technical and scenario management of high-fidelity simulation. A program of supportive mentoring by nurse educator mentors experienced in high-fidelity simulation, engaging with existing simulation associations, will enhance and sustain nurse educator knowledge, attitude and skills in a protected environment further, so that they can optimise training they provide to students for safe quality care of patients in the future. © 2021 Elsevier Ltd
What's in a name? Clarifying the nomenclature of virtual simulation
- Authors: Cant, Robyn , Cooper, Simon J. , Sussex, Roland , Bogossian, Fiona
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Simulation in Nursing Vol. 27, no. (2019), p. 26-30
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- Description: Clinical simulation is an essential component of health professional education. Digital technologies can provide students with near-reality, interactive virtual simulation learning experiences on static and mobile appliances. Clarification is needed, however, regarding the various types of virtual simulation and the different program components. We drew on published literature to define virtual simulation modalities and to offer definitive terminology to clarify the nomenclature and composition of virtual simulation. Reporting should include description of ‘Fidelity’ ‘Immersion’ and ‘Patient’ to add clarity and utility to research in the field.
Best practice in clinical simulation education − are we there yet? A cross-sectional survey of simulation in Australian and New Zealand pre-registration nursing education
- Authors: Bogossian, Fiona , Cooper, Simon J. , Kelly, Michelle , Levett-Jones, Tracy , McKenna, Lisa , Slark, Julia , Seaton, Philippa
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 3 (2018), p. 327-334
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- Description: Background: Simulation is potentially a means of increasing clinical education capacity. Significant investments have been made in simulation but the extent to which this has improved uptake, quality and diversity of simulation use is unclear. Aim: To describe the current use of simulation in tertiary nursing education programs leading to nurse registration Australia and New Zealand, and determine whether investments in simulation have improved uptake, quality and diversity of simulation experiences. Methods: A cross sectional electronic survey distributed to lead nursing academics in programs leading to nurse registration in Australia and New Zealand. Findings: 51.6% of institutions responded and reported wide variation in allocation of program hours to clinical and simulation learning. Simulation was embedded in curricula and positively valued as an adjunct or substitute for clinical placement. While simulation environments were adequate, staff time, training and resource development were barriers to increasing the quality, amount and range of simulation experiences. Quality assurance and robust evaluation were weak. Discussion: Simulation program hours are inconsistently reported and underutilized in terms of potential contribution to clinical learning. Benefits of capital investment in simulation physical resources have been realised, but barriers persist for increasing high quality simulation in nursing programs. Conclusion: Transitioning components of clinical education from the clinical to tertiary sectors has resource implications. Establishment of sustainable, high quality simulation experiences requires staff training, shared resources, best practice and robust evaluation of simulation experiences in nursing curricula. © 2017 Australian College of Nursing Ltd
The impact of a Web-based educational program on the recognition and management of deteriorating patients
- Authors: Liaw, Sok , Chng, Devon , Wong, Lai , Ho, Jasmine , Mordiffi, Siti , Cooper, Simon J. , Chua, Wei , Ang, Emily
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 26, no. 23-24 (2017), p. 4848-4856
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- Description: Aims and objectives: To evaluate the effectiveness of a Web-based educational program to enhance enrolled nurses’ knowledge and skills in the recognition and management of deteriorating patients. Background: Ward nurses of different skill levels play a pivotal role in detecting and responding to deteriorating patients. A skill mix of registered nurses, enrolled nurses, licensed practical nurses or healthcare assistants is often employed for the provision of nursing care in acute settings. Non-registered nurses frequently perform bedside care and are in the best position to detect deteriorating patients and initiate immediate actions, including commanding the attention of registered nurses. Education is needed to improve the knowledge and skills of these nurses. Design: A randomised controlled trial with a pretest–post-test design. Methods: The sample included enrolled nurses from an acute care tertiary hospital. Following a baseline evaluation, the experimental group received a Web-based educational intervention. Pre–post assessment of skills and knowledge was performed with a simulated scenario and a knowledge questionnaire. Sixty-four nurses completed the entire study. Results: Following the intervention, participants from the experimental group were significantly more likely than those in the control group to monitor the patient's respiratory and pulse rates. In addition, they had significantly higher post-test mean scores for knowledge and skills in assessing and managing clinical deterioration and reporting deterioration. Conclusion: The Web-based educational intervention significantly improved enrolled nurses’ knowledge and skills in the recognition and management of a deteriorating patient in a simulated setting. Relevance to clinical practice: Ease of access to the Web-based platform contributed to the feasibility and acceptability of this study, which has the potential to positively impact patient safety. © 2017 John Wiley & Sons Ltd
An analysis of nursing students’ decision-making in teams during simulations of acute patient deterioration
- Authors: Bucknall, Tracey , Forbes, Helen , Phillips, Nicole , Hewitt, Nicky , Cooper, Simon J. , Bogossian, Fiona , FIRST2ACT Investigators
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 72, no. 10 (2016), p. 2482-2494
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- Description: Aim: The aim of this study was to examine the decision-making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions. Background: Missed, misinterpreted or mismanaged physiological signs of deterioration in hospitalized patients lead to costly serious adverse events. Not surprisingly, an increased focus on clinical education and graduate nurse work readiness has resulted. Design: A descriptive exploratory design. Methods: Clinical simulation laboratories in three Australian universities were used to run team based simulations with a patient actor. A convenience sample of 97 final-year nursing students completed simulations, with three students forming a team. Four teams from each university were randomly selected for detailed analysis. Cued recall during video review of team based simulation exercises to elicit descriptions of individual and team based decision-making and reflections on performance were audio-recorded post simulation (2012) and transcribed. Results: Students recalled 11 types of decisions, including: information seeking; patient assessment; diagnostic; intervention/treatment; evaluation; escalation; prediction; planning; collaboration; communication and reflective. Patient distress, uncertainty and a lack of knowledge were frequently recalled influences on decisions. Conclusions: Incomplete information, premature diagnosis and a failure to consider alternatives when caring for patients is likely to lead to poor quality decisions. All health professionals have a responsibility in recognizing and responding to clinical deterioration within their scope of practice. A typology of nursing students’ decision-making in teams, in this context, highlights the importance of individual knowledge, leadership and communication. © 2016 John Wiley & Sons Ltd
Enhancing the management of deteriorating patients with Australian on line e-simulation software : Acceptability, transferability, and impact in Hong Kong
- Authors: Sparkes, Louise , Chan, Maggie , Cooper, Simon J. , Pang, Michelle , Tiwari, Agnes
- Date: 2016
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 18, no. 3 (2016), p. 393-399
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- Description: International concerns relating to healthcare professionals’ failure to rescue deteriorating patients exist. Web-based training programs have been developed and evaluated in Western settings but further testing is required before application in non-Western countries, as traditional modalities of learning may differ between cultures. We trialed an Australian English language online simulation program for the management of deteriorating patients, Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTWeb), to test cultural acceptability, transferability, and educational impact. The study was designed as a quasi-experimental evaluation of the FIRST2ACTWeb program with final year nursing students from a Bachelor of Nursing program at the University of Hong Kong. Participants completed pre-course and post-course tests, three interactive scenarios, and program evaluations. The program was positively evaluated, with significant improvements in knowledge, skills, self-rating of performance, confidence, and competence. Outcomes were comparable to earlier evaluations with Australian students, demonstrating that an interactive simulation-based program of patient deterioration management has cultural and language acceptability and transferability across communities with significant educational impact. © 2016 John Wiley & Sons Australia, Ltd.
Graduate nurse program coordinators' perspectives on graduate nurse programs in Victoria, Australia : A descriptive qualitative approach
- Authors: Missen, Karen , McKenna, Lisa , Beauchamp, Alison
- Date: 2016
- Type: Text , Journal article
- Relation: Collegian Vol. 23, no. 2 (2016), p. 201-208
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- Description: Aims: The purpose of this study was to describe the formal preparation nursing graduates are given throughout their first year of nursing in terms of educational structure and content of work-based year-long graduate nurse programs, from the perspectives of Graduate Nurse Program Coordinators. Background: In Australia, graduate nurse programs aim to provide a supportive learning environment, assisting nursing graduates in applying their theory to practice and supporting them in becoming safe, competent and responsible professionals. Internationally, research has demonstrated an increase in the job satisfaction and more importantly retention rates of newly qualified nurses who are supported in their first year of employment in some type of transition program. Method: Using a descriptive qualitative approach, individual semi-structured interviews were used. These interviews were audio recorded, transcribed verbatim and thematically analysed to reveal themes and sub-themes. Results: The interviews provided an insight into the various aspects of preparation that nursing graduates are given in their first year of practice with the main theme to emerge from analysis, nature of transition programs. The three subthemes associated with nature of transition programs consisted of composition of rotations and study days and supernumerary strategies. Findings indicate variation in pedagogical models underpinning graduate nurse programs across Victoria. Clinical rotations varied between three to twelve months, the number of study days offered were between four and thirteen days and there was variation in supernumerary time and strategies within the programs investigated. © 2015 Australian College of Nursing Ltd.
Doing the right thing at the right time: Assessing responses to patient deterioration in electronic simulation scenarios using course-of-action analysis.
- Authors: Cooper, Simon J. , Cant, Robyn , Bogossian, Fiona , Bucknall, Tracey , Hopmans, Ruben
- Date: 2015
- Type: Text , Journal article
- Relation: CIN: Computers, Informatics, Nursing Vol. 33, no. 5 (2015), p. 199-207
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- Description: International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.
E-simulation:pre-registration nursing students' evaluation of an on-line patient deterioration program
- Authors: Cant, Robyn , Young, Susan , Cooper, Simon J. , Porter, Joanne
- Date: 2015
- Type: Text , Journal article
- Relation: CIN: Computers, Informatics, Nursing Vol. 33, no. 3 (2015), p. 108-114
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- Description: This study explores preregistration nursing students’ views of a Web-based simulation program: FIRST2 ACTWeb (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends-Web). The multimedia program incorporating three videoed scenarios portrayed by a standardized patient (human actor) aims to improve students’ recognition and management of hospital patient deterioration. Participants were 367 final-year nursing students from three universities who completed an online evaluation survey and 19 students from two universities who attended one of five focus groups. Two researchers conducted a thematic analysis of the transcribed narratives. Three core themes identified were as follows: “ease of program use,” “experience of e-Simulation,” and “satisfaction with the learning experience.” The Web-based clinical learning environment was endorsed as functional, feasible, and easy to use and was reported to have high fidelity and realism. Feedback in both focus groups and surveys showed high satisfaction with the learning experience. Overall, evaluation suggested that the Web-based simulation program successfully integrated elements essential for blended learning. Although Web-based educational applications are resource intensive to develop, positive appraisal of program quality, plus program accessibility and repeatability, appears to provide important educational benefits. Further research is needed to determine the transferability of these learning experiences into real-world practice.
Leadership and teamwork in medical emergencies: Performance of nursing students and registered nurses in simulated patient scenarios
- Authors: Endacott, Ruth , Bogossian, Fiona , Cooper, Simon J. , Forbes, Helen , Kain, Victoria , Young, Susan , Porter, Joanne , First2Act Team
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 24, no. 1-2 (2015), p. 90-100
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- Description: Aims and objectivesTo examine nursing students' and registered nurses' teamwork skills whilst managing simulated deteriorating patients.Background Studies continue to show the lack of timely recognition of patient deterioration. Management of deteriorating patients can be influenced by education and experience.DesignMixed methods study conducted in two universities and a rural hospital in Victoria, and one university in Queensland, Australia.Methods Three simulation scenarios (chest pain, hypovolaemic shock and respiratory distress) were completed in teams of three by 97 nursing students and 44 registered nurses, equating to a total of 32 student and 15 registered nurse teams. Data were obtained from (1) Objective Structured Clinical Examination rating to assess performance; (2) Team Emergency Assessment Measure scores to assess teamwork; (3) simulation video footage; (4) reflective interview during participants' review of video footage. Qualitative thematic analysis of video and interview data was undertaken.ResultsObjective structured clinical examination performance was similar across registered nurses and students (mean 54% and 49%); however, Team Emergency Assessment Measure scores differed significantly between the two groups (57% vs 38%, t = 6·841, p < 0·01). In both groups, there was a correlation between technical (Objective Structured Clinical Examination) and nontechnical (Team Emergency Assessment Measure) scores for the respiratory distress scenario (student teams: r = 0·530, p = 0·004, registered nurse teams r = 0·903, p < 0·01) and hypovolaemia scenario (student teams: r = 0·534, p = 0·02, registered nurse teams: r = 0·535, p = 0·049). Themes generated from the analysis of the combined quantitative and qualitative data were as follows: (1) leadership and followership behaviours; (2) help-seeking behaviours; (3) reliance on previous experience; (4) fixation on a single detail; and (5) team support.Conclusions There is scope to improve leadership, team work and task management skills for registered nurses and nursing students. Simulation appears to be beneficial in enabling less experienced staff to assess their teamwork skills.Relevance to clinical practiceThere is a need to encourage less experienced staff to become leaders and for all staff to develop improved teamwork skills for medical emergencies.
Preparing nursing students for the future: development and implementation of an Australian Bachelor of Nursing program with a community health focus
- Authors: Cooper, Simon J. , Cant, Robyn , Browning, Mark , Robinson, Eddie
- Date: 2015
- Type: Text , Journal article
- Relation: Contemporary Nurse: A Journal for the Australian Nursing Profession Vol. 49, no. (2015), p. 68-74
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- Description: This paper focuses on changes in the educational preparation of undergraduate nurses in line with contemporary primary and preventative healthcare models. We evaluated a new Australian nursing and community care degree programme using focus groups with 38 students in their first years of study, and quantitative performance data (regarding entry, performance and course attrition). Four main themes were identified related to students’ course experience: ‘I think community health should be an elective’; ‘Focus on relevance to practice’; ‘Teaching by non-nursing academics’ and ‘Access to support during transition to university.’ Overall pass rates were 94% (first year) and 97% (second year) with a low 11% attrition rate. We conclude that based on prior experiences and stereotypical views, students may be ambivalent about the inclusion of primary and preventative care models which nevertheless are essential to enhance practice and to prepare the future nursing workforce
Undergraduate nursing students' peformance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: Quantitative results from an Australian multi-centre study
- Authors: Bogossian, Fiona , Cooper, Simon J. , Cant, Robyn , Beauchamp, Alison , Porter, Joanne , Kain, Victoria , Bucknall, Tracey , Phillips, Nicole
- Date: 2014
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 34, no. 5 (2014), p. 691-696
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- Description: Objectives This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Design Mixed-method multi-centre study. Setting High fidelity simulated acute clinical environment in three Australian universities. Participants A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. Method In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Results Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%. Conclusions Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.
Managing the deteriorating patient in a simulated environment: Nursing students' knowledge , skill, and situation awareness
- Authors: Cooper, Simon J. , Kinsman, Leigh , Buykx, Penny , McConnell-Henry, Tracy , Endacott, Ruth , Scholes, Julie
- Date: 2009
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 19, no. 15 (2009), p. 2309-2318
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- Description: Abstract AIM: To examine, in a simulated environment, the ability of final-year nursing students to assess, identify and respond to patients either deteriorating or at risk of deterioration. BACKGROUND: The early identification and management of patient deterioration has a major impact on patient outcomes. 'Failure to rescue' is of international concern, with significant concerns over nurses' ability to detect deterioration, the reasons for which are unknown. DESIGN: Mixed methods incorporating quantitative measures of performance (knowledge, skill and situation awareness) and, to be reported at a later date, a qualitative reflective review of decision processes. METHODS: Fifty-one final-year, final-semester student nurses attended a simulation laboratory. Students completed a knowledge questionnaire and two video-recorded simulated scenarios (mannequin based) to assess skill performance. The scenarios simulated deteriorating patients with hypovolaemic and septic shock. Situation awareness was measured by randomly stopping each scenario and asking a series of questions relating to the situation. RESULTS: The mean knowledge score was 74% (range 46-100%) and the mean skill performance score across both scenarios was 60% (range 30-78%). Skill performance improved significantly (p < 0.01) by the second scenario. However, skill performance declined significantly in both scenarios as the patient's condition deteriorated (hypovolaemia scenario: p = 0.012, septic scenario: p = 0.000). The mean situation awareness score across both scenarios was 59% (range 38-82%). Participants tended to identify physiological indicators of deterioration (77%) but had low comprehension scores (44%). CONCLUSION: Knowledge scores suggest, on average, a satisfactory academic preparation, but this study identified significant deficits in students' ability to manage patient deterioration. RELEVANCE TO CLINICAL PRACTICE: This study suggests that student nurses, at the point of qualification, may be inadequately prepared to identify and manage deteriorating patients in the clinical setting.
Developing culturally competent reflective practitioners. Part 2. The culturally responsive reflective practice model
- Authors: Stockhausen, Lynette , Serizawa, A.
- Date: 2008
- Type: Text , Journal article
- Relation: Asian Journal of Nursing Vol. 11, no. 1 (2008), p. 8-12
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- Description: This paper extends the issues and arguments raised in Part 1 of this article, and outlines the dimensions of a new framework designed specifically for the introduction of reflective practice into different cultures and becoming culturally attuned as competent reflective practitioners. The framework for the development of culturally competent reflective practice draws on theories, models, and explanations of both reflective practice and culture, and benefits from the cultural experiences of the authors, which adds further authenticity to the model's development and use. This educational model can be used by educators to sensitise themselves to cultural nuances, aid students in becoming culturally responsive (aware, safe, or competent), provide a structure for class planning, and remind themselves of the need for cultural competence when introducing reflective practice within a 'different' culture. © 2008 Scientific Communications International Limited.
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Developing culturally competent reflective practitioners. Part 1. Cultural reflections
- Authors: Stockhausen, Lynette
- Date: 2007
- Type: Text , Journal article
- Relation: Asian Journal of Nursing Vol. 10, no. 4 (2007), p. 212-217
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- Description: Reflective practice is principally a widely recognised Euro-western concept that has been used to promote inquiry; however, explanations of the natures and use of reflective practice in its present form may not be easily transferable to some Asian cultures. The cultural significance of introducing an educational practice as unfamiliar as reflective practice to experienced nurse practitioners and undergraduate nursing students in Japan and Vietnam are highlighted. Part 1 of this 2 part article on developing culturally competent reflective practitioners reflects on previous research studies, the literature, and the author's experiences as a teacher and consultant in Japan and Vietnam. © 2007 Scientific Communications International Limited.
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Nursing education in Iran : Past, present, and future
- Authors: Tabari Khomeiran, Rasoul , Deans, Cecil
- Date: 2007
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 27, no. 7 (2007), p. 708-714
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- Description: Nursing education in Iran has undergone significant change since its genesis with foreign missionaries over one hundred years ago. More recently, following the 1979 Islamic revolution, nurse education has followed the direction taken by most other countries in moving from an apprenticeship model of training to an academic model. A series of transformative changes to nursing education specifically-and across the higher education system generally-has resulted in nurses now being able to undertake study across all university-based programs up to and including doctoral level. Contemporary nursing students have access to full-text professional journals through the internet, and they may pursue their doctoral studies in other countries. Although these improvements in nursing education in Iran are to be applauded, much more needs to be accomplished to ensure that highly competent nurse practitioners continue to be produced in this country. This article presents an historical overview of the development of nursing education in Iran, within its economic and sociopolitical contexts. Recommendations based upon lessons learned from historical and contemporary realities are presented in order to advance nursing education in this part of world. © 2006 Elsevier Ltd. All rights reserved.
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- Description: 2003005859