New Nursing Curriculum in Sudan: History, Design and Application

1
New Nursing Curriculum in Sudan History, Design
and Application

• Professor Abdelaziz Elamin
• Dean College of Nursing Sciences
• University of Khartoum
• E-mail azizmin_at_hotmail.com

2
Introduction

• Nursing curriculum is the basic nursing
  educational program which qualify nurses to
  professional practice.
• It contains the essential material that covers
  the fundamentals of nursing knowledge and
  practical skills

3
History

• Historically the first nursing program in Sudan
  was designed by a WHO expert panel in 1955.
• The curriculum of that program was designed to
  graduate diploma nurses following 3 years of
  theoretical and practical studies.

4
High Nursing College

• A high nursing college for girls was established
  under the umbrella of the ministry of health in
  1956, and the first patch of students admitted
  were 20.
• In 1972, the college was affiliated to the
  ministry of higher education with self autonomy .
• The number of registered students increased
  gradually.

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High Nursing College/2

• In 1992 a new nursing curriculum was introduced.
• The course of the program increased to 4 years
  and a BSc degree is awarded instead of the
  diploma.
• The new curriculum was designed to prepare
  nurses to respond adequately to the health needs
  of their clients and the community.

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Faculty of Nursing Sciences

• In 1994 the nursing college became part of the
  University of Khartoum under a new name Faculty
  of Nursing Sciences
• Based on the reputable academic heritage of the
  university, the university formulated a committee
  to modernize the curriculum of the new faculty of
  nursing sciences to raise the standard of the
  nursing care to individuals, families and
  community.

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Why do we need a curriculum revision?

• Keep current with regional trends and reflect
  contemporary worldwide nursing practice
• Ensure seamless articulation among nursing
  institutions across the country
• Outcome based and student-centered curriculum
  with integration is the desired model, which was
  lacking in previous curricula.

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Curriculum Development

• The curriculum committee started the revision and
  development of the curriculum and worked for may
  years to produce its document, which was passed
  by the senate of the university of Khartoum.
• The pathway was not covered with flowers and
  several hurdles were on the way.
• They start by answering basic questions.

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Why new curriculum

• According to the 2001 Sudan Health declaration,
  by the year 2015 all nurses in Sudan should be
  certified nurses with Bachelor degree (BSc) or
  in line to bridge their nursing diploma to BSc
  level.

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Nursing categories

• Currently there are 4 different undergraduate
  nursing programs in Sudan
• Three years diploma
• Tow years bridging program to upgrade the three
  years program to BSc
• Four years BSc
• Five years honor BSc

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Factors Influencing Nursing Education at Global
Level

• Recommendations cited in 2004 report of the
  American Nursing Council Task Force on Nursing
  Workforce including the need to meet
  international accreditation standards
• Regulatory laws set by governments professional
  organizations.
• Recommendation made by experts like WHO
• Funding issues.
• Philosophy vision of higher education in the
  country.

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Curriculum change requires

• Courage the willingness to take risks in order
  to achieve a goal
• Trust in each other and the process
• Strong commitment by faculty leaders
• Communication and collaboration with each other
  and key stakeholders
• Ability to balance the need for change with the
  instinct to protect what has been achieved

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It all starts with your

• Philosophy
• Identify major concepts that will be threaded
  throughout courses
• Examples
• Evidence-based practice
• Health Informatics
• Communication Skills
• Interdisciplinary teams
• Quality in Health
• Infection Control

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The Second Step is

• Organizing framework
• Examples
• Administrative Competencies Provider of care,
  manager of care, member of the discipline
• Core Competencies Professional behaviors,
  Communication, Assessment, Clinical Decision
  Making, Caring Interventions, Teaching and
  Learning, Collaboration, Managing Care
• Specific competencies Safe Effective Care
  Environment, Health Promotion and Maintenance,
  Psychosocial Integrity, Physiological Integrity.
• Functional Health Patterns
• Systems Evaluation

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Terminal Objectives

• Educational Outcomes or Terminal Objectives
• This is what you want your graduate to look like
  or be able to do when they graduate
• They will be broad statements that relate back to
  the major concepts identified in the philosophy

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Enabling Objectives

• Level objectives or course objectives
• Determine the number of levels for your program
• These must demonstrate progression.
• They also provide the framework for the clinical
  evaluation tool.
• The objectives for the final course are the same
  as the educational outcomes or terminal objectives

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Course Design

• Determine the content for each course
• The major concepts identified in philosophy are
  deepened throughout the program
• The organizing framework provides the structure
  for the content
• It is impossible to cover everything the
  challenge is to identify the concepts that are
  critical

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Learning Teaching Activities

• Use appropriate teaching methods e.g. interactive
  lectures, seminars, small group discussions
  ..etc.
• Facilitate active student search, discovery, and
  learning of essential material
• Faculty do not need to feel responsible for
  covering all of the material.
• Pre and post course students questionnaires help
  in quality assurance.

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Assessment

• All assessments should reflect the depth and
  breath of content described in course objectives.
• Continuous assessment is mandatory as well as end
  of course comprehensive examination
• Both summative and formative assessment methods
  should be used.
• Post test validation is important

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Begin with the end in mind

• Used competencies as organizing framework
• Three level objectives were developed for each
  competency
• Professional Behaviors
• Communication
• Assessment
• Clinical Decision Making
• Caring Interventions
• Teaching and Learning
• Collaboration
• Managing Care

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Course Development

• 8 semesters with several courses offered in
  shorter blocks or over the entire semester
• Separate courses for basic sciences,
  pharmacology,
• and nursing administration leadership.
• Geriatrics is integrated in family community
  nursing.
• Courses may be offered in any sequence, but many
  institutions offer professional nursing concepts
  and assessment in the first semester and nursing
  care of multi-system failure must be in the last.
• Evidence-based nursing practice is emphasized in
  all courses.

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Staff Queries may include ..

• What is wrong with the present curriculum?
• Will there be time for more content in the new
  curriculum?
• What will we give up?
• Can we teach the new content effectively?
• What if we dont teach the right things?
• What if customers satisfaction rates go down?
• What if skill levels decline?
• Do we have the expertise?
• How will this impact my teaching load?

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The 2006 Curriculum

• In 2006 the revised curriculum was adopted by the
  university of Khartoum
• A 5th year was added to give honor degree
• The following slides describe issues related to
  that curriculum.
• College staff were dedicated to take
  responsibilities and work in team and apply
  nursing ethics effectively

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Curriculum objectives

• develop the students' affective, cognitive and
  psychomotor skills for clients care
• provide high standard, holistic nursing care for
  individual, family and the community according to
  policies and procedures
• be more effective in caring for clients according
  to (NANDA approved) nursing diagnoses that
  reflect the client's health needs and priorities

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Old new curricula

• The new curriculum is tailored to have the
  following characteristics
• Community-oriented
• Outcome-based
• Student-centered
• Although the old and new curricula are different
  in some specific objectives and contents, every
  program consists essentially of four parts as
  follow

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Old new curricula/2

• First part where the students learn
• Nursing Ethics history of nursing
• fundamental Nursing skills
• Communication skills
• Basic medical sciences
• Introduction to community nursing
• Psychology sociology

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Old new curricula/3

• Second part
• Include clinical courses in medical nursing,
• surgical nursing, pediatric nursing and
• midwifery.
• The students move from theory to practice. It
  gives them a broad understanding of clinical
  nursing protocols.

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Old New Curricula/4

• Third parts
• in which students learn to
• Care for specific clients
• practice nursing care in different medical
  specialties
• Share in community health promotion through
  specific activities
• Fourth part
• application of research methodology
• Specialty courses for those who progress to 5th
  year

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Curriculum application

• General
• To obtain a degree of Science in Nursing,
  students are required to successfully complete
  full-time study of approved
• 5 semesters for bridging
• 4 semesters for upgrading
• 6 semesters for the Diploma
• 8 semesters for the general B Sc
• 10 semesters for honor B Sc
• The academic year is often 2 semesters
• The semester s varied between 15 - 18 weeks
• The total credit hours are 16-22 per semester

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Admission requirements

• The BSc program was designed to accept secondary
  schools graduates (boys girls) who wish to
  study nursing and satisfy the following criteria
  
• Are 16 years or above
• Score 80 or above in the secondary school
  certificate
• is medically fit
• pass face to face interview

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Teaching and learning strategies

• Focus on
• practical training under supervision
• Active self learning
• Problem solving approach throughout the stages of
  training
• Evidence-based practice
• Community orientation to identify its problems
  and shared solution

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Evidence-based Practice

• Is conscientious use of current best evidence in
  making decisions about patient care.
• EBP components
• Systemic research for and critical appraisal of
  the most relevant evidence to answer a clinical
  question.
• The clinical experience of the concerned doctor
  or nurse and experts opinion in the absence of
  evidence.
• Patients preference values.

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Teaching and learning Methods

• Methods for Theoretical part
• Group discussion
• Interactive lectures
• Seminars
• Problem solving case studies
• Tutorials
• Assignments

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Methods for Practical training

• Skill training on manikins (skill lab)
• Skill training on real patient under tutors
  supervision
• Simulation role play
• Programmed clinical training following the
  nursing process
• Nursing rounds
• Writing clinical nursing reports

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Practical Training cont.

• Home visits
• Field work
• National training trips
• International trips
• Student research
• Residency program for honor students

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Students Evaluation

• Theoretical
• Continuous evaluation (Practical training ,quiz,
  discussion, seminars presentation projects).
• Final written /practical examination
• ( 60 for the practical and 40 for the
  theoretical).

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Curriculum Evaluation

• Achievement of objectives
• Outcome quality
• College exams results
• Nursing council Qualifying examination
• Surveys for client satisfaction
• Employer satisfaction survey
• Nursing audit

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Facilities

• Academic institutions
• Faculties
• Schools under the umbrella of some faculties of
  medicine
• Nursing Academy which is belonging to the
  ministry of health
• Even the limited facilities are well designed and
  equipped

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Health Care Institutions

• Hospitals
• Health centers
• Polyclinics
• Specialized centers
• Other community institutions

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Honor Degree

• In some nursing colleges including that of the
  university of Khartoum, the students enrollment
  in upper-division (5th year) is limited to those
  who meet the following criteria
• completed all required courses in the fresh
  students semesters with a minimal grade of clear
  pass
• maintain full-time study at nursing institute
• minimum cumulative grade point of 3.5
• minimum grade of B in the specialty subject

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Challenges facing curriculum application

• Increased number of academic institutions,
  compared with the very limited number of
  qualified teaching staff
• The educational institutions are facing financial
  difficulties that hinder development and
  maintenance of skill laboratories libraries
• Variation of language used in teaching curriculum
  material applications

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Challenges facing curriculum application

• The absence of specialized nursing council makes
  it difficult to unify or standardize the
  undergraduate nursing programs in Sudan.
• The clinical educational institutions are not
  well prepared or equipped to meet the students
  training needs (reality shock).
• Difficulties in evaluation and revision of
  student-centered policies, procedures, and
  guidelines.

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Acknowledgments

• In preparing this lecture I used some material
  from the following source
• Dr. Rashida Abdelfatah, Nursing College,
  University of Khartoum, a lecture on nursing
  curriculum presented at a workshop in Khartoum
  (unpublished).

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Enjoy Nature
The End