Nursing Education and Competencies

1
Nursing Education and Competencies

• Anne-Marie Ryan PhD, MSc, BNS, RGN, RNT, FFNMRCSI
• Chief Education Officer, An Bord Altranais and
  Chair of FEPI WG ETC

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Themes

• WG ETC of FEPI
• Nursing Education in Europe
• Evolution of EU Nurse
• Regulation to date

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The European Federation of Nursing Regulators
- FEPI

• FEPI was founded as a result of increasing
  mobility of nursing professionals across Europe
• No longer a committee in Europe of
  representative interests to advise on the
  training of nurses (ACTN) since 2000

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WG ETC

• The Working Group Education Training and
  Competence
• Meets quarterly
• Has participation from 14 countries
• Has an action plan
• Conducted 2 data gathering exercises and response
  to consultations and prepared papers
• Tuning Exercise - mapping
• Educational preparation - 16 countries

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Goals of Regulation

• Defining the profession and its scope of
  practice,
• Setting education standards and standards of
  ethical and competent practice
• Establishing systems of accountability and
  credentialing processes

6
European Recognition of Nurses

• European Directives
• Sectoral Directives 77/452 EEC, 77/453 EEC
  (Generalist Nurse)
• General Systems Directives
• Directive 2005/36/EC

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New Directive

• Directive 2005/36/EC,
• liberalisation of the provision of services
• Recognition of qualifications
• Flexibility of procedures

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The Bologna Process

• Ministries encourage the member states to
  elaborate a framework of comparable and
  compatible qualifications for their higher
  education systems, systems, which should seek to
  describe qualifications in terms of WORKLOAD,
  LEVEL, LEARNING OUTCOMES, COMPETENCES and
  PROFILE. They also undertake to elaborate an
  overarching framework of qualifications for
  Higher Education Area.
• Berlin Conference (2003)

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WG ETC Questionnaire

• Captured
• Setting the standards for nurse education
• How programmes are meeting EU Sectoral Directives
• Academic recognition of programmes incl. Bologna
• Programmes other than general nurse
• LLL requirements and regulation
• Language requirements

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Similarities and Differences

• The questionnaire was completed by 16 countries
  Austria, Croatia, Denmark, France, Greece,
  Ireland, Italy Malta, Norway, Poland, Portugal,
  Romania, Slovakia, Spain Sweden UK
• The competent authority is a nursing council in 6
  countries with 8 countries having a combination
  of the Ministries of Health or Education
• General nursing is offered as the only initial
  registration in 10 countries
• Vocational education is offered in 2 countries
• 13 countries offer a bachelor education programme

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Similarities and Differences

• Minimum duration of a programme is 3 years with 2
  countries requiring 3.5 years and 5 countries
  offering 4 year programmes
• ECTS range 180 (n5) 210 (n1) 240 (n4)
• The regulators are involved in the guidance of
  programmes in 6 countries with the others relying
  on the Ministry of Health or Education
• In 9 countries the programme cannot operate
  without the approval of the regulator

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Similarities and Differences

• Specialisation is offered as an initial
  registration in 4 countries
• Specialisation is offered after registration in
  13 countries with 7 countries defining areas a
  nurse can work with the specialisation required.
• LLL is linked to registration in 5 countries
• Knowledge of host language required currently in
  8 countries and this is managed by employers 1
  country requires an exam for registration.

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Findings Suggest

• These findings when compared to the initial
  exercise that was conducted in 1980 by the
  Advisory Committee on Training in Nursing
  (III/D/258/3/80) demonstrate significant
  developments in the interpretation of the
  Sectoral Directive and the manner in which
  programmes are currently delivered across Europe.
  
• Currently there is a wide diversity of structures
  supporting regulation of nursing programmes and
  the processes for delivering the programmes

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Changing Landscape

• The European Union is looking at regulated
  professions from a competition policy perspective
• The economic impact of regulating professions is
  being challenged i.e. public good vs. stifling
  competition
• Collaborative scopes of practice
• Shared competencies
• Costs and bureaucracy of regulation
• Changing practice environments
• Intergovernmental rules affecting the profession

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Professional Directions

• Standards
• Competencies
• Code of ethics
• Scope of practice
• Setting standards of education preparation
• Establishing systems of accountability and
  credentialing

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Four Beliefs about the Future

• Role of Nurses will change
• Value of nursing contribution to health
• Experienced nurses will participate more in
  project planning and evaluation
• Leadership and supervision of Primary Health Care

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Responding to Change

• Development of health care and nursing in Europe
  will benefit all EU citizens
• Growing complexity of science and technology
  requires more knowledge and information and a
  range of new competencies for nurses
• Increasing chronicity of diseases and treatment
  options will expand the role of nurses
• Impact of Information Technology requires our
  recognition systems to go beyond the mere input
  model of education preparation.

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Conclusion