PAHO-WHO Subregional Workshop on the Development of Competencies for Nurse Educators Ramada Princess City Hotel
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1 PAHO-WHO Subregional Workshop on the Development of Competencies for Nurse Educators Ramada Princess City Hotel Belize City, Belize 2-4 December, 2015
2 DOMAIN Barriers/ Challenges Gaps Solutions 1 Tutor s reluctance (personal bias) to follow prescribed standards; Weakness of nursing councils to enforce standards can create a barrier; Not all organizations use competency-based curricula. Many programs still use a syllabus based system; Skills of students were always taught and measured, but sometimes only observed in labs; Negative attitudes of faculty members; Lack of knowledge for front-line faculty; Different levels of training and baseline knowledge; Quality of training not standard across institutions; Lack of involvement of all faculty in curriculum design; Need for continuous education for faculty/additional training/mentoring for faculty; Reinforcement of interprofessional collaboration. This collaboration helps to broaden the educator's worldview; Conduct baseline research among educators to evaluate their knowledge of adult learning principles; Utilize results from baseline research to inform capacity building and training; Develop core competencies for educators; Focus on the outcome, which should be what we want our graduating nurses to know or do; Support for course assignments is required;
3 DOMAIN Barriers/ Challenges Gaps Solutions 2 Lack of qualified nursing educators/some faculty have limited clinical experience; Lack of using evidence-based practices in teaching and learning process; Absence of data on students learning styles; Lack of resources for training and research; Lack of local research to support practice; Limited, or no access to technology use of live models as an alternative to the Simulator doll; Lack of appropriate training in the use of technology; Existing political climate can pose a barrier to ongoing training of nurse educators; Working with time bound curricula; Lack of support for social programs; Lack of qualified educators; Textbooks don t always reflect reality; Nurses must be prepared to provide care in the context of country needs to positively impact the health of the people they serve (socially accountable curricula)/standardized curriculum with content specific to communities There is a need for regular review of curriculum for relevance to current country needs; Curricula must take into account the social determinants of health and its impacts; Evaluate curricula to identify gaps; Curriculum development must include not only individuals from the nursing school but must also include individuals from the public and private sector, nursing councils, nursing associations, a student representative and an international contributor; Align competencies with curriculum and licensure exam; Determine the appropriate model of care within a particular country; Early introduction of the importance of teaching; Building quality training programs to prepare qualified nurse educators/develop relevant courses; Post graduate training for educators should be no less than 3 years; Sharing research findings on a monthly basis (this occurs in some countries in faculty meetings); Increase training and involvement of faculty in research; Must have some level of clinical experience between educational pursuits;
4 DOMAIN Barriers/Challenges Gaps Solutions 3 Limited or non-availability of continuing education programs; Nursing councils do not require specific hours of continuing education in specific field of practice (related often to lack of requirement to re-license practitioners); Courses are not needs based; There should be standard preparation of nurse educators as opposed to the difference that now obtains (Nurse Educator/Clinical Educator); The absence of team teaching; Lack of funding to attend conferences; Lack of compliance at the country level in applying of Caribbean standards; Ability to apply (the competencies 3.1, 3.2, 3.3); The development of commercially driven institutions willing to provide education programs (not in keeping with national/caribbean standards); The sense of I have arrived when an individual has attained higher education certification which leads to reluctance to pursue continuing education; Timing of courses being offered may not be appropriate for attending; There is no standardized requirement for nurse educators to continue educational development; Lack of human resources; Encouraging involvement in research/publish or perish; Attendance at medical/nursing conferences; More support is needed from ministries of education and ministries of health More local courses should be offered; Have a coordinator for continuing nursing education for educators; Initiation of program development stemming from needs assessment following observation of practice; Brown bag discussions; Socialization of new members into the culture; Time off as an incentive.
5 DOMAIN Barriers/Challenges Gaps Solutions 4 Nurses are not sufficiently involved in initiating research or knowing how to understand and utilize research Nurses have limited research training; Lack of resources to undertake training; Lack of interest or Insufficient opportunities for sharing research; Insufficient publication of research; There is limited access to evidencebased research in most countries because of the need for subscriptions to journals; Undependable internet access; Research is not core for some curriculum; There is an absence of institutional framework such as Internal Review Boards (IRB); Most research is done for academic purposes; Availability of technology which plays a significant role in research and evidence generation; Nurses being principal investigators; Paring interested persons with PhD prepared faculty; Training educators to facilitate understanding and utilization of research; Defining scope of research which can be small projects; Standardizing fora where students can present research; Development of Journal clubs or writing clubs; Presentation of papers throughout graduate programs; Formation of Internal Review Boards with nurse participation; Coalition of nurse education (institutions)/nursing collaboration; Collaborating with regional and international agencies; Collaboration among institutions;
6 DOMAIN Barriers/ Challenges Gaps Solutions 5 Educators are left out of the decision making process; Lack of confidence to collaborate; Practice affected due to lack of research; Training is done in silos; Absence of skills needed for conflict resolution; Collaboration needs to be done with regional and international agencies so that nurses are aware of current issues that need to be addressed; Maintain link between ministries of education and ministries of health; Nurse educators need to sit at decision making levels within the ministry of health; Continuous IT training is needed; Developing more culturally sensitive programs/training of educators in transcultural nursing; Develop and make available a comprehensive orientation package for nurse educators; Develop and make available policies and guidelines; Established protocols for accessing records and releasing information (in promoting research culture among educators and those in nursing practice);
7 DOMAIN Barriers/Challenges Gaps Solutions 6 Enforcing accountability as it relates to academic honesty and provide impartial evaluation (student not meeting requirement)/avoid bias to favour some students over others; Difficulty of nursing educators to manage student issues; The inexperience of educators; High student to teacher ratio which limits ability to control clinical placements; Overcrowding of the clinical space (preferential treatment for students or organizations who can pay, violation of patients rights to privacy etc.); Continuing to train students in a limited job market; Institutions offering programs that are not accredited; Decision makers do not understand the issues of nursing; Disconnect between theory and practice; Allocation of funding to build capacity in nurse educators; Build a link between education and practice; Must be a memorandum of understanding at all nursing colleges within the region; Maintain high standards of care; Recruiting persons with the right qualification/increase cadre of qualified and competent staff; Develop mechanisms to attract high caliber student of excellence (examine selection process, recruitment strategies, review qualification); Grandfathering students in training programs with known deficiency in competency; Accountability must be developed for the nurse s code of practice/enforcing an ethical code of conduct; Rethink, Revisit and reframe principles of professionalism; Sensitize the population on the diversity of nursing;
8 Poor compliance with ethical codes of conduct; Lack of clarity as to the role of nursing councils to deal with professional misconduct; Inadequate level of involvement in professional organizations; Political interference; Accommodating the various religious orientations without compromising individual freedom or standards; Human rights issues different culture; Drug related issues; Gender issues; Strict adherence to the code of conduct;
9 DOMAIN Barriers/ Challenges Gaps Solutions 7 Lack of program monitoring/evaluation of in-house test; Assessments are too limited to evaluate the competence of multiintelligent student population; Lack of standardization of assessment tools used in evaluation of educators; Programs that are not accredited (held to standard); Concerns with the quality of the graduate; High failure rate at Regional Examination for Nurse Registration (RENR). Faculty preparation; Teacher/student ratio; Quality of the clinical experience; Inadequate Human Resources; Inadequate Materials Resources; Inadequate resources such as clinical space; Inadequate resources such as classroom space. Accreditation process for schools; There must be a clear outline of the monitoring and evaluation process and identify who will be conducting the evaluation; Improve standardization of assessment tools used in evaluation of educators; Create different forms of faculty performance evaluations such faculty peer evaluation; This be an unannounced, ad hoc, continuous evaluation focus group and students evaluation; Utilize a variety of assessment tools and methods to ascertain student competencies in cognitive affective and psychomotor domains and provide timely feedback; Improve assessments to evaluate the competence of multi-intelligent student population; Give the students a blue print of the examination;
10 DOMAIN Barriers/Challenges Gaps Solutions 8 Lack of Leadership and patient advocacy skills (risk-taking for the greater good of the patient); Deficiencies as it relates to the preparation of educators to manage finance and human resources; Engage in quality reviews. Develop greater linkage between the human resource departments and the academic institutions. Academic institutions should become increasingly involved inn manpower planning; The Chief Nursing Officer must advise the minister of health on nursing matters; Get nurses in strategic and decision making position; Have the right person in the right position; Sensitizing educators on the association for nurse educators which has been established; Strong leadership/management is needed to guide the direction of the institution; Educators should have Leadership and management skills: classroom, unit and schools/training in Leadership and management/training in leadership at clinical and higher levels; Cross-training between educators and administration is needed; Strengthen training and leadership at all levels of nursing education and nursing care; Educators should take professional courses; Develop better linkages with accreditation mechanisms; Identify funding to ensure accreditation of nursing education institutions nationally and regionally; There should be adherence to the blueprint as agreed by RNB for the evaluation of schools of nursing; Have collaboration regionally and internationally; Establish mentoring programs; Encourage on-going educational development; Encourage inter-professional collaboration;
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