Comparison of Nursing Education among Different Countries☆

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Comparison of Nursing Education among Different Countries☆

Fei-Fei Deng

Nursing College, Chongqing Three Gorges Medical College, Chongqing 404000, China

After reviewing Chinese and foreign language literature published in recent years, this study analyzed nursing education in China and other countries and China in terms of basic nursing education and training, curriculum and teaching contents, teaching materials, and teaching methods and evaluated the characteristics of nursing education andcontinuing education, etc., to draw experience and lessons from successful foreign nursing education programs and to provide examples for nursing education reform in our country.

?2015 Shanxi Medical Periodical Press. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

☆This article is founded by: Scientific research nursery project of Chongqing Three Gorges Medical College: Study on international comparison and reference on the cooperation between higher vocational colleges and hospitals of nursing profession (2014mpxj19).

*Corresponding author.

E-mail address: dengfeifeigigi@163.com (F.-F. Deng).

Peer review under responsibility of Shanxi Medical Periodical Press.

http://dx.doi.org/10.1016/j.cnre.2015.11.001

2095-7718/ ?2015 Shanxi Medical Periodical Press. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

1. Introduction

Nursing is a service-oriented comprehensive applied discipline that includes scientific techniques. The nursing profession also occupies an extremely important position in the health system. Teaching fund a mental concepts and basic knowledge of nursing and nursing skills are the first steps in the process of nursing education.1The task of nursing education is to provide the best understanding of how to meet the needs of society. The author reviewed the relevant literature about nursing education from several countries, including the United States, Canada and Australia, etc.. Moreover, the author has summarized and analyzed detailed aspects of nursing education.

2. Comparison

2.1. Basic nursing education and training methods

In the United States, nursing education is classified as follows: the licensed practical nursing program (LNP), diploma nursing program, associate degree nursing program (AND),bachelor of science in nursing (BSN), master of science nursing program, and the doctoral nursing program. These seven levels range from low to high, and all levels are connected to one another. Students can increase their education level to continue learning. This method provides students with a variety of choices.2Undergraduate nursing education is quite common in Australia, which also provides masters and doctoral programs. Thus, a considerable number of nurses have master’s and doctoral degrees.

Nursing education in Canada is divided into several stages.(1) Someone who finishes 2 or 3 years of education in technical secondary school can only be an assistant nurse. (2) Someone who completes the 3-year junior college education program can qualify for the registered nurse examination to qualify as a registered nurse. (3) After 4 years of bachelor’s education or continuing education to obtain a bachelor’s degree, they are eligible to participate in community medical care services.

At present,there are 5 nursing education levels in China: technical secondary school, college, undergraduate, postgraduate and PhD. Although nursing education in China has developed rapidly in the past 30 years, the number of technical secondary and tertiary education schools is large, but the number of master’s and doctoral programs is small. Continuing nursing education is still limited.

2.2. Curriculum provision

Different curriculum provisions may reflect different educational ideas. In Britain, the curriculum is many in basic, few in practical, this is the style of traditional medical education. They put particular emphasis on the courses of Prophylactic and pharmacology medicine. In the United States, the curriculums are based on education resources,school concepts and the characteristics of students, and they follow the nursing professional higher education standards.3Nursing theory, nursing process, “Biological-Psychological-Social” pattern, etc. form the framework of the curriculum.Courses focus on community care and disease prevention, and they attach importance to the humanities and emphasize independent thought; there is a greater level of clinical practice. They pay attention to evidence-based practices. At the same time, the programs attach great importance to the cultivation of the ability to work with high and new technology. In addition, the nursing education curriculum varies according to the different levels of nursing education.

In Australia, undergraduate nursing courses at the university level consist of fundamental nursing, nursing research and application, biological science, social science and clinical practice. Fundamental nursing courses primarily involve emergency care, preoperative nursing care and geriatric care. Biological science provides knowledge such as physiology, pathology, immunology and pharmacology. In addition, social science teaches about the nursing ethics, law, politics, and economics and cultures that impact nursing. Nursing research and application is a course that teaches nursing students about nursing technology. The master’s degree program has two focuses: (1) nursing theory research and nursing scientific research and (2) clinical nursing teaching and nursing management.4

In China, the curriculum in most nursing colleges is still the traditional “Discipline-Centered” model, which primarily includes the public elementary courses, basic medical course, and nursing and clinical practices. The curriculum emphasizes discipline theory knowledge systems and integrity. However, the disconnection between theory and practice is serious.

2.3. Teaching contents and teaching activities

In Britain, the teaching contents reflect the model of “Theory-Practice-Professional Theory-Clinical Practice”, from the basic theory rose to professional theory and practice gradually. In the United States, the teaching focus ranges from clinical nursing to community nursing and from disease management to disease prevention. It attaches greater importance to the students,who gain cross-cultural nursing abilities, and it focuses on the latest technology.5The time arrangement is more efficient and flexible between theory and clinical practice, and the clinical practice teaching lasts throughout the whole clinical nursing course rather than being concentrated in the last years.5,6

Australia always pays more attention to the multicultural development of students, teaching them more about humanities and community nursing; the teaching content reflects the “Biological-Psychological-Social Medical” model. There are close connections between practice and theoretical learning, alternately, highlighting the characteristics of nursing with cultural and practical knowledge.5

In China,the nursing courses focus on clinical nursing. The teaching focuses on the classification of clinical diseases, includes labor education and emphasizes political and professional knowledge. To impart knowledge,the teachers have long led the teaching process, with students rarely actively learning. Clinical practice is arranged after finishing all of the theoretical learning (approximately 1 year).

2.4. Textbook

In America, there are no unified teaching materials. The curriculum does not center on “teaching material”teaching. The teacher decides what type of textbooks to use to ensure that the students can meet the educational standard, and the use of cycle of textbooks is limited.7In Australia, there are also no unified textbooks for nursing courses. Teachers usually provide the related books that the courses require, and others may recommend reading resources to guide students in the learning process. There are unified textbooks for nursing courses in most areas of China. It is obvious that imparting knowledge is more important than ability and learning guidance. As a result, the cycles of using the textbooks and other teaching materials are always long.

2.5. Teaching forms and characteristics

Using different teaching methods can greatly impact the acceptance level of knowledge and the cultivation of practical ability. In America, classroom teaching is flexible, and it fully manifests the educational concept of student-oriented ideology, emphasizes students’ clinical decision making and practical problem solving skills. Teaching methods are also flexible, such as case analysis, scenario simulation, group discussion, cooperative learning, et al. Clinical education and school education are performed simultaneously, and clinical practice is often arranged 2-3 times per week. It is not rigid emphasis on the unity of the operational steps and procedures. In Australia, teaching methods are combined with theoretical study, inspiration thinking and ability cultivation. In China, the traditional teaching method of lectures is still used. Students listen to what the teachers say and there is a strict emphasis on standardization of the operational steps and procedures. Clinical practice is arranged in the final year, therefore, it is easy to keep the theory teaching and practice teaching disconnected. The following Table 1 shows the differences of nursing education teaching among several countries.

Table 1 Characteristics of nursing education teaching among countries.

ItemsTheUK8,9TheUSAAustraliaChinaCoursedistributionmanybasiccourses,fewpracti-calcoursesfewbasiccourses,manyhumanitiesfewinbasiccourses,manyprofessionalmanybasiccourses,fewcoursesinhumanitiesHighlightsofthecourseprophylacticmedicineprophylacticmedicinecourseshumanitiesandlifesci-encescoursesclinicalnursingTeachingproceduretheory-practice-professionaltheory-clinicalpracticechild-adult-geriatricgeriatric-adult-childbase-theory-clinicalpracticeTeachingguidingideolo-gypatient-centeredholisticnurs-ingpatient-centeredholisticnursingpatient-centeredholisticnursingcourses-centeredtheoryknowledgeMainteachingformmulti-mediamulti-mediaandself-learningself-learninglectureMaintestformwrittenwritten,professionalac-creditationwritten,professionalac-creditationwritten

2.6. Evaluation of nursing education

Evaluation of education is a process that is based on objective standards, using a variety of measurements and related data collection to objectively and scientifically measure and judge the effect of the teaching activities.10

Developed countries establish the evaluation system according to the course outline. Course content is required to be memorized in the form of written examination. The curriculum contents that must be understood and analyzed are always tested through comprehensive evaluation forms (e.g. through experimental reports and writing science and technology articles). The method of simulating standard wards is used to evaluate the clinical abilities of students. In America, nursing education is evaluated by the National League for Nursing Accrediting Commission (NLNAC)and the Commission of Collegiate Nursing Education (CCNE), which are responsible for implementing educational assessments. The agencies aim to ensure program authenticity, standardize the characteristics of the nursing profession and ensure that the standard evaluation and index system accurately reflects the requirements to cultivate the nursing talents and develop nursing profession.11

In Australia, the evaluation methods consist of a variety of procedures, including written and oral book reports, case discussions and clinical ability tests, etc. State government departments of education and the Association of State Boards of Nursing jointly review the nursing educational standards. Computer network information management provides a fundamental guarantee of quality control.

In China, education evaluation particularly stresses theory, therefore, written examination is the primary teaching evaluation method. However, the student evaluation system changed greatly in recent years. It has also attached great importance to theoretical, clinical and comprehensive evaluations, but the system still needs many improvements. It cannot comprehensively test independent analysis and problem solving abilities. Another problem is that nursing education is not independent, and it lacks special features compared to the whole nursing field. As a result, it systematically limits the professional development of nursing education and nursing knowledge.

2.7. Continuing education

Continuing nursing education in America is flexible and varied; it includes academic conferences, special skill training, seminars, topic discussion, et al. The American Nursing Association (ANA) provides many opportunities and projects for improving the continuing education of nursing staff, including special courses, seminars, short-term training, et al.12It is equipped with professional learning and education websites, such as the American Association of Critical-Care Nurses premier continuing education selections, et al.

In Canada, the Registered Nurses Association offers continuing nursing education and standardized training, including participation in various academic nursing activities to improve the nurses’professional skills and provide them with more career choices and higher salaries. In Australia,continuing nursing education combines nursing degree education and job training, which provides abundant learning opportunities and platforms for the nurses. There are nursing upgrade courses, post-graduate education, a variety of short-term training courses and remote nursing education courses.13In recent years, China has paid more attention to continuing nursing education. First comes professional knowledge and skills training, then specialist nurse training and continuing education,which are consistent with their jobs, according to the nurses’abilities. Currently, remote education is a new continuing education method. However, there is currently no timely, targeted, systematic model of continuing education. The curriculum, methods and evaluation systems must still be improved.

Conflicts of interest

None declared.

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