Journal of Community & Public Health Nursing
Open Access

Community care; Curriculum design; Nursing education; Nursing students

Introduction

Many Western countries are progressively emphasising the significance of a solid workforce of well-educated community nurses to meet the significant increase of nursing care given outside the dividers of facilities. This healthcare move, related to expanded chronic illnesses in a maturing patient population, regularly with multiple health issues, leads to a long enduring highly complex nursing care. As there's a growing worldwide acknowledgment of this shift in caregiving, nursing education is coming up with revised curricula where hospital care is not seen as the essence of nursing and that include new concepts related to community care, for example within the USA (AACN, 2008) and the UK. A recent example is the European curriculum for family and Community nurse (Upgrade) extend, leading to community-based educational programs of 60 European Credits (ECs), to be integrated into existing nursing curricula [1].

In the Netherlands, comparative developments took place with a new national profile for baccalaureate nursing education ‘Bachelor Nursing 2020′. This more community-oriented educational profile is based on a more dynamic concept of health that replaces the WHO definition of ‘the state of total physical, mental and social well-being’, as many educators felt that this definition no longer fits the current healthcare circumstance. With the increased emphasis on extramural care, the concept defined as ‘the capacity to adapt and self-manage’ is considered more appropriate. These themes refer to the part of the community nurse as a caregiver in circumstances where ‘the ability to adjust and self-manage’ is central and where ‘complete physical, mental and social well-being’ is no longer a reasonable option. In the event that this move is approached as a paradigm-shift, the ancient paradigm would speak to nursing interventions where the nurse is active and helps the quiet become and stay sound, while the new paradigm represents intercessions where the nurture helps the patient ended up active in working on optimal quality of life conditions, despite conceivable limited capabilities and/or conditions.

However, a less highlighted issue is the impact of modern educational substance on students’ concrete conduct in the shape of new nursing care interventions. It remains vague in the event that students’ intervention choices alter following content changes in nursing curricula and thus moves from old to modern standards in health care. For case: will a understudy who gets education on the unused curriculum subject ‘how to collaborate with the social system of the patient’ choose distinctive interventions within the caregiving compared with a understudy who gets education according to the ancient curriculum, in such a way that family and kin are included in that caregiving [2-3]. Since nursing education has the ultimate responsibility to educate understudies for the healthcare of end of, the behavioural alters must be evaluated. In spite of the nearness of unused more community-oriented educational module, there is a lack of inquire about examining how modern curriculum content influences students’ concrete behaviour in community care. This study aims to fill this crevice. The theory underlying this study is that new themes in nursing education on community care will lead to different intervention choice within the caregiving.

Methods

A quasi-experimental study with a historic control gather and an mediation gather was performed. The historic control group experienced a more traditional, ‘hospital-oriented’ nursing curriculum (two understudy cohorts graduating in 2016 and 2017). The intervention bunch (one cohort graduating in 2018) underwent a overhauled curriculum with broad components of community care. The new curriculum was planned to educate understudies new nursing intercessions related to the new topics within the revised Dutch instructive profile. The curriculum overhaul comprised of an integrator three-way approach: 1) new instructive elements within the in-school curriculum; 2) speakers as envoys; and 3) positive student-placement experiences. Efforts were made to guarantee that understudies would come into contact with attractive enthusiastic part models, both as teacher and as tutor amid their placement [4-6]. To measure the result of the study, defined as ‘intervention choice in community nursing’, a vignette instrument was developed. Vignettes are “brief descriptions of events or situations to which respondents are inquired to respond, designed to inspire data about respondents’ recognitions, opinions, or information on a certain phenomenon”. Vignettes provide data on how people might behave in circumstances which are difficult to watch in way of life. In a vignette, usually between three and five themes/variables are included and these factors can be manipulated within the vignettes’ plan in a manner that would not be conceivable in observation studies.

For our purpose we created a vignette instrument ‘Assessment of Intervention choice in Community Nursing. It consists of three vignettes where a situation in caregiving within the patients’ home is depicted. To expand outside validity, the vignettes are based on real-life case think about fabric and described in such a way that a community nurse is confronted with a situation within the patients’ domestic where a concrete nursing intervention is required. Each vignette joins all five unused curriculum topics (cultivating quiet selfmanagement, shared decision-making, collaboration with the patients’ social system, using healthcare technology and allotment of care). The interventions with regard to each subject are a realistic alternative, whereas more traditional intervention choices are also possible [7]. To avoid understudies responding in a way they think to be correct, they were not told of the instrument’s basic purpose (i.e., deciding the five subjects). After reading each vignette, the respondents briefly (two lines per mediation) formulate five, in their opinion, most appropriate intercessions for nursing caregiving. The 15 interventions yield qualitative information.

The developed vignettes were investigated on clarity and detailing by three people included in different parts in community nursing (community nurture, an understudy mentor and a supervisor). They were intentionally chosen on the basis of their different viewpoints in proficient practice [8-9]. To improve the clarity of the data, some minor textual alterations and/or additions were made. In the second step, the vignettes were verified for confront and content validity by a panel of nine specialists (four community nurses and five teachers in nursing education). They individually given criticism on the instructions and the vignette texts, and their comments and responses were utilized to educate changes. These experts too really used the instrument. Third, the instrument was pilot-tested in a student group not included within the study. Twelve nursing students within the last stage of their education and within the nearness of researcher filled in the instrument. As the students had no substantial questions or comments and the 30 min time to fill in the instrument appeared to be suitable, the AICN was considered final.

Discussion

The objective of this study was to explore the effect of a curriculum with more elements of community care on nursing students’ intervention choice in community care. The generally comes about appear a critical positive impact, though generally little. The number of times a new educational modules topic was chosen appears the same design: an increment in most new topics (with a critical positive effect in two of them), but with a moderately little number compared with the interventions that are not related to the modern curriculum themes The subject ‘allocating care’ is more regularly chosen than the other themes with extents of 10.3% resp. 13.5% (ancient vs. modern educational programs). While it is enticing to think that (Dutch) baccalaureate nursing students are mindful of the fact that they have the legitimate competence to distribute care, involving other care disciplines may too reflect their vulnerability regarding their claim capacities. Earlier studies uncovered that numerous students feel that, in a work plan with little opportunity to trade thoughts with colleagues, making your own choices could be a great responsibility [10]. one of the reasons why they prefer to collaborate with other caregivers in a team.

Conclusion

A more ‘community-oriented’ baccalaureate nursing curriculum containing modern themes related to community care was effective in influencing students’ intercession choice, in the sense that understudies that experienced the unused curriculum more regularly chose care interventions related to the unused subjects and (2) more understudies chose the modern subjects. Be that as it may, more ‘traditional’ intervention choices are still most favourite. Seeing this move in how students choose their care interventions as a step within the right direction and considering that such improvements take time, it can be anticipated that the community care field within the longer term will benefit from better taught modern graduates, who are able to take on the multi-faced part of an autonomous caregiver in people’s homes.

Conflict of Interest

The authors declare no conflict of interest.

Acknowledgement

None

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