Comparative Study On Baccalaureate Nursing Curriculum In China, Britain And United States

Comparative Study on Baccalaureate Nursing Curriculum in China,Britain and United States —Comparison of Adult Health Nursing/Medical-Surgical Nursing CourseIn recent years, with the aging of world population, change of the social health needs as well as the medical model, and the reform of medical healthcare system, the professional role of nurses are required to be repositioned. Nurses are not only the ones who provide high-quality nursing with good skills, but also the main force of primary health care and health education, as well as the equal partner in the medical healthcare team. In this context, the training objectives, length, degree has been adjusted and courses establishment, teaching methods, media and organization has been reformed in baccalaureate nursing education of China, which has formed quite scientific and sound training model of nursing undergraduates. However, with the deepening of reform, we find the study on baccalaureate nursing curriculum is not enough, and theoretical system and teaching contents in most courses are still be molded on traditional medical education curriculum which is biomedical-model based and lays much emphasis on illness and treatment, while little on clients, families and societies, and nursing and prevention. All of these are not consistent with the expanded professional roles and training objectives of nurses. For these reasons, our study is to reflect present baccalaureate nursing curriculum in our country and give some suggestions about course reform by comparing adult health nursing/medical-surgical nursing course in China, Britain and United States.Part One: On the basis of elaborating modern education theories, curriculum theories and nursing theories, the comparative study project was made, which include purposes, contents, methods of study, principles and frameworks of comparison. And the elements of comparison were also defined.Part Two: Descriptive study on the present situation and features of adult health nursing/medical-surgical nursing course in China, Britain and United Statesrespectively.Baccalaureate medical-surgical nursing course in 6 nursing colleges of China has following characteristics: (1) The course name, structure and contents are basically unified. 5 colleges establish the course of medical nursing as well the surgical nursing, with national textbooks published by People's Health Publishing House. Only 1 college establishes Clinical Nursing I beyond the disciplinary boundaries and uses its own teaching materials. The main course structure and contents are basically similar. (2) The knowledge system of course is quite complete. All the clinical nursing courses are established in terms of medical departments in the clinical settings. The structure and contents of medical and surgical nursing courses are established by the form of secondary and tertiary clinical medical disciplines. Every chapter of a specific body function is taught in the logical sequence from general introduction to different diseases with the nursing process integrated into. (3) Biomedical model is obviously reflected in course. The course teaching contents are illness-and-clients centered, with great emphasis on treatment and nursing care of diseases. And course teaching focuses on patho-physiological changes by diseases, observation of clients, treatment, rescue and nursing. And the patho-physiological changes by diseases are always the logical start and basis in establishing nursing knowledge system, while the content related to health and illness quite lacks, including the knowledge of psychology, society, culture and environment. (4) Teacher's dominant role in teaching is obvious. Teachers attach much importance to lecture course on theories, with much emphasis on teaching contents and teaching plans in course teaching in order to assure the quality of teaching. However, influenced by the traditional education philosophies, the main body of students is not intensified in spoon-feed teaching. The abilities of self-study, critical thinking and creativity of students are not well trained.Baccalaureate adult health nursing course in 4 nursing colleges of Britain has following characteristics: (1) Theory teaching and clinical practice are closely combined. Their training models and course establishment fully reflect the features of professional training. Courses are arranged according to the strict requirement of the length ratio of 1 to 1 of study on campus and clinical practice, which are donealternately. (2) The theoretical system of course is not quite systematic and complete. The baccalaureate training program for pre-registration nurses include general education in the 1st year, adult health nursing, child nursing, mental heath nursing and child learning disability in the 2nd and 3rd year, whose course establishment and teaching contents are not based on disciplinary theory system. In addition, for the sake of limited time of study on campus and without fixed textbooks, the theoretical system of adult health nursing course is not quite systematic and complete. (3) There are various ways to tutor students' self-study. The teaching hours in colleges of Britain are definitely specified, therefore, different kinds of teaching forms which are centered on students' self-study are often applied. Some teaching methods, such as case study and problem-based learning, assignments and flexible exams or tests are always used. (4) Students have strong abilities of providing adult health nursing with nursing process. Students are well trained to be able to satisfy the needs of adult patients in a variety of health care facilities.Baccalaureate adult health nursing course in 5 nursing colleges of United States has following characteristics: (1) There are varieties of curriculum and each of them has its particular emphasis. The administration of higher education in United States is self-autonomous. Every university or college has its own aims and training objectives for different kinds of talents. In this respect, course orientation, textbook, teaching contents, course teaching of adult health nursing in nursing universities are quite self-determined, flexible and have some discrepancies. (2) The professional features of course contents are very obvious. From the perspective of nursing profession, the teaching contents of adult health nursing highly emphasize on the responses and influences of the illness brought to the client's biological, mental and social life, and its nursing interventions. (3) The development of student's abilities are attached importance to. The course objectives, contents, implementation and evaluation are all centered on the development of student's abilities, including critical thinking, self-study, applying nursing process, communication and health education. (4) The course contents are comprehensively integrated. The courses are established based on the life-cycle model. The adult health nursing course has a wide coverage, includingthe common health problems in adults, its nursing interventions, health maintenance and health education, which well mirrors the essence of modern nursing science.Part Three: Comparison of Adult health nursing/Medical-Surgical Nursing Course in China, Britain and United States were made in detail based on the comparative framework. Moreover, the backgrounds influencing the course in these countries were analyzed.The main objectives, general contents of Adult health nursing/Medical-Surgical Nursing Course of these three countries are quite consistent. Firstly, the course well follows the nursing process and makes it the guidance of thinking, decision-making and practice in nursing, which reflects much consistence of nursing profession development in these three countries. Secondly, the health education is regarded as an important task for nurses in the course of these three countries, which suggests nurses, as the main force of health education, play more and more important roles in health maintenance, health education and health restoration. This represents the trend of global nursing development.There exist the differences among Adult health nursing/Medical-Surgical Nursing Course of these three countries: (1) The Medical-Surgical Nursing course of China is generally knowledge-based, while the course of Britain and United States are quite abilities-centered. In such circumstances, the objectives of the Medical-Surgical Nursing course of China put much emphasis on the cognition domain, while little on affection and skill domain. However, the objectives of Adult health nursing course of Britain and United States cover both the domain of affection and skill, which are also embodied in the teaching contents, teaching implementation and evaluation. (2) The Medical-Surgical Nursing course of China still follows the traditional model of clinical departmentation, which reflects the "disease-centered, treatment-oriented, and hospital-based" nursing perspective in narrow sense. However, the Adult health nursing course of Britain and United States is established according to the life-cycle model, and reflects the "health-centered, health maintenance, promotion and oriented, hospital-community-family-based" nursing perspective in broad sense. Besides, the contents of humanities, social science and psychology are well integrated in thecourse of United States, which are quite systemic, complete and have its professional characteristics. In addition, the course of Britain excessively emphasizes the practicability, but is not quite systemic and theories need to be intensified. (3) The organization forms of the Adult health nursing/Medical-Surgical Nursing course of these three countries are different. The course of China mainly focuses on theory teaching, with little clinical observation and laboratory practice. The faculties of Medical-Surgical Nursing course are only in charge of theory teaching. But in United States, the teaching of Adult health nursing course consists of theory teaching and clinical practice, which are carried out simultaneously or consecutively. The faculties of this course should be engaged in arrangement, organization, teaching, and evaluation of students' clinical practice besides theory teaching. In Britain, Adult health nursing is an independent professional orientation, whose knowledge and skills are allocated into several modules, with classroom teaching and clinical instruction carried out alternately. The clinical nurses are in charge of the arrangement, teaching and evaluation of students' clinical practice. (4) Different teaching strategies adopted in this course of these three countries indicate the difference of education philosophies. China emphasizes on teaching by teachers, while Britain and United States put much emphasis on students' learning.Part Four: Suggestions about the reform of Medical-Surgical Nursing course in China were put forward: (1) Renew the perspective of course establishment and the course needs to be abilities centered. (2) Reform course model and keep it up with the trend of nursing profession development. So the Medical-Surgical Nursing course needs to be integrated into Adult health nursing course. (3) Intensify the professional characteristics and rich course teaching contents, so as to establish the independent and professional adult health nursing system which can be consistent with bio-psycho-social medical model and development of health care service in our country. (4) Improve course design and intensify quality training, making the transition of course teaching from imparting knowledge to training students the abilities of independent study and work. (5) Accelerate the process of faculties training and assure the quality of course reform. (6) Develop a complete series of...