A Theoretical Study To Developing A Competence-based Disaster Nursing Curriculum

The aims of this study is to clarify fundamental competence in disaster nursing practice in China and to develop a competence-based disaster nursing curriculum which integrating primary components after identifying important learning goals, selecting main contents, formulating appropriate feedback & assessment procedures and selecting effective teaching & learning activities. The syllabus of the curriculum provides the useful guidance for nursing educators.MethodologiesAn exploratory, descriptive research design using both qualitative and quantitative methodologies was used. The research process comprised the following stages.Stage I: Theoretical analysis of factors influencing curricular goals. Basic concepts involving in the study were identified and roles of related theories were introduced. The study borrowed ideas from theories of curriculum development, i.e. The Tyler model of curriculum design and the integrated course design model of Fink; from learning theories, i.e. Behaviorism, cognitive and constructivist theories; and from disaster nursing models, i.e. Jennings disaster nursing management model and Wynds model for disaster military nursing. A main factors influencing curricular goals was analyzed including those from social, students and concept of subjects so that basic principles for developing disaster nursing curriculum was summarized.Stage II: Clarification of fundamental competencies in disaster nursing practice. The framework of fundamental competencies was developed based on the framework of existing disaster nursing models. Competence contents were firstly identified using content analysis on literatures relating to disaster nursing which published on main Chinese journals. Semi-structured interview with nurses and nurse administrators who have experienced in disaster nursing practice was also used to help structure the competence model. The major themes generated from the analysis of interview data and text contents were used to structure the questionnaire. Nurse educators, nurses employed in emergency department and critical care units, and nurse students were recruited to answer the questionnaires. The results of survey were used to confirm the previous competence model.Stage III: Design of disaster nursing curriculum. Theoretical approach was used to integrate the factors influencing the disaster nursing curriculum and disaster nursing competence so that learning goals and main contents of disaster nursing curriculum was identified. The other key components was developed using the techniques of curriculum design, including selecting effective teaching/learning activities, formulating appropriate feedback & assessment procedures, and integrating the primary components together. Finally, a curriculum syllabus to guide how to implement this curriculum was developed and suggested for nursing educators.ResultsBasic principles for developing disaster nursing curriculum was summarized as: 1) goals of disaster nursing curriculum should be developed basing on disaster types those are most possible to occur in China and to cause mass casualties at the present stage. 2) Curricular goals should be decided basing analyses of students, such as the requirement of study and their previous knowledge and skills level. 3) Curriculum user should make a dynamic analysis for curriculum goals to adapt the differences among areas, periods, and changes of studentsA competence model with three dimensions, seven factors and twenty-eight items evolved after analyses of literatures, qualitative interviews and surveys. Educators, students and nurses indicated agreement that the components on the survey were realistic and important for disaster nursing. Among the competence model, there was two factors identified in pre-disaster dimension basing the factor analysis procedure, i.e. special competencies (including disaster information assessment, developing disaster plan, and field survival) and general competencies (physical quality and psychological quality); four factors identified in during-disaster dimension, i.e. emergency nursing (patient assessment, first aid, triage, evacuation, intensive care), patient management (caring for patients with common diseases, patients transfer, multidisciplinary cooperation, materials management, foundational nursing), mental health nursing (self-mental regulation, psychological assessment, psychological intervention), and safety protection (individual protection, special infection identification, environmental risk assessment, epidemic prevention and control); one factor identified in post-disaster dimension, including items of psychological assessment, psychological intervention, infectious diseases prevention and control, caring for the sick and wounded, reestablishing working order, and health education.Learning goals of the disaster nursing curriculum was identified and described using curricular developing techniques, which consisted six categories relating to foundational knowledge, application, integration, human dimension, caring, and learning how to learn. According to the above learning goals, main contents of the curriculum was selected, three types of teaching/learning activities were selected including those providing information & ideas, experience, and reflective dialogues and four types of feedback & assessment procedures were formulated including forward-looking assessment, criteria & standards, self-assessment by learners, and feedback by teachers. Finally, the main components of the curriculum were integrated into a coherent whole and a syllabus was developed as guidance for curriculum implementation.ConclusionsMillions of people in China are affected by disasters or major incidents annually. Disaster preparedness has reached a new level of urgency in China, thus, nurses will now have to become involved in disaster management in order to function effectively in disaster situation. Education is a crucial way to prepare nurses to this role. This study developed a model of disaster nursing competence and designed an integrated disaster nursing curriculum which will provide guidance for further study and education in this field.