Accreditation Standards For Academic Quality Of Baccalaureate Nursing Programs In China

Objectives:1. To develop the accreditation standards for academic quality of baccalaureate degree nursing programs in China based on the situation of our country and the international trends of baccalaureate degree nursing education. It would be applied as the standards or guideline for the accreditation of baccalaureate degree nursing programs.2. To explore the cause of formation and implementation mechanisms of nursing accreditation institution in developed counties and compare the formal rules and informal rules horizontally and vertically among them, in order to put forward suggestions for the establishment of nursing accreditation system and quality assurance guarantee mechanism of baccalaureate nursing programs of China.Methods:1. The standards of nursing and medical programs in domestic and foreign countries were reviewed to find out the current trends in the research of accreditation. The concepts of nursing educational standards, specialized accreditation of nursing programs, nursing accreditation institution, and others were explored and defined using theoretical and literature research.2. According to the theoretical framework of new institutional economics, we used comparative method in education, put forward by George Z. F. Bereday, to compare the history and evolution, formal rules (accreditation agency, standards, and procedures), informal rules, and implementation mechanisms of nursing accreditation institution of America, United Kingdom, and Australia to learn about their characteristics, differences and factors relating to their formulation.3. Based on theoretical study, comparative study and literature review, we put forward the principle of developing standards for academic quality of baccalaureate nursing programs of China and developed the framework of standards preliminary. Focus group/ expert panel meeting were conducted with 18 experts on nursing education, clinical nursing, nursing management and other related fields to discuss the content and structure of the standards. Two researchers analyzed the data together through recording, coding and epurating themes. Then the framework and elements of the standards were identified.4. Through reviewing the current status of baccalaureate nursing education of China, the draft of accreditation standards for baccalaureate nursing programs of China were developed.5. Experts from 98 schools of nursing located in different parts of China were consulted with using Delphi technique. The experts participated in two rounds of iterations to evaluate the relevance, specificity, comprehensiveness, level, application of each item of the draft of the standards and reached consensus on the final standards.Results:1. The concepts of nursing educational standards, specialized accreditation of nursing programs, nursing accreditation institution, and others were defined. The standards of nursing and medical programs in domestic and foreign countries were reviewed.2. We obtained the main cause and factors influencing the formation and developing of the nursing accreditation institution in developed countries, which encompassed market, specialty development, governmental factors, and civil society, through vertical comparison of the history and evolution process among them. In the horizontal comparison, firstly we analyzed the similarities and differences in the nature, organization, and management of nursing accrediting agencies in those countries; secondly, we described the common characters and differences in the content, structure and form of the accreditation standards from two perspectives: essential quality standards and course quality standards; thirdly, we analyzed the similarities and differences in accreditation procedures, participants and outcome of the nursing accreditation, and emphasized the mechanisms'impartiality, objectivity and rationality. In the comparisons of the informal rules, we studied the common characters of the nursing accreditation institution from three aspects: values,ethical norms, customs. The common characters included individualism, academic freedom and autonomy, impartiality, multicultural and openness, rule consciousness, innovation, and so on. In the comparison of implementation mechanisms, analyzed their similarities: rationality of institution, institution represent the interest and the choice of all stakeholders, default cost, and information publicity mechanism.In conclusion, we put forward the following suggestions: Improvement of external quality assurance mechanisms in the nursing education; establish and improve relevant policies, transform government functions, to promote the development of nursing professional organizations; speed up to establish accreditation standards of nursing programs that is the minimum eligibility criteria of nursing education; establish certification procedures and relevant regulations, to establish scientific implementation guideline of the program; establish advanced culture which complies with the nursing accreditation system.3. According to the general system theory, Taxonomy of Educational Objectives, Hammond education evaluation mode theory, based on an analysis of literature review, we proposed the principle of building the standard, including principle of comprehensive development etc. According to Task Force'related research and organization of expert panel meeting, we obtained the basic elements and formulated the framework of undergraduate nursing standards for professional education. Also we proposed essentials to be paid attention to in the research.4. Through literature analysis on the status quo of competence of nursing graduates (objectives of the bachelor's degree nursing programs) and on the basic education requirements of undergraduate nursing education at home and abroad, the draft of "standards of undergraduate medical education - nursing profession" (discussion paper) were established.5. Through 2-round Delphi technique with 98 nursing schools, we developed the final standards, which were composed of competency standards for bachelors of nursing and basic standards for baccalaureate nursing education institutions. The formal part includes 29 teaching goals in cognitive, affective, and psychomotor domains; the latter part includes 10 domains such as mission and objectives, students, academic staff/faculty etc and a total of 40 items.6. Analyzed of the theoretical and practical significance and application of the "Standards of undergraduate medical education - nursing profession ", summed up the trends of accreditation system for nursing and the problems we should pay attention to in the development, which would provide a reference for other specialties.Conclusions:1. In this study, we applied systems theory, theory of educational objectives, educational evaluation theory, and management theory into the construction of educational standards and formed a comprehensive theoretical foundation of the study.2. In this study, we developed the standards for accreditation of baccalaureate degree nursing programs in China for the first time and provide instruments and tools for the nursing accreditation. On the basis of theory study, expert panel meetings, literature research and nationwide Delphi survey, we developed standards, which were composed of competency standards for bachelors of nursing and basic standards for baccalaureate nursing education institutions. It could be applied in all nursing schools having undergraduate nursing education in China. The standards emphasized on the training targets with international competency, interdisciplinary clinical practice ability, creativity and humanity. They were also the minimum requirements for baccalaureate nursing programs of China and had relatively high reliability and validity. The standards reflected the needs for accreditation of nursing programs in China and would bring benefits to improve the quality of baccalaureate nursing education. They were flexible with more qualitative indicators, leaving much space for development of characteristic and education reform of nursing schools.3. We introduced the analytical framework of the new institutional economics into nursing professional accreditation system for the first time. By comparative study, we proposed the following tasks for baccalaureate nursing accreditation: transforming government functions, development of diversified nursing education evaluation; establishing relevant laws and policies to promote the development of nursing certification intermediary organizations and disposing appropriate relations with the government and the community; to maintain the quality of professional certification standards for nursing and treat it as the core to carry out professional accreditation; an open, transparent and impartial professional certification procedures and steps; issuing accreditation policies and standardizing the certification process; the construction of relevant excellent culture.