Background to the Research

• In 1986, UKCC published 'Project 2000': A New Preparation for Practice'. This proposed 25 recommendations in order to reform nurse education. In 1989, government accepted the proposals and new 3 year programmes of preparation for practice were introduced. Project 2000 commenced in Northern Ireland in October 1991. This report sought to carry out an evaluation of Project 2000 in NI.
  

Research Approach

• Attitudinal type questionnaires were administered to nurse teachers, clinical facilitators, nursing students and diplomates, and focus groups were held with nurse teachers and nursing students. Semi-structured interviews were carried out with nurse education and service managers, educational support staff, university and DHSS representatives. Open-ended questionnaires were sent to Directors of Nursing at Unit/Trust level in the private and voluntary sector. Quantitative data were analysed using SPSS and qualitative data using Hyperqual.
  

Main Findings

Structure

• There was a high level of collaborative planning and activity between DHSS, NBNI, HSSBs and colleges of nursing.
• The rationalisation of colleges of nursing from 7 to 5, and the agreeing of links with the two universities in NI was achieved by June 1990. The first intake of nursing students began the new diploma courses in October 1990.
• The amalgamation of colleges meant that curriculum planning teams were structured to include colleagues from amalgamating sites to create common ownership and a shared ethos.

Recommendations

• Conjoint curriculum planning between associated institutions should be established.
• Adequate time should be allowed for the planning of innovations based on local needs.
• The NBNI, universities and colleges should clearly establish the contribution of HE to Project 2000 courses.
• With the coming integration of nurse education into the HE sector, collaboration and a partnership approach should be adopted by the interested parties.

Process

• Nursing teachers, nursing students, diplomates and clinical facilitators observed that the amount of practical experience during the course was inadequate in comparison to the amount of theory.
• Both nursing teachers and students stated that the imbalance of theory and practice had an impact on the integration of theory and practice.
• Nursing teachers and students considered the CFP too long, educational managers agreed and suggested that the balance between duration of the CFP and branches was flawed.
• Nursing students and teachers perceived that the health orientation of the CFP with placement experience primarily in illness-orientated settings was adversely affecting the integration of theory and practice.

Recommendations

• The period of time spent on theory and practice both within CFP and the branches should be reviewed.
• The idea of self-directed learning should be reviewed and the management and planning for this element of the course addressed so that students gain maximum benefit from this element of the course.
• The levels of understanding amongst teachers and clinical staff concerning diploma level education and practice should be reviewed and addressed. The rostered service element of the course should be reconsidered with a view to students being supernumerary for the total duration of the 3 year programme.

Outputs and Outcomes

• When comparisons are made between the period 1985-89 and the first 4 cohorts to complete the diploma course, the wastage rates for nursing students in NI has increased by 2.0%.
• Students' asking to withdraw from the course accounted for a higher mean percentage wastage rate than examination failure.
• Two colleges of nursing had a slightly higher percentage of wastage rate than the other three colleges through examination failure, when compared with students' requests and other reasons.
• The mean percentage wastage rates for students on the mental health, mental handicap and children's nursing branch were higher than for the adult nursing branch.

Recommendations

• The monitoring of wastage rates for nursing students for the purposes of workforce planning should continue.
• Research should be undertaken to ascertain the reasons for nursing students withdrawal from the diploma course.
• The monitoring of wastage rate due to examination failure across colleges should continue.
• The effectiveness of diplomates within the workforce should be researched.

Overall Recommendations

Short Term

• Clarify the contribution of HE to Project 2000.
• Review the balance of theory and practice.
• Review the management and placing of self-directed learning courses.

Intermediate

• Research the perceived theory-practice gap.
• Design reliable and valid assessment tools.
• Clarify roles in respect of meeting students' supervisory needs.

Long Term

• Review the total 3 year programmes in light of research findings in relation to the duration and nature of the CFP, the branches and increased options for further branches.
• Review the academic standing of the 3 year programme of preparation with a view to moving towards degree level.