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European Journal of Cardiovascular Nursinghttp://cnu.sagepub.com/

Education for nurses working in cardiovascular care: A European survey

e Working Group of the Education Committee of the ESC Council on Cardiovascular Nursing and Allied ProfessionEur J Cardiovasc Nurs2014 13: 532 originally published online 19 December 2013

DOI: 10.1177/1474515113514864

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http://cnu.sagepub.com/content/13/6/532

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33/40

23, 20 14


34/40

536 European Journal of Cardiovascular Nursing 13!"


35/40

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36/40

Astin et al. 53

Co&&unication ith patient% an! a&i"ie%

atient a!.ocacy an! patient centere! care

/einin# the ro"e o the &e&er% o the tea&

$ea! an! criti?ue re%earch or e.i!ence-a%e! care

U%e co!e o ethic% or nur%in#

&p"e&ent e.i!ence-a%e! c"inica" practice chan#e

ua"ity i&pro.e&ent inititia.e%

None

0 10 20 30 40 50 60 0 0 A0 100

Figure 3. E!ucationa" acti.itie% aout &u"ti!i%cip"inary tea& ui"!in# tau#ht in po%t-re#i%tration nur%in# pro#ra&&e% (nB41)

$o learn& -arriers $o learning& and 'o $o define and evalu,a$e

learning ou$co(es. l(os$ one,fif$' of $'e progra((es

repor$ed $'a$ $'e did no$ $eac' an educa$ional $'eor.

O'(ective 0) &s$c%osocial assessment and support.

os$ progra((es $aug'$ pa$ien$,cen$red care& psc'osocial

assess(en$ and $'e principle of involve(en$ of pa$ien$s and

fa(il. Jus$ over 'alf of $'e surveed progra((es included

con$en$ a-ou$ screening for nega$ive (ood s$a$es anie$ and

depression#.& 'erapeu$ic counselling $ec'niues& co(,(uni$&

lifespan and cul$ural co(pe$ences ere availa-le in less $'an 50

of progra((es. ee +igure 2.

O'(ective ) &romoting multidisciplinar$ team

/or2. Con,$en$ rela$ed $o (ul$idisciplinar $ea( or%

ere included in $'e (aori$ of $'e progra((es +igure 3#.

'e (os$ freuen$l repor$ed ac$ivi$ies cen$red on effec$ive

co((u,nica$ion s%ills& pa$ien$ advocac and $'e defini$ionof $'e roles of (ul$idisciplinar $ea( (e(-ers.

*eac%ing and learning met%ods. 'e (os$ idel used

$eac'ing and learning s$ra$egies in surveed progra((es ere

face,$o,face lec$ures and se(inars. +ace,$o,face lec,$ures and

se(inars 'en s$uden$s presen$ $opics $o o$'er s$uden$s

folloed - a discussion# ere ran%ed as $'e (os$ co((onl

repor$ed educa$ional deliver (e$'ods used in =7& and 85&

of progra((es respec$ivel.

'e predo(inan$ fra(eor% used $o assess $'e co(pe,

$enc levels for $'e educa$ion progra((es as (os$ of$en

-ased on a coun$r,defined assess(en$ 48#& or a s%ill

c'ec%lis$ 35#. +if$een

37# progra((es ere

lin%ed $o EC i$'

alloca$ed poin$s varing

fro( 7.5F180. :$'er

progra((es 'adi(ple(en$ed al$erna$ive

credi$ ss$e(s 'ils$ o$'ers

ere unsure of 'a$ as

offered for credi$

Assessmentapproac%es. varie$ of(e$'ods ere used $o

assess %noledge and s%ill

co(pe$enc -u$

ea(ina$ions/ %noledge

$es$s ere $'e (os$

freuen$l used $ec'niues

folloed - essas and

case s$udies. :$'er less

co((onl used assess(en$

approac'es ere o-served

s$ruc$ured clinical

assess(en$& por$folio& self

assess(en$ or peer revie.

o progra((es did no$

repor$ an assess(en$

approac' for s$uden$s.

Course evaluation.

>rogra((e evalua$ion as

(os$ fre,uen$l conduc$ed

- s$uden$s n3=& =5#&

educa$ors n24& 58#&

'ospi$als/universi$ies 16&

3=#& and e$er,nal

revieers n18& 44#. llresponden$s repor$ed an

in$eres$ in $'e develop(en$

of a pos$,regis$ra$ion pro,

gra((e in C! nursing

s'ould i$ -e availa-le.

4iscussion

Nurses are recognised as a

significan$ or%force and

'ave $'e po$en$ial $o

con$ri-u$e $o $'e vision of

$'e EC 'ic' is $o reduce$'e -urden of C!".

snaps'o$ of curren$ educa,

$ional provision gives a

useful insig'$ in$o $'e

capa-ili$ of $'e European

nursing or%force. )n 200=

less $'an 'alf of $'e ini$ial

nurse educa$ion as

provided - 'ig'er educa$ion

ins$i$u$ions.5 'is sugges$s

$'a$ organisa$ions providing

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37/40


voca$ional educa$ion ere so(e'a$ underrepresen$ed in our

sa(ple as over 70 of par$icipan$s ere e(ploed - a

universi$. *oever& despi$e $'is 'ig'er $'an average repre,

sen$a$ion fro( 'ig'er educa$ion ins$i$u$ions& onl 'alf of $'e

progra((es iden$ified offered gradua$e or pos$gradua$e level

educa$ion. 'is finding 'ig'lig'$s $'a$ a large propor,$ion of

nurse educa$ion con$inues $o -e delivered a$ a rela,$ivel loacade(ic level 'en co(pared $o o$'er 'eal$'care disciplines.

9'en eploring $'e con$en$ of $'e curricula i$ as evi,den$

$'a$ $'e educa$ional focus as -ased predo(inan$l upon $'e

(anage(en$ of pa$ien$s i$' coronar 'ear$ dis,ease C*"#

i$' less focus on $'e needs of pa$ien$s i$' o$'er for(s of C!

disease. 'e focus on C*" see(s logi,cal as i$ re(ains $'e

leading cause of dea$' across Europe& ecep$ in Hreece& $'e

for(er Kugoslav ;epu-lic of acedonia& and >or$ugal 'ere

s$ro%e $a%es $'e lead&1-u$ i$ ould -e advisa-le $o $a%e a ider

vie of $'e i(pac$ of C!" on 'eal$'. No$ all of $'e diagnos$ic

procedures received $'e sa(e a$$en$ion in C! educa$ional pro,

gra((es. ECH in$erpre$a$ion as included - al(os$ $'ree,uar$ers of par$icipa$ing organisa$ions 'ereas o$'er aspec$s of

p'sical assess(en$ suc' as cardiac and respira,$or

auscul$a$ion and c'es$ I,ra in$erpre$a$ion received less focus.

'is (a reflec$ $'e e$ended scope of nursing prac$ice

eviden$ in so(e coun$ries co(pared $o o$'ers.

'e assessed curricula included general infor(a$ion on

p'ar(acological (anage(en$ of C! pa$ien$s& e$ onl 'alf of

all progra((es 'ave in$egra$ed con$en$ of (edica,$ion

ad'erence 'ic' is a li(i$a$ion given $'a$ nurses are in an

ecellen$ posi$ion $o suppor$ pa$ien$s i$' $'e (an,age(en$

and ad'erence of prescri-ed (edicines. 'is is par$icularl

i(por$an$ given $'a$ (edica$ion ad'erence is a significan$

pro-le(. edicines ill onl or% if $'e are $a%en and less

$'an 'alf of pa$ien$s ad'ere $o $'eir reco(,(ended regi(e.14

:$'er aspec$s of self,(anage(en$ sup,por$ and lifes$le

c'ange ere -e$$er represen$ed -u$ $'e $'eories and

in$erven$ions lin%ed $o pa$ien$ educa$ion and -e'avioural

c'ange s$ra$egies ere less ell covered $'an $'e specific

'eal$' -e'aviours. 'is sugges$s $'a$ $'ere is a focus upon

'a$ lifes$le -e'aviours s'ould -e c'anged ra$'er $'an an

e(p'asis on 'o in$erven$ions can -e used $o facili$a$e

c'ange. Nurses can (a%e a significan$ con$ri,-u$ion $oards

reducing $'e -urden of C*" $'roug' $'eir con$ri-u$ion& as a

(e(-er of $'e (ul$idisciplinar $ea(& in $'e i(ple(en$a$ion

of secondar preven$ion guidelines in clinical prac$ice.15o do$'is $'e need $o -e euipped i$' a -asic unders$anding of

educa$ional and -e'avioural $'e,or. 'e lac% of e(p'asis on

$'is con$en$ i$'in $'e cur,riculu( as surprising as

co(pe$encies around effec$ive co((unica$ion& infor(a$ion

provision and educa$ion of pa$ien$s and fa(ilies for( $'e

corners$one of preven$ive cardiolog in prac$ice. 'ese aspec$s

of nursing curricula arran$ a$$en$ion. elf,(anage(en$

suppor$ $o fos$er a 'eal$' lifes$le for people diagnosed i$'

C!" is an

essen$ial co(pe$enc for'eal$' care or%ers in $'e21

s$cen$ur.

10

'e i(por$ance of

pa$ien$,cen$red care as

reflec$ed in curricula& as

as $'e assess(en$ of

psc'osocial needs and

fa(il involve(en$. :$'erareas suc' as screening for

neg,a$ive (ood s$a$es&

cul$urall co(pe$en$ care&

counselling s%ills and

(a$erial descri-ing nor(al

and a-nor(al coping

responses ere less

eviden$. Educa$ion a-ou$

uali$ i(prove(en$

ini$ia$ives as also fairl

li(i$ed& (eaning $'a$ an

a-ili$ $o de(ons$ra$e $'e

provision of 'ig' uali$care (ig'$ -e lac%ing.

'e a in 'ic' $'e

con$en$ is delivered as

$picall $'roug' face,$o,

face lec$ures. 'e gro$' of

educa$ional $ec'nolog ill

(ean $'a$ (ore crea$ive

learning and $eac'ing

approac'es ill evolve and&

'ere possi-le& (e$'ods $'a$

encourage nurses $o engage

i$' $'eir learn,ing and

consider cri$ical aspec$s of

care s'ould -e consid,ered.

Gi%eise& (os$ progra((es

used %noledge $es$s and

ea(ina$ions i$' o$'er

assess(en$ (e$'ods& 'ic'

are po$en$iall (ore li%el $o

assess unders$anding& so(e,

'a$ underrepresen$ed& e.g.

supervisors repor$ of clinical

s%ill& por$folio and self,

assess(en$. 'e 9*: repor$

argues $'a$ 'ig'l educa$ednurses are a-le $o provide

'ig' uali$ care and

ul$i(a$el reduce (or$ali$

200=#.3C'an 2013# argues

fur$'er $'a$ i$ is vi$al $'a$ e

crea$e and sus,$ain a -e$$er,

educa$ed nursing or%force

$o (ee$ $'e co(,ple service

needs of $'e fu$ure.16

)f e

are $o ac'ieve $'is ai( i$ is

necessar $o increase $'e

level of educa$ion of $'e

nursing or%force 'ils$

ensuring $'a$ learning and

$eac',ing (e$'ods produce

co(pe$en$& co(passiona$e&

%nol,edgea-le& cri$ical and

reflec$ive prac$i$ioners. )n

order $o adop$ a pan,

European approac' $o $'e

develop(en$ of nurse

educa$ion i$ (a -e

necessar $o e$end $'e use

of $'e EC poin$s 'ic' is

no$ e$ co((on. (ore

ide,spread adop$ion of $'is

ini$ia$ive ould suppor$

euiva,lence of aards

across differen$ ins$i$u$ions

'ic' ould confer a range

of -enefi$s suc' as en'ancing

s$uden$ (o-ili$& aiding

curriculu( design and

flei-le rou$es $o 'ig'er

aards as ell as suppor$ing

uali$ assurance

processes.7&8

)n su((ar& findings

sugges$ $'a$ curricula for

pos$,regis$ra$ion C!

educa$ion are s$ill largel

driven - a (ed,ical (odel

and c'arac$erised -

$radi$ional curricular

s$ruc$ures and (e$'ods.

oreover& $'e e(p'asis on'ospi,$al care is s$ronger

$'an on pri(ar and

co((uni$ 'eal$' care and

co(pe$encies $'a$ ould

prepare nurses $o care for

$'e eponen$iall,groing

group of pa$ien$s $'a$ live

i$' one or (ore c'ronic

illnesses including C!"

disease are given li(i$ed

a$$en$ion.

European corecurriculu( for pos$,

regis$ra$ion C! educa$ion

(a -e one approac'

$oards 'ar(onisa$ion of

nurse educa$ion across

Europe -u$ consensus (us$

-e reac'ed a-ou$ $'e

c'arac$eris$ics of $'e core

co(pe$encies and $'e

feasi-ili$ of $'is approac'

across coun$ries i$' diverse

regula$or& educa$ional and

legisla$ive fra(eor%s.

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38/40

Astin et al. 53A

9'ils$ $'is s$ud is one of $'e firs$ pu-lis'ed s$udies $o assess

C! nurse educa$ion in Europe i$ 'as several li(i$a,$ions 'ic'

(us$ -e considered. 'ere ere considera-le c'allenges lin%ed

$o $'e sa(pling approac' adop$ed. Hiven $'a$ no lis$ of

European pos$gradua$e progra((es eis$s& a s$aged sa(ple

approac' as needed. concer$ed effor$ as (ade $o securerepresen$a$ion across all coun$ries $o (ini(ise selec$ion -ias.

9e used %e infor(an$s in $'e various European coun$ries

'o su-seuen$l iden$ified and direc$ed us $o con$ac$s 'o

ere %noledgea-le a-ou$ pos$,regis$ra$ion C! nurse

educa$ion progra((es in $'eir respec$ive coun$ries. 'e

failure $o iden$if %e infor(an$s in all European coun$ries

and/or $'e su-seuen$ unsuccess,ful dis$ri-u$ion of surves

i$'in coun$ries& par$l -ecause of language -arriers as $'e

surve as in Englis'& resul$ed in a nu(-er of European

coun$ries no$ -eing included in $'e surve suc' as +rance&

)$al& pain& Nora& ;o(ania& for(er Kugoslavia& ur%e and

*ungar. 'e process as also $i(e consu(ing 'ic' resul$ed

in a dela -e$een so(e da$a -eing collec$ed and pu-lis'ed.

9e ac%noledge $'ese li(i$a$ions -u$& given $'e scarci$ of

infor(a$ion on $'is $opic& e -elieve $'a$ our findings s$ill

arran$ a$$en,$ion. 9e soug'$ advice regarding co((on

educa$ional $er(s $o suppor$ euivalence across differen$

coun$ries/lan,guages -u$& despi$e $'is& so(e $er(s (a no$ -e

accura$el $ransla$ed across educa$ional se$$ings.

Conclusion

)n conclusion& $'ere is varia-ili$ in $'e con$en$& $eac'ing&

learning& assess(en$ and evalua$ion (e$'ods in pos$,regis,

$ra$ion C! nurse educa$ion progra((es in Europe. 'isreflec$s $'e varia$ions in scope of nurse prac$ice across dif,

feren$ coun$ries. C! nurse educa$ion ould -e s$reng$',ened

i$' a s$ronger focus upon con$en$ $'a$ aligns (ore closel

i$' curren$ 'eal$' c'allenges faced in Europe. -roader vie

of C!" $o include s$ro%e and >!" ould -e advan$ageous

i$' an e(p'asis on preven$ion& re'a-ili$a,$ion and a grea$er

aareness of $'e i(pac$ of 'eal$' ine,uali$ies. s $'e

popula$ion ages& $ea(or%ing across professions and

special$ies ill -e %e as pa$ien$s ill -e older and presen$

i$' (ul$iple co,(or-idi$ies reuiring co(ple care and long,

$er( suppor$. n e(p'asis on in$erdisciplinar educa$ion ill

fos$er (ore effec$ive $ea(,or% across (ul$idisciplinar $ea(sand $'e use of advanced educa$ional $ec'nolog $o deliver

-lended learn,ing in a flei-le a can afford (an po$en$ial

-enefi$s.

"plications for practice

1 Educa$ional provision for cardiovascular

nurses varies considera-l across Europe.

2 ccess $o gradua$e level educa$ion for nurses&

$'e larges$ or%force in Europe& re(ains

inconsis$en$.

1 odernisa$io

n of nursing

curricula

s'ould

include

addi$ionaleduca$ion on

'per$en,sion&

s$ro%e and

perip'eral

vascular

disease

2 ddi$ional

educa$ion

lin%ed $o

lifes$le

-e'aviour

c'ange isreuired i$'

e(p'asis on

preven$ion&

re'a-ili$a$ion

and 'eal$'

ineuali$ies.

3 'e use of

educa$ional$ec'nolog(a idenaccess $oeduca$ion for

nurses.

Acknowledgeents

'e au$'ors ould li%e $o

ac%noledge $'e suppor$ of

$'e EC and na$ional socie$ies

in suppor$ing $'is s$ud.

Conflicts of interest

'e au$'ors declare $'a$ $'ereare no conflic$s of in$eres$.

Funding

'is researc' as suppor$ed

- funds fro( $'e European

ocie$ of Cardiolog.

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Documents

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