Janice Gullick1, Frances Lin2, Debbie Massey3, Lorraine Wilson4, Melanie Greenwood5, Katina Skylas6, Mark Woodard7, Agness C Tembo8, Marion Mitchell9, Fenella J Gill10. 1. Susan Wakil School of Nursing & Midwifery (Sydney Nursing School), Faculty of Medicine & Health, University of Sydney, MO2, 88 Mallett Street, Camperdown, NSW, 2050 Australia. Electronic address: janice.gullick@sydney.edu.au. 2. School of Nursing and Midwifery, Menzies Health Institute Queensland, G40 Griffith Health Centre, Level 8.86, Gold Coast campus, Griffith University, QLD 4222, Australia. Electronic address: F.Lin@griffith.edu.au. 3. School of Nursing, Midwifery and Paramedicine, Sunshine Coast University, Locked Bag 4, ML40, Maroochydore, QLD, 4558, Australia. Electronic address: dmassey@usc.edu.au. 4. Royal Perth Hospital, GPO Box X2213, Perth, WA 6847, Australia. Electronic address: lorraine.wilson1@health.wa.gov.au. 5. School of Health Sciences, University of Tasmania, Private Bag 135, Hobart, TAS 7001, Australia. Electronic address: melanie.greenwood@utas.edu.au. 6. Concord Repatriation General Hospital, Hospital Rd, Concord West, 2139, NSW, Australia. Electronic address: katina.skylas@health.nsw.gov.au. 7. Perth Children's Hospital, Child and Adolescent Health Service, Hospital Avenue, Nedlands, Perth, 6009 Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Curtin University, Kent St, Bentley, WA, 6845, Australia. Electronic address: mark.woodard@health.wa.gov.au. 8. School of Nursing and Midwifery, Faculty of Health and Medicine, Callaghan Campus, University of Newcastle, NSW, 2308, Australia; The Maitland Hospital, 560 High Street, Maitland, NSW, 2320, Australia. Electronic address: Agness.Tembo@hnehealth.nsw.gov.au. 9. School of Nursing and Midwifery, Menzies Health Institute Queensland, N48 Nathan Campus, Griffith University, QLD 4102, Australia; Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba Brisbane, Queensland, 4102, Australia. Electronic address: marion.mitchell@griffith.edu.au. 10. Perth Children's Hospital, Child and Adolescent Health Service, Hospital Avenue, Nedlands, Perth, 6009 Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Curtin University, Kent St, Bentley, WA, 6845, Australia. Electronic address: f.gill@curtin.edu.au.
Abstract
OBJECTIVES: The objective of this study was to review and synthesise international literature to reveal the contemporary structures, processes, and outcomes of critical care nurse (CCN) education. METHOD: An integrative review on specialist critical care education was guided by Whittemore and Knafl's integrative review steps: problem identification; literature search; and data evaluation, analysis, and presentation. Donabedian's Quality Framework (Structure-Process-Outcome) provided a useful analytical lens and structure for the reporting of findings. RESULTS: (1) Structures for CCN education incorporated transition-to-practice and ongoing education programs typically offered by hospitals and health services and university-level graduate certificate, diploma, and masters programs. Structural expectations included a standard core curriculum, clinically credible academic staff, and courses compliant with a higher education framework. Published workforce standards and policies were important structures for the practice learning environment. (2) Processes included incremental exposure to increasing patient acuity; consistent and appropriately supported and competent hospital-based preceptors/assessors; courses delivered with a flexible, modular approach; curricula that support nontechnical skills and patient- and family-centred care; stakeholder engagement between the education provider and the clinical setting to guide course planning, evaluation and revalidation; and evidence-based measurement of clinical capabilities/competence. (3) Outcomes included articulation of the scope and levels of graduate attributes and professional activities associated with each level. The role of higher degree research programs for knowledge creation and critical care academic leadership was noted. CONCLUSIONS: Provision of high-quality critical care education is multifaceted and complex. These findings provide information for healthcare organisations and education providers. This may enable best practice structures and processes for critical care specialist training that meets the needs of industry and safely supports developing CCN expertise. There is an acknowledged tension between the expectations of governing bodies for policies, standards, and position statements to enhance quality and reduce care variance and the availability of high-quality evidence to underpin these across international contexts.
OBJECTIVES: The objective of this study was to review and synthesise international literature to reveal the contemporary structures, processes, and outcomes of critical care nurse (CCN) education. METHOD: An integrative review on specialist critical care education was guided by Whittemore and Knafl's integrative review steps: problem identification; literature search; and data evaluation, analysis, and presentation. Donabedian's Quality Framework (Structure-Process-Outcome) provided a useful analytical lens and structure for the reporting of findings. RESULTS: (1) Structures for CCN education incorporated transition-to-practice and ongoing education programs typically offered by hospitals and health services and university-level graduate certificate, diploma, and masters programs. Structural expectations included a standard core curriculum, clinically credible academic staff, and courses compliant with a higher education framework. Published workforce standards and policies were important structures for the practice learning environment. (2) Processes included incremental exposure to increasing patient acuity; consistent and appropriately supported and competent hospital-based preceptors/assessors; courses delivered with a flexible, modular approach; curricula that support nontechnical skills and patient- and family-centred care; stakeholder engagement between the education provider and the clinical setting to guide course planning, evaluation and revalidation; and evidence-based measurement of clinical capabilities/competence. (3) Outcomes included articulation of the scope and levels of graduate attributes and professional activities associated with each level. The role of higher degree research programs for knowledge creation and critical care academic leadership was noted. CONCLUSIONS: Provision of high-quality critical care education is multifaceted and complex. These findings provide information for healthcare organisations and education providers. This may enable best practice structures and processes for critical care specialist training that meets the needs of industry and safely supports developing CCN expertise. There is an acknowledged tension between the expectations of governing bodies for policies, standards, and position statements to enhance quality and reduce care variance and the availability of high-quality evidence to underpin these across international contexts.