Year

1990

Degree Name

Doctor of Philosophy

Department

School of Learning Studies

Abstract

Continuing nursing education is perceived by many nurses as an important professional issue. Many earlier studies elaborate on the problems of continuing nursing education without taking up the challenge of curriculum development. Using a developmental framework derived from life/career stages theory, the aims of the present research were threefold.

The first aim was to identify the nurses' career stages. In an attempt to introduce a somewhat systematic treatment to the intangible notions of career stages, the exploratory exercise of Delphi technique was conducted. A panel of experts covering a wide range of nursing, education and administration experience was invited to participate on the basis of their professional experience and an appreciation for research. Using a two dimensional approach of Importance and Confidence Scales (as indices of the nursing experts' judgement), three career stages, namely, the Beginning Nurse Practitioner, the Developing Nurse Practitioner and the Experienced Nurse Practitioner were identified. For the three career stages, three different methods (the Dollar Voting, Relevance Test and the Magnitude Estimation Procedures) were employed to test the variable reliability and stability over scaling technique.

The second aim of the research was to develop a continuing nursing education curriculum that would meet the needs of nurses of different career stages. Continuing nursing education is important to all of these groups. However, the researcher is particularly interested in the beginning nurse practitioner stage, especially at the point where the nursing student is newly graduated. The basic strategy for selecting relevant curricular content for the beginning practitioner was designed in three stages involving careful analysis and classification of data, expert assessment of that data and validation through the continuing nursing education preferences inventory. A quasi-experimental pretest-posttest design discussed by Campbell and Stanley (1966) was employed in order to determine gains and losses of nurses on indices of intended outcomes over a set period of time. A total of 74 participants was involved, representing 5% of the total number of potential college nurse graduates in New South Wales in 1988.

The third aim of the work was to investigate the clinical environment that might influence the desired effect presumed to arise from a continuing education programme. The purpose of this follow-up study was to answer the research question:

What are the factors which influence the beginning nurse practitioner's commitment in continuing education? A case study methodology was used to examine four hospital settings.

The findings show that the experimental curriculum used could be an effective curriculum format. The beginning nurse practitioners undertaking the experimental curriculum held more positive attitudes in all aspects of criterion measures immediately after the experiment. However, after a period of six months, while the experimental nurses remained positive in some dimensions, the control group showed increasing improvement. Examining the changes over time, it was shown that the curriculum had significant effects on some aspects of criterion measures. Six months later, these significant effects disappeared. The follow-up case studies showed that clinical areas were conducive to continuing nursing education had developed staff development strategies and good interaction between various staff. In order to implement continuing nursing education successfully, the involvement of the nurse unit managers was indispensible.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.