A comprehensive systematic review of evidence on the effectiveness and appropriateness of undergraduate nursing curricula

Abstract

Objectives The objective of this review was to appraise and synthesise the best available evidence on the effectiveness and appropriateness of undergraduate nursing curricula. Inclusion criteria This review considered research papers that addressed the effectiveness and appropriateness of undergraduate nursing curricula. Studies of higher evidence levels were given priority over lower-evidence studies. Participants of interest were undergraduate nursing students, nursing staff and healthcare consumers. Nursing staff outcomes, consumer outcomes and system outcomes (e.g. competency, satisfaction, critical thinking skills, healthcare consumer rights and cost-effectiveness) that impact on the evaluation of undergraduate nursing curricula were considered in the review. Search strategy The search strategy sought to find both published and unpublished studies and reports limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken, followed by an analysis of the text contained in the title and abstract, and of the index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Finally, the reference list of all identified reports and articles was searched for additional studies. Methodological quality Each paper was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the Unified Management, Assessment and Review of Information (SUMARI) package. Results A total of 16 papers, experimental and textual in nature, were included in the review. The majority of papers was descriptive and examined the relationships between nursing curricula and specific learning outcomes such as critical thinking skills. Because of the diverse nature of these papers, meta-analysis of the results was not possible and this section of the review is presented in narrative form. In this review, four undergraduate nursing curriculum models were identified: integrated curriculum, subject-centred curriculum, problem-based learning, and an integrated critical thinking model. It was possible to examine the effectiveness of an integrated curriculum model and a subject-centred curriculum model; however, the other two models could not be compared because of a lack of evidence. Conclusion The evidence regarding the effectiveness and appropriateness of undergraduate nursing curricula is notably weak because of the paucity of high-quality comparative studies and meaningful outcome measures of available studies. Therefore, no strong conclusion can be made regarding the effectiveness and appropriateness of undergraduate nursing curricula.

An integrative review and evidence-based conceptual model of the essential components of pre-service education

“…Few studies indicated that a teacher in the health professions must be equally skilled as both a classroom teacher and a clinical preceptor or mentor (an individual who guides learning for one or more students in the clinical setting). Rather, the descriptive literature supports the importance of the preceptor/mentor role as complementary to the role of the academic educator [30]. The role of the preceptor has been particularly well explored, and studies confirm the need for preceptors to develop skills in clinical teaching, identification of student learning needs, assessment of student learning, and prioritizing and time management [31,32].…”

Competency-based education: The essential basis of pre-service education for the professional midwifery workforce

“…Jayasekara et al (2006) offer a systematic review of comparative studies that attempt to distinguish between the effectiveness of various approaches to curriculum design in nursing. These authors note the paucity of studies that address overall effectiveness of any approach.…”

Cost-effectiveness of peer role play and standardized patients in undergraduate communication training

“…There are little data to offer a valid base to estimate incremental costs (or savings) or revenue requirements. This lack of high-quality comparative studies with meaningful outcome measures allows no definitive conclusion regarding the general effectiveness of undergraduate curricula [ 4 , 5 ].…”

“…Our current literature search retrieved only 8 publications addressing cost-effectiveness and issues of medical education with the search terms (“cost effectiveness*”[TI] OR “cost benefit*”[TI]) AND analy* AND (“medical education” OR student* OR undergraduat*). Only four of these referred to the cost effectiveness or cost benefit of medical training itself [ 4 , 6 – 8 ]. The costs within medical education programs seem worryingly high with – at least in part – little student satisfaction even in issues of perceived strong relevance (as shown for a course teaching on terminal care [ 7 ]).…”