Structures, processes and outcomes of specialist critical care nurse education: An integrative review

Abstract

Objectives: 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 non-technical 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

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“…The provision of high-quality critical care education has many aspects and complex problems. Health education and education providers must prepare the best practice structures and processes for training critical care specialists who meet the needs of the organization (Gullick et al, 2019).…”

Critical care nursing workforce: Global imperatives, innovations and future-proofing – A call for papers

“…The survey also highlighted that lack of recognition for critical care as a speciality and lack of protection for the title, also impacted education programs (Endacott et al, 2015). More recently a review of specialist critical care nurse education identified the importance of collaborative education provision between clinical settings and recognised education providers, and for structures, outcomes and unit, organisational, and governmental policy to align with future expectations and current and emerging need (Gullick et al, 2019).…”

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“…Transfer of specialty postgraduate nursing education from hospitals to higher education began in the early to late 1990s. Even in specialty education, international variations exist (Marshall 2019) in addition to questions about poorly reported practice and patient impacts of postgraduate education (Gullick et al 2019;Ng et al 2014). Most post-registration education in critical care existed as ad-hoc training for nurses and doctors together until the 1960s, when more formalized post-registration education was developed in Australia and the UK (Marshall 2019).…”

“…Most post-registration education in critical care existed as ad-hoc training for nurses and doctors together until the 1960s, when more formalized post-registration education was developed in Australia and the UK (Marshall 2019). In some settings today, hospitals and health services offer specialist nurse education as part of partnership arrangements with tertiary institutions (Gullick et al 2019).…”