Learning in the field: curriculum issues in a diploma in public health nursing

Illuminative evaluation of a public health nursing curriculum shows that there was a gap between theory and practice, originating in the ways in which public health nursing was understood in the field, and therefore during students' placements, and in the university. The difference was chiefly in how the community staff and the lecturers understood primary health care. The former had a 'medical/professional' understanding of primary health care, implying that the professional knows best and that the client is an individual, a family or a group. The lecturers held a philosophy of primary health care with special emphasis on partnership with clients at all levels: individual, family, group and community; the partnership approach was intended to permeate the entire curriculum. Besides philosophical differences, there were other features of the theory practice gap demonstrated elsewhere. Fieldwork practice is integral to learning public health nursing so these contrasts created a serious disjunction within the curriculum. Actual and potential ways of improving curriculum integration are discussed.