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Teaching self-management support in Dutch Bachelor of Nursing education: A mixed methods study of the curriculum
Susanne M van Hooft1, Yvonne N Becqué2, Jolanda Dwarswaard2
1Research Centre Innovations in Care, Rotterdam University of Applied Sciences, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands.
Background:
Nurses are expected to support people to self-manage. Student nurses therefore need to master competencies that include the assessment of peoples' needs and preferences, and shared decision-making, whilst respecting and enhancing peoples' autonomy. Adapting nurse education programmes to meet this goal requires insight into the practice of teaching self-management support. In order to reveal this practice, one can distinguish between the intended, the taught, and the received curriculum.
Objectives:
This study aimed to explore how Dutch Bachelor of Nursing students are educated to support peoples' self-management in clinical practice.
Design:
Mixed methods.
Methods And Participants:
Focus group meetings with 30 lecturers, and qualitative semi-structured interviews with four coordinators and four (associate) professors of four Dutch schools for Bachelor of Nursing. Syllabuses were screened for learning objectives related to self-management. A survey measuring self-efficacy and behaviour regarding self-management support was distributed among 444 final-year students of these schools, resulting in 238 valid responses (response rate 53.6%).
Results:
Much attention is paid in the curriculum to assessment of people's preferences and healthcare education but less attention is given to teaching the arrangement of follow-up care. The study further reveals that students have problems transferring theory into practice, and that they experience conflicting values between their nurse education and internships.
Conclusions:
Currently, students are taught to provide people with self-management support by learning about theoretical models, developing communication skills, and reflecting on their internships. This approach seems inadequate to prepare students for this task in daily practice. A shared view on self-management support based on authentic situations, having role models at university and on internships and empowering students may enable them to better support people to self-manage.
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