Adapting the Donabedian model in undergraduate nursing education: a modified Delphi study

Area of Science:

• Nursing Education
• Healthcare Quality Improvement
• Educational Frameworks

Background:

• The Donabedian model is a recognized framework for quality assessment.
• Adapting this model for nursing education can enhance institutional evaluation.
• A comprehensive understanding of educational components is crucial for performance indicators.

Purpose of the Study:

• To adapt the Donabedian three-component model (structure, process, outcome) for undergraduate nursing education.
• To identify key elements within each component for evaluating nursing institutions.
• To provide a framework for developing relevant performance indicators in nursing education.

Main Methods:

• A modified Delphi study involving nursing faculty and Ph.D. students.
• Three rounds of expert consensus building using a 5-point Likert scale questionnaire.
• Statistical analysis including kappa coefficients and One Sample T-Test to ensure stability and consensus.

Main Results:

• 55 initial items were confirmed, with 5 new items added and refined over three rounds.
• Key structure elements: staff, equipment, guidelines, resources, facilities, student demographics.
• Key process elements: communication, education, evaluation, cooperation, consultation.
• Key outcome elements: knowledge, nursing image, alumni/student outcomes, medical center performance, accreditation, satisfaction.

Conclusions:

• This study successfully defined the elements of a nursing education institution at the bachelor's level using the Donabedian model.
• The findings can guide the development of comprehensive and systematic evaluations for nursing programs.
• The adapted model has potential applicability to other nursing courses and educational fields.