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

Janice Gullick, Frances Lin, Debbie Massey, Lorraine Wilson, Melanie Greenwood, Katina Skylas, Mark Woodard, Agness C. Tembo, Marion Mitchell, Fenella J. Gill

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Objectives: The objective of this study was 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 nontechnical 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 best practice structures and processes for critical care specialist training that meets the needs of industry and safely supports developing CCN expertise. There is an acknowledged tension between the expectations of governing bodies for policies, standards, and position statements to enhance quality and reduce care variance and the availability of high-quality evidence to underpin these across international contexts.

Original languageEnglish
Pages (from-to)331-345
Number of pages15
JournalAustralian Critical Care
Volume32
Issue number4
DOIs
Publication statusPublished - Jul 2019
Externally publishedYes

Fingerprint

Critical Care
Nurses
Education
Quality of Health Care
Curriculum
Student Health Services
Patient Acuity
Patient-Centered Care
Clinical Competence
Critical Care Outcomes
Practice Guidelines
Lenses
Industry
Learning
Organizations
Delivery of Health Care
Research

Cite this

Gullick, Janice ; Lin, Frances ; Massey, Debbie ; Wilson, Lorraine ; Greenwood, Melanie ; Skylas, Katina ; Woodard, Mark ; Tembo, Agness C. ; Mitchell, Marion ; Gill, Fenella J. / Structures, processes and outcomes of specialist critical care nurse education : An integrative review. In: Australian Critical Care. 2019 ; Vol. 32, No. 4. pp. 331-345.
@article{e1a66a0708234efe96292ed93d9d03d5,
title = "Structures, processes and outcomes of specialist critical care nurse education: An integrative review",
abstract = "Objectives: The objective of this study was 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 nontechnical 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 best practice structures and processes for critical care specialist training that meets the needs of industry and safely supports developing CCN expertise. There is an acknowledged tension between the expectations of governing bodies for policies, standards, and position statements to enhance quality and reduce care variance and the availability of high-quality evidence to underpin these across international contexts.",
keywords = "Critical care nurses, Education, Integrative review, Intensive care nurses, Literature review, Ongoing education, Postgraduate education, Speciality practice, Transition-to-practice programs",
author = "Janice Gullick and Frances Lin and Debbie Massey and Lorraine Wilson and Melanie Greenwood and Katina Skylas and Mark Woodard and Tembo, {Agness C.} and Marion Mitchell and Gill, {Fenella J.}",
year = "2019",
month = "7",
doi = "10.1016/j.aucc.2018.09.007",
language = "English",
volume = "32",
pages = "331--345",
journal = "Australian Critical Care",
issn = "1036-7314",
publisher = "Academic Press",
number = "4",

}

Gullick, J, Lin, F, Massey, D, Wilson, L, Greenwood, M, Skylas, K, Woodard, M, Tembo, AC, Mitchell, M & Gill, FJ 2019, 'Structures, processes and outcomes of specialist critical care nurse education: An integrative review' Australian Critical Care, vol. 32, no. 4, pp. 331-345. https://doi.org/10.1016/j.aucc.2018.09.007

Structures, processes and outcomes of specialist critical care nurse education : An integrative review. / Gullick, Janice; Lin, Frances; Massey, Debbie; Wilson, Lorraine; Greenwood, Melanie; Skylas, Katina; Woodard, Mark; Tembo, Agness C.; Mitchell, Marion; Gill, Fenella J.

In: Australian Critical Care, Vol. 32, No. 4, 07.2019, p. 331-345.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Structures, processes and outcomes of specialist critical care nurse education

T2 - An integrative review

AU - Gullick, Janice

AU - Lin, Frances

AU - Massey, Debbie

AU - Wilson, Lorraine

AU - Greenwood, Melanie

AU - Skylas, Katina

AU - Woodard, Mark

AU - Tembo, Agness C.

AU - Mitchell, Marion

AU - Gill, Fenella J.

PY - 2019/7

Y1 - 2019/7

N2 - Objectives: The objective of this study was 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 nontechnical 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 best practice structures and processes for critical care specialist training that meets the needs of industry and safely supports developing CCN expertise. There is an acknowledged tension between the expectations of governing bodies for policies, standards, and position statements to enhance quality and reduce care variance and the availability of high-quality evidence to underpin these across international contexts.

AB - Objectives: The objective of this study was 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 nontechnical 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 best practice structures and processes for critical care specialist training that meets the needs of industry and safely supports developing CCN expertise. There is an acknowledged tension between the expectations of governing bodies for policies, standards, and position statements to enhance quality and reduce care variance and the availability of high-quality evidence to underpin these across international contexts.

KW - Critical care nurses

KW - Education

KW - Integrative review

KW - Intensive care nurses

KW - Literature review

KW - Ongoing education

KW - Postgraduate education

KW - Speciality practice

KW - Transition-to-practice programs

UR - http://www.scopus.com/inward/record.url?scp=85052926490&partnerID=8YFLogxK

U2 - 10.1016/j.aucc.2018.09.007

DO - 10.1016/j.aucc.2018.09.007

M3 - Review article

VL - 32

SP - 331

EP - 345

JO - Australian Critical Care

JF - Australian Critical Care

SN - 1036-7314

IS - 4

ER -