An Analysis of Nurse Education and Training in Europe: Defining Competence :An Analysis of Nurse Education and Training in Europe: Defining Competence Anne-Marie Ryan PhD, MSc, BNS, RGN, RNT, FFNMRCSI Chair of FEPI WG ETC Chief Education Officer, An Bord Altranais http://rndegrees.net/ Online Nursing Degrees


Themes :Certifying Nursing Competences in an Ever Closer EU Themes WG ETC of FEPI Nursing Education in Europe Evolution of EU Nurse Regulation of Education to date & possibilities


The European Council of Nursing Regulators - FEPI :Certifying Nursing Competences in an Ever Closer EU The European Council of Nursing Regulators - FEPI FEPI was founded as a result of increasing mobility of nursing professionals across Europe No longer a committee in Europe of representative interests to advise on the training of nurses (ACTN) since 2000


WG ETC :Certifying Nursing Competences in an Ever Closer EU WG ETC The Working Group Education Training and Competence: Set up in 2006 Has participation from 14 countries Has an updated action plan Exploring a project in relation to 2005/36 EC Conducted 2 data gathering exercises and response to consultations and prepared papers Tuning Exercise - mapping Educational preparation - 16 countries


Goals of Regulation & Education :Certifying Nursing Competences in an Ever Closer EU Goals of Regulation & Education Defining the profession and its scope of practice, Setting education standards and standards of ethical and competent practice; FEPI Ethical Code – Key Principle 3 Quality and Excellence


European Recognition of Nurses :Certifying Nursing Competences in an Ever Closer EU European Recognition of Nurses European Directives Sectoral Directives – 77/452 EEC, 77/453 EEC (Generalist Nurse) General Systems Directives Directive 2005/36/EC


New Directive :Certifying Nursing Competences in an Ever Closer EU New Directive Directive 2005/36/EC, liberalisation of the provision of services Recognition of qualifications Flexibility of procedures


Directive 2005/36 EC :Directive 2005/36 EC Due for re-visiting by DG Int Mkt in 2012 “Where a national & EU-level professional organisation for a regulated profession makes a reasoned request for specific provisions for the recognition of qualifications on the basis of coordination of minimum training conditions, the Commission shall assess the appropriateness of adopting a proposal for the amendment of the Directive” (para.29) Certifying Nursing Competences in an Ever Closer EU


Directive 2005/36 EC :Directive 2005/36 EC “... Professional organisations should be able to propose common platforms at EU level... Professional associations which are in a position to submit common platforms should be representative at national and EU level. A common platform is a set of criteria which make it possible to compensate for the widest range of substantial differences which have been identified between the training requirements in at least two thirds of the member states...” (para 16) Certifying Nursing Competences in an Ever Closer EU


Directive 2005/36 EC :Certifying Nursing Competences in an Ever Closer EU Directive 2005/36 EC Article 31 – Nurses responsible for general care The content listed in Annex V, point 5.2.1 may be amended in accordance with the procedure referred to in Article 58 (2) with a view to adapting it to scientific and technical progress...(para 2) ...nurses acquire the professional knowledge, insights and skills necessary for organising, dispensing & evaluating overall health care” (para 4)


Annex V :Annex V Theoretical Instruction Nursing Ethics, health, med/surg Basic Sciences Anatomy etc. N=7 Social Sciences +administration, teaching, legal Clinical Instruction Medicine Surgery Child & paeds Maternity Mental health Elderly home Certifying Nursing Competences in an Ever Closer EU


Similarities and Differences :Certifying Nursing Competences in an Ever Closer EU Similarities and Differences The questionnaire was completed by 16 countries – Austria, Croatia, Denmark, France, Greece, Ireland, Italy Malta, Norway, Poland, Portugal, Romania, Slovakia, Spain Sweden & UK The competent authority is a nursing council in 6 countries with 8 countries having a combination of the Ministries of Health and/or Education General nursing is offered as the only initial registration in 10 countries Vocational education is offered in 2 countries 13 countries offer a bachelor education programme


Similarities and Differences :Certifying Nursing Competences in an Ever Closer EU Similarities and Differences Minimum duration of a programme is 3 years with 2 countries requiring 3.5 years and 5 countries offering 4 year programmes ECTS range 180 (n=5) – 210 (n=1) – 240 (n=4) The regulators are involved in the guidance of programmes in 6 countries with the others relying on the Ministry of Health or Education In 9 countries the programme cannot operate without the approval of the regulator


Similarities and Differences :Certifying Nursing Competences in an Ever Closer EU Similarities and Differences Specialisation is offered as an initial registration in 4 countries Specialisation is offered after registration in 13 countries with 7 countries defining areas a nurse can work with the specialisation required. LLL is linked to registration in 5 countries Knowledge of host language required currently in 8 countries and this is managed by employers – 1 country requires an exam for registration.


The Bologna Process :Certifying Nursing Competences in an Ever Closer EU The Bologna Process “Ministries encourage the member states to elaborate a framework of comparable and compatible qualifications for their higher education systems, systems, which should seek to describe qualifications in terms of WORKLOAD, LEVEL, LEARNING OUTCOMES, COMPETENCES and PROFILE. They also undertake to elaborate an overarching framework of qualifications for Higher Education Area.” Berlin Conference (2003)


Tuning Project Competencies :Certifying Nursing Competences in an Ever Closer EU Tuning Project Competencies Study of nursing in 11 of the 27 countries of the EU Found an economic value of the nurse as a contributor to health in EU -Generic Competencies apply knowledge in practice Make decisions, work autonomously, LLL, critical thinking, problem solving etc. -Subject Specific Competencies risk management, team nursing, delegation, I.T., practical procedures, interpersonal, etc


Changing Landscape :Certifying Nursing Competences in an Ever Closer EU Changing Landscape The European Union is looking at regulated professions from a competition policy perspective The economic impact of regulating professions is being challenged i.e. public good vs. stifling competition Collaborative scopes of practice Shared competencies Costs and bureaucracy of regulation Changing practice environments Intergovernmental rules affecting the profession


Professional Directions :Certifying Nursing Competences in an Ever Closer EU Professional Directions Standards Competencies Scope of practice Setting standards of education Practice expectations


Four Beliefs about the Future :Certifying Nursing Competences in an Ever Closer EU Four Beliefs about the Future Role of Nurses will change Value of nursing contribution to health Experienced nurses will participate more in project planning and evaluation Leadership and supervision of Primary Health Care


Responding to Change :Certifying Nursing Competences in an Ever Closer EU Responding to Change Development of health care and nursing in Europe will benefit all EU citizens Growing complexity of science and technology requires more knowledge and information and a range of new competencies for nurses Increasing chronicity of diseases and treatment options will expand the role of nurses Impact of Information Technology requires our recognition systems to go beyond the mere input model of education preparation.