Development of an Instructional Model to Enhance Gerontological Nursing Competencies among Nursing Students

Abstract

The objectives of this study were to develop and examine the effectiveness of an instructional model for enhancing the competencies of nursing students in gerontological nursing. The research design was a mix-methods with four phases focusing on two main procedures. The study was conducted during the 2015-2018 academic year. In phase 1, the researchers conducted a situational analysis of gerontological nursing competency including the policy, vision, curricula, co-curricular and extra-curricular instruction; studied components and indicators of gerontological nursing competence to a part of the model development. Participants of this phase were 345 nursing instructors of Boromarajonani College of Nursing, Songkhla, and registered nurses; and conducted a mixed-method which included the assessment of nursing students’ competencies in gerontological nursing among 468 freshmen, sophomores, juniors, and seniors of the 2016 academic year. In phase 2, the conceptual framework and components of the instructional model were developed based on the results from phase 1. During phase 3, an action research was conducted to try out the prototype model with 88 nursing students throughout the four-years in the Bachelor of science in nursing (BSN) program. Then the researchers assessed the effects of the prototype model by evaluating from (1) gerontological nursing competency, (2) nursing students’ attitudes toward elderly, (3) nursing students’ perceptions on the prototype model, and (4) nursing instructors’ perceptions on the prototype model. In phase 4, the researchers adjusted the prototype model based on the trial findings, and the model was approved via connoisseurship by seven experts. The final version of the instructional model was finalized. It was found that the developed instructional model, so-called CAN Model, consisted of four main components: (1) the key concept of the model was a continuous quality improvement in education, (2) the instructional process was a form of active learning based on Kolb’s Experiential Learning Theory including (2.1) providing practicum experiences in four settings which were at hospitals, home visits, senior clubs, and elderly care centers, (2.2) reflection on experiential learning, and (2.3) using project-based learning and case management enhanced summarizing and applying skills of nursing students which impacted on successive development of gerontological nursing competency throughout the BSN program, as well as positive attitudes toward elderly, (3) the four core competencies comprising of holistic health promotion, empowerment & quality of care, research utilization, and ethical competencies. According to the effects of the CAN model, gerontological nursing competencies among the fourth-year nursing students compared to that assessed when they were in the first year in program significantly increased (p=0.012). Nursing students reported that their competencies were increasing in relation to their year in program, however, those between the third and fourth year were not statistically different. Nursing students reported that this instructional model enhanced all dimensions of gerontological nursing competencies. In the meanwhile, nursing instructors perceived that this model was applicable to their instruction. Moreover, this model was approved by connoisseurship in terms of accuracy, suitability, and efficiency. Thus, this model should be implemented in other nursing education institutions for the success of competency development of nursing students in gerontological nursing.