Overview report: Bachelor of Nursing16/02/2023
QUALITY THROUGH RESILIENCE & INNOVATION; THESE ARE THE FLEMISH BACHELOR PROGRAMMES IN NURSING
NVAO has confidence in the quality of the Bachelor's degree programmes in Nursing. This is evident from the overview report published by NVAO on the assessments of these programmes. However, this was not the case in 2015, when NVAO issued negative accreditation decisions for all these nursing programmes. What followed was a thorough reform of the curriculum and an extension of the duration of studies. NVAO’s overview report sketches a general picture of the assessment procedures and the substantive findings of the assessment panels. The report concludes with NVAO's insights and policy recommendations.
In 2015, all fourteen bachelor's degree programmes in nursing received a negative accreditation decision. NVAO took these decisions because the programmes did not comply with Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications. This European Union directive determines, among other things, the minimum training requirements for a graduate to be recognized as a general nurse anywhere in Europe. That is why nursing programmes should be widely applicable and should include at least 2,300 hours of clinical education (internship). As a result of NVAO’s negative accreditation decisions, the government decided to extend the Bachelor's programmes in Nursing from 180 credits (nominal three academic years) to 240 credits (nominal four academic years). This would give these progrmmes the necessary generic character and 2,300 hours of clinical education. In September 2016, the new Bachelor's programes in Nursing started. The external assessments of these programmes took place in the academic year 2021-2022.
Breeding grounds for innovation
The assessments show that the Bachelor's programes in Nursing have successfully extended the duration of study and indeed meet the European criteria. NVAO appreciates the efforts of all those involved in developing a high-quality and innovative curricula. The programmes have been developed together with the stakeholders and are well founded in terms of professional content and education. The good practices and recommendations of the assessment panels will help these programmes in their further development. The programmes are a breeding ground for innovation through the use of high-tech skills labs and new didactic concepts. However, the limited number of available internships in certain healthcare domains puts pressure on clinical education and the quality of the internships. That is why the valorisation of innovative technologies is imperative, but the European directive is currently still putting the brakes on this. So there is a need for a review to deliver the best possible EU-recognised nurse. NVAO recommends that the federal government make room in federal legislation for this educational innovation in the bachelor's programmes in nursing. The assessments also show that the programmes clearly work on clinical reasoning in all necessary domains and the research skills of the students. In addition, the assessment panels note that the students develop a critical attitude, entrepreneurial spirit and that creativity is stimulated. There is a strong feedback culture in the programmes. This is made transparent through follow-up via (digital) portfolios, which are also increasingly being adopted by the professional field in the context of competence growth. A range of broadening and in-depth elective courses, the contract internship and the Bachelor's thesis provide room for individual profiling of the students. The assessment panels refer to the high quality of the assessment. The evaluation forms used, lead to a coherent, substantiated, transparent, valid and reliable assessment at level 6 of the Flemish Qualification Structure. In the professional field, there is great satisfaction with the achieved learning outcomes and the employability of Flemish students in various care contexts.
The overview report shows that there is a need for a clear profile for the nursing programmes at level 5. The lack of this profile weighs on the bridging paths that the Bachelor's programmes offer to graduates of these level 5 programmes. For example, there is no validated domain-specific learning outcomes framework at level 5 and there is also uncertainty about compliance with the European directive. The Bachelor's degree programmes in Nursing should therefore exercise caution when admitting students from level 5 programmes and identify and remedy deficiencies. Following on from a clear professional profile, NVAO asks the Flemish government to give the level 5 nursing programmes a clear profile of their own and to turn them into fully-fledged higher education programmes, including a domain-specific learning outcomes framework, credits and ECTS course catalogue.
Monitoring remains necessary
In addition to the aspects that are directly related to the quality of the bachelor's programmes in nursing, NVAO also makes recommendations in the overview report that may affect this quality:
- The Flemish government must put an end to the uncertainty about the paid contract internship;
- The Federal and Flemish governments must remove the financial barriers to specialisations for students and the professional field;
- The Bachelor's programmes involved must update the domain-specific learning outcomes framework, explicitly including the European criteria;
- The level 5 nursing programmes should become full-fledged higher education programmes (wherever they are offered) based on a domain-specific learning outcomes framework;
- Institutions of higher education must, in order to guarantee the quality of their own programmes, pay attention to the relevant regulations for access to, in this case, the nursing profession and include this in their assurance decision and their public information about this;
- Given that the amendment of the EU directive is not imminent, NVAO recommends that the federal government makes room in federal legislation for current educational innovation in nursing programmes.