‘Tuning’ and Bologna:Implications for undergraduate,postgraduate and continuingeducation in health professionsDr Mary GobbiTuning ProjectSubject Lead for Nursing and UK representativeUniversity of SouthamptonM.O.Gobbi@soton.ac.ukMary Gobbi, Lille 2004
Aim of PresentationSummarise the basic principles of theTUNING project in the context of BolognaOutline the issues facing health careeducation especially at graduate/bachelors/first cycle levelConsider the example of nursing as a nongraduate occupation with a GeneralDirective
The TUNING project is a project by and for universities.It is the Universities’ response to the challenge of theBologna DeclarationTUNING MOTTOTuning of educational structures and programmes onthe basis of diversity and autonomyInitiated by Universities of Groningen and Deusto
Tuning MethodologyLearning outcomes and competencesGeneral tendencies in Higher EducationShift of paradigm: moving from a staff orientedapproach to a student centred approachLess specialised academic education in the firstcycleMore flexibility in first and second cycle programmesWhat should a student know, understand and be ableto do to be employable?
Bologna Key points1. Adoption of a system of easily readable andcomparable degrees2. Adoption of a system essentially based on two cycles3. Establishment of a system of credits4. Promotion of mobility5. Promotion of European co-operation operation in qualityassurance6. Promotion of the European dimension in highereducation7. Lifelong learning8. Higher education institutions and students9. Promoting the attractiveness of the European HigherEducation Area10. Doctoral level introduced Berlin 2003 (third cycle).
A methodology for designing,planningand implementing curriculaTuning approach:student centreddefinition of academic and professional profilesdefinition of learning outcomesidentifying generic and subject specificcompetencesoutput oriented curriculaTuning methodology and model:appropriate for mono-disciplinary, inter- andmultidisciplinary, integrated and joint degreeprogrammesvalid for graduates with a wide range of profilesfocus on competences
TUNINGFocuses on the development of generic andsubject specific competences which act ascommon reference pointsRespects diversity and autonomyInvolves stakeholdersMethodological approach comprising 5 lines:Line 1: Generic competencesLine 2: Subject specific competences(knowledge, understanding and skills)Line 3: ECTS as a European credit accumulationsystem: new perspectivesLine 4: Mapping of approaches to teaching /learning and assessment in different countriesLine 5: Quality enhancement
TUNING ANDNURSINGTo implement the Bologna - Prague - Berlin processon university level: we are the first regulated groupTo find ways to implement two cycles (now three) ina practice based professionTo identify common reference points from disciplineand university perspectiveTo develop professional profiles and comparableand compatible learning outcomes for nursingTo facilitate employability by promotingtransparency in educational structures (easilyreadable and comparable degrees)To develop a common language which is understoodby all stakeholders (Higher education sector,employers, regulators, , professional bodies andusers of service)
The Tuning Methodology appliedLine 1: Generic competencesThese were developed in Phase 1 through stakeholder survey.When applied to nursing, ‘application to practice’ and ‘ethicalcommitment’ were the highest ranked competencesLine 2: Subject specific competences (knowledge,understanding and skills)Through the mapping of the subject area, common reference pointsare established for subject specific competences. Please comment.Line 3: ECTS as a European credit accumulation system: newperspectivesDevelopment of ECTS as a tool for programme design: basis isstudent workload measured in time. How to apply to nursing/healthcare professions?Line 4: Mapping of approaches to teaching / learning andassessment in different countries - for health care groupsLine 5: Quality enhancement- to include practice based learningThe clinical learning environment makes us different
European Credit and TransferSystemStudent centred system based onstudent workload required to achievethe objectives of the programme(preferably expressed in terms oflearning outcomes and competences).The principle of Credit Accumulation isintegral to this approach.
Workload of creditsBased on convention that 60 credits measurethe workload of a full time student duringone academic year. In most cases in EU thisequates to 36/40 weeks per year.I credit = 25-30 working hours (1500-18001800hours)75 credits are considered the norm for a oneyear full time masters degree where thestudent ‘attends’ for longer.? Some health professions may constitutean exceptional case?
Health profession challengesNot all health professions aregraduate/bachelors level across European AreaEducation is not always University orPolytechnic basedSome are regulated by General Directives thattend to specify content of course and number ofhours. Most were designed in mid 1970s andreflect thisThose without General Directives have issuesrelated to freedom of movementCountries differ in their scope of practice,workforce composition, resources andeducational levels for licence/registration
Nursing ChallengesEU Directive (see Conseleg:1977L0453) specified hours,no competences and no academic level.– National and professional regulation– Registered/ licence to practice Nurse Education nottied to first cycle ‘bachelors’ degreeNo commonly agreed competences, especially at higherlevels: (ICN, WHO, Standing Committee)Few established and operating networks to accessUniversities and other stakeholdersLabour market conditions and employer demands(health /social care, private and public providers)
Differences between Members States• First cycle is sometimes not requirement forregistration/licence (irrespective of EUDirectives)• Different stages of academic development ofthe profession/occupation• Different histories for:• Role of practitioner (and sometimes women)• Scope of practice• Employability requirements different• Resource allocation to health care andworkforce
Decision of Nursing GroupUnanimously agreed to apply TUNING:To first cycle degree with professionalnurse registrationTo second cycle degree associated withpracticeTo establish mechanisms for dialogueconcerning EU DirectiveTo liaise with the thematic network (inprogress)
Levels of complexity andcompetence‘Ability to undertake comprehensive and systematicassessments using the tools/frameworks appropriate tothe patient/client taking into account relevant physical,social, cultural, psychological, spiritual and environmentfactors.’ This includes being able to:Assess normal health (theory and practice)Effectively use assessment and measurement toolsUse, and is sensitive to, cultural knowledgeDemonstrate good interpersonal and communicationskills in written, (non) linguistic and informatic mediaAssess and diagnose/refer deviation from normal
Implications forprofessional profile Profession in transition (what is desirabletoday may become a requirement tomorrow) Some health care programmes are directentry in some countries and not in others (e.g.Midwifery) Multidisciplinary agenda in Health Caremeans more first and particularly secondcycle programmes are shared with others
Issues for debate anddiscussionViews on the nursing competencesthemselves (please forward comments)Perspectives on ECTS and its application tonursing.Should we specify the nos of ECTS percompetence? (No) Level descriptors? (yes)!Level of nursing below RN with first cycleThe impact of Bologna: first cycle is entry intothe labour market. How does this match withsecond cycle qualifications with registrationand an increasingly graduate workforce?