SAI COLLEGE OF MEDICAL

SCIENCE AND TECHNOLOGY

KANPUR

DEPARTMENT NURSING

ASSIGNMENT
ON
TRENDS AND ISSUES IN NURSING EDUCATION
(SUBJECT: NURSING EDUCATION)

SUBMITTED TO SUBMITTED BY

SHIVANI TIWARI ]

M.Sc Nursing First Year

 INTRODUCTION

The changes that are occurring in the social and cultural life of the society as a result of the impact of
advancements in the science based technology are broadly described as modernization. Since education is a
multipolar process , it is influenced by the modernization in different ways. A profession is a dynamic
integration of various faculties of knowledge. Since nursing education is a professional education , it is
dynamic by its own nature and thereby giving rise to trends .A number of issues and controversies now face
educators and communities: social issues and ethical issues.

DEFINITION OF EDUCATION
“Education is the all-round drawing out of the best in child and man body , mind and spirit.”
- Mahatma Gandhi.
Nursing education is a professional education which is consciously and systematically planned and
implemented through instruction and discipline and aims the harmonious development of the physical,
intellectual, social, emotional, spiritual and aesthetic power or abilities of the student in order to render
professional nursing care to people of all ages, in all phases of health and illness , in a variety of settings , in
the best or highest possible manner.
DEFINITION OF NURSING EDUCATION
“Nursing education is the professional education for the preparation of nurses to enable them to
render professional nursing care to people of all ages, in all phases of health and illness, in a variety of
settings.”

HISTORY: DEVELOPMENT OF TRENDS IN NURSING EDUCATION IN INDIA:

PRE-INDEPENDENCE :

INTRODUCTION

Nursing had originated independently and existed many centuries without contact with modern medicine.
The members of the family at home met the nursing needs of the sick. Evolution of medicine, surgery and
public health into complicated technical are quiring many procedures by persons specially trained and
having an understanding of scientific principles, which brought two professions closer and together.
1. Nursing in Pre-historic Times

There is no historical evidence available on ancient history on nursing care of sick. In primitive times
discovered through myths, songs and archeologist to get rid of ;evil spirit ‘unpleasant conditioning like
beating, starving, magic rites,nauseous medicines, loud noises sudden fright are used methods. Primitive
man had the skill of massaging, fermentation bone setting, amputation, hot and cold bath, heat to control
hemorrhages.

Role of Nurse in Primitive Period:

Women were protecting and caring for their children, aged and sick members of the family. Nursing
evolved in response to the desire to keep healthy as well as provide comfort to sick. This was reflected in
caring, comforting, nourishing and cleansing aspect of the patient. These love and hope were expressed in
empirical practice of nursing.

Nursing - Vedic Period (3000 B.C - 1400 B.C)

Indian medicines are found in the sacred books of "Vedas & quot;. The ;Ayur-veda&; is thought to
have been given by Brahma. 1400 BC Sushruta, known as ;Father of Surgery; in India wrote book on
surgery and years later ;Charaka; wrote a book on internal medicine. By these writings we can learn that
those days surgery had advanced to a high level, also had 4 wings of treatment ;Chatushpada Chikitsa.
1.Physician - Bhishak
2.Nurse - Upacharika (Attendent - Anuraktha)
3.Therapeutic drugs - Dravya
4.Patient – Adhyaya

Characters of Upacharika (Nurse)

● Shuchi - Pure or clean in physical appearance and mental hygiene.

● Daksha - Competency
● Anuraktha - Willing to care
● Buddhiman - Co-ordinator with the patient and doctor / intelligent.

3. Nursing Post Vedic Period (600 BC - 600 AD)

Medical education was introduced in ancient Universities of ;Nalanda; and;Thakshashila;. King Ashoka
(272-236 BC) constructed hospitals for the people and animals. Prevention of the disease was given first
importance and hygienic practices were adopted. Cleanliness of the body was religious duty. Doctors and
midwives were to be trustworthy and skillful. They should wear clean clothes and cut their nails short. Lying
rooms were kept well ventilated. Religious ceremonies and prayer precedes co-operations. The nurses were
usually ;men or old women;. Women are restricted activities at home and cared for sick members in the
family during 1 AD period superstition and black magic replaced more in daily practices. Medicines are
remained in the hands of priest - physicians, who refused to touch the blood and pathological tissues.
Dissection was forbidden. Other religious restriction and superstitious practices probably declined the
development of nursing.
4.Nursing in Mogul Period (1000 AD)

Unani system of medicine developed during the Arab civilization. It was practiced in Indo-Pakistan
subcontinent. The basic framework consists of blood, phlegm, yellow bile and back bile. Temperament,
strengthening of body and nature are the real physician. Not believed in eradication of disease greatly
depend on defense mechanism of the body and self-care and positive health habits. Therefore, it becomes
part of Indian medicine practice.

5. British period (16th Century onwards)

After the mogul period the nursing in India hindered due to various reason like low state of women, system
of “pardha” among Muslims, caste system among Hindus, illiteracy, poverty, political unrest, language
difference and nursing looked upon as servants work. During the 16 th century, nursing development in
India taken three dimensions.
1. Military Nursing
2. Civilian Nursing
3. Missionaries Nursing
1. Military Nursing

Military nursing born during 1st world war but developed very slowly. British officers informed need of
nurses to take care British officials and soldiers in India. On 1888 February 21 st – 10 fully qualified nurses
from Florence Nightingales, arrived to Bombay to lead nursing in India. This paves the way to develop one
of the best nursing in the world. 1894 regular system of training for men for hospital work started. Medical
officers given lecturing to them. Some men were voluntary did the course and applied for nursing certificate.
After two months of practical posting to word, on the account of supervised sister’s report, first time hospital
‘orderliness’ issued certificate and had official status. This system laid the possible foundation to existing
system of training and higher education.

1927- Description of Indian Military Nursing services formed with 12 matrons, 18 sisters, 25 staff nurses.
They are responsible for supervision, instruction and training of nursing services for entire Indian hospital
corps.

2nd world war expanded nursing services to India and overseas under the direction of chief principal Matron.
3 years training carried out in selected military hospital preliminary training schools. After completion sent
to military hospital for training. After successful training certificate issued as “ Registered Nurse” and they
are a member of Indian Military Nursing services Auxiliary Nursing Services. Shortage of trained nurses in
India after the 2 nd world war the government initiated short course of intensive training in 1942 which led
to the Auxiliary Nursing Services. Basic training for 6 months in selected civil hospital after passing
examination at military hospital in India sent to overseas to serve in the capacity of ; Assistant Nurses; 3000
women given auxiliary training.

2. Civilian Nursing in India

● 1664 - East India company built Government General Hospital at Madras for civilian.
● 1871 – This hospital undertook training of nurses. On 1854 midwives training school granted
certificates of ‘diploma in Midwifery’ for passed students and ‘sick nursing’ for failed students. First
time 6 nurses came out as Diploma in Midwifery Nurses.

3. Missionary Nursing
Missionary nursing started training for Indian people as nurses. Various other countries supported. This
brought fully qualified Indian nurses. Those days there were several obstacles for nursing development.
Girls were not allowed to do work. Degrading and unworthy attitude of people. Hindus were hold back due
to deep seated caste system. Muslims held under ‘paradha’ system. So Christian girls encouraged and
trained first. Frequent disappointment, degradation difficulties nursing training came into existence and
looks its own shape. In the beginning there is not uniformity in nursing education. There is no particular
standards were given.
 After the course of lecturing 18 months to 2 years, written examination conducted. If failed training
extended to 3 years. From 1888-93 five years various experts like doctors, surgeons, nursing superintendent,
pharmacists- draw up a curriculum for training. 1907-10 North India united board of Examiner formed to
maintain nursing administration and standards.

● 1928- Hindi text book for nurses developed.

● 1939- helped to develop postgraduate school for nurses.

Community Health Nursing: William Rathbone foamed visiting Nurses Association at England. She
emphasized on charity free care etc. Florence Lees improved the visiting Nurses by giving specialized
training for their work. It is influenced in india, because of the terrible conditions under which children were
born recognized as cause for high mortality rate. Because untrained ‘Dais’ are attending women at the time
of child birth. Dais was unwilling to train and patients will accept the old customary methods.

● 1926 – Midwives Registration Act formed for the purpose of better training of midwives. Slowly
community Nursing Training needs felt by the Government.
● 1946 – Community Health Nursing was integrated in Basic Nursing Programme at Delhi, Vellore
and Madras.

TRAINED NURSES ASSOCIATION OF INDIA (TNAI)

● In 1908 – TNAI formed to uphold the dignity and honor of the nursing profession. Florence Mac
Haughton was the first president of TNAI.
● In 1910 – TNAI published journals.
● In 1912 – TNAI affiliated to international Nursing Council as a 8 th Association in the world.
● In 1917 June 16 th under the registration Act No:21 of 1860
● In 1922 – SNA formed.

DEVELOPMENT OF NURSING EDUCATION IN INDIA : POST INDEPENDENCE

On 15th August 1947 India became independent and self govermentation. Social changes were taking
place rapidly but an alarming absence of public health and sanitary measures continued. The ratio of nurse
to patient remained dangerously low. The opening of nursing schools associated with college gave
nursing profession a higher social and economic status, than it had previously known. The formation of
many commission and committees, establishment of INC and tremendous work of TNAI brought about
change in nursing education post-independence.
TRAINED NURSES ASSOCIATION OF INDIA:
TNAI helps the initiation of university level education in India.
Recommendations of the Bhore committee were implemented within a year .
1. Passing of the INC act
2. Deputation of Indian nurses abroad for post basic education
The TNAI made significant achievements in the field of nursing education. It creates awareness among
nurses through Nursing journal of India and organizing continuing education programmes. TNAI also offers
scholarships to deserving candidates to take up studies within the country and abroad.

ESTABLISHMENT OF INDIAN NURSING COUNCIL

The INC was constituted to establish a uniform standard of education for nurses, midwives, health visitors
and auxiliary nurse midwives. The INC act was passed following an ordinance on December 31st 1947. The
council was constituted in 1949.
Main Purposes of The Council:

● To set standards and to regulate the nursing education of all types in the country.
● To prescribe and specify minimum requirements for qualifying for a particular course in nursing.
● Advisory role in the state nursing council.
● To collaborate with state nursing councils, schools and colleges of nursing and examination board.

STATE REGISTRATION COUNCIL.

Functions:

● Inspect and accredit schools of nursing in their state.

● Conduct the examinations
● Prescribe rules of conduct.
● Maintain registers of nurses, midwives, ANM and health visitors in the
● state.
● The state registration council are autonomous except they do not have power
● To prescribe the syllabi for courses.
● RECOMMENDATIONS OF VARIOUS COMMITTEES PERTAINING TO NURSING
EDUCATION.

The recommendations given by committees and commission provided guidelines for improvement and
growth of nursing education.

1. Health survey and development committee (Bhore committee 1946)

 ● Establishment of nursing college.
● Creation of an all India nursing council.

2. Shetty committee 1954

● Improvement in conditions of training of nurses.

● Minimum requirement for admission to be in accordance with regulation of the INC.

3. Health survey and planning committee (Mudaliar committee 1959-61)

● Three grades of nurses viz. the basic nurses (4yrs), auxillary nurse midwife (2yrs) and nurses with
a degree qualification.
● For GNM minimum entrance qualification matriculation .
● For degree course passed higher secondary or pre university.
● Medium of instruction preferably English in General nursing.
● Degree course should be taught only in English.

4. Mukherjee committee, 1966.

● Training of nurses and ANMs required for family planning.

4. Kartar singh committee,1972-73

● Multipurpose health worker scheme

● Change in designation of ANM’s and LHV
● Setting up of training division at the ministry of health and family welfare

7. Sarojini varadappan committee, 1990 (A high power committee on nursing and nursing
profession.)

● Two levels of nursing personnel

● Post basic BSc nursing degree to continue
● Masters in nursing programme to be increased and strengthened.
● Doctorate in nursing programme to be started in selected university.
● Continuing education and staff development for nurses.

8. Working group on nursing education and manpower,1991.

● By 2020 the GNM programme to be phased out

● Curriculum of BSc nursing to be modified
● Staffing norm should be as per INC
● There should be deliberate plan for preparation of teachers MSc/M phil
 ● and PhD degrees.
● Improvement in functioning of INC
● Importance of continuing education for nurses.

DEVELOPMENT OF NURSING EDUCATION.

Basic General Nursing And Midwifery Education

1. Training of Dais(Birth Attendant )

The Dai training continued past independence. The goal was to train one Dai in each village and
ultimate goal was to train all the practicing Dais in country.Duration of training was 30 days. No age limit
was prescribed, training include theory and practice, more emphasis on field practice. This training was done
at sub Centre and equipment provided by UNICEF.

2. Auxillary Nurse Midwife

In 1950 Indian Nursing Council came out with some important decisions relating to future patterns
of nursing training in India. One of the important decision was that there should be only two standard of
training nursing and midwifery, subsequently the curriculum for these courses were prescribed. The first
course was started at St. Marys Hospital Punjab,1951.The entrance qualification was up to 7/8 years of
schooling. The period of training was 2 years witch include a 9 month of midwifery and 3 months of
community experience. In 1977, as a result of the decision to prepare multipurpose health worker & amp;
vocationalization of higher secondary education, curriculum was revised a designed to have 1.5 year of
vocationalized ANM programme and six months of general education. The entrance qualification was
raised from 7th passed to matriculation passed.

Under multipurpose scheme promotional avenue was opened to senior ANMS for undergoing six months
promotional training for which course was prescribed by INC.

3. Lady Health Visitor Course

Training of LHV course continued post independence. The syllabus prepared and prescribed by INC
in 1951.The entrance qualification was matriculation. The duration was two and a half years which
subsequently reduced to 2 years.

4 . General Nursing And Midwifery Course

GNM course existed since early years of century. In 1951,syllabus was prescribed by INC.In 1954 a
special provision was made for male nurse.In1954 public health was integrated into basic nursing course.
First revision of course was done in 1963. In1964-65 Psychiatric nursing was included in curriculum. The
duration of course was reduced from 4 years to 3.5 years. Second revision was done in 1982. The duration of
the course reduced to 3 years. The Midwifery training of one year duration was gradually reduced to 9
months and then six months, finally three year integrated programme of GNM was prescribed in 1982.

5. Post-Basic/Post Certificate Short-Term Courses And Diploma Programmes

During 1948-50 four nurses were sent to the U.K.by Govt. of India for mental health nursing
diploma.During 1954 Manzil Medical Health centre,Lucknow gave psychiatric nursing orientation course of
4 – 6weeks duration. In 1951 a one year course in public health was started at college of nursing Delhi.Govt.
of India felt urgent need for psychiatric nurses during 1953-54,this resulted in first organized course at All
India Institute of Mental Health. In 1962 diploma in pediatric nursing was established at J.J.Group of
Hospitals, Bombay. At present there are many other courses of three months duration which are monitored
and recognized by INC. The ultimate aim of all the post- basic/ post certificate programme is to
improvement of quality of patient care and promotion of health.

6. University-Level Programmes.

1. Basic BSc Nursing

First university programme started just before independence in 1946 at the University of Delhi. And
CMC Vellore. In 1949, on the recommendation of university education committee and education
commission(1964-66) and conference workshop held by TNAI, The WHO and UGC,some more colleges
came up in different state affiliated to different state university. INC prescribes the syllabus which has been
revised three times, the last revision was done in 1981.It was done on basis of the 10+3+2 system of general
education. At present the BSc Nursing programme which is recommended by the INC is of four years and
have foundations for future study and specialization in nursing.
2. Post Basic BSc Nursing
The need for higher training for certificate nurses was stressed by the Mudaliar Committee in1962.
Two years post basic certificate BSc(N) programme wa started in December 1962.for nurses with diploma
in general and midwifery with minimum of 2 years experience. First started by university of Trivandrum. At
present there are many colleges in India offering Pc BSc(N) Course.

3. Post Basic Nursing by Distance Education Mode.

In1985 Indira Gandhi National open university was established. In1992 Post Basic BSc Nursing programme
was launched, which is three years duration course is recognized by INC.

4. Post- Graduate Education-MSc Nursing

First two years course in masters of nursing was started at RAK College of Nursing in 1959.and in 1969 in
CMC Vellore. At present there are many colleges imparting MSc Nursing degree course in different
specialties.

5. M.Phil

INC felt need for M.Phil programme as early on 1977,for this purpose committee was appointed. In 1986
one year full time and two years part time programme was started in RAK College of nursing Delhi.

6. Ph.D in Nursing

Indian nurses were sent abroad for Ph. D programme earlier. From1992 Ph D in nursing is also available in
India.MAHI is one of the university having PhD programme.

Current Educational Patterns In Nursing:

1.Non University Programme

● Basic – ANM-GNM
● Advanced-Post-Certificate diploma

2. University Programmes

● Basic- BSc(N)
● Post-Basic BSc(Regular)
● Post-Basic BSc(N).IGNOU
● Advance:MSc (Nursing)
● M. phil
● Ph.D.

Trends in nursing education changes from basic general nursing service to doctorate education in nursing.

Critical Care Nurse Practitioner Program

*INC has also started Nurse Practitioner (critical care) programme recently in India, after bsc nursing & 1-2
yrs of clinical experience (preferably in ICU settings).

The NP program is a Nursing residency program with a main focus on Competency based training. The
duration is of two years with the curriculum consisting of theory that includes core courses, advanced
practice courses and clinical courses besides clinical practicum which is a major component.
Critical Care Nurse Practitioner Program is intended to prepare registered BSc Nurses to provide advanced
nursing care to adults who are critically ill. The nursing care is focused on stabilizing patients’ condition,
minimizing acute complications and maximizing restoration of health. These NPs are required to practice in
tertiary care centers. The program consists of various courses of study that are based on strong scientific
foundations including evidenced based practice and the management of complex health systems. These are
built upon the bachelor’s program in nursing. When authorized by the nursing regulatory council/s, state or
national laws, they may prescribe drugs, medical equipment and therapies. The NPs in CC when exercising
prescriptive authority or drug administration as per institutional protocols, they are accountable for the
competency in:
a) Patient selection/admission into ICU and discharge
b) Problem identification through appropriate assessment
c) Selection/administration of medication or devices or therapies
d) Patients’ education for use of therapeutics
e) Knowledge of interactions of therapeutics, if any
f) Evaluation of outcomes and
g) Recognition and management of complications and untoward reactions.

CURRENT TRENDS IN NURSING EDUCATION IN INDIA

1. Curriculum Changes to facilitate diversity of educational opportunity and overcoming barriers of
time & distance. Nursing curricula are competency based and it focuses on outcome and emphasizes
student participation & responsibility for learning. Accrediting bodies of respective countries revise the
curriculum of nursing education from time to time. Indian Nursing Council (INC) revised the syllabus
of Auxiliary Nursing & Midwifery (ANM) course in 2006-07. The revised curriculum had;
components of National Rural Health Mission (NRHM), Skilled Birth Assistant (SBA) module of
Ministry of Health and Family Welfare (MoHFW), Standard safety guidelines for infection control
practices and bio- medical waste management policies (Indiannursingcouncil. org, 2015) .General
nursing and midwifery (GNM) curriculum was revised in the year 2005-2006. The course duration was
extended to 3.5 years (including 6 months of internship). Revised syllabus for BSc. Nursing and Post
Basic BSc.Nursing were implemented from 2005-2006 in all Indian Universities. The syllabus revision
was made in tune with National Health Policy 2002. The concept of National Rural health Mission
(NRHM), Integrated Management of Neonatal and Childhood Illnesses (IMNCI), Evidence Based
Nursing were incorporated in the revised syllabus. (Kaur K 2009, Kumar D, 2010,
Indiannursingcouncil.org, 2015). In 2013 Manipal University revised its curriculum for MPhil
Nursing. Evidence Based Practice was included as a course for this program (D’Souza P et al, 2015).
A national consortium for Ph.D. in Nursing was constituted by Indian Nursing Council (INC) in
collaboration with Rajiv Gandhi University of Health Sciences, Karnataka in the year 2005
(Indiannursingcouncil.org, 2015).

2. Innovation In Teaching And Learning leading to intellectual, personal & career development.
 Evidence Based Practice: Evidence-Based Practice (EBP) is defined as “a problem-solving approach to
clinical care that incorporates the conscientious use of current best evidence from well-designed
studies, a clinician’s expertise, and patient values and preferences” (Fineout-Overholt,
Melnyk & Schultz, 2005). Incorporating research based evidence in nursing education enhances
evidence based practice. The quality of nursing practices improves in a greater form by using evidence
based practices.
Advanced Clinical Nursing Education: Apart from being care provider nurses are performing different
roles. It includes independent roles like Nurse Midwifery Practitioner,Nurse Anesthetist, and Nurse
Specialist. Acknowledging the need for specialty trained nurses at the bedside as the front line care
managers, in 2008 Indian Nursing Council (INC) developed curriculum for Post basic diploma in 10
nursing specialties including an independent nurse practitioner program in midwifery.
Supervised Training by Nurse Educators: As per INC norms the teacher student ratio is 1: 10 this
ensures effective supervision for each student. Nursing educational institutions strive towards
improving the clinical teaching learning process. Teacher- practitioner model and faculty student
practice clinic are two newer concepts in clinical training. According to this model the teacher who
teaches the students in classroom will guide the students in clinical area by guided practice and role
modeling.
Clinical Instruction – Training the Trainers: Over a period of time more emphasis is given on clinical
nursing education. Nursing faculty is now taking up responsibility & accountability to patient care and
they acknowledge the fact that clinical exposure of the student doesn’t mean the clinical
practice/learning. To overcome this dilemma faced by novice as well as experienced faculty, now,
clinical teaching is given more emphasis and training of all nursing faculty in clinical area is getting
mandatory in Indian settings.

● Knowledge Expansion:
Expanded Nursing Literature: the last decade had witnessed a great expansion in nursing literature.
The CINAHL, Cochrane, PubMed databases serve as the excellent treasure for nurses & nursing
students. This has considerably helped a lot in disseminating the research findings across the
geographical and economical barriers.Expansion of research based literature fosters EBP as
‘retrieving evidence from different sources’ is one of the main components of EBP.
Research in Nursing Education: Research has become a major area in curriculum. Action research and
the use of qualitative methodologies in research is getting wider acceptance now. Educational research
focuses on enhancement of the teaching and learning process.

● Evaluation System:
 University Based Education: Previously, the GNM and ANM courses were offered in Schools of
Nursing that were not affiliated to any University. Now, B Sc. Nursing and MSc. Nursing courses are
being offered to nursing students in Colleges of Nursing which is either affiliated to, or a constituent of
a university.
Innovative Evaluation Strategies: Innovative evaluation strategies like ‘Objective Structured Clinical
Evaluation’(OSCE), Rubrics, are now widely being used in nursing education. OSCEs are widely used
to evaluate clinical skills and competencies. In clinical nursing education, rubrics are used to
objectively assess student performance and it focuses on aspects of patient safety.

● Modes Of Education:
Distance Education in Nursing: Different universities all over the world have started offering nursing
courses through distance education. Foreign universities provide courses such as accelerated RN
program, LPN to RN programs in distance education modes. In India; Indira Gandhi National Open
University (IGNOU) offers various courses in nursing via distance mode.
E Learning & Online Education: E learning and online education are becoming important icons of
nursing education which increases the scope of universal learning. Education is becoming accessible in
the tips of every nurse by the technological advancements and the implementation of e learning in
nursing. wide number of free online Continuing Education (CE) programs helps nurses to keep
updated with the current knowledge.
Interprofessional Education (IPE): The need of collaborative practices among health care professionals
led to the emergence of IPE. Individuals from different professions learn together in the milieu of
interprofessional education.
3. Educational Quality Assurance is a process for monitoring and evaluating the efficiency and
effectiveness of educational provision and to institute remedial measures as & when needed.
Educational Quality Assurance: The trend of educational quality assurance has emerged recently. It is
a process of monitoring and evaluating the efficacy and effectiveness of educational provision and to
institute remedial measures as and when needed. In India nursing education is flourishing in an
unprecedented manner, naturally this will lead to the dilution in the quality of nursing education.
Accrediting agencies like ISO has taken the initiative of accrediting colleges of nursing in India.
Advanced Nursing Courses: In recent years nursing is finding new arenas for its development and
autonomous practice. Nurses in clinical area is also now focusing on their carrier advancements by
continuing nursing education programs and in-service education. Higher studies in abroad is also
becoming more popular in developing countries like India. There is a high demand for; Nurse
Practitioner, Clinical Nurse Specialist, MPhil and PhD programmes.
4. More Reliance On Technology for teaching & learning with judicious use of educational psychology
in the development & practice of educational technology being user-friendly in nature. Technology
exerts greater influence on nursing education as a tool for teaching and learning. Computers are used in
all fields of healthcare with the advent of advanced technology. That’s why computer education has
been introduced in the revised nursing curriculum.

5. Emphasis On High Tech- High Touch Approach to preserve the humancomponent of nursing care
without undermining the advantages of technological advancements in field of patient care. Present
day nursing education is preparing students to maintain the human element of nursing care with the
help of sophisticated technology and gadgets.Advanced educational technology media like projectors,
Smart boards, computer models and simulation labs are now widely used by nursing teachers to
provide effective teaching experiences to students. Nursing students widely use smartphones, tablets
and android applications as means for educational support. Android apps provide information to the
fingertips of the students in no time and is increasingly used in clinical nursing education.
Simulations in Nursing Education: Simulations are getting wider acceptance in nursing education
system, where concepts of patient safety and consumer protection are accent. Simulation is the
“process of designing a model of a real system and conducting experiments with this model for the
purpose of either understanding the behavior of the system and/or evaluating various strategies for the
operation of the system”

Animations & Cinematic Technology: Animations are now widely used to enhance the learning
experience. Video assisted teachings with the help of animation are being widely used in nursing
education. Nursing procedures, physical examination, breath sounds and stages of labor can be made
 clear and thorough with the help of this visual learning technologies. The use of cinematic technology
in the classroom teaching provides a varied learning experience which engages students in learning
complex material through visual illustrations.
6. Preparation Of Global Nurses to reap benefits created by globalisation & liberalisation by way of
preparing global nurses.
7. Transational Acceptance of national education programmes of one nation by other nations for
development of nursing education in countries like India.
8. Ensuring A Promising Career in India & abroad to maintain this status for long term.
9. Emergence Of New Specialities to meet the needs of the community.
10. Increased Opportunities For Higher Studies so that an eligible candidate can easily pursue higher
education without much time lag.
11.  Diminishing Government Role in preventing shortage of funds with taking certain policy decisions
to prevent the govt. From investing further in the field of nursing education.
12. Uniformity And Standardization in universities & nursing boards by conducting nursing
programmes similar to each other.
13. Coping With The Impact Of Globalization to inculcate the traditional values of nursing profession
during their student period because the status of nursing is shifted from a caring to a rewarding
profession.
14. Enhanced Student Status to consider nursing students as ‘nursing students’ & not ‘student nurses’.
Enrolment of Men as Nursing Students: Nursing was considered as a female profession at least in
India. In present generation, the trend is changing. In the past few decades the number of males
enrolled for Nursing has increased, it is expected to increase this number in the coming years.
Changing demography of Nursing Students: In older days nursing care was provided by nun sisters and
many of the major hospitals were established by missionaries. Present day nursing students represents
a diverse population in terms of gender, age and socio economic status.

THE CURRENT TRENDS AND THEIR RELATED ISSUES IN NURSING EDUCATION IN INDIA
1. Sociodemographics, cultural, diversity, economic, and political changes, and global issues:
● Increased aging population; increasing multicultural, ethnic diversity requires increased learning
● Immigration conflicts, protests; consequences for access and health care
● Global community, globalization health issues; global nursing networks
 ● Social, economic, and political changes 5. Multidimensional content, client care, clinical learning
sites.

2. Rapid knowledge expansion; increasing use of technology and informatics in education and
practice:
● Choosing the most effective electronic and technology option
● Information overload; virtually unlimited global resources, global research opportunities, issues
● Identifying current and accurate information; material rapidly outdated
● Expanded expectations, limited time, rapid response expected; little time for reflection
● Expansion of nursing informatics, content and skills development

3. Practice-based competency: outcomes and evidence-based content:

● Learning focused on core practice competency outcomes, professional skills beyond technical
psychomotor skills; core practice competencies; multiple conflicting versions; which to use?
● Integration of evidence-based standards, research findings into practice; emphasis on critical
thinking, problem solving.
● Changes in standards; ensure patient safety.

4. Performance-based competency:learning and objective assessment methods:

● Multiple teaching-learning methods: interactive collaborative, in-class and out-of-class projects;
problem-based learning; increasing self responsibility; accountability for learning and competence;
interprofessional learning; using electronic devices, media to access resources
● Competency assessment based on performance examinations, specified portfolio documentation;
standards-based assessment methods; emphasis on patient safety

5. Community-focused interdisciplinary approaches:

● Interprofessional collaborative learning
● Diverse alternative health practices, influence of cultures
● Broad scope of nursing; clinical approach; increasing use of diverse experiences throughout
community; continuum from acute care to health promotion; from hospitals to home to rural to
global settings
● Multiple teachers, preceptors, staff instructors, part-time, with varying abilities; time constraints.

6. Patient-centered care: engagement, safety, and privacy:

● All expect value, quality, individual respect, consideration, attention; privacy issues
● Patient initiatives for involvement and protection; balance standards and preferences
 ● Increased litigation, medical-nursing errors; focus on safe, competent patient care
● Increased individual responsibility, accountability for learning and practice.

7. Ethics and bioethical concerns:

● Alternative solutions to ethical dilemmas; issues regarding diverse beliefs; disputes regarding
biotechnology and bioengineering in health care
● Many gray zones instead of black-and-white absolutes; separate professional practice
responsibilities from personal opinions, consequences for competence, and patient safety
● Integrate into professional practice acceptance of the individual’s right of choice regarding life
and death issues, health care methods; respect, tolerance for patient’s decisions, ethical
competencies for students
● Standards of quality care, patient’s rights issues
8. Increasing shortage of nurses and faculty:
● Shortage of staff results in limitations in clinical learning; heavy workload; using preceptors,
part-time instructors; less one-to-one help for students; consequences for learning and patient
safety
● Shortage of qualified faculty; aging, retiring; increased part-time instructors, clinical staff,
national and global problems, influence quality education and future nursing staff; need for
increased educational funding
● Students need more clinical learning; more responsibility for self- directed learning, seek
assistance from others
● Increased use of simulation; required to validate initial and continuing competence
9. Disasters, violence, and terrorism:
● New learning skills required for major natural disaster events; new program options, new
courses, and new skills needed for emergency responders
● Violence in society, homes, workplace, schools; abuse against women and children
● Preparedness for terrorism; skills, programs for first responders; increased anxiety, uncertainty
10.  Increasing professional and personal responsibility:
● Lifelong learning to meet professional expectations; certification requirements
● Increasing competency assessment in workplace
● Changes in standards for quality care practice
● High stress from competing demands of school, home, meeting competency requirements

THE FUTURE TRENDS IN NURSING EDUCATION :10 TRENDS TO WATCH

The millennium has become the metaphor for the extraordinary challenges and opportunities available to the
nursing profession and to those academic institutions responsible for preparing the next generation of nurses.
Signal change is all around us, defining not only what we teach, but also how we teach our students.
Transformations taking place in nursing and nursing education have been driven by major socioeconomic
factors, as well as by developments in health care delivery and professional issues unique to nursing. Here
are 10 trends to watch, described in terms of their impact on nursing education.

1. Changing Demographics and Increasing Diversity : Schools of nursing must be prepared to confront
the challenges associated with today's more mature student body, and educational methods and policies,
curriculum and case materials, clinical practice settings, and research priorities need to value and reflect the
diversity of the student body, as well as the population in general. At the same time, schools must focus
recruitment efforts on the more traditional, younger student.

2. The Technological Explosion : Nurses of the 21st century need to be skilled in the use of computer
technology. Already, distance learning modalities link students and faculty from different locales and
expand the potential for accessible continuing professional education. Technically sophisticated preclinical
simulation laboratories will stimulate critical thinking and skill acquisition in a safe and userfriendly
environment. Faster and more flexible access to data and new means of observation and communication are
having an impact on how nursing research is conducted.

3. Globalization of the World's Economy and Society :Nursing science needs to address health care
issues, such as emerging and reemerging infections, that result from globalization. Nursing education and
research must become more internationally focused to disseminate information and benefit from the
multicultural experience.

4. The Era of the Educated Consumer, Alternative Therapies and Genomics, and Palliative
Care. :Palliative and End-of-Life Care Technological advancements in the treatment of illness and disease
have created new modalities that extend life while challenging traditional ethical and societal values
regarding death and dying. Greater recognition of the need to ensure comfort and promote dignity is
reflected in the now nearly universal promotion of advanced directives, organ donation, and palliative care
for the terminally ill. New settings for care, such as inpatient and home-based hospice, and new forms of
care, including pain management, spiritual practices, and support groups and bereavement counseling, are
now likely to be part of well-developed health care systems. A significant gap in the body of scientific
knowledge and clinical education with regard to palliative and end-of-life care remains, and nursing
education must prepare graduates for a significant role in these areas.

5. Shift to Population-Based Care and the Increasing Complexity of Patient Care:Providing services for
defined groups "covered" by managed care will demand skills and knowledge in clinical epidemiology,
biostatistics, behavioral science, and their application to specific populations. Nurses must demonstrate
management skills at both the organizational and patient care levels. These concepts must be incorporated
into the nursing curriculum.
6. The Cost of Health Care and the Challenge of Managed Care: Concerns about cost have led to the
popularity of managed care options, first by corporations for their employees and now by governments,
through the Medicare and Medicaid programs. Despite recent federal budget surpluses and proposals to
expand funding and benefits in Medicare, there is serious concern among economists, legislators, and
bureaucrats about the long-term solvency of both publicly funded programs.

7. Impact of Health Policy and Regulation: The impact of federal and state health policy and regulation
on the practice of nursing cannot be ignored. Issues surrounding health care are often complex, involving the
fields of medicine and economics, and affecting individuals' rights as well as access to health care.
Consumers are concerned about quality, and corporations and individual providers are concerned about
economic survival.

8. The Growing Need for Interdisciplinary Education for Collaborative Practice : With care
management a critical component in health care delivery, nurses must demonstrate leadership and
competence in interdisciplinary and collaborative practice for continuous quality improvement. Team-based,
interdisciplinary approaches have been shown to be highly effective for improving clinical outcomes and
reducing cost. Teaching methods that incorporate opportunities for interdisciplinary education and
collaborative practice are required to prepare nurses for their unique professional role and to understand the
role of other disciplines in the care of patients.

9. The Current Nursing Shortage/Opportunities for Lifelong Learning and Workforce Development :
Nursing shortages have a negative impact on patient care and are costly to the health care industry. A
significant nursing shortage exists today, particularly in acute and long-term care settings. It results from
many factors. For example, nurses of the "baby boom" generation are beginning to retire; women today have
numerous career opportunities; and there is a lingering perception of nursing as a "trade," versus a
"profession," which contributes to the lack of new individuals entering the field. As the age of entering
students rises, the number of years of practice decreases, also affecting supply. While the number of male
and minority students has been steadily rising, their ranks are still underrepresented.

10. Significant Advances in Nursing Science and Research : Nursing research is an integral part of the
scientific enterprise of improving the nation's health. The growing body of nursing research provides a
scientific basis for patient care and should be regularly used by the nation's 2.5 million nurses. Most studies
concern health behaviors, symptom management, and the improvement of patients' and families' experiences
with illness, treatment, and disease prevention. Research is conducted to improve patient outcomes and
promote the health and well-being of communities, especially of the most vulnerable populations.

Other future trends may include :

● Increased collaboration between nursing practice and nursing education.

● Increased emphasis on collaboration between healthcare disciplines.
● Increased development of educational products for faculty and students.
 ● Increased student and nurse mobility (including increased licensure mobility) .
● Increased distance (online) learning.
● Schools of nursing providing ongoing professional development for competence requirements.
● Increased teaching of evidence-based practice.

SUMMARY
Education is a purposeful process aimed at the development of human beings.it is concerned directly with
the child in the matter of bringing out his hidden talents. The changes that are occurring in the social and
cultural life of the society as a result of the impact of modernization.

Nursing education have expanded considerably post-independence. University education in nursing brought
about changes in nursing education. The type of nurses required today is an “all round personality”.
Education brings changes in behavior of the individual in a desirable manner. It aims at all round
development of an individual to become mature, self-sufficient, intellectually, culturally refined. Socially
efficient and spiritually advanced.

CONCLUSION
Trends are the changes that takes place and become vogue. The technological changes, changes in
demographics and health patterns have contributed to various trends in nursing education. The dynamic
nature of nursing education strive to enhance the quality of care, the core of nursing.

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