Preparing graduates for professionalism and person-centred practice: developing the patient voice in nurse education

Nurse education is placing more emphasis on the value of using patient’s voice in undergraduate curricula. This is in response to health care shifts from the historical paternalism that sustains the expertise of the professional to more empowering person- centred models of practice. Reforms that improve standards, advance nursing as both a discipline and a profession, and prepare graduates as global citizens are underway. As schools of nursing strive to facilitate change, new conceptual models for nurse education are emerging that are informed by contemporary education theories, evidence-based perspectives, high fidelity simulation, internationalisation, innovation in education in clinical settings and interprofessional education. This reflects a shift away from competency-based education and the teaching of discrete areas of discipline specific knowledge to more holistic means of developing learners’ professional attributes for transforming healthcare. This reflects the new healthcare paradigm which has a sharper focus on professionalism and requires nurse education to better prepare graduates for practice that places the person at the centre of their own care.

Work is currently underway at one Australian University to develop a contemporary undergraduate Bachelor of Nursing (BN) course. Through alignment of its pedagogical philosophy and conceptual framework, new teaching, learning and assessment approaches are being developed to place the patient at the centre of learning. The BN works from the premise that nurse education is a critical professional socialisation process that shapes nursing students professional identities within a frame of person-centredness. Situated within a critical realist paradigm, the curriculum uses a realist approach to knowledge that is consistent with evidence-based practice and acknowledges there are multiple sources of knowledge that are relational. The new curriculum therefore uses participatory processes, such as longitudinal case studies and videos depicting patient’s experiences, from which students can reflect on to reinforce the centrality of person centredness.

This article focusses on the qualities that future graduate nurses should have for drawing upon social and political processes that shape participation and engagement with patients as equals in nursing care. It describes how the curriculum employs a strengths-based framework which highlights the patient as a person who has the capacity to make informed choices and with whom the nurse has a reciprocal relationship. We explore ways reflective models are being supplemented and refined to shape nursing students as deliberative practitioners by using longitudinal case studies and videos of patients describing their health and disability experiences as a basis of classroom discussion and reflective journaling. We anticipate these teaching and learning approaches will enhance student learning of professionalism, person centredness and allow them to develop empathic dispositions.