Embedding fundamental care in the pre-registration nursing curriculum: Results from a pilot study

Abstract

International evidence suggests nursing is not providing fundamental care consistently or adequately, resulting in poor outcomes for patients and healthcare systems. One possible reason for this inadequate care delivery is nursing education, with fundamental care often implicit or invisible in nursing curricula. To understand how best to teach fundamental care to pre-registration (pre-licensure) students, we developed and piloted a six-week intervention that incorporated into the first-year curriculum a more explicit focus on fundamental care. A conceptual fundamental care framework was used to guide students' learning, and clinical skills sessions were structured to reinforce the framework's conceptual understanding and enable students to practice delivering fundamental care in an integrated manner. The intervention's impact was explored via a pre-post survey and focus groups. The survey demonstrated that the intervention did not affect students' ability to identify patients' fundamental care needs; however, focus groups showed the intervention assisted students in understanding the complexity of fundamental care and its importance to patients' experiences. The pilot provides preliminary evidence on the importance of embedding fundamental care into nursing curricula early and explicitly, and emphasising the integrated nature of such care, particularly through structured debriefs, consistent terminology, and opportunities for students to experience care as a patient.

Exploring nursing students’ use of the Fundamentals of Care framework in case‐based work

“…Students in this study highlight the importance of a concurrence in how FoC is used and articulated across school and clinical setting. This is in line with a study by Feo et al () underlining the significance of explicit consistent use of terminology for helping students to develop a vocabulary for fundamental care.…”

“…This is unfortunate as the intention of using the FoC framework is to improve the understanding of the complexity of nursing care and not focus on a few selected needs as previously reported in a study by Jangland et al (). Additionally, the findings highlight the relevance of being continuously introduced to the framework from day 1 which complements findings of Feo et al (). These notions have to be taken into consideration when planning curriculum and teaching sessions along with clear descriptions of where and how the students are expected to work with the FoC framework in case‐based work.…”

“…In this study, students reported that the concepts within the FoC framework were with them implicitly and seldom articulated. A study by Feo, Donnelly, Frensham, Conroy, & Kitson, also found that nursing students perceived fundamental care as common sense and innate (Feo et al, ). The students do not necessarily see a need for being explicit about FoC and articulating it.…”

“…The students emphasised the importance of having a supervisor who continuously reminds and asks them to draw on the framework in their case‐based work. The importance of a continuous articulated and explicit reinforcement of the importance of fundamental care in order for the students not to default to a task‐based approach has previously been described by Feo et al (). Continuous articulation of the framework through exercises, reflections and teaching sessions may be one way to meet this requirement.…”

Finding the fundamental needs behind resistance to care: Using the Fundamentals of Care Practice Process

“…It may even be necessary to address certain concepts from the beginning of the training so that the participants will concretely integrate the three dimensions into their learning. Several strategies to develop Fundamentals of Care and to implement the FOC framework in baccalaureate nursing education have been tried (Feo, Donnelly, Frensham, Conroy, & Kitson, ; Jangland et al, ; Voldbjerg et al, ). Of course, these attempts will be carefully considered for the development of training strategies based on the FOC‐PP.…”