Primary health care content in Australian undergraduate nursing curricula

Abstract

a b s t r a c tThe importance of primary health care PHC is receiving increasing attention. The demand for skilled workers is due to an increased emphasis on community-based care but until recent times pre-registration preparation for nurses, including clinical placements, have focussed on acute care specialties. Aim: To systematically review, measure and describe the PHC content in the undergraduate nursing curriculum in Australian schools of nursing over time. Methods: A cross-sectional study of all Australian universities offering undergraduate (pre-registration) baccalaureate degrees was undertaken in February 2017. Curriculum artifacts were retrieved from university websites. A terminology matrix guided retrieval of PHC content. Findings: All 29 universities offering pre-registration undergraduate nursing degrees in Australia were included in this study. While most universities cite PHC principals as core values underpinning their undergraduate curriculum, only 12 (<2%) of the 694 subject titles had obvious or manifest "primary health care" content and these were mainly offered in 1st and 3rd year. Subject outlines tended to demonstrate more explicit content than subject titles. Discussion: This study confirms ambiguity in PHC interpretation and nomenclature, and opportunities for undergraduate preparation for nursing roles in the home setting is limited. Prospective undergraduate nurses seeking careers in PHC might be deterred by a lack of manifest PHC content in the public domain, which may or may not accurately represent the actual content provided. Conclusion: The predominance of acute episodic care in both curricula and clinical experiences potentially diminishes the importance of PHC. This study offers some direction for education providers and policymakers wishing to attract and prepare next generation nurses for roles in PHC.

Final‐year undergraduate nursing students’ perceptions of general practice nursing: A qualitative study

“…Furthermore, only a few participants had experienced clinical placements in general practice where they could be exposed to the GPN role. This is consistent with the international literature describing an overall lack or inconsistent delivery of PHC content (Betony & Yarwood, 2013; Keleher et al, 2010; Murray‐Parahi et al, 2020; Wojnar & Whelan, 2017). As students’ career decision‐making is influenced by positive learning environments (Hickey et al, 2013), providing high quality theoretical and clinical experiences may enhance students’ understanding and interest in general practice nursing (Hoekstra et al, 2010; van Iersel et al, 2018; Koh, 2012; McCann et al, 2010).…”

Nurses Transitioning to Primary Health Care in Australia: A Practice Improvement Initiative

“…The increasing burden of chronic conditions, ageing population, and rising costs have increased the focus on primary health care (PHC) ( Murray-Parahi et al, 2020 ). When comprehensively enacted, PHC is the most effective, efficient, and equitable approach to enhance health and has been identified as essential in achieving universal healthcare ( Murray-Parahi et al, 2020 ; World Health Organization & United Nations Children's Fund, 2018 ).…”

“…The increasing burden of chronic conditions, ageing population, and rising costs have increased the focus on primary health care (PHC) ( Murray-Parahi et al, 2020 ). When comprehensively enacted, PHC is the most effective, efficient, and equitable approach to enhance health and has been identified as essential in achieving universal healthcare ( Murray-Parahi et al, 2020 ; World Health Organization & United Nations Children's Fund, 2018 ). In Australia, the United Kingdom (UK), and New Zealand, healthcare reforms have focused on how to build PHC workforce capacity to respond to the growing numbers of people with chronic illnesses and complex care needs ( Parkinson & Parker, 2013 ).…”

“…The COVID-19 pandemic has impacted workplace conditions and may be influencing the wellbeing of Australian nurses, midwives, and care workers ( Adelson et al, 2021 ). Furthermore, there is little pre-registration clinical exposure to PHC settings for nurses and a lack of familiarity with the scope of PHC nursing practice ( Murray-Parahi et al, 2020 ). Ample evidence describes the important role nurses play in improving access to PHC and the quality of the care delivered ( Abou Malham et al, 2020 ).…”

The community nurse in Australia. Who are they? A rapid systematic review

“…An astounding finding considering the rising incidence of chronic disease, and because mental health support was the third most frequently listed direct care activity, is that few nurses were accredited to manage these common reasons for GP visits (Finley et al, 2018 ; Kimble et al, 2020 ). Some have argued that postgraduate courses are limited (McKenna et al, 2015 ; Parliament of Australia, 2002 ) and that minimal attention is paid to P&C health in the undergraduate curriculum (Keleher et al, 2010 ; Murray‐Parahi et al, 2020 ). However, it is almost 30 years since nursing education transitioned to the tertiary sector, and although P&C nurses acknowledged the importance of education for professional status, they also have a preference for short courses (Parker et al, 2011 ).…”