Healthcare is changing dramatically due to the advancement of medical sciences and technology, the abundance of clinical research and the higher demands of consumers. As a key profession of healthcare, these changes represent a significant challenge to the nursing profession and nursing education in terms of maintaining the quality of services and preparing nurses for the future (AACN, 2011; Jayasekara & Amarasekara, 2015; Kraft, Kastel, Eriksson, & Hedman, 2017). It is evident that nursing education is increasingly being restructured in many countries to prepare nurses for contemporary and future demands of healthcare (Kraft et al., 2017; Lee et al., 2016). Sri Lanka is a rapidly developing country and has made a significant development in nursing education during the last decade.
In Sri Lanka, nursing education is currently taking place in separate nursing schools and universities. Being government institutions, schools of nursing are attached to the Ministry of Health (MOH), while universities are managed by the University Grant Commission (UGC) and Ministry of Higher Education in Sri Lanka. Currently, pre-registration nursing education in Sri Lanka is based on a three-year diploma level nursing program in schools of nursing and a four-year Bachelor of Science (B.Sc.) in nursing programs at universities. The post-registration nursing education is taking place in the Post Basic College of Nursing in Colombo. In 2000 a Master of Nursing Science (MNSc) program was introduced as a three-year WHO sponsored project under the academic auspices of the University of Adelaide, South Australia. The major aim of this program was to establish a future faculty for university nursing education; however, this program was discontinued after the second intake due to inadequate coordination of accessing WHO funds for the program (Jayasekara & Amarasekara, 2015). A lack of postgraduate nursing education has led to a severe shortage of qualified nurse educators for senior nursing academic positions in Sri Lanka although few nurse educators have completed postgraduate research degrees in foreign universities (Aluwihare-Samaranayake, Ogilvie, Cummings, & Gellatly, 2017).
According to the UGC in Sri Lanka, five universities offer degree programs leading to B.Sc. in Nursing with more than 300 students for 2017 intake (UGC, 2017). More than 1000 graduate nurses are currently working in the national healthcare sector, and most nurses are seeking postgraduate qualifications to develop their career prospects. Therefore, the purpose of this project was to assess the feasibility of postgraduate nursing programs enabling to develop the first Master of Nursing program in Sri Lanka. This innovative program will meet an identified need for accessible, flexible postgraduate nursing education that prepares nurses to provide leadership in healthcare, education, management and research within a complex and dynamic, healthcare system.
Method
This preliminary need assessment project was part of the Emerging Educational Administrator Institute’s (EEAI) 18-month mentored-leadership experience program utilising the Triad Model (EEAI, 2018) A descriptive cross-sectional survey was utilised to assess the graduate nurses’ intention to enrol in a master of nursing program in Sri Lanka. This preliminary survey was limited nursing graduates of the University of Sri Jayawardenepura (USJP), which started the first undergraduate nursing program in Sri Lanka. Nursing graduates passed out from the USJP from 2010-2018 (n=100) participated in this study. The research team developed a self-administered questionnaire with two sections; Part A-demographic data (e.g. age, gender, occupation, etc.), part B- the need of a Master of nursing program (e.g. preferred speciality area, language proficiency, IT literacy, preferred learning mode, etc..). The initial contact was done via email with the survey consent form. If the participant agrees to participate in the survey (after returning the completed consent form), the survey questionnaire was emailed or posted at the participant's request. The postal questionnaire was included an envelope with a stamp to return the completed questionnaire. Before the main study data collection, a pilot study was conducted (n=10) to understand the efficiency and the feasibility of the questionnaire and to reduce the mistake and other irregularities in the analysis. Ethical approval was obtained from the Ethics review committee of the Faculty of Medical Sciences, USJP, Sri Lanka.
Findings
The findings of this preliminary survey indicated that the majority of nursing graduates (60%) worked as nurses in the government hospitals or private hospital in Sri Lanka. Nearly 30% of the participants were nursing academics of the state universities. More than half of the participants (60%) have work experience for less than five years. Most of them rated their English and IT literacy as excellent. The majority (90%) of the participants reported that they intend to enrol in a master of nursing program. The preferred speciality areas were nursing management (40%), gynaecology and obstetrics nursing (34%), mental health nursing (33%), adult nursing (32%), and nursing education (30%). The preferred teaching-learning methods were lectures (58%), self-directed learning (54%), workshops (50%) and problem-based learning (42%). The majority of participants (80%) preferred to part-time enrolment.
Discussion
The results indicated a strong desire to enrol in a master of nursing program and high demand for nursing management speciality. The motivation to study further indicates that graduate nurses are positively responding to the current and future demand of the profession. The findings of this preliminary survey can be used to curriculum planning and establishing the Master of Nursing program in Sri Lanka ensuring the best possible educational outcomes. In the future more than ever, nurses will need a high-quality university education, assertiveness skills, technical competence and ability to deal with a rapidly changing health care environment.