The training of clinical nurse specialists is a new mission for our university. Following the establishment of the curriculum for infectious disease clinical nurse specialists in 2013, we plan to expand the clinical nurse specialist education curriculum to include cancer nursing, mental health nursing, and pediatric nursing beginning in 2018, in addition to nursing training and postgraduate education at the National Advanced Specialist Medical Research Center, a driving force of medical care in Japan.
At present, in May 2017, there are 265 registered mental health clinical nurse specialists. Of these, 4 are affiliated with the National Advanced Specialist Medical Research Center and 5 with the National Hospital Organization, while the majority are affiliated with non-governmental hospitals.
In our university’s training curriculum for clinical nurse specialists, we are developing a program aiming to train human resources in the form of mental health clinical nurse specialists who can actively participate in the National Advanced Specialist Medical Research Center as well as training liaison mental health clinical nursing specialists who perform advanced mental health care in departments other than the department of psychiatry, in addition to mental health clinical nurse specialists focusing on individuals with psychiatric disorders.
“Clinical nurse specialist” refers to those recognized as possessing superior practical nursing skills in a specific field of nursing. Clinical nurse specialists fulfil 6 roles in order to efficiently provide high quality nursing care to individuals, families, and groups with complicated and difficult nursing problems. These roles are education, practice, consultation, regulation, ethical regulation, and research. These roles can contribute not only to the fulfillment of the policy-based medical care field for which the National Advanced Specialist Medical Research Center is responsible, but to the promotion of clinical research, education and training, and the dissemination of information.
The objective of this research is to report on the specialized course education program (lecture course, seminar course, practical training) enabling the acquisition of the latest techniques and theories for improving the advanced and specialized practical skills of clinical nursing and nursing research skills at the National Advanced Specialist Medical Research Center and the National Hospital Organization as well as investigation into the roles and challenges of mental health clinical nurse specialists.
Methods:
A．Lecture/seminar course category classification
Our university’s mental health clinical nurse specialist field lecture/seminar courses—created based on the 2018 edition of the Advanced Practical Nurse Education Curriculum Standards and Advanced Practical Nurse Education Curriculum Review Requirements from the Japan Association of Nursing Programs in Universities—were classified categorically by contents.
B．Organization of the equivalence between the lecture/seminar course and various practical trainings
Results:
Table 1. Collation of specialist education curriculum (lecture/seminar courses)
|
Educational contents based on the JANPU regulations |
Categories of theory and technique to be acquired |
Relevant Course |
|
1. Course on history/legal system |
[The roles and challenges of nursing including the characteristics of mental health problems and understanding of policy-based medicine] |
Advanced A－I |
|
2. Course on evaluation of mental and physical condition |
[Information gathering and assessment using a medical model, psychological model, and psycho-social model] |
Seminar A－II |
|
3. Course on mental health treatment techniques |
[Diagnostic/treatment techniques and theory and technique for specialist nursing practice] |
Advanced A－II |
|
[Treatment intervention techniques and support techniques for suicide, violence, traumatic stress] |
Seminar A－I |
|
|
4. Course on mental health nursing theory, support techniques |
[Self-treatment utilization in advanced nursing practice activities and theoretical background of the strength model/self-care model] |
Advanced A－III |
|
Seminar A－III |
||
|
5. Course on subspecialties |
[Psychological sociology regarding support and assessment of recovery in individuals with mental disorders] |
Chronic Mental Health Nursing |
|
[The roles and functions of liaison mental health clinical nurse specialists and support techniques] |
Liaison Mental Health Nursing |
Table 2. Correspondence table regarding the specialist education curriculum (practical training courses)
|
Educational contents based on the JANPU regulations |
Relevant Course |
Experience Contents |
|
1. Practical training on the role and function of clinical nurse specialists |
Practical Training A－Ⅰ |
Participation, observation, and experience of the roles and functions of mental health clinical nurse specialists in practice, consultation, regulation, ethical regulation, and education |
|
2. Practical training on mental health diagnosis and treatment |
Practical Training A－Ⅱ |
Participation, observation, and experience regarding diagnosis and treatment in the department of psychiatry from a physician or clinical psychologist |
|
3. Direct care at a medical facility |
Practical Training A－Ⅲ |
Practice of direct care with a patient with a mental disorder or their family |
|
4. Consultation/coordination practical training |
Practical Training A－Ⅲ |
Practice of consultation/coordination with a case covering problems in mental health nursing |
|
5. Direct care practical training in the field of chronic mental health nursing |
Practical Training A－Ⅳ <Chronic Mental Health Nursing> |
Practice of discharge support, lifestyle support, employment support, visiting nursing activities with a patient with a chronic mental disorder and their family |
|
6. Direct care practical training in the field of liaison mental health nursing |
Practical Training A－Ⅳ <Liaison Mental Health Nursing> |
Practice of the psychotherapeutic approach, nursing interview, self-care support, relaxation, and medication management with a patient with both a physical illness and mental challenges and their family |
Table 3. Correspondence table regarding the lecture/seminar courses and practical training courses
|
Educational contents based on the JANPU regulations |
Relevant Course |
Relevant Course |
|
1. Practical training on the role and function of clinical nurse specialists |
Advanced Nursing Eucation, Advanced Nursing Management, Theoretical Nursing, Nursing Research Method, Consultation in Nursing, Nursing Ethics, Nursing Policy, Advanced A－I |
Practical Training A－Ⅰ |
|
2. Practical training on mental health diagnosis and treatment |
Clinical Pharmacology for Nursing Practice, Physical Assessment, Pathophysiology, Advanced A－II, Seminar A－I |
Practical Training A－Ⅱ |
|
3. Direct care at a medical facility |
Advanced A－II, Advanced A－III, Seminar A－I, Seminar A－Ⅱ, Seminar A－Ⅲ |
Practical Training A－Ⅲ |
|
4. Consultation/coordination practical training |
Consultation in Nursing, Advanced Nursing Management |
Practical Training A－Ⅲ |
|
5. Direct care practical training in the field of chronic mental health nursing |
Advanced A－II, Advanced A－Ⅲ, Seminar A－I, Seminar A－Ⅱ, Seminar A－Ⅲ, Advanced A－Ⅳ<Chronic Mental Health Nursing> |
Practical Training A－Ⅳ <Chronic Mental Health Nursing> |
|
6. Direct care practical training in the field of liaison mental health nursing |
Advanced A－II, Advanced A－Ⅲ, Seminar A－I, Seminar A－Ⅱ, Seminar A－Ⅲ, Advanced A－Ⅳ<Liaison Mental Health Nursing> |
Practical Training A－Ⅳ <Liaison Mental Health Nursing> |
Conclusion:
Unique characteristics of mental health clinical nurse specialist education at our university are: ① liaison mental health clinical nurse specialist training and ② improving advanced practical nursing skills upon understanding of policy-based medicine.
Meanwhile, as those enrolled have diverse clinical experience and academic backgrounds, it is necessary to revise instruction based on student evaluations of classes and evaluations from practical training facilities.
Further, the creation of a support system available until application for certification as a clinical nurse specialist is considered an additional challenge.
The characteristics of curriculum structure and the significance of mental health clinical nurse specialist training at our university were revealed through collating the contents of lectures/seminars and various practical trainings.
We would like to make efforts to construct a unique educational system at our university based on evaluations from those enrolled and practical training facilities.