Southeast Asia has a nursing shortage, and one of the lowest graduation rates of new professionals, according to a new World Health Organisation report. The region has fewer than 17 nurses serving every 10,000 people – one of the most severe shortages in the world.

Singapore Institute of Technology (SIT) is countering this trend with courses that combine hard knowledge, soft skills, and a polished curriculum.

GovInsider spoke with Associate Professor Elaine Siow, faculty with SIT and part of the team that developed the institution’s joint degree programme in Nursing with the University of Glasgow, to find out what’s needed to foster a new generation of nurses.

The nurse’s toolkit

Skilled, well-trained nurses provide better care and collaborate with other members of the healthcare team to improve the level of healthcare provision available to all.

But educating the next generation of nurses is a herculean task. “It’s not possible to teach them everything, mainly because we don’t really have all the answers to the world’s problems and, the other thing is, knowledge is constantly evolving,” concedes A/Prof Siow.

If there is one thing an educator must impart, however, it is the ability to identify problems and find solutions to address the problem. “What are the clinical problems? What is the service gap and how do we find appropriate solutions to address the evolving needs of the population?” emphasises A/Prof Siow.

For this, evidence-based practice is essential. This entails being able to critically analyse the literature, identify the best evidence from studies, adapt them to the clinical setting and evaluate their effectiveness on the local population. When providing evidence-based care, nurses have to take into consideration patient preferences and values in order to deliver quality care to achieve the best patient outcomes.

In SIT, students are taught “research methods, [which] help them develop the skills and knowledge to conduct research in a clinical setting and critique the literature,” explains A/Prof Siow.

Soft skills are equally essential. Every day, nurses deal with “life-threatening, life-changing events [and] helping patients cope with their medical conditions”. Characteristics like empathy, compassion, the ability to assess and evaluate patient conditions, enable nurses to understand their needs and deliver the best care to patients.

In SIT, students pick these skills up through clinical placements and specialised modules. For instance, the Health Assessment and Clinical Reasoning module “relies on role play to instill empathy and compassion through therapeutic communication skills,” A/Prof Siow says.

New modules for new realities

SIT’s curriculum is designed to equip students to deal with wider issues, such as the public health crisis we are facing now. One example is its Health Systems Module, which covers different healthcare systems and prompts students to consider issues from regional and international perspectives. “Things do not just happen in Singapore, and there are many factors that can influence health and well-being,” says Prof Siow. “Health issues that happen outside the country can have an impact on Singapore, just like what’s happening now with Covid-19.”

The nursing curriculum also ensures that students grasp the impact of emerging technologies on healthcare. The Healthcare Innovation Module encourages students to think critically about how technology can enhance and impact patient care. Students learn about various technologies that are being used in Singapore such as mobile health and telehealth — which has gained relevance given limited hospital visitations during Covid-19 — and artificial intelligence.

The Healthcare Innovation Module even allows students to develop tech solutions of their own. Over a two-week clinical placement in a nursing or elderly care home, students identify pain points and develop prototypes to resolve these issues (e.g. a sputum trap device on tracheostomy and handwashing reminder alerts).

Adapting nursing education to Covid-19

Institutions must urgently adapt to the remote conditions and limitations placed on hospital visitations during Covid-19. Nurses are more vital than ever, so training providers must continue to ensure that they qualify. Existing e-learning and simulation technologies can help students continue to polish their clinical nursing skills.

“During Covid-19, we made use of teaching and learning activities such as synchronous and asynchronous blended online learning approach,” says A/Prof Siow. Students can access pre-recorded lectures and participate in interactive online tutorials and discussion forums from their homes. While placements have been put on hold, SIT is considering inviting experienced nurses to share clinical experiences virtually, and developing other modes of applied online learning to supplement students’ learning.

The use of simulation labs augments this learning experience by allowing students to “practise the health assessment skills on machines rather than on actual patients, thereby replicating hospital conditions. As part of their learning, students are also required to make an assessment based on a clinical case scenario and document their findings,” says A/Prof Siow.

According to the United Nations, Covid-19 threatens to undo decades of progress in healthcare delivery. Now more than ever, more highly-skilled nurses need to answer the call. Nursing education, as the first port of call, must leverage on innovative practices to prepare the next generation of nurses for the arduous task ahead.

This article was first published in GovInsider. Image by cecil miller.