UK training = dangerous?

ClaireMacl · Aug 24, 2005

Hi John,

First off, I qualified three years ago and we were told EBL was EVIDENCE based learning! I certainly was taught through a system of evidence based practice, I'm not sure where you've heard the term "enquiry"!

Yes, during my training, during class based time only, we were given specific topics and asked to present our facts to the class with references which could be shared with everyone, for example, I personally remember spending some time learning about schizophrenia and burns grading and immediate treatment. This was only within a small tutor group, each person presenting on an individual topic and others questioning the results. This, in my opinion, helped students improve their own research skills and how to present an opinion and back it up with fact. We also didn't do that as a majority, I can only remember about two days worth of learning being based that way and the study was independent and was not "funded" by the NHS or the college, but in our own time!

As far as exams and checking the "learning" we were acquiring, this was completely separate to the independent time we spent. As with most training courses, the majority of learning was within the lecture theatre environment and was continually monitored through exams and through tutor groups to ensure we were grasping the information, as well as lecturer practitioners meeting us on placements to gauge our learning and mark us accordingly.

You don't say where you trained. At my college, we used the Bondy system to grade our formal teaching in the practical environment. If you didn't meet the grade, as with every mentor/student relationship, you would be marked accordingly and a meeting with your personal tutor would ensue to discuss progress.

To be honest, I'm not sure exactly what your argument is.

As far as the current system goes, I would be inclined to argue for more clinical time and less tutorgroup time to ensure the safety of practitioners, since I remember the jump when qualifying, but I don't feel that was a fault of my college, rather the current training system.

You say the quality of material is bad, how so? What do you base that on?

My personal worry as a mentor is 2nd or 3rd year students who come onto placement and are unable to take a manual blood pressure or to report on saturation's which are 88% on a young, non COPD patient. I don't believe, however, that these are measurable within the college situation, rather the practical.

madwife2002, BSN, RN · Aug 24, 2005

Hi Claire,

Haven't time to answer in full but I can assure you that in Portsmouth and Southampton University EBL stands for Enquiry based learning., and it is a load of rubbish. Enquiry because you go away and enquire.

I trained the old fashioned way initially but I did my midwifery as a second qualification and at degree level, we did EBL. We were taught nothing and had to go away do the work and present it to the class. We were all mature nurses who had already been trained as RN's, so responsible you think, h ha no we did 1-2 hours work per presentation and spent the rest of the time enjoying ourselves, we soon found that you didnt have to do very much at all just print of a few sheets from the internet. One nurse did no research what so ever and made up all the stuff as she was presenting. half the time the tutors didnt turn up till late so hadn't a clue who presented what. We obviously had to do assignments but that was a different thing all together. At no time did we ever have a formal lesson and I am talking 2000. So if you get 18 yr olds and older straight from school you can only imagine what tricks they will pull :)

Scottish-Fee · Aug 24, 2005

Hi Claire

I finished my training in 2003, I trained in Scotland and EBL stands for Evidence Based Learning. It was a good way to do things some times because you had to back all your work up with refrences and you got quizzed by tutors!! I know in Scotland the girls are getting alot more time in the wards which I completley agree on as it is a huge jump but I also feel that it is up to their mentors to make sure they get the best out of the students and vice versa.. as alot of the time students are told to go and do obs but haven't got a clue what to look for..

It appears that training across the uk varies so differently and it really shouldn't because at the end of the day we are all nurses.. :uhoh3:

jjjez · Aug 25, 2005

EBL is not dangerous but unfortunately like most nursing theory it had to be invented albeit at short notice. It is poorly taught and the subject is crtainly not given the gravitas it needs i fit to be truly taken in and used as a format for learning and research.

The unfortunate outcome is that many students trying to use EBL and EBNursing, fuind that research rarely comes down on one side of the hypothesis, and certainly for their assignments, opting for one argument without lengthily describing its failures is a sure way to fail.

Like alot of nursing students i meet, their main complaints are that the course has borrowed heavily form sociology and psychology courses in an attempt to legitimize nursings' claim to the emotional well-being of it's patients at the expense of real science, whihch most in adult nursing will have to learn informally on the wards on in their own time.

ClaireMacl · Aug 25, 2005

I've finally been accepted onto the Mentorship course, I'll be interested to see if I can tweek information from this thread into a presentation... although its not necessarily going to change things, I do like kicking up a fuss

It's interesting to see that EBL means different things in different colleges, I trained at King's College, London and EBL was evidence based... how strange to see they call it "enquiry" and use different learning methods at different institutions! I thought P2000 was a way of consolidating the variations in nursing training, although I knew when I was training that P2000 was a pretty poor replacement, its amazing just how wide the variations are!

Jjjez, I was lucky, because I am a sociology graduate, I managed to APEL out of the sociology and psychology etc courses, from what I read from fellow students, I'm very glad I could!

jjjez · Aug 25, 2005

I've finally been accepted onto the Mentorship course, I'll be interested to see if I can tweek information from this thread into a presentation... although its not necessarily going to change things, I do like kicking up a fuss
It's interesting to see that EBL means different things in different colleges, I trained at King's College, London and EBL was evidence based... how strange to see they call it "enquiry" and use different learning methods at different institutions! I thought P2000 was a way of consolidating the variations in nursing training, although I knew when I was training that P2000 was a pretty poor replacement, its amazing just how wide the variations are!
Jjjez, I was lucky, because I am a sociology graduate, I managed to APEL out of the sociology and psychology etc courses, from what I read from fellow students, I'm very glad I could!

Ha! i was training at King's but I/we hated it thre. Many people left in my first year, not to quit but to transfer soewhere else, as has been the case for the past 3 years. I'm gonna finish at Kingston in February. Ah the lucky APEL, i got APEL'ed from a whole placement because i had spent nearly a year in a HDU. But people were APEL'ed if they had so much as set foot in a nursing home or baby sat children (Paeds students) and maybe even had a crazy friend!! (sic).

Scottish-Fee · Aug 26, 2005

Your lucky you got to opt out of some subjects! We didn't have the option we had to do it all no matter what experience we had! Also P2000 doesn't exist here anymore which im glad about because apparantly it was quite bad i missed doing it by 6months... :specs:

ClaireMacl · Aug 26, 2005

You hated it? That surprises me actually, I felt I got a great education at Kings, but as with everything, it depends on your tutors and the hospitals you are attached to... I spent 90% of my time at Tommy's, loved every minute, but was glad to get to a smaller hospital on qualifying, I like knowing all the staff

I done the two year graduate course, we, like you, had a huge dropout rate, but that was more because the two year course was so intense and they couldn't hack it, lol. I don't think I would have done nursing training if I'd have had to endure Sociology, Psychology etc after already doing it at degree level! I can't believe the rules have changed so much in three years that they apel people just because they have worked in a care setting, that's just rediculous.

Best of luck with the rest of your training!

Ha! i was training at King's but I/we hated it thre. Many people left in my first year, not to quit but to transfer soewhere else, as has been the case for the past 3 years. I'm gonna finish at Kingston in February. Ah the lucky APEL, i got APEL'ed from a whole placement because i had spent nearly a year in a HDU. But people were APEL'ed if they had so much as set foot in a nursing home or baby sat children (Paeds students) and maybe even had a crazy friend!! (sic).

ClaireMacl · Aug 26, 2005

One of my mum's friends was a primary "inventor" of P2000, I soooo wanted to have it out with her about the failings of the system after I started it, but since she'd retired, I bit my tongue!

Did you know P2000 originated with Scottish nursing lecturers? They made a wee mistake eh?

I done Pre-nursing in Glasgow in 1989, just before P2000 started, sadly I had such a bad experience that I thought nursing was the most thankless and maddest job out there for years.... on my first day EVER on the wards, with no clinical training, the sister in charge told me I had to independently catheterise a patient - I refused of course, but was met with the most negative response!!! Took me another 11 years before I figured that all hospitals were not like that one and finally took up formal training, lol.

Your lucky you got to opt out of some subjects! We didn't have the option we had to do it all no matter what experience we had! Also P2000 doesn't exist here anymore which im glad about because apparantly it was quite bad i missed doing it by 6months...

karenG · Aug 29, 2005

I trained pre P2000............ thank goodness!!

yep the training is awful now!! I get students for their community placement who think they have come for a rest......they turn up late,ask to leave early and ask such stupid questions!! was told by one student that you can take someones temp via the umbilicus............ unless there has been a new invention I have missed... I dont think so....!

remember though, when I trained, it was all work based learning. we spent 9 weeks in introductory block- learning how to make beds, give bedbaths etc then we were sent to the wards... so my group of 36 hit the wards in batches! we travelled in gangs- usually 6 of us allocated to a ward. we worked.. did the same shifts as the trained staff and did as we were told. this meant, bedbaths, obs rounds, making the beds, doing the back round.. then later changing drips, doing drug rounds (and you had to know every drug in the trolley and what it was for etc) then NG feeds.. taking people to theatre... gradually doing more until by mid second year you were left in charge while sister went to coffee! that was scary! but it meant we knew what we were letting ourselves in for!! I can still do a bedbath and make beds in my sleep! we didnt get weekends off- you usually got 1 weekend off in 10, nights meant 10 nights on and 8 off.. we worked our tails off!

what it meant was the wards usually had 2 sisters, 4-6 staff nurses, 4 or so SEN's, HCA's and about 20 students. so beds were made before coffee... patients were washed and dressed by coffee too. we did 4 back rounds a day and would have been mortified to send a patient home with a pressure sore (something I see only too often now) we knew our patients, they knew us and we didnt spend hours writing care plans... we spent hours delivering the care.

so .. I dont think students get the training we had, nor do I think they have half the fun we did!! getting sent for fallopian tubes to theatre.. or for a long wait on another ward.........yes a friend fell for that one!!

Karen

(getting off soap box now)

Fonenurse · Aug 29, 2005

Karen

Whilst I agree that our training was better, it isn't the fault of the students that what they get is c**p. What I would like to know is how we go about changing the system so that they get a much better training without any of the bad things we had - like 10 nights on duty in a row, being left in charge when we were not ready for it etc etc - there's no excuse for the 'see one, do one, teach one' mentality of our student days...

I do despair of the horror stories I hear, and I shudder when I start uttering the words "it was much better in our day" because I know I have crossed the line from in touch nurse to old fogie... :sleep: I also wonder, are we flogging the old dead horse or can we change things for the better? :deadhorse