The number of participants able to attend all or part of each workshop was influenced by clinical demands at the time and ranged from nine (Workshop 3), to 16 (Workshop 2) and 21 (Workshop 1).
The data formed eight categories that fell within two main themes. These two themes are summarised in the two matrices presented in Tables 1 and 2. Matrix 1 [or theme 1] (Table 1) harmonises the first two categories: the mandatory factors that shape postgraduate nursing curricula in Australia and the need for a unifying model of nursing practice across educational contexts. Matrix 2 [theme 2] (Table 2) systematically articulates the remaining six categories. These cover the principles and processes that should be thought-out when developing and delivering emergency nursing curricula. These include good practice principles of professional learning; types of professional learning; stakeholder terms of engagement; scaffolding of teaching and learning; harnessing the diverse contexts of learning; and assuring course quality. The data were also drawn on to develop an interim framework (Figure 2). The categorised data were also provided to participants for review and feedback.
The two matrices aligned the postgraduate emergency nursing education goals and curriculum development processes of the local health care service industry, national health care regulators and national higher education bodies, as well as the professional learning and credentialing needs of students and their employers. A robust thread running through both themes was the importance of work-integrated learning to prepare postgraduate students for practice. The culmination was mutual agreement of an operational framework to optimise learning of emergency nursing based on an academic-industry-student collaborative approach (Figure 2) as well as the creation of a graduate certificate in emergency nursing curriculum exemplar. This led to establishment of principles to guide future curriculum development, implementation and evaluation.
Five guiding principles (Figure 1) of curriculum development, implementation and evaluation were then established to inform the processes subsequently used in the study. Beneficial in the establishment, maintenance and development of a co-curricular distributed leadership partnership, the principles demarcate and represent the evolutionary steps involved in moving through design and creation phases to achieving capability with tangible outcomes and future direction. Emerging from curriculum development milestones and processes undertaken during the workshop series, the principles articulate the architecture of collaborative, linear and iterative scaffolded processes through which participants can transition while designing and constructing sustainable and suitable curricula. As such, a key outcome of Workshop 3 was the finalisation of a clinical-academic integration strategy and framework construction. This resulted out of a consortium approach of distributed leadership and jointly-determined, fully-articulated, fit-for-purpose roles for industry, university and student roles – the third principle.
However, to achieve capability, it was determined that respectful relationships between industry and academe must be maintained, and that affiliations that embedded joint mentoring and capacity building processes must be established. This would ensure a viable longer-term teaching and learning community of practice. To ensure robust development and delivery, successful postgraduate curriculum transformation also relies on health service provider engagement in appropriately-resourced academic activity. These were the final two guiding principles, delineated with the intention of providing future recommendations. The adoption of five guiding principles potentially supports the sustainable implementation of co-curricular partnerships.
Matrix 2 (Table 2) captures expectations of the various stakeholders with respect to learning and teaching quality and enhancing student employability. The participants considered it essential that all stakeholders understand and articulate the good practice principles of nursing curriculum development and delivery before they determine teaching and learning processes. Participant summaries generated through workshops are represented in Table 2 and Figures 1 and 2.
Process issues were also important for participants, as summarised in Matrix 2. They encouraged stakeholders to formulate agreed terms of engagement from the outset. For example, explicit discussions occurred about who should be involved in the professional learning agenda, how to identify and resolve health service, university, credentialing and regulatory issues, articulation of enablers, barriers and solutions to engagement, the most desirable timing and format of joint communications, and how best to enact distributed leadership taking place before course development. It was also considered important to tease out technical issues, such as how best to scaffold learning. Participants further identified that workable cross-institutional ways of ensuring learning and teaching standards and undertaking mutual peer review and moderation were essential to ensure courses met student needs. While resolution of these issues was beyond the scope of this study, these notions certainly warrant further research as to how they might be achieved.
Graduate certificate of emergency nursing curriculum exemplar
In harmonisation with the principles and objectives that transpired through creation of a framework, an exemplar Graduate Certificate of Emergency Nursing was developed. Key facets were also delineated as part of the second matrix. It is positioned as a course outline that can be used by any health service or university, an instrument that guides the development of learning and teaching strategies and curriculum content [10].
A fit-for-purpose university-industry integration framework
An important issue identified during workshops was the need to harmonise regulatory and other imperatives, while ensuring that course content and level of learning are congruent with the student’s target level of nursing practice. In essence, the course should overtly and systematically prepare the nurse for either specialty emergency practice, advanced emergency nursing practice or for a nurse practitioner position. Participants further identified that postgraduate education is often undertaken to enhance employability. Hence, successfully-completed courses should readily help students to progress through the levels of practice embodied in the nursing career structure. Workshop consensus was that to ensure harmonisation and to assist career progression, a unifying model of nursing practice that accurately reflects the target practice profile and maps to the career pathway is needed. This would underpin all postgraduate courses, irrespective of whether they are offered by universities or health services. Subsequently, a university-industry integration framework (Figure 2) was developed, to represent the structures, processes and outcomes required in developing and delivering postgraduate nursing courses that are co-created in university-industry service provider partnerships.