India revises curriculum of nursing degree programme

From January 2022, the syllabus for India’s BSc nursing degree programme underwent a complete overhaul, with emphasis placed on nursing skills and a competency-based framework. It is the first revision to the programme since 2004.

The new BSc nursing degree programme, designed by the Indian Nursing Council in collaboration with expert nurse educators, is a four-year full time programme comprising eight semesters, which prepares students to practice nursing and midwifery in a variety of settings in India and abroad.

HMi caught up with key figures behind the new syllabus.

HMi: What is the background to the syllabus change?

Nurses and nursing professionals constitute about 75% of the workforce in Indian healthcare, which makes nursing an important sector within the healthcare sector for a country with a population of over 1.3 billion.

Over many years, the Government of India has enhanced its focus and investment in the nursing sector; as part of the 12th five-year plan (2012 – 2017) it proposed an investment in nursing of US$427m. Yet, according to NITI Aayog, the national planning body, India currently faces a shortage of two million nurses or nursing professionals.

Providing quality nurse education is thus a priority to manage healthcare demands.

‘The new Nursing curriculum focuses on competency development. It will enable the nursing students to develop essential competencies in cultural diversity, communication technology, teamwork and collaboration, safety, quality, and evidence-based practice.

The content of the curriculum is very broad and has included all the latest concepts and recent developments. Nursing informatics and forensic nursing are two newly added subjects. The mandatory modules will empower the students with lifesaving skills.’

Dr Latha Venkatesan, Principal, AIIMS College of Nursing, New Delhi

HMi: What is the overall purpose of the change? And how will the new curriculum achieve those aims? In other words, what are the most significant changes and what tools/processes are being introduced around the changes?

The new curriculum aims to produce ‘knowledgeable competent nurses and midwives with clear critical thinking skills who are caring, motivated, assertive and well-disciplined in responding to the changing needs of the profession, the healthcare delivery system and society.’

Another unique feature of the curriculum is to encourage students to make independent decisions in nursing situations within the scope of practice, protect the rights of individuals and groups and conduct research in the areas of nursing practice and apply evidence-based practice. As diverse career choices are evolving, the new curriculum aims to equip nurse graduates to take up careers in all healthcare settings.

The new curriculum adopts credit system and semester system with minor modifications suitable to professional education in a hybrid form. Modular learning is also integrated in the foundational as well as mandatory core courses. The programme prepares nurses and midwives for generalist nursing including midwifery practice. Knowledge acquisition related to wellness, health promotion, illness, disease management and care of the dying is core to nursing practice.

Mastery in competencies is the focus. Students are provided with opportunities to learn a complete range of skills in addition to acquiring knowledge related to nursing practice (nursing and midwifery). This is achieved through learning in skill lab/simulated lab and clinical environment. Simulation will be integrated throughout the curriculum wherever feasible to enable them to develop competencies before entry into real field of practice.

‘The BSc Nursing program encompasses foundational, core and elective courses integrated with modular learning. The curriculum embraces competency-based and outcome-based approach through mastery learning and self-directed learning.

The students assimilate and synthesize knowledge, cultivate critical thinking skills, and develop care strategies in areas of cultural diversity, communication technology, teamwork and collaboration, safety, quality, therapeutic interventions, and evidence-based practice. Preparing nurses to provide safe and competent care to patients across their life span and influence patient outcomes.’

Dr Sheeja CV, Principal, Aaffinity College of Nursing, Bangalore

HMi: How does the new curriculum attract new students?

Nursing is one of the most sought after careers in India, primarily because of the opportunities for  graduates to work in high income countries. There are over 2,000 BSc nursing colleges in India with an annual enrolment of more than 100,000 students. The global shortage of nurses and the pandemic scenarios have made nursing a high paying career option for nurses trained in India. The new curriculum has brought the BSc nursing programme in India up to date. It is modern, relevant, and globally competitive.

The clinical exposure and skill emphasis in the syllabus would make the programme even more attractive to students as global nurse recruiting healthcare organizations would increasingly recruit nurses trained in the new curriculum. The growing private healthcare and public healthcare systems also provide great opportunities for skilled graduates within India.

The new curriculum equips them to quickly join the workforce. All 2,000 colleges are mandated to follow the new syllabus.

‘The new syllabus is based on a Choice Based Credit System. So, credit transfer is possible between countries. Students have an opportunity to select the modules based on their area of interest.

The new curriculum is a competency based curriculum, which focus more on outcomes. Additional modules such as health Informatics and Forensic nursing are added in new curriculum.’

Dr G Balamurugan, HoD, Department of Mental health nursing. Ramaiah Institute of Nursing Education and Research, Bangalore

HMi: How does the new syllabus prepare nurses for the changing healthcare environment?

The post Covid world needs a large number of nurse professionals who are able to handle the technological changes transforming healthcare. Care delivery for a vast and populous country like India is even more challenging in a post covid scenario. Telemedicine and remote care are the new normal and are fast emerging as a prominent segment of care delivery. The new curriculum introduces Informatics in the second semester and provides an in-depth understanding of technology integration in healthcare supported with practical labs.

The new curriculum is designed to develop the following ten core competencies which would equip students to develop skills required to excel in the evolving healthcare environments.

  1. Patient centred care Provide holistic care recognizing individual patient ‘s preferences, values and needs, that is compassionate, coordinated, age and culturally appropriate safe and effective care
  2. Professionalism Demonstrate accountability for the delivery of standard-based nursing care as per the Council standards that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles
  3. Teaching & Leadership Influence the behaviour of individuals and groups within their environment and facilitate establishment of shared goals through teaching and leadership
  4. System-based practice Demonstrate awareness and responsiveness to the context of healthcare system and ability to manage resources essential to provide optimal quality of care
  5. Health informatics and Technology Use technology and synthesize information and collaborate to make critical decisions that optimize patient outcomes
  6. Communication Interact effectively with patients, families and colleagues fostering mutual respect and shared decision making to enhance patient satisfaction and health outcomes
  7. Teamwork and Collaboration Function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared decision making, team learning and development
  8. Safety Minimize risk of harm to patients and providers through both system effectiveness and individual performance
  9. Quality improvement Use data to monitor the outcomes of care processes and utilize improvement methods to design and test changes to continuously improve the quality and safety of healthcare system
  10. Evidence based practice Identify, evaluate and use the best current evidence coupled with clinical expertise and consideration of patient ‘s preferences, experience and values to make practical decisions