The training of nurses in this country has been, over the years, worrying, to say the least. There are some concerns, which began to arise around 2010 that still niggle. One might recall that this was the year a World Bank study highlighted “sub-optimal quality of training” in Guyana and noted that nursing students were allowed to write their final exams three times.
Four years later, in 2014, just 19 student nurses of the 120 who wrote the final exam passed. Moreover, that 120 had been whittled down from an original intake of 255. It didn’t end there. In 2016, after the state final exam was completed, it was declared compromised; there were rumours that students had cheated. The nurses were allowed to resit that final in February 2017 and only 23 were successful out of a reported 179 students.
Less than two years ago, in May 2021, the Ministry of Health had suspended classes at the Charles Rosa School of Nursing In Linden. It had claimed that places were discriminatorily awarded to applicants from Region Ten to the detriment of potential students, who had been identified as eligible for training from regions One, Seven, Eight and Nine.
The reasoning behind this move was extremely disturbing as the Health Ministry proffered no grounds why those potential students could not be accommodated at the Georgetown or New Amster-dam schools. It did say that it would “review and balance” the intake before classes resumed. One assumed this meant removing some students who were already accepted and replacing them with those purportedly left out. There has been no indication whether this plan was actually carried out. Ideally, the nursing schools should be removed from the remit of the Health Ministry and absorbed by the Ministry of Education, but there is nothing ideal about this situation is there?
Fast forward to 2022 and we heard Dr Anthony spout a lofty goal of training 1,000 nurses a year to address the local shortfall, in his end-of-year report. This initiated some amount of head shaking, not only when held up against the 2021 suspension action, but the situation regarding nursing education as recently as 2017.
Notwithstanding all that, Minister Anthony is ploughing full steam ahead. In response to a question asked by his opposition counterpart Dr Karen Cummings, on Thursday last in the National Assembly, he reiterated the intent to soon be able to train 1,000 registered nurses (RNs) a year. Further, he was quoted as saying that the RN programme will be moved from the classroom to a virtual format and that this would be done in partnership with the online education platform Coursera.
Perhaps the minister was misquoted, and one sincerely hopes this is the case, as there is no nation in the world that would voluntarily switch its classroom RN programme to online. There are, of course, very many universities that offer an online bachelor’s degree in nursing, but it is always supplementary to, and alongside the traditional classroom format. Incidentally, Coursera advises that prerequisites for entry to the RN programme include completing high school with passes in biology, chemistry and maths. For the bachelor’s degree, prospective students need a GPA of 3.0 or higher, and 2.0 to 2.75 for the associate’s degree.
Meanwhile, there are other ramifications that surround Dr Anthony’s proposed online RN programme. The most obvious problem is students experiencing a blackout or internet failure – both of which are par for the course here – in the middle of an online Zoom class, or worse yet, an exam or quiz that is being timed.
In reality, the best option for an online RN programme in Guyana would be a blended one where students access academic learning virtually, but have hands-on clinicals. Much thought would be required in this scenario, however, to bridge the considerable chasm between the theory taught by foreign professionals and the practical experience the students would have. While some universities are offering virtual simulation of patient care, that can never replace the actual experience at a bedside.
Then there is the issue of accreditation. A cursory glance at what is available online reveals that not all programmes have the same quality and competent course content; some are non-accredited. The latter tend to be less expensive. Local students need to pay close attention, therefore, to what they are being offered.
It is worth noting here that as a member of Cari-com, Guyana’s medical, dental, veterinary and degree nursing education programmes should be accredited by the Caribbean Accreditation Authority for Education in Medicine and other Health Professions (CAAM-HP), which was established in 2003 under the aegis of Caricom. According to its website, the University of Guyana School of Medicine was accredited by CAAM-HP with conditions from 2017-2022. The body said it had concerns as regards staffing: the role of guest lecturers and residents as teachers. It also said that UG’s quality assurance mechanism needed improvement. There is to be a site visit this year.
Last but certainly not least, Caricom has a Regional Nursing Body, which has collaborated on the development of a Regional Examination for Nurse Registration that is managed by the Caribbean Examinations Council. It would be of interest to learn if this has been factored into the proposed online RN programme and also whether the local Nursing and Midwives Council has been consulted.
