RESUMO
Aim: We aimed to build consensus on a holistic critical thinking (CT) assessment tool involving cognitive skills and disposition for undergraduate nursing students in a socialist low-middle income country, Lao People's Democratic Republic (Lao PDR). Background: University degree nursing education program in Lao PDR has been started since 2011 to strengthen the ability to think as professional nurse, and nursing regulations have progressively developed last decade. However, there are still few studies assessing the CT ability of nursing students in Lao PDR. Design: Delphi study. Methods: We conducted three rounds of Delphi survey of 14 panel members consisting of nursing faculty members and clinical supervisors. The first and second survey rounds involved a combination of a series of questionnaires and face-to-face interviews to obtain ideas or opinions about descriptions of the CT assessment tool. The third round was the meeting with 13 panel members to reach a consensus on the descriptions of the CT assessment tool. Results: The number of descriptions changed from 29 to 30 under seven assessment criteria of the cognitive skills and from 34 to 32 under 10 assessment criteria of the habits of mind as disposition. The panel provided active comments on the descriptions in terms of social, cultural, and educational backgrounds. Especially the descriptions of criteria applying standards and creativity were discussed from practical viewpoints such as the hierarchical social structure in hospital, limited educational resources, and the cultural value of harmony. Conclusions: The holistic CT assessment tool that resulted from the consensus is anticipated to help Laotian nursing educators to assess undergraduate nursing students' CT ability more efficiently with confidence at both the university and hospitals continuously. Subsequent implementation of the CT assessment tool in a socialist low-middle income country is warranted.
RESUMO
Strengthening nursing leadership in health systems has been identified as a priority for achieving Universal Health Coverage (UHC). We aimed to analyse the characteristics of Japanese technical assistance projects for nursing human resource development in Lao People's Democratic Republic (Lao PDR) and suggest directions for future assistance. An upgrading program, as part of human resource development, was initiated in the 1990s; it has contributed to the development of nursing leaders. Moreover, technical assistance from development partners has had synergistic effects by consistently promoting the involvement of nursing leaders in administration, education, and clinical practice to establish a functional regulatory system. In resource-limited settings, the application of both edge-pulling (leadership development) and bottom-up (quality improvement of the mass population) strategies are required. From a long-term perspective, development partners should continue to invest in increasing the number and quality of nursing leaders by upgrading the courses and leadership training programs, starting from the younger generation.