Integrated course assessments in an undergraduate nursing program.

Curriculum integration is a partnership amongst multidisciplinary members to create a cohesive curriculum and improve education. Basic and clinical science integration helps students learn deeply. Integrated curricula facilitate students to become lifelong learners. It encourages critical thinking and clinical reflection and helps students become active, self-directed learners. A comprehensive integrated exam was conducted at Aga Khan University, School of Nursing and midwifery to establish meaningful learning and enhance theoretical knowledge application in clinical practice, using competencies from four different courses in second year of study. Comprehensive Integrated Exam prepared students to assess a client and design complete nursing care based on health assessment, adult health nursing, pharmacology, and pathophysiology course concepts. This integrated exam was very effective as 97 % of students who took the exam passed on their first attempt. Faculty members involved found the comprehensive integrated exam a successful strategy to evaluate students learning, whereas the students related that this exam helped them to bridge the gap between applying theoretical concepts from different courses to clinical practice.

Perceptions, knowledge and attitudes towards the concept and approach of palliative care amongst caregivers: a cross-sectional survey in Karachi, Pakistan.

BACKGROUND: Limited comprehension of the concept of palliative care and misconceptions about it are barriers to meaningful utilisation of palliative care programs. As caregivers play an integral role for patients with terminal illness, it is necessary to assess their perceptions and attitudes towards the palliative care approach. METHOD: A cross-sectional survey was conducted. Data was collected from the Aga Khan Hospital in-patient and out-patient departments and home-based palliative care services. All adult caregivers who met the inclusion criteria and consented, completed a questionnaire till the sample size was reached. Univariate and multivariate multivariable analysis was done and results were reported as crude prevalence's, crude and adjusted prevalence ratios with 95% confidence intervals using Cox-proportional hazard algorithm. Mean difference of knowledge and attitude scores by caregiver variables were assessed using one-way ANOVA. SPSS version 18 was used and a p-value of less than 5% was treated as significant. RESULTS: Out of 250 caregivers more than 60% were 40 years or less, majority were males and at least graduates. Approximately 70% of the respondents agreed with the statement that the person suffering from cancer should be informed about the diagnosis and disease progression. About 45% (95% C.I.: 39.03, 51.37%) of the study respondents had enhanced understanding about palliative care. Individuals under 40 years old, those with an education level of at least grade 10, children or relatives were found to have significantly more enhanced knowledge about palliative care. The majority believed that the patient should be informed about the diagnosis and should be facilitated to carry out routine activities and fulfill their wishes. CONCLUSION: Nearly half of the caregivers had enhanced understanding of the palliative care approach. They showed consistent understanding of two foundational aspects indicating correct knowledge across age groups, gender, education level, and relationship with the patient. Firstly, that palliative care should be offered to everyone suffering from a terminal illness and, secondly, that this approach encompasses not just physical, but also psychological and social needs of the patient and the family. These findings will help inform the establishment of a palliative care program that fills the gaps in comprehension and knowledge of caregivers.

Challenges in Teaching Palliative Care Module Virtually during COVID-19 Era.

With the COVID-19 pandemic hitting the global community, routine activities of universities, offices, and industries have been hindered. People are being forced to rethink the ways of working virtually from home for providing education, business, and health services in this social distancing during the COVID era. This sudden shift also posed challenges of online teaching in a private university, in urban Karachi, Pakistan. The Aga Khan University, School of Nursing and Midwifery recently conducted an online palliative care module using a virtual learning environment and Microsoft Teams for Trainee Nurse Interns. Although the first experience of online teaching and learning was a successful venture for faculty and students, in a lockdown situation, numerous challenges were also encountered being a lower middle-income country. The issues of electricity shutdown, Internet connectivity, and quality assurance were anticipated on transition to online pedagogy, but backup plans were formed to make execution promising.