V5-1507: Nursing as a scientific discipline in Slovenia: An internationally comparable secondary and tertiary education system in nursing care as the foundation of research and scientific contribution to the sustainable development of society (CRP project)


15. 10. 2015 – 14.10. 2017


Faculty of Health Care Jesenice
UP Faculty of Health Sciences
Educational Research Institute
UM Faculty of Health Sciences
International School for Social and Business Studies
National Institute of Public Health

Project leader:

prof. Brigita Skela Savič (SICRIS, ResearchGate)

Project leader at UP Faculty of Health Sciences:

Assist. prof. Katarina Babnik (SICRIS, ResearchGate)



Introduction to the problem: On a European Union (EU) scale, the field of nursing education is governed by Directive 2013/55/EU of the European Parliament and Council, which was passed on 20.11.2013 and replaced Directive 2005/36/EC. International associations such as the International Council of Nurses (ICN), World Health Organisation for Europe (WHO for Europe), European Federation of Nurses (EFN), European Federation of Nurse Educators (FINE), etc. also focus on the field of nursing education. Their objective is mostly additional explanation of the minimal standards of education for nurses and midwives, setting the required education standards to a higher level and commitment to the importance of raising knowledge and the education level in nursing.

The strategic development of nursing in Slovenia 20122020 (Kadivec, et al., 2013) gives guidelines for vocational education in nursing on both secondary and tertiary levels. The most recent research on the educational needs of nursing was published in 2004 in research carried out by the Institute for Health Protection (Albreht, 2005), however it only defines educational needs on a tertiary level and not on a secondary level. In Slovenia, we have nursing education on two levels, secondary and tertiary. In the field of nursing education, as of yet there is no clear development perspective for education on two levels or on the scope of education on a secondary level. In Slovenia, we also do not have a tradition of education on a Master’s of Doctorate level in nursing. The fact of the matter
is that four Master’s programmes are implemented in nursing, the first started in 2007/2008, the graduates do not have the opportunity to get a job with a Master’s in nursing (level 7 EQF), which is equivalent to the position of Advanced Nurse Practitioner. The agreements of the development of specialisation in nursing has been ongoing from at least 2012, when the strategic development of nursing in Slovenia 20122020 (Kadivec, et al., 2013) was passed, however to this day no moves in the direction of defining the actual needs in a clinical environment have been made.

In addition, there is no developed national plan to increase employment of tertiary education staff in nursing in respect to demographic trends and decreasing the number of personnel with secondary education in nursing, despite the fact that the strategic development of nursing in Slovenia 20122020 is directed towards this change (Kadivec, et al., 2013). The OECD data on the number of nurse specialists per 1000 people (Buchan & Black, 2011) should also be a warning to politicians,professional associations and nursing management, on how to reach a satisfactory number of quality educated staff in nursing on a tertiary level and how to decrease the scope of secondary education. The data shows that Slovenia has 7.9 members of nursing staff for every 1000 residents (the OECD average is 9), of this only 35% are educated at a tertiary level, which shows that the share of nurse specialists is one of the lowest amongst countries included in the analysis.

Research problem: Slovenia falls into the category of badly organised nursing education systems on all levels, from the secondary to Doctorate level, when considering this we take into account the following: content and scope of education and competencies of graduates on an individual level and international comparability of the nursing education system as a whole. This slows down the development of nursing as a scientific discipline, which gives developed EU countries an important contribution to efficient and quality medical treatment and health care system as well as healthy society. An organised education system is this basis of every profession and is the basis for the development of the vocation as well as scientific discipline.

Purpose of TRP: is to establish an internationally comparable secondary and tertiary nursing education system which allows for the development of the profession and science, as well as setting the framework for the establishment of interdisciplinary research connected with nursing, which can have a significant influence on sustainability of social development.

TRP Objectives: 1. Prepare an analysis of formal education in the field of nursing in the EU, competencies gained for work and useful model for the development
and strengthening of nursing as a scientific discipline.
2. On the basis of research amongst key stakeholders in education and nursing and users of education, check the understanding of needs for
change in formal education and place research for the development of nursing as a scientific discipline.
3. Prepare a proposal for changes for secondary education in the health discipline, which by professional competencies will be comparable with
international professional guidelines.
4. Prepare an integrated competencies model for all levels of education in nursing, which by professional competencies will be comparable with
international professional guidelines.
5. Prepare a proposal for a national development model and strengthening of nursing as a scientific discipline which will be interdisciplinary and interprofessional as well as contribute to the recognition of nursing as a socialpolitical, socioeconomic and educational influence on the scientific discipline.
6. Popularise nursing as a scientific discipline in different target groups: on a general level, amongst young people, professions and researchers.

Methods: This project has 6 work packages (WP). WP 1 – Analysis of formal nursing education system in the EU; WP 2 – Research: “Understanding nursing education and integrated needs by renewing formal nursing education and placing a new competency model in RS that follows international guidelines”; WP 3 – Renewing the secondary model of education, taking into account international guidelines and results of WP 1 and WP 2; WP 4 – Integrated competency model for all levels of nursing education. WP 5 – National development model and strengthening nursing as a scientific discipline; WP 6 –Popularising nursing as a scientific discipline in different target groups: on a general level, amongst young people, professions and researchers. For the implementation of WP 1 we will use a systematic literature review. WP 2 will be carried as quantative nonexperimental research between actors in education (middle school, high school, employers) and amongst users of education (elementary pupils, secondary health directed pupils and students of nursing). WP 3, WP 4 and WP 5 will be implemented with the use of the focus group method.

Results: This project will collect 17 findings, which will be based on the scientific research approach. These findings are systematic analysis of practices in the EU, results of research on the understanding of healthcare as a scientific discipline and importance of understanding education on three levels (primary, secondary, tertiary) for the development of science in nursing, proposals for change in education will be made, a competency model on the secondary and tertiary levels of education will be made, a development model for nursing as a scientific discipline will be propose for the RS. Informing the professional and general public will be done through a website, viewing of short films on nursing as a scientific discipline, organising round tables and professional conferences, the project results will be shared on a national and international level.

Importance of project: The development and strengthening of nursing as a scientific discipline, their interdisciplinary research and cooperation with other disciplines, will influence more efficient nursing awareness, efficient dissemination of the scientificresearch results and popularisation of knowledge received from the research work. This project is very important for Slovenia and the international community due to the fact that Slovenia is in the group of countries where nursing as a scientific discipline is badly developed and as we are the EU member country with the least amount of tertiary educated nurses (OECD, 2013), with otherwise developed education on other levels, which is not implemented in the workplace and without a developed doctoral study programme. A country can promote itself as having successfully implemented an integrated approach in the field of managing issues in professions regulated by European Directives,
supported by proof and international recognition (WP 1), own evaluation of understanding nursing as a scientific discipline (WP 2), discussions conducted with key actors of change in nursing education on all levels (WP 3), prepared model of competencies for all levels of education (WP 4) and national development models and strengthening of nursing as a scientific discipline (WP 5). The results of this project will have a significant impact on the region; a characteristic of former Yugoslavian countries is that the nursing education system is unorganised and that nursing is not developed as a scientific discipline. This meant that strong emphasis has been put on secondary education in the then state, which when establishing an independent state was not developed to be internationally comparable also because of the established hierarchical organisational culture in nursing, which does not put the patient and their needs first, but rather the vocational group, where a dominant role is taken by medicine. The project will also allow for better international inclusion, as successfully implemented changes are always examples where a country with their experience can assist better efficiency of Europe and help solve similar issues in the EU and popularise
scientific research work of a scientific discipline and science as a whole. The project will give clear guidelines for the human resource development also from the standpoint of the education system on a secondary and tertiary level. The proposed changes will show in the shortterm, mediumterm and longterm needs for personnel in the education sector.

In addition, the developed system of competencies and national development model of the scientific discipline will give clear guidelines for employment policies, and human capital development in the next 20 years and plan for the reorganisation of job positions in health and social institutions and with this the clear needs for education on all levels. This project will also contribute to educating and informing elementary pupils in the third triade, who are deciding for a vocation, where one of the options is also a job in nursing. By presenting vocational work (short films), which includes professional and scientific aspects, the project will contribute to the good knowledge of the profession, the help of the counselling department, assist educators to efficiently inform and direct pupils and parents on nursing. This project will have a complex effect on the education sector, nursing sector and on society as a whole. Recognising nursing as a scientific discipline will assist with raising the level of education; research up until now has only strongly associated it with medical treatment. The model for developing nursing as a scientific discipline will be strongly connected with the education sector, academic environment and direct work in health and social sector, which is one of the objectives for popularisation of science and connections between basic and applied research work. This project will also contribute to the education and development of personnel throughout the whole education system, as with strengthening research work in nursing there will be more and more reason to develop the doctoral study programme, appropriate research efficiency will be reached, nursing will be recognised as a research field, where the results will contribute to social welfare. This is why politicians, with the help of the results of this project and further development and research work, will gradually recognise the importance of an internationally comparable education system, support it and include nursing as a profession and a science in discussions on important social questions in the fields of education and health.