Programme description for Master in Advanced Practice Nursing – Clinical Nurse Specialist (2023–2025)

Upon completion of the programme, students will have the following knowledge, skills and general competence:

• specialised nursing with a specialisation in anaesthesia, intensive, theatre or paediatric nursing that ensures functionality and professionally defensible specialised nursing care for appropriate patient groups
• research and development experience enabling them to participate actively in research and development in the field of specialised nursing

Knowledge

The student

• • will demonstrate in-depth knowledge about the specialised nurse's functions and responsibilities
• will demonstrate advanced knowledge about various directions, designs and methodological approaches in clinical research
• will demonstrate advanced knowledge in medical and natural science topics and specialised nursing for specific patient groups
• will demonstrate advanced knowledge in the individual's behaviour and reactions in connection with acute and/or critical illness and suffering related to age and background (patients, their families, health personnel)
• will demonstrate in-depth knowledge on how to observe, identify, and assess the patient's general and specific needs in the event of the failure or threat of failure of vital functions
• will demonstrate in-depth knowledge about functionality, controlling, maintenance, and application of appropriate medical equipment in a safe and sound way
• will demonstrate in-depth knowledge on how to identify various ethical dilemmas and how to reflect and act in difficult ethical situations

Skills

The student

• is able to initiate and undertake an independent, focused research and development project with supervision and in accordance with current research-ethical guidelines
• is able to relate critically to and apply different theoretical scientific directions, methodological approaches and design
• is able to debate and communicate the relationship between theory and empirical evidence
• is able to carry out professionally sound specialised nursing care in accordance with health legislation requirements for professionalism, knowledge of the subject matter and values
• is able to carry out advanced specialised nursing care in accordance with the specialised nurse's areas of functionality and responsibility
• is able to apply advanced knowledge about medical and natural science topics and specialised nursing based on clinical experience by demonstrating the ability to compensate partially or completely for failure of the patient's vital functions
• is able to apply advanced knowledge about the individual's behaviour and reactions in connection with acute and/or critical illness and suffering, related to age and cultural background (the patient, family and health personnel)
• is able to take responsibility for infection prevention to the patient, their surroundings, equipment and personal hygiene
• is able to take responsibility for employing modern medical technological equipment safely and securely

General competence

The student

• is able to communicate and disseminate an independent, focused research and development project
• is able to contribute to innovation
• is able to analyse and apply knowledge and skills in specialised nursing in new areas and unfamiliar situations
• is able to disseminate and communicate professional specialised nursing with different specialists in the field as well as the general public
• is able to communicate and disseminate his/her own values and attitudes, and take independent positions on ethical dilemmas in the profession
• is able to analyse and apply knowledge about the general and specific needs of the patient and their families

• demonstrate an ability to act by analysing and partially or completely compensating for failure of the patient's vital functions

  • collaborate constructively in stressful and conflict-ridden situations

Requirements for admission to the master's programme in special nursing with the majors anaesthesia -, pediatric -, intensive care - or theatre nursing include possession of a bachelor´s degree in nursing (180 credits), and at least two years of practice as a fully employed authorised nurse.

Admission is given according to the University of Agder´s regulations for admission to master programmes and continuing education (http://www.lovdata.no/cgi-wift/ldles?doc=/sf/sf sf-20051214-1750.html) with supplementary rules for admission to the Master´s Programme in Special Nursing.

Applicants who have passed continuing education in anaesthesia, paediatric, intensive care or theatre nursing (90 ECTS credits), may transfer credit into the master's programme. Courses with the same contents and at the same level may be approved after individual application and evaluation.

The purpose of the master's programme is to educate highly qualified professionals who can deliver specialised nursing services in a high-technology environment to patients of all ages who will undergo surgery, have sustained an injury, have an acute or critical illness or are experiencing a deterioration of a long-term illness, while supporting their families. The programme meets demands for specialised nursing and is in accordance with health legislation requirements for professionalism, knowledge of the subject and professional values.

The programme will work toward increasing theoretical, practical and research-based knowledge in specialised nursing and lay the foundation for the nurse to apply relevant research and contribute actively through direct contact with patients, education, research and professional development. The specialised nurse will also be skilled in critical analysis, reflection and research-based approaches to the subject.

The master's thesis is a central part of the programme, and is an independent scientific project in nursing with a major in anaesthesia, paediatric, intensive or theatre nursing, where students must employ relevant research and have the opportunity to contribute to research and development.

In order to sustain and develop the nurse's skill and performance, the study programme builds upon the national curriculum for continuous education in anaesthesia, paediatric, intensive and theatre nursing, 2005. A course booklet with further course descriptions will be made available to students at the start of the semester through the university's learning management system,.

The programme consists of general courses and specialised major courses. The general courses will provide insight into qualitative and quantitative research traditions and methods that are particularly relevant to research, development and quality improvement initiatives in the health profession in general, and work with acutely or critically ill patients in particular. The major courses will provide insight into topics such as experiences, reactions and coping strategies for being acutely or critically ill, and subject-specific topics related to providing nursing in the different majors. The master's thesis is an independent scientific work in specialised nursing. Clinical studies make up 45 ECTS credits of the programme, and appear as individual major courses.

The courses cover the national curriculum's main courses 1 to 3:

• Nursing professional specialisation and social science courses (general topic areas)
• Medical and natural science courses with majors in anaesthesia, intensive, theatre or paediatric nursing (general and subject-specific topics)
• Specialised nursing - professionalism (major topics)

Philosophy

The programme builds upon a sociocultural view of learning that emphasises learning as a group activity and social practice. Learning presumes that the student works independently, but that learning also occurs through collaboration with others in a learning community that includes fellow students, teachers and others.

Learning is also understood to be constructionist, meaning that the learner must construct his knowledge through his own activity. The idea is that students learn the best when they commit to other students, teachers and other people, and when their learning is coordinated so that they work thematically and restricted in terms of time and space. The constructionist premise implies that the learner constructs his own understanding of the subject matter, presents it in public and receives feedback on his draft quickly so that he can further construct his insight. In the learning community, feedback, formative evaluation and supervision are central activities that promote further learning.

Learning is seen as a process where the goal is an altered understanding of knowledge, behaviour and attitudes. Teachers, practitioners and students have joint responsibility for creating a good and open learning environment which contributes to personal and professional development and also affects the results.

Work methods

The programme stresses the integration of theoretical knowledge and clinical experience, emphasising varied teaching and work methods and close contact with each individual student. Feedback is given throughout the programme in the form of various assessment discussions, several short tests and submission of assignments.

Various methods requiring student participation are used, such as web based teaching, group work, seminars, reflection and tutorial groups, simulations, clinical studies and independent study. Lectures are also given.

While working on the master's thesis, students participate in various tutorials and seminars. During these sessions, progression on the master's thesis is the main focus, including presentation of research questions and choice of methodology, with responses from fellow students and teachers.

During the clinical studies, functionality and reaction ability in specialised nursing is achieved. Students will develop competence in knowledge-based practice. Specialised nursing of the acutely and/or critically ill requires, among other things, a solid base of knowledge to enable acquisition of the skills necessary to swiftly gain an overview of the patient's situation, make quick decisions, enact and evaluate initiatives, at the same time making ethical evaluations throughout the process.

To achieve this, supervision is provided in the form of an "apprenticeship," reflection groups, reflection notes and integration of research-based knowledge in collaboration with practical placement supervisors, teachers and fellow students. In order to develop active skills as a specialised nurse, continuous shifts between theoretical specialisation and competence development in the clinical field will be made.

Functionality can be described as having methodical, academic, social and learning competence. These four elements are developed through theoretical and clinical studies, and make up what is referred to as active competence (Pettersen og Løkke, 2004).

Methodological competence refers to knowing how and why. Explore and justify actions.

Academic competence refers to the systematic ability to observe, analyse and reflect upon academic theoretical understanding and insight.

Social competence refers to the ability to establish, cultivate and maintain relationships. In the master programme, this refers to colleagues, patients and their families.

Learning competence refers to "learning to learn." This implies the ability to solve new and unfamiliar problems based on previous experience and new knowledge.

(Pettersen og Løkke, 2004)

Students in the master's programme are already authorised nurses with advanced competence gained through education and practice, and they posses knowledge gained through experience. Research shows, among other things, that knowledge gained through experience is connected to concrete actions in concrete situations, examples and stories. Work methods throughout the programme are therefore based on both a theoretical presentation of issues in the profession and reflection upon the students' own experiences in the field, as well as the experiences of others. In clinical studies, lectures and groups, students will problematise, reflect upon and to a certain degree practice methods that are important to clinical specialised nursing.

A variety of forms of assessment are used in order to ensure a connection among the various courses learning outcomes and work methods, and to ensure the quality and completeness of the programme.

Theoretical courses are assessed through written examinations, take-home examinations and portfolio assessment. In the portfolio assessment the student hands in individual assignments which are then compiled in a portfolio for a final assessment. This allows for a greater degree of individual initiative and effort, which is an important aspect of the programme. Compulsory attendance is required for parts of the teaching. Most theoretical courses are assessed using grades A-F.

Clinical studies are assessed through formal discussions, described in further detail in the course booklets for the master programme. The discussions are between the student, teacher and placement supervisor, and their purpose is to provide a written evaluation of the student regarding the prescribed learning outcomes. Compulsory attendance of at least 90% is required in the clinical studies, and various examination requirements such as reflection groups and reflection notes must be approved to pass the clinical studies. A separate assessment sheet is used. The courses are assessed as pass/fail upon completion of the practical placement.

The masters thesis is assessed by internal and external examiners. The written thesis must be passed before the student defends the thesis. The thesis is discussed with the student in a final oral examination. The thesis is assessed using grades A-F. The grade may be adjusted after the oral examination.

For more information about the grading scale (A-F) and guidelines regarding examinations, see the Examination Regulations of the University of Agder.

Required reading is approximately 7000 pages. Please refer to the syllabus for each course.

Specialised nursing with a major in anaesthesia: The nurse anaesthetist will be qualified to work in the anaesthesia department, intensive care, and the emergency ward. The nurse anaesthetist will have a central position in pre- hospital work during call-outs and transportation of acutely and/or critically ill patients.

Specialised nursing with a major in paediatric nursing: Paediatric nurses will be qualified for work in the neonatal wards at hospital, paediatric wards and intensive care wards, policlinics and adult wards with a number of beds for children. Habilitation wards, Municipal health services and psychiatry services for children and adolescents are also relevant.

Specialised nursing with a major in intensive care nursing: Intensive care nurses primarily work in special units in hospital; that is intensive care units and post-operative wards. They can also work in the paediatric wards, the ambulance services, the emergency centres, casualty wards and dialysis units

Specialised nursing with a major in theatre nursing: Theatre nurses will be qualified to work in the hospitals´ operating theatres, outpatients departments, emergency ward, casualty ward, catastrophe team, and sterile centre and in areas of catastrophe or war.

The theoretical component is divided between Kristiansand and Grimstad. The clinical studies preferably take place at Sørlandet Sykehus HF (SSHF) in Arendal, Kristiansand and Flekkefjord. In order to participate in clinical studies, students must fill out a declaration regaring MRSA and tuberculosis. If the practice location requires it, the student must take and document an MRSA examination and/ or TB test. For students taking a major in anaesthesia nursing, vaccination against Hepatitis B is required. More detailed information will be given at the start of the semester. Students must also present a clean police record when they are admitted to the programme. Marks on the police record can result in the applicant being barred from the programme.

Not all majors will necessarily be offered each year. There must be at lease six students admitted to a certain major for it to be carried out.