Vocational Education and Training of Nurses in Lithuania:
Possibilities of ICT Appliance Seeking for Transparency of European Qualifications
Žymantė Jankauskienė, Erika Kubilienė
Vilnius College Health Care Faculty
Violeta Karenauskaitė, Ričardas Rotomskis
Vilnius University Physics Faculty
Paper presented at the European Conference on Educational Research, University College Dublin, 7-10 September 2005
Introduction
Europe today faces a large number of challenges which have already and will continue to have a strong influence on the expectations that Lithuanian vocational education and training system must be able to fulfil. The impact of globalisation, continuos development of the knowledge economy and society lead to increased competition; technological and organisational changes require higher skill levels and at the same time these skills and competences are continuously changing. Another important challenge is related to the ageing population. Number of elder people active in the labour market is constantly increasing.
In the context of such challenges the European Employment Strategy came into existence in 1997 and implementation was started in 1998, based on a set of employment guidelines setting targets for the Member States to achieve. These targets also referred to the area of education and training as a means to improve employability and adaptability with a priority focus on Lifelong Learning.
Education and training areas have become the underlying within the Lisbon Strategy (2000), three strategic objectives have been set out for these systems in the European Union: improving the quality and effectiveness of education and training systems in the EU, increasing possibilities to gain education, opening up education and training systems to the wider world (PeterdeRooij,2002). In March 2000 the European Council in Lisbon came to conclusion that a successful transition to knowledge based economy and society has to be accompanied with the transition to Lifelong Learning. European Employment Strategy emphasizes rising and grown significance of education and training. However the main goal of training system remains activating of individual potential and developing of personal abilities, which allow taking part in community life and labour market. Fundamental changes in education programmes are required.
In the process of economic and social changes in Lithuania it is necessary to orient to shift in demand of vocations and specialities, core skills and abilities analogous to those defined in “A Memorandum on Lifelong Learning” (2001): ability to use information technologies, knowledge of foreign languages, entrepreneurial skills (ability to create new work places and to get self-employed), social skills (self-confidence, self-direction, initiative, independence), ability to learn, to acquire new skills and adapt to new requirements (Jovaisa etc., 2003). Complete integration into European processes and the emerging knowledge society aren’t the only challenges the Lithuanian vocational education and training system has had to meet. Lithuania has consistently to monitor its vocational education and training system, teaching/learning process to make attractive to both students and teachers (transferability, visibility and portability of acquired qualifications), to provide for timely and effective feedback through evaluation, monitoring and quality control (Helmut Zelloth et. al., 2003; Gudaityte, 2001; Peter de Rooij, 2002)
The main European education development dispositions commit Lithuania to develop its vocational education and training oriented to the European dimension direction: provide vocational and cultural education, adequate to the contemporary level of science as well as the requirements of chosen vocational field, create necessary conditions for upgrading and requalifying skills, empower employees to be more flexible in adapting to the changing labour market needs, ensure the continuity of vocational education and training, develop personal features necessary for the future vocational activity and independent work in the society based on democratic principles under the market economy conditions (Juceviciene, 2000; Miskiniene, 2002; Monkevicius, 2002).
The development of the European Union raised an adequate learning outcome valuing problem. It is possible to speak about free labour force movement only if we know the answer to labour force value recognition question. Variety of learning forms and outcome recognition integrity are very important issues for vocational education and training. Formalisation of lifelong learning outcomes, i. e. recognition of the acquired qualifications, is a necessary motive of non-traditional learning, promoting knowledge acquisition by all possible forms. Therefore assessment criteria, that indicate outcomes of formal and non-formal learning, have to be prepared. Assessment criteria become clearer when learning has a clearly expressed target – a certain competence as a capacity to perform particular actions. Planning of competence-based learning has huge perspectives in formal and informal vocational training and corresponds best of all to the international accreditation perspective (Lauzackas, Pukelis, 2000, Lauzackas, 2002). Solving these goals it is necessary to implement flexible forms and methods of studies through expanding remote learning, establishing intensive studies, to stimulate teachers to apply active methods of teaching/learning, reducing number of contact hours in study process, assuring high study quality(Gudaityte, 2001).
Market laws begin to run in such unconventional areas like health care. A patient gains status of client, as a medic becomes service conveyor. Essence of health service system reform becomes process of systemic structural changes, seeking to deliver residents high quality health care services with low input (Janusonis, 2000).
On the other hand, modern educational technologies (ICT, active teaching/learning methods) open wide opportunities for increasing efficiency of teaching, accumulating of information, for promotion of students’ self-studying. Creative preparation of learning materials and presentation on the Internet, continual curriculum development, implementation of remote learning courses allow improving and obtaining knowledge at freely selected time and place, effectively using time for learning (Jankauskiene, 2000; Birmontiene, Zalys et al, 1999).
Seeking for the transparency of qualifications and mutual recognition of certificates and diplomas of general care nurses the higher claims for the qualification of medical professions are raised, so new learning methods, teaching tools and innovative management must be introduced into medical education. Particular attention must be focused on cooperation between universities and colleges, partnership on national, regional and European level to improve the quality and attractiveness of vocational training.
But there is a lack of special educational and ICT tools for high quality learning of medical students and professionals in Lithuania. Following investigation, carried out at Vilnius College Health Care Faculty, most of applicants prefer an extramural form of learning comparing with the evening courses. There are young people initiating vocational training in health care section (general care nurses) and postgraduate professionals wishing to improve their competences in nursing by lifelong learning strategies with the view of new employment possibilities, social inclusion and personal development.
Therefore, in our research we pursued the answers to questions: What is the real demand of nursing specialists for transparency of European qualifications in Lithuania and are there possibilities to achieve it? How to fulfil learning needs of students of medical colleges and medical professionals? Which methods and ways is the most convenient and relevant?
The aim of this article is to evaluate the demand for nurses’ vocational training and lifelong learning in Lithuania and to estimate possibilities of appliance information and communication technologies (ICT) with a view to transparency of European qualifications of nursing specialists in the cooperation with the partners from European countries.
The research object is training of general care nurses and problems of developing of their qualifications.
The research methods were analysis of research literature, statistical data and national standards, which regulate training of nursing specialists and professional activity. This research method contributed to define professional competences of nursing specialists and possibilities of appliance of innovative technologies. Questionnaire survey and analysis of the documents serviced for investigation of adult demand for learning in Lithuania.
This article consists of three parts. The concept, relation and structure of qualification and competence are analysed in the first part of the article. The second part of the research describes present and future trends of adult education in Lithuania. Final part of the article proposes the ways to create new possibilities for nurses’education in Lithuania and other countries as well through Pilot project of Leonardo da Vinci “Digital Compendium: Innovative Learning Materials for Remote Tutoring”.
Qualification and Competence in the Context of nursing specialists’ Vocational Training
The vocational qualification (available or the one that is being acquired) has to be constantly renewed (improved) with regard to the changes of the labour market. It is necessary to create such learning conditions that the acquired qualification would allow the future specialis to successfully function in the labour market. Qualification is a degree of person‘s suitability for a certain job, possession of necessary knowledge, skills and experience. Qualification is the completeness of knowledge, abilities, skills and experience, acquirement of which enables to perform qualitatively a job of appropriate kind and complexity. Vocational qualification includes skills, abilities and knowledge expressed in the form of ability, learning, and study certificate. The latter definition emphasises also the aspect of evaluation and recognition of knowledge, which is expressed in a certain formal form. The activity of nurses is manifold and integrated; it includes ability to perform a certain number of activity functions and is related to matching these functions while solving various problems. Consequently, if a nurse wants to perform job in qualified way, he/she has to possess characteristic functional competences (e.g. planning), which would enable to realise activity functions successfully (Zydziunaite, 2003). The completeness of such functional competences leads to vocational qualification of a certain degree.
Competence is functional ability to carry out adequately certain activity; it defines ability to apply the knowledge in a concrete situation efficiently solving the upcoming problems. Competence is a concrete ability to perform a certain function of nursing activity. To carry out every function of vocational activity it is necessary to have appropriate competences. Their qualitative and quantitative totality allows nurse to perform his/her work in a more or less qualified way (Barnett, 1994; Juceviciene, 2001; Lepaite, 2003; Zydziunaite, 2003).
Research function is increasingly gaining importance in vocational nurses‘ activity. It is important to prepare a nurse capable of reflecting upon his/her practical activity and its outcomes. In oder to do that it is necessary to have certain information about the discussed phenomenon. The quality of reflection greatly depends on the following abilities: to identify, what kind of information is necessary; to decide how to obtain it and be able to obtain it; to understand what this information means (to be able to give meaning to it). Quality of vocational qualification is described by knowledge, abilities, skills and attitude towards the activity. The same parameters indicate the quality of each functional and content competence, which is greatly influenced by the employee‘s attitude towards profession: understanding of the importance of his/her social status, prestige, compliance with personality structure or coherence between the subjective and objective side of a vocation etc., i.e. value system of specialist. Nurse‘s value system manifests itself as medical worthiness of personal features and is an important factor of successful activity that can be treated as independent content competence of personality‘s self-education.
The realization of functional competences is based on content competences, they both have the same structure and consist of sub-competences. Basis of content competences consists of knowledge, but the most significant criteria of the employee‘s professionalism are skills. In the contemporary changing world of work the skills necessary to carry out a successful activity also change very rapidly. Scientists and practitioners as well have noticed that vocational education and training oriented to acquisition of certain specialised skills has become meaningful. At present the necessity for development of general competences and abilities has received the increasing attention.
Rapid socialeconomic changes in Lithuania and the whole world raise new demands for the system of vocational education and training. The vocational qualification (even the one that is being acquired) has to be constantly renewed or improved with regard to the changes of the labour market. It is necessary to create such learning and studying conditions in the vocational training institution, that the acquired qualification would allow the future specialist to compete successfully in the labour market.
Great extent of reforms in education and public health areas has begun in Lithuania since 1990, when an independence was reinstated. The government has appreciated human resources – the primary worth of society looking for economic and social welfare, striving to compete in the world market. Education and health – there are two basic areas yearning for quality of life in all fields of activities, in which commonly experts are assessing the quality of service, not servicereceiver, but results can be seen rather after long time when it’s too late to correct anything.
Cooperation agreement between Lithuanian Ministry of Health and Denmark Nursing Organization was underwritten in 1993 as concerns Project „Creation of Curriculum of Undergraduate Nursing Studies and Juridical Base of Nursing”. Whereupon, during 19941995, a new Nurse program was get in readiness by lecturers of Vilnius College (at that time Advanced Medical School). This Program was named as an experimental, because therefore considerable qualitative changes in Health Care System were occurred. Qualification is being provided changed as well as content of studies.
Government of Lithuania has adopted new curriculum of medical studies at all levels since 1995. The curricula are reorganized according to the requirements of EU with regard to local needs. The ideas of EU Directive No.77/453 of 27 June „On Legal and Administrative Coordination of the Performance of General care nurses” should be reflected not only in Lithuanian legal acts identifying the training and performance of nurses, but also should find place in the curriculum.
Thus, there have been made some changes in the ratio of theory and practice (1:1). Also new subjects obligatory for general care nurses have been suggested, subject contents have been expanded due to the implementation of the Special EU Directive, i.e. Biomedical Physics, Clinical Laboratory Testing, Old People Care and Geriatrics, Dietary Therapy, Anesthesia and Intensive Care. These conditions outweighed the creation of subject modules mentioned above, because they’ll be obligatory for recent students and those, who graduated earlier but are willing to gain European qualifications.
As Lithuania became a member of European Community in 2004, educational institutions, qualifying specialists for Lithuanian market, had met new opportunities – international mobility of their graduates. It’s very important to take this chance and to adapt to everchanging labour market requirements of EC. Transparency of qualifications in Europe and the legislation of the mechanism of their acknowledgement have been discussed in various institutions for a long period.