Defining the Cultural Milieu for Implementing Faculty Practice in Pakistan Michele J

View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by eCommons@AKU eCommons@AKU School of Nursing & Midwifery, East Africa Faculty of Health Sciences, East Africa January 2002 Defining the cultural milieu for implementing faculty practice in Pakistan Michele J. Upvall Aga Khan University Zeenatkhanu Kanji Aga Khan University, [email protected] Salma Jaffer Aga Khan University Khurshid Khowaja Aga Khan University Rubina Barolia Aga Khan University See next page for additional authors Follow this and additional works at: http://ecommons.aku.edu/eastafrica_fhs_sonam Part of the Nursing Commons Recommended Citation Upvall, M. J., Kanji, Z., Jaffer, S., Khowaja, K., Barolia, R., Amarsi, Y. (2002). Defining the cultural milieu for implementing faculty practice in Pakistan. International Journal of Nursing Practice, 8(6), 315-323. Available at: http://ecommons.aku.edu/eastafrica_fhs_sonam/65 Authors Michele J. Upvall, Zeenatkhanu Kanji, Salma Jaffer, Khurshid Khowaja, Rubina Barolia, and Yasmin Amarsi This article is available at eCommons@AKU: http://ecommons.aku.edu/eastafrica_fhs_sonam/65 Blackwell Science, LtdOxford, UK IJNInternational Journal of Nursing Practice1322-71142002 Blackwell Publishing Asia Pty Ltd 86December 2002 385 Implementing faculty practice in Pakistan MJ Upvall et al. 10.1046/j.1322-7114.2002.00385.x Research Paper315323BEES SGML International Journal of Nursing Practice 2002; 8: 315–323 ✠ RESEARCH PAPER ✠ Defining the cultural milieu for implementing faculty practice in Pakistan Michele J Upvall PhD FNP-C Professor and Director, BScN Programme, School of Nursing, Aga Khan University, Karachi, Pakistan Zeenatkhanu Kanji RN MScN Doctoral Student, University of Alberta, Edmonton, Alberta, Canada Salma Jaffer RN BScN Assistant Manager, Nursing Services, Aga Khan University Hospital, Karachi, Pakistan Khurshid Khowaja RN BScN Director, Nursing Services, Aga Khan University Hospital, Karachi, Pakistan Rubina Barolia RN BScN Senior Instructor, School of Nursing, Aga Khan University, Karachi, Pakistan Yasmin Amarsi RN PhD Associate Professor and Associate Dean, School of Nursing, Aga Khan University, Karachi, Pakistan Accepted for publication May 2002 Upvall MJ, Kanji Z, Jaffer S, Khowaja K, Barolia R, Amarsi Y. International Journal of Nursing Practice 2002; 8: 315–323 Defining the cultural milieu for implementing faculty practice in Pakistan Faculty practice can promote a collaborative partnership mutually beneficial to both nursing education and service. How- ever, little is known about its implementation in developing countries. The purpose of this study was to explore the potential for introducing faculty practice within the cultural milieu of Karachi, Pakistan. Focus groups of nursing faculty, staff and students were conducted in various settings: government, semigovernment and private institutions to elicit the data. Data analysis revealed that a more comprehensive definition of faculty practice is needed that will provide the foundation for a culturally acceptable model of faculty practice in Pakistan. Hierarchy dominates the current cultural milieu and must be addressed before faculty practice can be implemented. Key words: faculty practice, focus groups, nursing education, Pakistan. INTRODUCTION cil or other institutions in the country for faculty to main- The concept of faculty practice is relatively unknown in tain clinical competency, or even be present with students Pakistan. There are no requirements by the nursing coun- in the clinical area with the exception of one private school of nursing. Therefore, the current cultural milieu Correspondence: Professor Michele J Upvall, Aga Khan University, PO of nursing education in Pakistan promotes few opportu- Box 3500, Karachi 74800, Pakistan. Email: [email protected] nities for interaction between nursing faculty and nursing 316 MJ Upvall et al. staff in hospitals. Students receive the theory component • Dyad Model: faculty are paired with a clinical nurse of their courses from faculty and clinical supervision from specialist and joint projects related to education, nursing staff. The majority of nursing faculty neither pro- practice and research are completed. vide direct patient care services within the hospital nor do • Research Joint Appointments: nursing service they accompany students in the hospital wards. establishes a Director of Nursing Research who also The context of nursing education in Pakistan may be works with a School of Nursing. Utilization of research similar to that of other developing countries. There is a findings into practice is the result. dearth of research regarding the role of faculty and expec- • Integrated Model: both faculty and a graduate level tations of clinical competency. Nahas described nursing student share the responsibility for patient care. education in cosmopolitan Hong Kong noting that nursing • Entrepreneurial Model: faculty designs their own faculty, as in Pakistan, are not responsible for clinical practice as part of their faculty responsibilities. Faculty supervision of students.1 However, she advocated nursing may also negotiate to use their practice site as a faculty maintaining clinical credibility, or competence, as research and teaching site as well. faculty are accountable for students’ learning regardless Development of organizational models for faculty prac- of the classroom or clinical setting. Faculty must be pre- tice requires a conceptual definition of faculty practice. pared to answer questions from students and relate theory Definitions from prominent nursing organizations have to clinical situations. The purpose of this study was to been proposed as follows: explore the potential for introducing faculty practice to schools of nursing in Pakistan, specifically within the Faculty practice includes all aspects of the delivery of nursing service megapolis of Karachi, a port city in the province of Sindh. through the roles of clinician, educator, researcher, consultant and Karachi was chosen because it is the largest city in administrator.4 Pakistan with many hospitals and schools of nursing. Research questions guiding this study were: Practice scholarship encompasses all aspects of the delivery of nursing 1. What is the current definition of faculty practice service where evidence of direct impact in solving health-care articulated by nursing faculty, staff and students? problems or in defining the health problems of a community is 5 2. How can faculty practice be implemented in schools of presented. nursing? 3. What are the perceived challenges of implementing Such definitions of faculty practice allow for a variety faculty practice? of interpretations. The scope of these definitions allow faculty to define their own practice, regardless of setting. Perspectives of faculty practice in For example, faculty practice may be clinical supervi- developed countries sion of students, reading current nursing literature and As early as the 1960s, administration from the University applying it to the classroom, applying research findings to of Florida School of Nursing recognized that the separa- clinical practice, or providing direct patient care. The few tion between nursing education and service could be ulti- research studies relating to the evaluation of faculty prac- mately detrimental to student learning. However, expert tice demonstrate the need for a clear definition of faculty nurses would be in an optimum position for teaching stu- practice readily translated into a particular clinical set- dents clinical decision-making skills. ting.3,6 Barger asks the question, ‘Are we able to engage in Since the 1970s, nurse educators have developed orga- evolving collaborative relationships that are both more nizational models to facilitate nursing education-service interdisciplinary and more extensive without feeling that collaboration.2,3 These models include the: our unique contributions are being threatened?’.7 • Unification Model: nursing hospital administrators This thought-provoking question implies the need for have positions as educators. For example, the Dean of original thinking for the development of faculty practice. a School of Nursing is also a Director of Nursing Krafft emphasizes the need for a definition of faculty prac- Services. tice that can be shared within the context of a particular • Collaboration Model: a percentage of time is given to faculty.8 The definition of faculty practice will then influ- both education and service through a system of joint ence policies and impact issues at the university, school of appointments. nursing, and faculty levels. Implementing faculty practice in Pakistan 317 University issues include how scholarship is defined, included proactive communication between academia and the need to develop a reward system for faculty practice, service to prevent misunderstandings regarding work- and an assessment of risks and benefits of faculty practice. load, recognizing role ambiguity as faculty practice cred- For example, faculty may feel overworked and experience ibility is being established, and making a detailed contract burnout if they are expected to teach, conduct research, that clearly outlines expectations, including the cost of and maintain practice. Rewards and adjustment of teach- faculty practice. ing loads may then become necessary. Issues at the school All models of faculty practice have advantages and dis- of nursing level include using faculty practice as a method advantages. It is clear that faculty practice in nursing

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