Governance And Administrative Structure

Published Date: 02 Nov 2017

Hizbullah Khan

Muslim Shah

NU 561: Educational Design & Administration

Dr. Raisa Gul

Aga Khan University School of Nursing and Midwifery

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Introduction

Nursing is a valued profession throughout the world due to the mark of holistic and compassionate care for individuals, families, and communities. The leaders of the profession are trying to maintain and uplift its image to the maximum higher possibility, and hence their focus tends to converge on the quality of nursing education. Multiple nursing schools are started to this end, yet these schools face different challenges and deficiencies that make their success questionable. Therefore, it is necessary to have regular evaluation of these educational institutes to ensure the standards of nursing education and produce quality nurses.

As part of the academic activity in the course of educational design, we visited to Ziauddin College of Nursing and Dow University of Health Sciences, College of nursing. The purpose of this visit was to inspect and evaluate any one of those institutes, from different perspectives of the standards critically.

This paper aims to discuss about the overall processes of Ziauddin College of Nursing (ZCON), its background, vision, mission, and philosophy, the physical layout and infrastructure, different programs it offers, the faculty profile, and different policies of this institute. In addition, this paper will highlight the strengths and weaknesses of this institute, and will suggest some alternatives to overcome the challenges faced by it.

Background

In 1986, Ziauddin started its school of nursing as the first academic entity with three programs including general nursing diploma, pupil midwifery, and diploma in nursing midwifery. Gradually, it was upgraded by the inclusion of other programs, and its name was changed to college of nursing in 2009. Currently, it is offering eight different programs in the discipline of nursing that could be considered the achievement of this institute. The added programs include accelerated masters of science in nursing (MScN), fast track post RN (BScN), four years bachelor of science in nursing BScN, licensed practical nurse (LPN), and paramedical technician certification course. The overview of each program with its respective curriculum and recognition will be discussed later in this paper.

Vision, Mission and Philosophy

Every organization has its own vision, mission, and philosophy for the achievement of future goals. The vision of ZCON is to be a distinct, autonomous institution that promotes excellence, innovation, and critical thinking in graduate nurses. Its mission is the development of human capacities through discovery and decimation of knowledge, and application through service. To accomplish such broader vision and mission, ZCON has made several realistic aims and objectives. This college is moving coherently with its set goals towards its mission; this can be easily inferred from its initiatives in starting and successfully running of multiple programs. The philosophy of ZCON is to focus on preparing well-disciplined and qualified nurses to improve clinical practice, nursing education and research.

According to the briefing session, ZCON has all the post RN BScN faculty members for the undergraduate programs, and they have started an accelerated MScN program to prepare knowledgeable human resource for the provision of quality nursing education. Apart from BScN, this institute has also recruited the MScN faculty members. This shows that ZCON tries to adhere to the established objectives to be on the path of its mission.

Governance and Administrative Structure

According to the briefing, ZCON has a well-structured organogram. Chancellor of the university seats at the top of hierarchy, who is the president of Pakistan nursing council (PNC) as well. He holds the central administrative authority in his hands; no one can make major decisions or modification without his approval. Vice chancellor of the university comes after the chancellor, then dean of the college followed by respective programs’ coordinators, and then the faculty members in the hierarchy list. Dean of the ZCON is accountable for smooth operation of each program, and she needs to consult and persuade the chancellor for reforms and innovations in the college.

Organizational Policies

Policies of an institute are the principles to guide the actions according to the standards. Policy making is a difficult task, yet more crucial is adherence to it. ZCON has established different academic policies and they strictly follow those as per need. According to their students’ admission policy, advertisements are given in the newspapers. The details of admission criteria for each program are mentioned in prospectus of the university. Each student is called for interview after passing the aptitude test, and final selection is made after success in the interview. According to the briefing, students are selected purely on merit basis, which can be considered the strength of the college. In addition, ZCON does not exceed the number of students specified by PNC for each program.

According to the student progression and termination policy, each student has to maintain minimum accumulative grade point average (GPA) of 2.5, failure of which leads to termination. Moreover, if a student is failed in a subject, he/she may be progressed to next semester with the condition to pass the subject before progression to next year. This shows their focus on quality of education. According to the briefing, they have set strict code of conduct for students, disobedience of which leads to disciplinary actions against the student. For student guidance and counseling, ZCON has hired two senior most persons for the psychological wellbeing of the students. After meeting one of the counselors, I was worried that how can such person be an effective counselor or advisor for students, who is suffering from amnesia. Seniority is always respected, but limitation in performance must not be bypassed.

Official Record System

The institute has student affair office, responsible for keeping and maintaining the student’s official records. The administration office keeps records of faculty members and other staff who are working in the institute. These records are kept safe for future referral, and only authorized person has the right to access. Moreover, in the discussion no one mentioned about faculty performance appraisal and evaluation system. However, the records are maintained in individual record file and electronic data base system as well.

Curriculum

The ZCON offers eight programs of undergraduate and graduate level. There are three degree programs, Bachelor of Science (4 years), Fast Tract Baccalaureate of Science in Nursing (1 year), and Accelerated Master in Nursing (15 months). Three diploma programs, which are: Diploma in General Nursing (3 years), Diploma in Pupil Midwifery (18 months), and Nurse Midwifery (1 year). The two certificate programs are Licensed Practical Nurse (2 years) and Paramedical Technician (1 year).

MScN is a thesis based degree program, and it was started in collaboration with PNC on the need basis to develop nurse educators, with advanced knowledge and skills, who can teach in various nursing degree programs. It is recognized by PNC and it follows PNC curriculum. The limitation of this program is that, it is not approved by Higher Education Commission (HEC) due to credit hours less than required for master program. Moreover, there is no PhD faculty in nursing disciplines, who supervise students in their thesis.

The ZCON started the fast tract BSN program for the first time in Pakistan. The program is designed for faculty members who are registered nurses with specialty, and hold diploma in ward and teaching administration. The aim of this program is to fulfill the shortage of degree holder faculty members to teach at undergraduate level. This program is recognized by PNC, and its curriculum is also adapted from PNC.

The four years BScN is a degree program that aims to prepare clinically competent professional nurses, and to equip the students with knowledge, skills, and attitude needed to practice safe nursing. The curriculum for this program is adapted from HEC, and this program is recognized by PNC and HEC.

The three years General Nursing Program is recognized by PNC that follows PNC curriculum, and it is affiliated with Sindh Nurses Examination Board. The outcome of this program is to prepare nurses to deliver, safe, competent nursing care to individuals, families, and communities.

Diploma in Pupil Midwifery and Nurse Midwifery are the programs, which aim to train midwives to promote maternal and child health, and to reduce maternal mortality in the country. The curriculum is adapted from PNC, and these are also recognized programs by PNC.

ZCON offers two certification programs: LPN and Paramedical Technician. LPN is recognized by PNC, and it is the first program only started at Ziauddin College of Nursing. The goal of this program is to prepare nurses, who are able to provide comprehensive care at primary, secondary, and tertiary level within the hospitals and communities. Paramedical Technician is one year program and it is recognized by Sindh Medical Faculty.

ZCON has its own curriculum committee and board of studies which are responsible of reviewing the curriculum of each program. Curriculum committee meetings are conducted on monthly basis regularly. However, as the curriculums are adapted from PNC or HEC, so, it is lengthy and difficult process to make changes according to needs. According to Billings and Halstead (2005), in current situation resources are rapidly shifting and institutions need to make a variety of changes in curriculum to meet the challenges of the future. Therefore, the curriculum should be revised on regular basis as per need required, and new trends in standard practices. In the curriculum committee of ZCON, there is no representation from students; therefore they cannot offer any suggestion for modification. Although, it would be better that PNC may have a functional curriculum committee that could revise the curriculum of different programs annually according to the needs of the society and nursing profession. The PNC should assess and to monitor the curriculum at school level and to provide guidance and facilitation, and to implement or improve the existing curriculum (Dias, Ajani, & Mithani, 2010). ZCON needs to incorporate the course and faculty evaluation in all programs effectively to accomplish the terminal objectives in a better way.

Infrastructure and Learning Resources

Physical location and facilities are of vital importance for learning environment. ZCON is located opposite to Ziauddin Hospital, in Karachi. It is single story building that comprises of class rooms, library, computer lab, skills lab, dean’s office, shared faculty office, student affairs office, counselor’s office, examination office, and conference room. Besides, there is a small ground within the college that is used for assembly and other recreational activities. A tuck shop and stationary shop are located at the entrance of the college, which entertain the students and the faculty members in reasonable prices.

The class rooms are well furnished and properly lighted, however we did not observe proper natural ventilation. Multimedia and white boards were used as teaching strategies in the class rooms. All the rooms were very close to each other and there was no enough space outside. However, due to number of programs, the numbers of classes are less than required. There is only one room for master program with few computers. We also observed that skill laboratory and computer laboratory were used for sessions because of less number of classrooms. These labs were not suitable for sessions because of lack of essential resources, such as multimedia and proper seating arrangement. We visited skill laboratory which was in small room and contained three dummies. The computer lab was equipped with computers, and the systems were provided with internet access to make the availability of updated information, and it provides access to the online library. However, the computer lab needs more computers to facilitate students in a better way. There is a small library with latest books and journals, but there were no enough sitting arrangements. There was one conference room, which is used for usual meetings and discussions. Apart from the above facilities, the institute provides accommodation to female students only and there is no hostel for male students. However, the Dean discussed that, they are in process of finding suitable building for their college, as this building is not sufficient to meet the required needs.

Clinical Placement

The students of ZCON go to Ziauddin hospital for clinical practice under the supervision of the respective nursing faculty. However, they did not discuss regarding the facilitation and evaluation process of the students during the clinical. These students are supervised by the nursing faculties in morning shifts only. In evening and night shifts, they are supervised by the staff nurses, who are well trained. The students of ZCON also use to go to Karawan-e-hayat for mental health clinical rotation. According to Morgan (2006), to enhance student competency the students should be prepared in a way to carry out the practical skills competently, and efficiently. Moreover, they have the ability to integrate theory into practice.

Support Services

The Ziauddin College of Nursing provides medical facilities to their students during their course of illness in Ziauddin hospital. The institute provides the opportunity of financial assistance to all the students entering in any program in the exchange of services provision after the completion of program. For stipendiary basis, it is mandatory to complete a service agreement requiring years of services depending on the duration of program. During their services, they are exempted to pay the fee of the program and they are paid full salary. The students can also participate in extra-curricular activities, so that they can improve their physical and mental capabilities. Faculty members have also the opportunity of professional growth; they can study and work together. Three of their faculties are enrolled in master program, they have to pay only fifty percent of fee, and they are teaching within the institute as well. In the college they have counselors, who provide counseling services to the students and faculty members.

Opportunities for Personal and Professional Growth

ZCON provides opportunities for the students to attend seminars, workshops, and conferences, so that they can grow personally and professionally in the field of nursing. They also provide these opportunities to the faculty members, but they have to pay the financial costs by their own. However, they did not discuss the students participation in such programs, neither had they mentioned about any projects run by the students.

Faculty Profile and Faculty to Student Ratio

ZCON has hired post RN BScN faculty members for undergraduate programs, while for MScN they have graduate members only. Although, post RN BScN can meet the needs of undergraduate program, but the faculty to student ratio need to be maintained as specified by PNC. Currently this institute does not fulfill 1:10 demand of PNC for clinical supervision which can affect the quality of care. The recommended ratio of faculty to student in classroom teaching provided by PNC is 1:20 (PNC Criteria, 2009); ZCON fulfills this criteria. Looking to the graduate program, ZCON lacks the required faculty both in quantity and qualification. This institute has only two proper MScN holders from a recognized institute who are not enough to run MScN program. Apart from MScN teaching, they do not have even a single PhD member to supervise students’ thesis properly.

Overall Strengths and Limitations

During our visit we were briefed well, and we got the chance to observe the layout of ZCON as well. Some of the strengths and areas of improvement are discussed in each component above, although few other need to be mentioned here. It can be supposed from the briefing and observations that the main political strength of ZCON is the dual role of its chancellor. He holds the key position at Ziauddin University and PNC at the same time, so initiation and recognition of any nursing program is not difficult task for him. Secondly, ZCON has a well reputed tertiary care hospital which can easily serve the purpose of clinical practice for its students. Thirdly, this college is headed by a dean who is MScN qualified from a renowned university of the country. According to Tomey (2004), higher education and expertise are the two necessary skills for quality leadership. Many of the nursing institutions in Pakistan are either run by non-nursing heads, or the key administrators are very less qualified nurses for their positions. Moreover, ZCON has started accelerated MScN on need basis to develop qualified man power for improving advance knowledge and skills.

Besides strengths of this institute, several areas of improvement are identified that need to be addressed promptly. Firstly, the infrastructure and the resources for eight programs are not enough. These include more number of classrooms, widening of library, facilitating skills laboratory with more dummies, increasing the number of computers with fast internet facility, and in-campus cafeteria. Secondly, we didn’t hear about clinical coordinator for undergraduate students that is also an important aspect of nursing education. One teacher can teach to fifty students in a large classroom, but he/she cannot supervise more than ten students at clinical area properly. Therefore, ZCON might increase the number of clinical faculty members for undergraduates to enhance their clinical practice.

Although, ZCON is achieving its milestones considerably good but it has several limitations for MScN academics as well. Besides PhD supervisors for thesis, ethical review committee (ERC) plays crucial role for research proposal’s approval. Though this institute has its own ERC, but there is no nursing representation in that committee at all. It is important for any nursing institute having MScN program, to have a nursing representation in ERC to review all the graduate students’ protocols from nursing perspective. Despite ERC, higher education commission (HEC) has not recognized MScN program of ZCON because of limitation in faculty profile and credit hours of the program. Although, PNC has given recognition for graduate program, which seems to be due to the influence of its president’s relationship with Ziauddin university; alone this is not enough because HEC has major role in curriculum and other modifications in higher education programs.

Conclusion and Recommendations

ZCON is one of the reputable institutes in Pakistan which is providing quality nursing education via different programs. Despite of limited resources, it is running eight programs successfully so far. They have taken multiple steps to achieve their set goals and objectives which are reflecting from their initiatives in the field of nursing education. However, ZCON needs to improve in certain aspects on immediate basis to move coherently according to their initiatives. This college needs to hire PhD and MScN faculty members for its graduate education. Moreover, it has to increase the credit hours of MScN program to make it full time; this will provide sustainability of the graduate program. They should also initiate scholarship programs for students and faculty members to overcome the shortage that the college is facing in terms of qualified human resource. Lastly, it can be doubtlessly said that if ZCON improves the above shortcomings, it can be proved one of the key institute of the country.