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his summer, when Dr. Natela Partskha-ladze and her colleagues boarded a plane for home, they each carried a loose-leaf binder worth its weight in gold. More than an inch thick, the binder contained a new undergraduate curriculum for establishing the first university-level nursing school in the Eastern European nation of Georgia.
     Developed in collaboration with the Nell Hodgson Woodruff School of Nursing, the new curriculum represents an unprecedented change for nursing education in that country. The curriculum evolved through the Atlanta-Tbilisi Healthcare Partnership, founded in 1992 and led by Emory School of Medicine professor Dr. Kenneth Walker to foster professional exchange between the sister cities.
     “From the beginning, the partnership was interested in starting a school of nursing in Tbilisi,” says Partskhaladze, one of four female physicians who worked on the curriculum at the School of Nursing last spring. “Everyone understood the importance of nurses being well educated. Unfortunately, in our country, nurses don’t have university degrees. They go through two or three years of training, and their educational background is quite limited. Everyone realized it was important to improve their education level by establishing a university-level nursing school.”
     The physicians came to Emory at the urging of the partnership’s Atlanta cohorts, including Dr. Judith Lupo Wold, 81MN, a Georgia State University nursing professor and a fellow of the Lillian Carter Center for International Nursing at Emory (see related story on page 20). Wold thought it would be beneficial for the physicians to enroll in a teaching institute led by Dr. Helen O’Shea, professor emeritus and former director of Emory’s BSN program. Established as a fast-track summer program in 2003, the institute enables master’s-prepared nurses to become skilled educators in order to address the widespread shortage of nursing faculty in the state of Georgia, the South, and the nation.
     As O’Shea notes, the greatest need is for clinical teachers. “If you have a class of 100 students, four or five people can teach most of the classroom courses. But when you divide students into groups of six or seven for clinical instruction, the groups need close supervision to ensure patient safety and for hands-on learning. When you take a large class and break it down into small groups, you obviously need a lot more people for clinical instruction.”
     Teaching students in a clinical setting is a novel concept for nursing education in the nation of Georgia. During the teaching institute, the Tbilisi physicians learned a great deal about clinical instruction at sites such as Grady Memorial Hospital and the geriatrics center at Emory’s Wesley Woods.
     “In my country, nurses mostly receive classroom instruction that is not very good because the curriculum is ancient and the books are very old,” says Partskhaladze. “Doctors teach nurses, and they are not the best prepared to teach nursing skills.”
     Because nursing students in Georgia are not educated at the university level, only physicians, who are university trained, are qualified to teach them. That will change when Georgia’s first BSN graduates take over nursing instruction in a few years.
     Although she is a physician, Partskhaladze found it difficult to practice in Georgia, where hospitals are often half full because so few patients can afford health care. She chose instead to focus on public health (she holds a master’s degree in public health from Central European University in Budapest and a master’s degree in social work from Washington University at St. Louis) and nursing education and now serves as the nursing program coordinator with the Partners for Health Association, the Georgian office of the Atlanta-Tbilisi Healthcare Partnership. Her Georgian colleagues at the Emory institute included Drs. Maia Gogashvili, chief specialist with the National Institute of Health and International Affairs; Maia Jashi, vice president of the Georgian Nursing Association; and Shorena Mindadze, a former nursing instructor. All are putting the skills and knowledge they learned at Emory to good use. “We are nurse educators, able to work as nurses in the clinical setting,” says Partskhaladze proudly.
     
     
  A BOLD NEW PLAN  

efore the Tbilisi physicians arrived at Emory, O’Shea gave considerable thought to how to help them develop a BSN curriculum. When the teaching institute began, she asked lots of questions: What do nurses do in your country? What do physicians do? How are they educated? Who’s in charge of nursing? Are nurses licensed? What is the health care system like? What resources are available for nursing education?
     “I had to educate myself before we started the process so we could determine where we were headed,” O’Shea says. As do students who take the teaching institute each summer, the physicians completed a series of mini courses on the philosophical and theoretical foundations of teaching and learning, curriculum and course design, teaching strategies for classroom and clinical instruction, and strategies for evaluating students in the classroom and clinical setting. The institute continued with a two-day course on teaching technology (i.e., PowerPoint and web-based course components), followed by a seminar on the faculty’s role.
     With the course content behind them, O’Shea and her students began the arduous task of designing a baccalaureate program. “We had
to decide what this new nurse should know and be able to do,” says O’Shea.
     Their task included defining the objectives of the BSN program and devising a four-year curriculum comprised of general university courses (three semesters) and nursing courses (five semesters). The physicians developed the curriculum based on what they had observed by auditing undergraduate nursing courses at Emory. They took the classes to better understand the level of expectation required of students and the teaching strategies used.
     When the physicians returned to Tbilisi in June, their bulging loose-leaf binders contained a mission statement, an education philosophy, a curriculum plan, program outcomes, and 27 course syllabi, all of which had to be translated into Georgian. The content formed the basis for a series of continuing education courses implemented by the physicians this summer for nurses at the National Medical Center and Central Children’s Hospital in Tbilisi. The physicians also developed workshops for nurses specializing in pediatrics, neonatal care, medical-surgical care, and midwifery.
     In late July, the physicians received an eagerly awaited vote of confidence when the Georgian Minister of Health approved the BSN curriculum to create a nursing school at Tbilisi State University. The first class of 20 students is expected to enroll in the fall of 2006. O’Shea will travel to Tbilisi to assist with policy development and other matters after the school opens.
     “It was very impressive to see how much Dr. O’Shea and other nursing faculty at Emory were willing to help us,” says Partskhaladze. “Without them, it would have been difficult to accomplish what we did.”
     
     
     
   
   
   
   
   
   
   
 
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