Original Article

A Comparative Study of the Educational Program of the Master’s Degree in Adult Critical Care Nursing at the University of Sharjah and Iran

Please cite this article as follows: Alipour N, Borzou SR, Hassan Tehrani T, Khalili Z. A comparative study of the educational program of the master’s degree in adult critical care nursing at the university of Sharjah and Iran. Avicenna J Care Health Oper Room. 2024; 2(3):102-109. doi:10.34172/ajchor.62

Introduction

Education is an important and sensitive field where any shortcoming can lead to the loss of human and financial capital. Therefore, the development of education and its promotion require an understanding of the education process and awareness of new methods of implementation (1). Educational planning is one of the main areas within education and training that plays an essential role in the optimal training of human resources. With the correct planning of organized affairs, provision of human resources, and leadership guidance, especially supervision and control, the outcome will be more effective and efficient. Educational planning is essential for achieving dynamic and successful higher education and for ensuring the quantitative and qualitative development of the universities. Educational programs should be developed, revised, and modified in line with the needs of society (2).

One of the goals of education planning officials is to update existing programs and transition toward new educational programs. This can be accomplished by reviewing the educational program standards of different fields of medical sciences at both the national and international levels and adapting the existing programs accordingly (3).

The training of nurses is of special importance among the employees working in healthcare centers due to their vital role in the healthcare system. Nursing education courses must be of high quality to train students as competent and professional individuals to provide safe and quality care. These individuals must be able to meet current needs and anticipate future needs (4). Critical care nursing is a specialized branch of nursing that through the care of critically ill patients enhances managerial, educational, research, ethical, and professional behaviors, leading to improved nursing care, reduced mortality rates, and decreased disease complications in specialized departments. The critical care nursing field is one of the master’s degree trends in nursing that was officially started in 2008 (5).

Nurses should have scientific and practical abilities aligned with their current knowledge to perform all nursing care at different levels. Identifying problems in nursing education and taking action to update them will improve the achievement of training goals, the education of skilled people, and the quality of health services. It will be treated at the country level (6). In the last few decades, there has been significant progress in nursing, especially in the field of education. The nursing education program has been strengthened and reoriented to ensure that graduates have the essential competencies to contribute effectively to the improvement of the health and quality of life of the people (7). Different educational systems can help improve the content and quality of the curriculum (8).

Conducting comparative studies is one of the most reliable and important methods for evaluating the effectiveness and efficiency of educational programs. These studies lead to an understanding of other devices, identify the strengths and weaknesses of current programs, and introduce examples of more successful programs for potential adaptation (9).

Comparative education tries to compare educational problems and solutions applied to them to improve educational methods. The study of comparative education helps learners better understand their educational systems. Moreover, these studies contribute to the flexibility of the country’s education systems (10). Several studies have compared Iran’s critical care nursing master’s program with those of other countries. Ashrafi et al compared the critical care nursing master’s program in Iran with that of Melbourne in Australia, applying part-time methods for student admission. They suggested designing additional educational programs for teacher training and providing a supplemental curriculum aligned with the needs and common diseases in the service environment to improve the nursing master’s program in Iran (11). Another study conducted by Rezaie et al indicated that decisions are based on clinical evidence in critical care. Although the intensive care nursing master’s degree course is free in Iran, clinical courses do not receive as much attention as in the Scottish curriculum. The existence of part-time courses, planning of courses aimed at faculty training, and online classes can increase the strength of the curriculum of this course in Iran (12). The University of Sharjah is the first university in the Arab world to receive a gold rating from the Sustainability Tracking, Assessment, and Rating System (STARS) in recognition of its sustainability achievements from the Association for the Advancement of Sustainability in Higher Education. Sharjah University in the United Arab Emirates (UAE) organizes a critical care master’s course to train specialist and professional nurses who can provide advanced care measures for adult patients with complex and numerous problems.

This research aimed to conduct a comparative analysis of the curriculum structure of the adult critical care nursing master’s program at Sharjah University in the UAE and the current educational program in Iran. The aim is to enhance the strengths and address the weaknesses of the Iranian curriculum. This comparison will provide a basis for revising the program and incorporating best practices identified in the process.

Methods

This comparative descriptive study was approved by the Ethics Committee in Biomedical Research of Hamedan University of Medical Sciences under the number 43 994 and was conducted in the first half of 2012 at Hamedan University of Medical Sciences using the Brady method. Comparative study using George F. Brady’s method involves placing two or more phenomena together and analyzing their differences and similarities (13). This method consists of four steps: description, interpretation, comparison, and juxtaposition (14).

To adapt and compare the adult critical care nursing curriculum, the nursing curricula from Iran and Sharjah were obtained from websites of the Ministry of Health, Treatment and Medical Education (15) and Sharjah University (as reliable and accessible sources) (16). Additionally, searches were conducted on websites such as Science Direct, Scopus, SID, PubMed, Magiran, and Google Scholar using keywords such as nursing education, Master’s degree in critical care nursing, curriculum of the UAE and Iran, and comparative studies. This comprehensive search covered the period from 2000 to 2023 and identified articles related to the comparative study of educational programs.

Based on Brady’s model, in the first stage, the existing situation, including the mission, vision, philosophy, goals of the field, acceptance conditions, program specifications, structure, course content, the student roles and duties of the students was described using evidence and information collected from various sources. In the interpretation stage, the collected data were analyzed and interpreted. In the juxtaposition stage, the information produced in the first and second stages was categorized and placed next to each other to provide a framework for the final stage. Finally, in the comparison stage, the similarities and differences in each component were compared.

Results

Tables 1 to 3 separately present the results obtained from the comparative analysis of each element of the nursing expertise curriculum, including philosophy, mission, perspective, goals, faculty roles, student admission conditions, the characteristics and structure of the course, implementation strategies, and educational progress. Analyzing each one of these elements and comparing their differences and similarities revealed several important points.

Discussion

The present study examined the similarities and differences between the adult critical care nursing master’s program at Iran and Sharjah Universities. While both countries share certain similarities and differences, the following points about the master’s program are significant for adaptation.

From a historical point of view, nursing education in Iran began about half a century before it started in the UAE. Similarly, the start of nursing university activities in Iran was also about half a century earlier than those in the UAE. Postgraduate nursing education courses in Iran, including master’s and doctorate degrees, started earlier than in the UAE, and nursing education has developed rapidly in Iran over the past 30 years (17).

Both curricula include philosophy, mission, and vision statements. In Iran’s curriculum, a comprehensive philosophy is mentioned separately, responding to the needs of the profession and field. It is expressed in a summary, general, and understandable way and guides the organization’s performance at high levels. However, no particular theory is mentioned. In contrast, the curriculum of Sharjah University does not explicitly express its philosophy in an official statement on the school website, but it can be inferred that the nursing school’s ideal philosophy is to train professional nurses with a focus on the use of technology and progress in care practice. Nursing practice is evidence-based and encourages students to focus on research principles, responding to the needs of the profession and field. The philosophy of this university guides the organization’s performance at a high level and has implicitly indicated that high-level nursing managers should be active in strengthening nursing students in the field of comprehensive service, research, management, and training. Furthermore, no particular theory is mentioned.

The mission of the master’s degree in critical care nursing in Iran is to train efficient graduates with the necessary abilities to improve and optimize nursing care for critically ill patients who need special care, ultimately reducing the mortality and morbidity of these patients. Graduates of this field can improve the quality of nursing care and service for sick patients using research, modern science, and increasing clinical skills. Continuous advancements in medical technology and patient care require nurses to develop skills such as problem-solving, research utilization, documentation, and clinical decision-making (18).

The mission of the University of Sharjah is also to train nurses with modern science and teamwork to meet the current and future needs of their local community and beyond, expressing a more general view of service provision. The vision in Iran is specifically mentioned with regard to the objectives of the critical care master’s degree, with a focus on nursing in the critical care department, without paying attention to globalization. In contrast, the University of Sharjah, describes nursing as a global profession with a research-focused approach, highlighting the need to provide a creative and supportive environment.

The goals of the University of Iran are clear, understandable, and attainable, addressing a wide range of issues. These goals can be measured and achieved using appropriate methods. Additionally, they are related to the organization’s vital functions, including meeting the health needs of clients, but they do not include all organizational performance. For example, no goals are written in the field of education. Likewise, the goals of the University of Sharjah are mentioned in a clear, comprehensible, general, and achievable way and are related to the vital factors within the organization. However, these goals do not include all aspects of organizational performance, with no goal related to education, ethical and professional issues, management, and leadership. The emphasis is on the education of nurses with a focus on the use of technology, progress in the critical care practice, and evidence-based nursing, which plays a crucial and key role.

In Iran, graduates of this field take on caring, educational, research, and management roles. Considering their training in these four areas, they can work as clinical and educational faculty nurses. Moreover, their training enables them to be involved in implementing and researching plans related to their field of activity (15).

As mentioned, the graduates of this field in Iran can be recruited as faculty members, so it is necessary to pay more attention to this role to improve education. Many experts in the field of education believe that nursing schools currently focus too much on research and less on the education and training of efficient teachers (19). Graduates of this field at the University of Sharjah take on care, support, and research roles, with goals and course units aligned with these roles. However, they do not work in university teaching positions.

In Iran, student admission is done in a centralized way and through a national master’s exam, with no evaluation of their clinical qualifications or skills. Since students from other disciplines, including the operating room, are allowed to enter this field and these students have completed fewer units related to nursing courses, especially critical care, compared to nursing students, they have less clinical skills in special care. However, since admission is based solely on the theory test, this difference in skills does not affect acceptance. Another disadvantage of the admission process in Iran is the removal of the condition of two years of hospital work experience. Work experience before admission increases students’ clinical competence and skills in this important and sensitive field (20). In their study, Fowler et al found that, in addition to education, real experience plays an important role in increasing self-confidence and provides and providing valuable bedside information (21).

A notable issue in Iran is that most students lack sufficient mastery of English, and general language mastery is enough to enter the nursing master’s course, but after passing general and specialized language units, many students still lack the language skills needed to meet scientific and professional needs (22). In contrast, the University of Sharjah requires a language certificate with a valid score for admission, which is important for students’ success and growth in the educational and research process as the course is held in English (23). In this university, graduates from other related fields can also pursue their studies for a Master’s degree in adult critical care nursing, provided that their qualifications are approved by the educational department, faculty, and council before entry. Due to the importance of the field, people with insufficient theoretical and clinical skills and qualifications are prevented from entering. At the University of Sharjah, there are no prerequisites for admission to the course.

One of the advantages of the course at Sharjah University is that it can be completed on a part-time or full-time basis. As a result, people can choose and continue a course that suits their working and living conditions. This course in Iran is offered only full-time, which poses challenges for many students who are married or employed. A part-time course can reduce the student’s family and career problems, allowing students to combine their learning with individual experiences, ultimately increasing the quality of education.

The course units in the Iranian curriculum are focused on critical care (24), so it is beneficial to teach units related to modern science such as evidence-based nursing, critical thinking, and the like. Although useful workshops are held during the course, their training on up-to-date nursing topics is insufficient in most of the workshops.

Evidence-based nursing care in Iran faces obstacles, including limited time for nurses, the lack of doctor cooperation and participation in applying research results, and insufficient attention from nursing managers and planners to nursing research and its bedside application. Implementing evidence-based care requires a wide range of nursing competencies at the bedside (25).

The curriculum at the University of Sharjah includes only a few theoretical units related to intensive care nursing (4 units). Given the importance of this field and the students’ need for better learning of the intensive care topics, the curriculum needs further attention in this field. Conversely, theoretical courses related to critical care in Iran exceed those at Sharjah University, which is one of the strengths of Iran’s program. Clinical-related units in both universities are almost the same; however, Sharjah University places a strong emphasis on the implementation of evidence-based nursing, which is mentioned in the objectives and included in the curriculum.

In the Iranian program, units of law, nursing ethics, and professional relations are taught, along with theories, models, and concepts of critical care nursing, which are not taught at Sharjah University. Given the rise in legal problems and complaints in nursing, it is necessary for nurses to be familiar with legal issues to effectively perform their bedside duties. Nursing ethics and professional relationships are also among the basic principles in nursing. In addition, using nursing theories in patient care can enhance patient care standards, reduce nursing care costs, and improve patient quality of life. Therefore, these people should be trained using different theories and should be familiar with changes in attitude or actions during patient care (26).

The advancement of technology and the presence of many devices in specialized departments highlight the need for incorporating lessons or holding workshops on medical equipment, an aspect overlooked by both universities.

In Iran, master’s degree nursing students in critical care follow a curriculum similar to other studies. Additionally, some universities require students to present articles extracted from their thesis to obtain final grades, which has significantly slowed down their graduation process. Education researchers argue that graduate-level nursing education programs at the graduate level lack clear philosophy, goals, and mission, are not appropriate to the needs of society, and lack necessary quality. This results in many theses being of limited use, with degrees often leading to relative learning at the knowledge level, minimal behavior change, and insufficient skills in education, management, and specialized nursing. Consequently, graduates are employed in fields of education, management, and fields where they do not have the expertise or the ability to apply their learning effectively (11).

To enhance the quality of the course, it is recommended to benefit from a community-oriented educational program, revise the curriculum according to the current nursing needs, and use the experiences of reputable foreign universities. Considering clinical skills in the admission of volunteers, paying attention to the individuals’ employment in critical care departments, offering varied and flexible training programs, and defining job positions based on completed units can improve nursing care in this field.

Conclusion

According to the results of this comparative study, some findings related to the educational program at Sharjah University were obtained as strengths and models for the designers of the nursing education program in Iran. It is recommended that these findings be considered by the authorities according to the conditions and facilities available in our country. Among the strengths of the University of Sharjah is its special attention to the English language, the use of a valid English language degree as an acceptance criterion for all native and non-native students, and teaching in English. Offering both full-time and part-time courses allows for continuing education for people with different living and work conditions. Given the advancement of technology, the increase in the number of students, and the reduction in educational space, it would be beneficial to consider the use of artificial intelligence, clinical online training, and simulators in clinical training to improve the quality of education.

Since graduates in this field can be recruited as faculty members in educational centers, paying attention to the teaching method unit within the educational program can be useful. Additionally, having work experience at the bedside for accepting students and using evidence-based nursing care can produce more efficient graduates to provide service to patients. Paying attention to the job placement of graduates of this field and providing infrastructures that are suitable for trends in medical units can increase the motivation of students and graduates, ultimately improving public health and meeting patients’ needs.

Due to the growing and dynamic nature of nursing, it is important to educate nurses with appropriate functional skills, critical thinking, clinical decision-making abilities, clinical judgment, moral reasoning, and effective communication with patients. Creating conditions for nursing care based on clinical evidence can be a priority in reviewing the nursing care delivery system in the country.

One limitation of the research is the lack of access to current students. Furthermore, the researcher exclusively used documents available on the University of Sharjah’s website. It is suggested that in the future more universities and countries be used for comparative studies. Additionally, it is suggested to communicate with students and university officials via e-mail and virtual platforms to obtain more comprehensive information.

Acknowledgements

The authors are grateful to the Vice President of Research and Technology of Hamedan University of Medical Sciences for their support.

Authors’ Contribution

Data curation: Nasim Alipour,Zahra Khalili.

Methodology: Nasim Alipour.

Project administration: Seyyed Reza Borzou, Taybeh Hassan Tehrani.

Writing–original draft: Nasim Alipour, Zahra Khalili.

Writing–review & editing: Nasim Alipour.

Competing Interests

There was no conflict of interests regarding the collection and analysis of the material.

Ethical Approval

This study is extracted from the research approved by the Student Research Committee and Medical Ethics Committee of the University of Medical Sciences Hamadan, dated 2024/02/19, with the ethics code IR.UMSHA.REC.1402.712.

Funding

This study was financially supported by the Research Administration of Hamadan University of Medical Sciences, Iran (No. 1402112410275).

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