Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Enduring Issue of Assessing Nursing Knowledge: Surgical Nursing Final Examinations in Australia and New Zealand, 1905-1930

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Enduring Issue of Assessing Nursing Knowledge: Surgical Nursing Final Examinations in Australia and New Zealand, 1905-1930

Article excerpt

Educators are continually faced with the issue of finding the most appropriate way to assess knowledge. The written examination is just one of the range of processes available for assessing knowledge at the end of a course. In nursing, as in other practice disciplines, educators also need to assess competence in the practice environment but examinations remain the common method for determining readiness for registration as a nurse. While these are now usually in the format of questions with multi-choice answers, in the past they required the candidate to display their knowledge through written responses.

Any process of written examination that draws candidates from several educational organisations requires significant preparation. Selecting appropriate examiners, constructing and marking an effective examination paper and making logistical arrangements are all issues. Educators often feel a responsibility to prepare students by coaching them in the best ways to respond to questions, so pay attention to feedback from previous examiners. These issues were also faced in the past by registrars, registration boards and professional associations assessing nurses' knowledge at the end of their course, and by nurse educators preparing them for the examinations. Little detail about this aspect of the history of nurse education is available in the literature. The purpose of this historical research was therefore to describe the final examinations in two countries, Australia and New Zealand, using the specific area of surgical nursing as an example, in the first three decades of the twentieth century when the examination process was first being established.

BACKGROUND

Toward the end of the nineteenth century, international interest in the place of nursing within health systems stimulated debate at the International Women's Congress in 1899 on the need to ensure quality nursing care and recognise trained nurses' qualifications (Nursing Record and Hospital World, 1899). On their return home, delegates from several countries continued arguing for the improvement and standardisation of nurse training and the formal recognition of qualified nurses. Some achieved success slowly, with opposition limiting their progress through the first decades of the twentieth century. In New Zealand, however, the Nurses Registration Act 1901 standardised nurse training to a 3-year course with a prescribed syllabus for all hospitals training nurses. Candidates for nursing registration sat state final examinations organised by the registrar, the chief medical officer in the central government department responsible for hospitals (later the Department of Health), assisted by the chief nurse. Names of successful nurses were entered on a register. The Nurses and Midwives Registration Act 1925 shifted this responsibility to a registration board with doctors and nurses included in its membership and the chief nurse became registrar. In Australia, the Sydney-based Australasian Trained Nurses' Association (ATNA), which also had doctors as members, set a syllabus in 1905 to guide training hospitals, held examinations for association membership and maintained its own register of qualified nurses. This examination process was also available for nurses in other Australian states but from 1902 Victoria had held its own examinations for membership of the Victorian Trained Nurses' Association and continued to do so. Later, as legislation was gradually enacted in individual states, Australian nurses were able to gain registration through registering boards' examinations. New South Wales (NSW), for example, passed legislation in 1924 and established a registration board in 1925 whose processes were based on those of the ATNA. In both countries' training hospitals, doctors delivered lectures while matrons, ward sisters and (increasingly from the 1920s) tutors taught specific aspects of nursing care and technique. Doctors set the final examination questions for registration or professional association membership, based on the syllabus. …

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