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Two educators from Kazakhstan leaning over a mannequin.

Twin Cities visitors: Nuridin Vohidov of Bukhara State Medical Institute in Uzbekistan (left) and Kalkaman from Ayapov of Almaty Nursing College in Kazakhstan check SimMan's vital signs. SimMan is the computer-run mannequin that joined the University's Academic Health Center in 2003.

Back to the future

School of Nursing faculty helping three former Soviet republics improve their nursing education programs

From eNews, June 8, 2006

When Sandra Edwardson, a professor in the University of Minnesota's School of Nursing, and five other faculty members toured healthcare facilities in Uzbekistan, Kyrgyzstan, and Kazakhstan in January 2004, they saw medical devices that had not been used in the United States for years. "Their hospitals are probably 1930s and '40s vintage," says Edwardson, former School of Nursing dean. "Some of the equipment I haven't ever used."

Likewise, when representatives of the three former Soviet republics visited Minnesota last October and sat in on nursing classes and observed nurses in action, they found themselves in equally unfamiliar territory. Not only was the equipment different, so were the roles of doctors and nurses.

They were surprised, for example, that U.S. nurses commonly use stethoscopes and otoscopes in routine health assessments of patients. In their countries, only a doctor would use such tools to examine a patient. "There, nurses are doing things that would be done by housekeeping staff or nursing assistants in this country," explains Edwardson.

But that may change, if Edwardson and a team from the School of Nursing are successful in their efforts to help the three Central Asian countries improve nursing education and expand the leadership capacity of nurses.

According Edwardson, who is leading the project, the countries' educational systems lag far behind their counterparts in Western Europe and the United States. "The issues that the School of Nursing had been working on 50 and 100 years ago are the issues that [these countries] are working on now--registering and licensing nurses, for example, and setting up professional associations," she says. The U.S. participants hope that their work will begin to help these countries take important steps forward to improve quality of nursing and therefore the care of patients.

Over the next couple of years, an $800,000 grant from the American International Health Alliance (AIHA) and the U.S. Agency for International Development will provide much-needed education materials and new equipment to the three countries. It will also provide several additional opportunities for delegations from both continents to visit each other.

Participating in the Nursing Education and Leadership Project with Edwardson are faculty members Donna Bliss, Laura Duckett, Carol O'Boyle, Laila Gulzar, Cheryl Robertson, Margaret Plumbo, Cathy Juve, and retired associate dean Marilee Miller, with staff member Stefannie Anderson providing support. Edwardson, who took a one-year sabbatical after serving as School of Nursing dean from 1990 to 2004, returned to her faculty position last fall.

After visiting schools recommended by the AIHA, the team selected two from each country, then met with representatives from the schools "to define what they wanted to accomplish, what we could offer, and come to consensus on what our goals would be," Edwardson says.

It was hard to know where to start. "Right now, they don't have nursing licensure," she says. "They're just beginning to develop registration systems for nurses, and just in the last two to three years they created professional associations."

The School of Nursing and Kazakhstan teams pose on the snowy mountains of Almaty, the largest city in Kazakhstan.

Last year, Edwardson and her team decided to focus on how to upgrade entry-level nursing education programs to approximate the Bachelor of Science in Nursing (BSN) in the United States. This year, the team has been focusing on master's-level education and hosted the October visit of a second delegation from Uzbekistan, Kyrgyzstan, and Kazakhstan.

Whereas the first group included only faculty and administrators from the schools, this one consisted mainly of nursing faculty and representatives from the Ministries of Health, who set the curriculum with which nursing schools must comply.

With the help of interpreters, the visitors were able to sit in on nursing classes and clinical sessions, study the curricula, tour the Academic Health Center, and hear about research by faculty and current nursing students.

While in Minnesota, the Central Asian visitors saw BSN and advanced practice nurses in action in several settings, from Mayo Clinic to nontraditional sites such as community clinics.

There will be more visits between the groups during the next year, and at the conclusion, Edwardson hopes that they will have helped the participants update their teaching. "Students don't have much of an opportunity to practice with patients," she says. "We hope that we can help them to understand that there's a link between what happens in the classroom and what happens in the clinical setting."

While most would see the work of the grant as an outreach effort, School of Nursing instructor Peg Plumbo echoes the sentiments of many of the U.S. participants who say gaining an international perspective on nursing was valuable to them. "My first work was to learn-about the customs, the political climate, and the day-to-day lives of the people," she says. "Meeting the people has been one of the most rewarding parts of the project. We are honored to be doing this work."