Page 20 - Nursing Education in Malaysia

NursiNg EducatioN iN Malaysia

With the exception of UKM graduates who are bound to Hospital Universiti
Kebangsaan Malaysia (HUKM) for at least five years up on graduation, other diploma
graduates are furnishing the current market nationally and internationally. Irrespective of
quality, they make a very attractive commodity. The impact in terms of “critical thinking,
problem solving and decision making” has not been apparent as a group – individually
perhaps, but this is rare and far between.

It is said that the product is as good as who makes them but on the other hand, the
product can only be as good as the input that is brought into the system. For more than 25
years, the entry requirements into the diploma programme have not changed. The same can
be said of the curriculum and its implementation. As far as nursing service is concerned,
this is the critical mass and the impact of patient outcomes is mostly generated by these
graduates. Further, the impact of the 12,000 diploma graduates produced per year has led
to the belief that for as long as the current situation continues to exist, nursing will remain
in the “support service” category and nurses will remain in the sub-professional group
within the government service.

If education is truly “an investment in human capital” then, the paradigm shift must
occur. The changing educational scenario is everywhere and nursing should and must be
a part of this scenario.

The UK experience where newly qualified nurses entering the profesion without the
necessary standard of skills most notably in numeracy and literacy and which has become
a growing problem for the National Health Service (NHS) is a lesson to be learned. This
statement sparked the issuance of a circular stating that by the time a student has qualified,
it expects to demonstrate the literacy and numeracy skills “essential for care delivery”.

In December 2008, NHS London had started introducing a quality control scheme,
a system called Quality Assurance, which rates the performance of all London healthcare
colleges and universities supplying staff to the NHS against key performance indicators
(KPI). Institutions would be issued a “traffic light” rating of red, amber or green. Those
with a red rating could have their contract terminated or reduced (the first rating was made
in April 2009).

The move was to ensure that the profesion recruits “The best candidates into nursing”.
It has been acknowledged that “The standard of pre-registration training-was not up to
scratch”. To this end, the National Committee had ratified proposals to make nursing “an
all-graduate profesion” across the UK by 2015. (Ford, 2009).

In the US, there are two levels of nurses: technical and profesional. The technical
nurse is to be prepared in a two year associate degree programme at universities or colleges
and the profesional nurse is to be prepared in a four year degree programme. The American
Nurses’ Association in 1985, proposed that the profesional nurse with a degree be licensed

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