education cancer nursing curriculum 2013 eons cancer nursing curriculum 2013 (4th edition) ly acute....

Cancer Nursing Curriculum 2013

(4th Edition)

EONS

ED

UC

AT

ION

Published by European Oncology Nursing Society (EONS)

Avenue Mounier 83/8, B 1200 Brussels

Tel: 0032 2 779 99 23

Fax: 0032 2 779 99 37

email: [email protected]

web: www.cancernurse.eu

Design and Production: © 2013 Harris DPI. www.harrisdpi.com

Printed by Richline Graphics. www.richline.co.uk

The EONS Cancer Nursing Curriculum was previously published as:

Third edition EONS Post-basic Curriculum in Cancer Nursing (EONS, 2005)

Second edition A Core Curriculum for a Post-Registration Course in Cancer Nursing,

(EONS, 1999)

First edition EONS Post-basic Curriculum in Cancer Nursing, (EONS, 1991)

This publication is copyright under the Berne convention and universal copyright convention.

All rights reserved. No part of this publication may be reproduced or transmitted in any form

or by any means including photocopying and recording without the written permission of the

copyright holder. Such written permission must always be obtained from the publisher before

any part of this publication is stored in a retrieval system of any nature.

This publication is available as an electronic publication on request from the EONS secretariat

© European Oncology Nursing Society (EONS, 2013)

Contents ACKNOWLEDGEMENTS 5

FOREWORD 7

A VISION FOR CANCER NURSING IN 2013 9

REFERENCES 11

EDUCATIONAL PHILOSOPHY 13

EDUCATIONAL STRUCTURE AND CURRICULUM MODEL 14

STRUCTURE, LENGTH AND MODE OF DELIVERY 14

THE EONS EDUCATIONAL FRAMEWORK 15

ENTRY REQUIREMENTS 15

LEARNING AND PRACTICE OUTCOMES OF THE COURSE 16

THE CONTEXT OF CANCER NURSING 16

BASIC SCIENCE AND TREATMENT OF CANCER 17

NURSING ASSESSMENT AND INTERVENTIONS IN THE MANAGEMENT OF PEOPLE AFFECTED BY CANCER 18

CANCER AS A CHRONIC ILLNESS / SUPPORTIVE AND PALLIATIVE CARE 19

UNDERSTANDING IMPACT OF CANCER ON THE INDIVIDUAL, FAMILIES and HEALTH CARE PROFESSIONALS 20

INFORMATION AND COMMUNICATION IN CANCER CARE 21

CLINICAL LEADERSHIP AND RESOURCE MANAGEMENT OF CANCER NURSING 22

EVIDENCE BASED AND APPLIED RESEARCH IN CANCER CARE 23

THE CONTEXT OF CANCER NURSING 24

BASIC SCIENCE AND TREATMENT OF CANCER 26

NURSING ASSESSMENT AND INTERVENTIONS IN THE MANAGEMENT OF PEOPLE AFFECTED BY CANCER 28

CANCER AS A CHRONIC ILLNESS / SUPPORTIVE AND PALLIATIVE CARE 30

UNDERSTANDING IMPACT OF CANCER ON THE INDIVIDUAL, FAMILIES AND HEALTHCARE PROFESSIONALS 33

INFORMATION AND COMMUNICATION IN CANCER CARE 35

CLINICAL LEADERSHIP AND RESOURCE MANAGEMENT OF CANCER NURSING 37

EVIDENCE BASED AND APPLIED RESEARCH IN CANCER CARE 39

STRATEGY FOR TEACHING AND LEARNING 41

THE VALUE OF USER PERSPECTIVES 41

LEARNING FROM PRACTICE AND WITHIN PRACTICE 41

LEARNING AGREEMENTS 41

PRACTICE-BASED SKILLS AND COMPETENCIES 42

ASSESSMENT 42

QUALITY CONTROL AND EVALUATION 42

ECTS AND ACCREDITATION 43

4

EONS CANCER NURSING CURRICULUM 2013 (4TH EDITION)

5

AcknowledgementsRevisions have been made to the EONS curriculum in a 5 year cycle of refreshment

following an expert review in September 2011 further work with an expert panel of

reviewers in 2012 are acknowledged with gratitude. Edited by Sara Faithfull, Professor of

Cancer Nursing Practice, University of Surrey, Guildford, UK.

The EONS educational group would like to thank the expert panel for reviewing the

EONS Cancer Nursing Curriculum and providing feedback:

Denise Cullus RN

Director of the Nursing Department at the Jules Bordet Institute, Brussels, Belgium

Birgitte Grube MEd, RN. EONS President

Head of Education in Advanced Cancer Nursing

Danish Nurses Organisation, Copenhagen, Denmark

Steven O Connor PhD, MSc, BSc (Hons), Grad Dip Once, FHEA, RN

Principal Lecturer and Honorary Reader in Cancer, Palliative and End of Life Care,

Centre for Practice Development, Canterbury Christ Church University, UK.

Sultan Kav PhD, RN. EONS Past President

Associate Professor at Baskent University

Faculty of Health Sciences, Department of Nursing, Ankara, TURKEY

Joy Notter PhD, MSc, PGCEA, PGDip Soc., RHV, CPT, HVT, SRN

Professor of Community Health Care Studies, Centre for Health and Social Care

Research, Birmingham City University and Lector Cross Border Health Care and

Social Work, Saxon University of Applied Sciences

Anita Margulies RN, BSN,

EONS Board Member, Zurich, Switzerland

Nurgun Platin PhD, RN

Professor of Paediatric Nursing, Ankara,Turkey

Sebastian Probst D. Clin Prac, MNS, RN

Senior Researcher in the Institute of Nursing at the Zurich University of

Applied Sciences, Zürich, Switzerland

Other external expert reviewers were invited to evaluate the contents. EONS would like

to thank these persons for their time and engagement.

6


7

T he EONS Cancer Nursing Curriculum was in-

itially developed in 1991 with funding from

the European Union’s Europe Against Cancer

(EAC) programme. It was revised in 1998, 2005

and now in 2013. This curriculum has remained

the basis for European Oncology Nursing Society

(EONS) accreditation over the past twelve years.

The curriculum provides information on the ra-

tionale for a post-registration course in cancer

nursing, the curriculum philosophy and modular

framework. This information includes entry crite-

ria, comprehensive course content, and bibliogra-

phy. Expected learning outcomes and competen-

cies for the programme are also defined. Advice on

assessment and course evaluation is also provided.

The need for continuous reflection and review

on EONS curricula has arisen for several reasons;

education needs to respond to the changing na-

ture of cancer epidemiology and multi-modali-

ty management with increasing cancer surviv-

al across Europe. Furthermore cancer needs to be

considered increasingly as both an acute as well as

a chronic disease with the advanced disease path-

way lasting longer and being more complex. The

changing workforce roles of nurses; including ad-

vanced nurse practitioners, nurses leading oncol-

ogy case management, clinical nurse specialists in

tumour specific care groups, and the emergence of

multi-disciplinary teams, all impact on education-

al requirements. This complexity is reflected in

future workforce planning for oncology nursing.

Nurses play an important role in cancer treatment

delivery, patient information and symptom man-

agement, as well as psychological and supportive

care. Across Europe cancer nurses work in many

different capacities. However, there are some fun-

damental skills and knowledge that are applicable

in all care settings. The revised curriculum recog-

nises these fundamental skills for nurses post in-

itial registration and is seen as the core require-

ment for nursing competence for those who are

working within the field of oncology. This curricu-

lum focuses on the adult with cancer. It can be im-

plemented in guiding curricula development for

all nursing education programs whether for nurs-

es working in cancer centers or in general prac-

tice/hospital settings. Furthermore, in many coun-

tries cancer nurses are required to take leadership

roles and develop the evidence base for cancer

nursing outcomes. The revised curriculum adds

new areas to the programme, reflecting the need

for wider skills in cancer nursing.

Academic credits and quality assurance guid-

ance reflect the Bologna agreement, the harmoni-

sation of educational levels across Europe, which

impacts upon nurse education. This agreement has

been about developing a common, three-tier sys-

tem of bachelors, masters and doctoral degrees. A

common European Credit Transfer System (ECTS),

allows learners to combine studies at different Eu-

ropean centres to develop their professional qual-

ifications. These are now well recognised within

some parts of Europe. The EONS Cancer Nursing

Curriculum 2013 is modular, providing eight mod-

ules that can be taken over a single period of 40

weeks. The curriculum is a framework for future

educational development, and EONS members are

advised to adapt it as necessary to meet their own

professional needs for cancer nursing within their

own country. In addition, guidance on supervision

of practice, training facilities and quality assur-

ance requirements is also provided.

Birgitte Grube

EONS President 2011-2013

Foreword

8


9

E ducation is clearly an important tool in the

development of cancer nursing within Eu-

rope. Nurses play an important role in support-

ing cancer therapy and have impacted on the

quality of care outcomes. Awareness of how

nurse’s impact on cancer care is well recog-

nised by patient groups and specialist teams

but workforce planning within health servic-

es often neglect the skill and education re-

quired to provide such support for individuals

with cancer and their families1. Education im-

proves care, can enhance patient outcomes2,3,4

through reducing emergency admissions, inpa-

tient stays, helps improve satisfaction and re-

duces adverse events of cancer treatment5,6.

Care is becoming more complex with the

ever changing and increasing complexity of

cancer treatment delivery, which is demanding

wider skills and critical thinking among nurses

working in oncology7,8. Individuals with cancer

are being cared for in community and ambula-

tory settings9 as well as in cancer centres and

general hospitals. This has created the need for

widening cancer knowledge to nurses work-

ing in other fields such as care of older people,

family medicine and public health10-12.

There are also social and economic pres-

sures that are influencing educational change

with the move of nursing vocational courses

into higher education13. EU directives provide

political pressure to ensure the effectiveness

and efficacy of cancer care raising the profile

by identifying the need to improve knowledge

of oncology. The commission identified the vi-

tal role of the different professions in the pro-

vision of cancer therapy; rehabilitation and

terminal care in its recent call for action to re-

duce inequalities in cancer outcomes (EPAAC).

There is also a global recognition that we need

to improve the knowledge and skills of health

professionals in cancer as well as in cancer pre-

vention and screening (WHO). It is timely to re-

flect on where cancer nurse education should

be in leading change and in advancing cancer

nursing roles within the next 5 years.

This curriculum introduction explores the

challenges ahead in how we develop our fu-

ture cancer nursing workforce. Over the last 10

years cancer care has been changing. Develop-

ments include reforms of health care systems,

changes in treatment and the development of

consumer focused provision. From all the re-

cent projections and figures14 we know that in

2008 12.7 million cancer cases were registered

and that there were 7.6 million deaths global-

ly. In Europe cancer incidence and mortality

vary between northern, western and southern

Europe. With an increasing ageing population

the cancer burden within Europe is expected to

rise over the next 10 years15. We also know that

those individuals who have cancer are more

likely to be surviving their diagnosis and re-

quiring prolonged monitoring and greater reha-

bilitation needs16. Responding to these scien-

tific and technological innovations is difficult

as often health services reform follows major

change with little planning or educational pro-

vision. The reality is that throughput of pa-

tients is high within cancer centres, bed stays

are short and hospital treatment is increasing-

A Vision for Cancer Nursing in 2013

10


ly acute. The increased use of ambulatory care

and oral medication has shifted care from hos-

pitals to the home where the provision of spe-

cialist nursing is often limited. Providing such

supportive care requires translation across dis-

ciplines and care settings with multi-agency

approaches to prevention and care17,18. These

changes coupled with ever increasing de-

mands in health care require a constantly de-

veloping and flexible nursing workforce19. In

many countries there are shortages of nurses

with future retirement and workforce numbers

fluctuating. In Europe retirement of nurses is

not being offset by sufficient numbers being

trained for example Italy and Germany have a

deficit. Unfilled specialist training places are

also found within e.g. Romania, France, Hun-

gary and Austria where other professions seem

more attractive. Evidence from some countries

suggests that health systems are struggling to

retain nurses with high turnover, becoming an

increasing problem. Studies have reported low

pay and also non-financial factors such as long

hours and work related stress as the main con-

tributory factors.

The economic crisis and cost containment

measures within health care are also profound-

ly affecting recruitment and retention of nurses

within almost half of the European countries22.

This also impacts on nurse migration depleting

areas of eastern and southern Europe of skilled

practitioners23. The European commission es-

timates a shortfall of around 1 million health

care workers by 202024. Oncology is an area of

high risk which requires staff to be motivated,

valued and with career prospects. Education

plays a pivotal role in maintaining skilled staff

and providing job satisfaction20,21.

Evidence is limited as to whether current

nursing provision is fit for purpose in meet-

ing these needs as there are few evaluation

studies of continuing professional cancer ed-

ucation. Although not oncology based, stud-

ies of nurse graduates have found that nurses

undergoing academic studies perform signif-

icantly better at decision making than their

non-academic colleagues. Practice outcomes

are difficult in oncology and such studies are

scarce and it is not surprising that evaluation

of nurses perceptions of their practice has

been the most common way of evaluating the

impact of continuing professional education.

Studies of the nurses themselves indicate that

continuing professional education improves

confidence and has a perceived impact on

practice3,4,25. A study of a UK health provid-

er found that nurses’ perceptions of training

needs are often different from that of health

managers and that curriculum content did

not reflect cultural characteristics of the local

health economy1. The wide variation in con-

tinuing educational provision has been seen

in specific courses such as in chemotherapy

administration and training with some nurses

receiving minimal education in the underpin-

nings of knowledge required for safe chemo-

therapy practice26. Much has improved in the

last few years in the provision of continuing

education for nurses across Europe. However

there is little agreement as to a universal edu-

cational currency or recognition of continuing

professional development27.

Recognising that the developments within

education have been quite dramatic in the last

few years more is being required of educators.

This has seen the implementation of the Bo-

logna declaration and the subsequent changes

in academic and vocational educational struc-

tures. Furthermore increasing financial con-

straints in education has meant that nurses

are finding it difficult to get time for or fund-

ing to allow further continuing professional de-

velopment within many EU academic institu-

tions. There is also an increasing need for short

11

work-based programmes. The development of

the EONS cancer nursing curriculum has made

an impact on learning resources and provided

guidance for structuring the learning content

of educational programs. Future development

of new specialist curricula and advancing lev-

els of practice through consensus and expert

panels identify these curricular as a gold stand-

ard of professional education across Europe.

We need more evidence as to the value of spe-

cialist education to continue developing con-

fident and expert nurses. Those in nurse edu-

cation face many challenges not only in how

cancer education is provided and to whom, but

also in redefining the skills needed by the can-

cer workforce for the future.

REFERENCES1. Kelly D, Gould D, White I, et al: Modernising can-

cer and palliative care education in the UK: In-

sights from one cancer network. Eur J Oncol Nurs

10:187-197, 2006

2. Coleman M: Responding to the challenge of cancer

in Europe, Institute of Public Health of the Repub-

lic of Slovenia, 2008

3. Doran D, Harrison M, Laschinger H, et al: Nurs-

ing-sensitive outcomes data collection in acute

care and long-term-care settings. Nurs Res 55:S75-

81, 2006

4. Given B, Sherwood P: Nursing sensitive patient

outcomes--a white paper. Oncol Nurs Forum

32:773-84, 2005

5. Griffiths P, Richardson A, Blackwell R: Outcomes

sensitive to nursing service quality in ambulatory

cancer chemotherapy: Systematic scoping review.

Eur J Oncol Nurs 16:238-46, 2012

6. Sussman J, Howell D, Whelan T, et al: Prospec-

tive study of specialist oncology community nurs-

ing resulting in improvements in key patient sup-

portive care outcomes. ASCO Meeting Abstracts

25:9107-, 2007

7. Farrell C, Molassiotis A, Beaver K, et al: Explor-

ing the scope of oncology specialist nurses’ prac-

tice in the UK. Eur J Oncol Nurs doi:10.1016/j.

ejon.2010.07.009:1-7, 2010

8. Ellen Wyatt D: The impact of oncology education

on practice--A literature review. European Journal

of Oncology Nursing 11:255-261, 2007

9. Sive J, Ardeshna K, Cheesman S, et al: Hotel-based

ambulatory care for complex cancer patients: a re-

view of the University College London Hospital ex-

perience. Leuk Lymphoma 53:2397-404, 2012

10. Wood C, Ward J: A general overview of the cancer

education needs of non-specialist staff. European

Journal of Cancer Care 9:191-196, 2000

11. Lobchuk M, Udod S: Oncology nurses’ perceptions

of their relations with family members in an ambu-

latory cancer care setting: a mixed methods study.

Can Oncol Nurs J 21:64-80, 2011

12. Szecsenyi J, Broge B, Eckhardt J, et al: Tearing

down walls: opening the border between hospi-

tal and ambulatory care for quality improvement

in Germany. Int. J. Qual. Health Care 24:101-104,

2012

13. Foubert J, Faithfull S: Education in Europe: are can-

cer nurses ready for the future? J BUON 11:281-

4, 2006

14. Jemal A, Bray F, Center M, et al: Global cancer sta-

tistics. CA Cancer J Clin 61:69-90, 2011

15. Berrino F, de Angelis R, Sant M, et al: Survival for

eight major cancers and all cancers combined for

European adults diagnosed in 1995-99 results of

the EUROCARE-4 study. Lancet Oncology 8:773-

783, 2007

16. Maher J, McConnell H: New pathways of care for

cancer survivors: adding the numbers. BJC 105:S5-

10, 2011

17. Jacobs LA, Palmer SC, Schwartz LA, et al: Adult

cancer survivorship: evolution, research, and plan-

ning care. CA Cancer J Clin 59:391-410, 2009

18. Dallred C, Dains J, Corrigan G: Nursing workforce

issues: strategically positioning nurses to facilitate

cancer prevention and control. J Cancer Educ 27

Suppl 2:S144-8, 2012

12


19. Gould D, Kelly D, White I, et al: The impact of com-

missioning processes on the delivery of continu-

ing professional education for cancer and pallia-

tive care. Nurse Educ Today 24:443-451, 2004

20. Girot E, Albarran J: Sustaining the education work-

force in healthcare: challenges for the future.

Nurse Educ Today 32:32-8, 2012

21. IOM: The Future of Nursing: Leading Change, Ad-

vancing Health, in the CotRWJFIo, Nursing Fo

(eds). USA, Institute of Medicine; Institute of Med-

icine, 2011

22. Wismar M, Maier C, Glinos I, et al: Health profes-

sional mobility and health systems. Evidence from

17 European countries, , in 23 OSn (ed): European

Observatory on Health Systems and Policies. Co-

penhagen, WHO Regional Office for Europe, 2011

23. Nurses EFo: Caring in crisis: The impact of the fi-

nancial crisis on nurses and nursing: A compara-

tive overview of 34 European countries, European

Federation of Nurses 2011

24. Commission E: An action plan for the EU health

workforce, Commision staff working document.

Strasbourg, 2012

25. Coleman E, Coon S, Lockhart K, et al: Effect of cer-

tification in oncology nursing on nursing-sensitive

outcomes. J Nurs Adm 40:S35-42, 2010

26. Verity R, Wiseman T, Ream E, et al: Exploring the

work of nurses who administer chemotherapy. Eur

J Oncol Nurs 12:244-252, 2008

27. Saltman D, Kidd M, Jackson D, et al: Transporta-

bility of tertiary qualifications and CPD: a continu-

ing challenge for the global health workforce. BMC

Med Educ 12:51, 2012

13

Key messages of the cancer

education philosophy:

●● Nurses should practice to the full extent of

their education and training

●● Nurses should achieve higher levels of ed-

ucation and training cross Europe

●● Nurses should be full partners in the multi-

disciplinary oncology team

●● Nursing education is essential for effective

workforce planning. In turn cancer patient

outcomes should improve

●● Nurses should be prepared and enabled to

lead change and develop evidence based

specialist cancer nursing practice.

Cancer nurses need:

●● to be capable of creating a therapeutic en-

vironment where it is possible for patients

and families to express their needs and to

have these needs met in a culturally sensi-

tive manner

●● to be accountable for their practice

●● to be able to recognise the limits of their

expertise

●● to be capable of providing care, which is

patient focused and based upon the best

available evidence.

When necessary, they should:

●● have the confidence to challenge practices

or decisions that may be detrimental

to patient outcomes

●● be aware of their role within the multi-

professional team and

●● be both confident and competent to

practice in a collaborative manner with

all members of that team.

Moreover, they should both value and be able

to articulate to others the therapeutic value of

nursing. Courses based on this curriculum need

to be practice-driven and dynamic enough to re-

flect both the changes in, and scope of, cancer

nursing practice in a particular country.

Teaching and learning within the curricu-

lum framework is designed to support student

development through lifelong professional

learning. Encouraging nurses to continue par-

ticipating in the learning process is one way

of individualising learning. This recognises

and develops the learning as person centred,

unique to that individual but within the broad

framework of the learning outcomes. Learning

through practice and experience is central to

the curriculum model, and the development of

professional knowledge is therefore given equal

value to the traditional approach to learning

through attainment of academic knowledge.

This style of learning encourages learner par-

ticipation and values the variety of experienc-

es that learners bring to cancer nursing across

Europe. Learning focuses on the processes

whereby desired outcomes of professional ef-

fectiveness are achieved, leading naturally to

an enquiry based learning approach. This in-

cludes the process through which practical ex-

perience, critical judgement and exploration

of the evidence base leads to the development

of professional knowledge and expertise. Such

knowledge is more reflective and is developed

through supervision, experience, dialogue and

discussion. These methods facilitate the appro-

priate development of critical analytic skills,

and the skills of communication, change man-

agement and decision making.

Educational Philosophy

14


The main educational aims of the EONS

curriculum are as follows:

●● Raise awareness of cancer nursing as a spe-

cialty within European health care.

●● Provide a practice-based framework for ed-

ucators and managers to facilitate post-reg-

istration cancer nurse training and profes-

sional development.

●● Enhance cancer nurses’ knowledge, un-

derstanding and practice skills to improve

health care management for people with

cancer.

●● Empower nurses to offer input into the

multidisciplinary cancer team for research,

management and practice.

●● Foster the development of strategic capacity

and capability within cancer nursing.

STRUCTURE, LENGTH AND MODE OF DELIVERYThe EONS curriculum for cancer nursing is

structured as a modular framework providing

eight modules that can either be taken together

as a long course or as stand-alone, short-course

modules contributing to lifelong learning and

continuing professional development (Figure

1). The length of the course includes practice

as well as theory elements, with each week

comprising 30 hours study. Thus the overall

length of the course is 40 weeks or 1200 hours,

which equates to 60 ECTS credit points. Learn-

ing outcomes and competencies have been

identified so that users of the framework can

apply for institutional credits at the appropri-

ate level. The course is set at level 6 (first cy-

cle) Bologna qualifications framework. Each

module provides a self-contained training ele-

ment with content, assessment of learning out-

comes and competencies for practice. In future

revisions this may need to be revised to lev-

el 7 as nursing becomes a graduate profession

throughout Europe.

Educational Structure and Curriculum Model

15

The EONS Educational Framework

ENTRY REQUIREMENTS To gain entry to a specialised oncology nursing education program a nurse must have achieved

the first-level qualification of a nurse as specified in the EC Directive 77/452/EEC (subsequently

amended by Council Directive 89/595/EEC) or its equivalent in other countries. It is recommend-

ed that students should have at least one year’s post-registration experience in either a general or

cancer setting. If the course is run on a part-time basis, the nurse must be involved in the care of

people with cancer and their families for the duration of the course.

16


Learning and Practice Outcomes of the Course

The Context of Cancer Nursing

LEARNING OUTCOMES:

THE STUDENT WILL BE ABLE TO:

PRACTICE-BASED SKILLS AND COMPETENCIES:


Critically review epidemiological and prevalence statistics for cancer within Europe understanding both demographic and cultural differences.

Direct individuals and family members to appropriate information sources about the epidemiology of cancer within Europe.

Identify common causes, signs and symptoms of cancer and explain how their recognition and early diagnosis influences morbidity.

Explain the multifactorial causes of cancer, to cancer patients and members of their family, provide appropriate health and risk advice so that individuals can monitor for early signs of cancer and adopt healthy lifestyle behaviours.

Describe how attitudes, values and beliefs in relation to cancer influence the care that cancer patients and their families receive.

Demonstrate knowledge of the wider physical, psychological, social and spiritual factors that can affect people treated for cancer.

Recognise the importance of employing culturally sensitive approaches in the care of people with cancer and their families.

Demonstrate a holistic, tolerant, non- judgmental and caring manner; promote the rights, beliefs, and wishes of individuals and families with cancer.

Critically review the different policy contexts in which cancer care is delivered.

Adjust professional behaviour to respond effectively to population and/or individual needs dependent on the cancer care setting.

Outline the principles of cancer nursing practice and explain how health care is organised through the cancer journey.

Communicate the different roles, responsibilities and functions of a cancer nurse and respond effectively to population and individual needs.

17

Basic Science and Treatment of Cancer

LEARNING OUTCOMES:




Demonstrate a clear understanding of the aetiology, biology and patho-physiology in the development of cancer.

Explain relevant information about the causes of cancer to patients and their families, assess their understanding of these, and provide information and reassurance where necessary.

Identify risk factors for cancer and describe approaches for prevention, screening and early detection of cancer.

Participate in health promotion activities and provide appropriate health education to safeguard the health and wellbeing of the public.

Describe approaches to the diagnosis and staging of cancer and the nurse’s role in supporting patients through this process.

Demonstrate sensitivity towards patients and families throughout all phases of the cancer journey.

Demonstrate understanding of the principles of cancer therapies and describe the application of multi- modality cancer treatment.

Assess the patient and/or family members’ understanding and is able to explain and facilitate patient education and choice in relation to these.

Demonstrate comprehensive knowledge of the common acute and late side effects of cancer therapies.

Undertake an accurate assessment of treatment side-effects and applies relevant treatment knowledge to the nursing care of treatment side effects.

Reflect on lay perspectives of health and illness. Provide a supportive environment in which patients and family members are encouraged to share their concerns.

18


Nursing Assessment and Interventions in

the Management of People Affected by Cancer

LEARNING OUTCOMES:




Demonstrate the principles of holistic assessment in cancer practice.

Undertake a comprehensive nursing assessment taking into account relevant physical, social, cultural, psychological and spiritual factors.

Appraise decision making and how this impacts on cancer nursing assessment using both objective and subjective health problems associated with cancer and its treatment.

Monitor the patient’s health status for signs and symptoms of deterioration and take steps to document, intervene or refer appropriately.

Demonstrate an understanding of the complex, changing, multiple health needs of patients with cancer and their families across the disease trajectory.

Implement and critically evaluate a range of evidence-based interventions to manage the complex, multiple health needs of cancer patients and their families.

Critically review the evidence base for nursing management of cancer symptoms and treatment side effects.

Work in partnership with the patient to manage symptoms of cancer and subsequent consequences of cancer treatment.

Demonstrate knowledge about the safe administration of cancer therapies and the nursing interventions necessary to manage an adverse reaction to treatment.

Demonstrate knowledge of health and safety implications for cancer treatments that impact on patients and other staff members. Safely administers and monitors treatments using the correct medical devices and/or techniques.

Construct a care plan for a patient with cancer and document.

Provide personalised care plans based on individual risks, needs and preferences of the patient.

19

Cancer as a Chronic Illness / Supportive

and Palliative Care

LEARNING OUTCOMES:




Demonstrate knowledge of the implications of chronic illness and long-term survivorship in those affected by cancer.

Appropriately consider co-morbidity, the impact of chronic illness and long-term survivorship on the health status of the patient with cancer and members of his or her family and implement appropriate referrals to other professionals and agencies in respect of these.

Understand the potential consequences of long term and late effects of cancer treatment.

Undertake a risk assessment and provide appropriate help and advice in respect to self-monitoring of long term consequences of cancer.

Describe the principles of rehabilitation, self-management and lifestyle interventions for improving quality of life in those affected by cancer.

Undertake an assessment of the motivation and capacity of the patient and members of his or her family to self-manage their condition and promotes a healthy lifestyle during cancer rehabilitation.

Understand the importance of long-term medicines management and the dangers of non-adherence in patients with cancer.

Effectively evaluate patient adherence and concordance when taking medication for cancer or other long-term chronic conditions and engage in patient education about the benefits of adherence.

Demonstrate an understanding of the importance of seamless transitions between the acute and home care and from active treatment to survival programs, palliative and end-of-life care.

Engage in appropriate discharge planning and co-ordinate care between different health and social care providers including voluntary and statutory care agencies.

Describe the role of supportive, palliative and end-of-life care, for patients and their family.

Facilitate appropriate discussions between health and social care professionals, patients and their family members to elicit their preferences with respect to the transition between active and palliative or end-of life care.

20


Understanding Impact of Cancer on the Individual,

Families and Healthcare Professionals

LEARNING OUTCOMES:




Demonstrate an understanding of the potential psychosocial consequences of a cancer diagnosis and its treatment on individuals and their family members.

Provide advice and support to enable people to manage the impact of diagnosis and treatment on their relationships with those important to them.

Recognise the differing care needs of patients from disadvantaged or vulnerable groups.

Use evidence-based strategies to deal with communication issues and refer appropriately.

Discuss the impact of inheritable, social or lifestyle traits which predispose particular individuals or families to cancer and consider the impact of these on family health and social wellbeing.

Undertake a family risk assessment and discuss social, heritable or lifestyle factors with at risk individuals whilst alleviating anxiety and providing help and reassurance to the worried well.

Describe the theories of supportive care and how coping strategies impact on quality of life of people with cancer and their families.

Assess the supportive care needs of patients and their families and be able to refer as appropriate support services.

Consider the potential emotional stress of caring for people who have cancer.

Recognise the social, financial and emotional consequences of a cancer diagnosis for patients with cancer and family members and respond appropriately making suitable referrals if necessary.

Consider his/her own attitudes, beliefs and behaviours towards end-of-life care and appraises the clinical value of bereavement theories in palliative and end-of-life care.

Demonstrate tact, reflexivity and sensitivity towards the needs of patients who are dying, and demonstrate awareness of their psychosocial and spiritual needs, and those of their family members.

21

Information and Communication

in Cancer Care

LEARNING OUTCOMES:




Identify the information requirements of individuals with cancer during their cancer diagnosis, therapy, after care and period of supportive care.

Direct individuals and family members to appropriate services and provide a plan or prescription of information.

Describe health promotion theories and apply the principles of teaching and learning to patient education.

Assess the on-going and changing needs of the patient and family members for education, evaluating the individuals understanding of advice and information over time.

Reflect on communication skills and consider theories of good communication in supporting the individual and family affected by cancer.

Demonstrate the use of a range of communication techniques to promote well-being in a person with cancer, for example: counselling skills, challenging behaviour and active listening.

Discuss how advocacy and disclosure in cancer care can benefit and cause conflict between individuals with cancer, families and health care providers.

Recognise the ethical and legal dilemmas as an advocate in providing informed consent and support for patients with cancer.

Identify how multidisciplinary team communication can benefit patient care and improve transitions between acute and home care.

Provide information and advice within the multidisciplinary team to support patient care.

Differentiate between the different roles information technology can have in improving cancer documentation, remote health management and in providing supportive care.

Engage in electronic documentation and in supporting e-health and telemedicine within cancer care, for example, care planning and documentation systems, survivorship care plan.

22


Clinical Leadership and Resource Management

of Cancer Nursing

LEARNING OUTCOMES:




Consider the importance of legal, ethical and professional issues in relation to the care and management of patients with cancer.

Demonstrate the application of legal, ethical and professional principles in his/her practice and seek to act as an effective patient advocate at all times.

Analyse and discuss the contribution made by quality standards to the care of cancer patients.

Provide leadership in the implementation and evaluation of cancer quality standards.

Articulate the principles of risk assessment and management in relation to the care of cancer patients.

Assess risk and implement appropriate risk management strategies in order to promote patient well-being and safety in their practice area.

Reflect on leadership styles and how different models of clinical leadership can impact on management of cancer care.

Apply appropriate leadership and management strategies in their practice area and evaluate the impact of these upon others in the cancer care team.

Discuss the strategies which might be used to facilitate both his/her own, and others’ learning in clinical practice.

Demonstrate evidence of his/her own continuing professional development and actively promote the learning of colleagues and others in the clinical practice area.

Discuss the importance of relevant resource management strategies in relation to cancer care.

Demonstrate the ability to plan, allocate, coordinate and evaluate the use of healthcare resources in an appropriate manner when providing care to patients with cancer and their families.

23

Evidence Based and Applied Research

in Cancer Care

LEARNING OUTCOMES:




Evaluate the importance of cancer nursing research to the field of cancer care.

Correctly identify he need for clinical evidence and formulate appropriate clinical questions when working in cancer settings.

Critically discuss the contribution of information technology to the implementation of evidence based practice in cancer nursing.

Make appropriate use of information technologies when retrieving evidence upon which to base cancer nursing interventions in their practice area.

Analyse different sources of information and apply as appropriate to practice.

Demonstrate the ability to provide evidence based rationale for the cancer nursing interventions implemented in their clinical area.

Describe the principles of cancer clinical trials and the contribution which nurses make to the safe conduct of multidisciplinary research.

Demonstrate his/her ability to participate in clinical trials as part of a multi-professional team and support more junior colleagues in this role.

Discuss ethical principles in relation to the conduct of cancer clinical trials.

Demonstrate appropriate strategies to safeguard the interests and wellbeing of patients including the obtaining of informed consent, maintaining patient confidentiality and dignity, documenting and reporting drug interactions or other adverse events where required.

Outline the use of health services research in cancer service development and explore the role of clinical audit in practice development.

Use specialist knowledge to contribute to the development of evidence based policies and procedures and practice development for cancer nursing.

24


Contact hours: 60 hours

Study hours with practice: 120 hours

ECT credit points: 6

MODULE SUMMARY This module introduces the learner to key con-

cepts which have shaped the development of

cancer services at a national and internation-

al level. The study content explores how na-

tions as well as individuals are affected by can-

cer incidence and diagnosis. The cultural basis

for cancer attitudes and values will be explored

and the relationship between self-beliefs and

care practices. Different contexts of cancer pro-

vision will be identified and the role of cancer

prevention, detection, health promotion and

patient education in reducing cancer incidence

will be explored and discussed.

LEARNING OUTCOMES 1. Critically review epidemiological and prev-

alence statistics for cancer within Europe

understanding both demographic and cul-

tural differences.

2. Identify common causes, signs and symp-

toms of cancer and explain how their recogni-

tion and early diagnosis influences morbidity.

3. Describe how attitudes, values and beliefs

in relation to cancer influence the care that

cancer patients and their families receive.

4. Recognise the importance of employing cul-

turally sensitive approaches in the care of

people with cancer and their families.

5. Critically review the different policy con-

texts in which cancer care is delivered.

6. Outline the principles of cancer nursing

practice and explain how health care is or-

ganised through the cancer journey.

PRACTICE BASED SKILLS AND COMPETENCIES Is able to:

1. Direct individuals and family members to

appropriate information sources about the

epidemiology of cancer within Europe.

2. Explain the multifactorial causes of cancer,

to cancer patients and members of their

family, provide appropriate health and risk

advice so that individuals can monitor for

early signs of cancer and adopt healthy

lifestyle behaviours.

3. Demonstrate knowledge of the wider physi-

cal, psychological social and spiritual factors

that can affect people treated for cancer.

4. Demonstrate a holistic, tolerant, non- judg-

mental and caring manner; promote the

rights, beliefs, and wishes of individuals

and families with cancer.

5. Adjust professional behaviour to respond

effectively to population and/or individual

needs dependent on the cancer care setting.

6. Communicate the different roles, responsi-

bilities and functions of a cancer nurse and

respond effectively to population and indi-

vidual needs.

CONTENT (in alphabetic order):●● Cancer and public health

●● Cancer risk and causation

●● Cancer trajectory: prevention, screening for

cancer, early detection, pre-diagnosis, man-

agement, treatment, post-treatment, follow

up, survivorship, chronic illness and end of

life care phases

●● Epidemiology of cancer within Europe

●● Explore the influence of healthcare policy on

cancer services (e.g. national cancer plans,

The Context of Cancer Nursing

25

advisory documents and national policy)

●● Health belief theories and their role in mod-

ifying cancer risk behaviours

●● Health promotion and health education

●● Legal and ethical requirements for cancer

nursing practice within Europe

●● Media and public attitudes to cancer

●● Policy context in different countries with-

in Europe

●● Professional context of cancer nursing and

specialist oncology nursing roles

●● Social and cultural attitudes to cancer and

their influence on policy and individual de-

cision making

●● Understanding cancer statistics and regis-

try data (National and International).

TEACHING AND LEARNING METHODS Lectures, reflective exercises, group work, case

studies, seminars, debate and discussion.

ASSESSMENT METHODS Subject knowledge: Analyse an aspect of can-

cer policy. Grade: 50%

Practice: Assessment of health risk of an indi-

vidual. Grade: 50%

BIBLIOGRAPHY AND RESOURCES AIKEN ET AL, 2012. Patient safety, satisfaction, and qual-

ity of hospital care: cross sectional surveys of nurses and

patients in 12 countries in Europe and the United States

BMJ,20;344:e1717

BAKKER,D STRICKLAND J, MACDONALD C, BUTLER

L, FITCH M, OLSON K, CUMMINGS G, 2013. The Con-

text of Oncology Nursing Practice: an integrative review,

Cancer Nursing 36 (1) 72-88

FARRELL C, MOLASSIOTIS A, BEAVER K, HEAVEN C.

2010. Exploring the scope of oncology specialist nurses’

practice in the UK. Eur J Oncol Nursing, 15(2): 160-6.

COWMAN S ET AL. 2010. Evaluation of the Role

of the Clinical Nurse Specialist in Cancer Care.

http://www.rcsi.ie/files/facultyofnursingmidwifery/

docs/20110518024459_Final%20Report%20CNS%20

Study%20July%2020.pdf

GRIFFITHS P, RICHARDSON A, BLACKWELL R 2012.

Outcomes sensitive to nursing service quality in ambu-

latory cancer chemotherapy: Systematic scoping review.

European Journal of Oncology Nursing 16: 238-246

MACMILLAN CANCER RELIEF,2010. Excellence in

cancer care The Contribution of the Clinical Nurse Spe-

cialist, http://www.macmillan.org.uk/Documents/Abou-

tUs/Commissioners/ExcellenceinCancerCaretheContri-

butionoftheClinicalNurseSpecialist.pdf

SCHNEIDER F, FAITHFULL S, 2011. “What does a special-

ist nurse mean across Europe”. EONS Magazine Spring

2011, 28-31.http://www.cancernurse.eu/documents/news-

letter/2011spring/EONS Newsletter, springPage28.pdf

WIENCEK CA, FERRELL BR, JACKSON M. (2011) The

meaning of our work: caring for the critically ill patient

with cancer. Adv Crit Care, 22(4):397-407

26





MODULE SUMMARY This module is about the basics of cancer de-

velopment and the biological processes that

contribute to the development of cancer. This

knowledge is important not only in under-

standing how cancer arises but also why and

the how cancer treatment is given. New de-

velopments in cancer treatment are occurring

rapidly and the need to update knowledge and

skills in an increasingly technical speciality is

important for the nurse.

LEARNING OUTCOMES 1. Demonstrate a clear understanding of the

aetiology, biology and patho-physiology in

the development of cancer.

2. Identify risk factors for cancer and describe

approaches for the prevention, screening

and early detection of cancer.

3. Describe approaches to the diagnosis and

staging of cancer and the nurse’s role in

supporting patients through this process.

4. Demonstrate understanding of the prin-

ciples of cancer therapies and describe

the application of multi- modality cancer

treatment.

5. Demonstrate comprehensive knowledge of

the common acute and late side effects of

cancer therapies.

6. Reflect on lay perspectives of health and

illness.


1. Explain relevant information about the

causes of cancer to patients and their fam-

ilies, assess their understanding of these,

and provide information and reassurance

where necessary.

2. Participate in health promotion activities and

provide appropriate health education to safe-

guard the health and wellbeing of the public

3. Demonstrate sensitivity towards patients

and families throughout all phases of the

cancer journey.

4. Assess the patient and/or family members’

understanding and is able to explain and fa-

cilitate patient education and choice in rela-

tion to these.

5. Undertake an accurate assessment of treat-

ment side-effects and applies relevant treat-

ment knowledge to the nursing care of treat-

ment side effects.

6. Provide a supportive environment in which

patients and family members are encouraged

to share their concerns.

CONTENT (in alphabetic order): ●● Acute and late side effects of cancer

treatment

●● Biology of cancer: carcinogenesis

●● Causality and prevalence of cancer treatment

adverse events

●● Combined treatment modalities

●● Definitions: dysplasia, metasplasia, neopla-

sia, carcinogenesis (differentiation between

Basic Science and Treatment of Cancer

27

benign/malignant tumours)

●● Genomics, genetics

●● Introduction to psycho-neuro-immunology

(study of the interaction between psycholog-

ical processes and the nervous and immune

systems of the human body)

●● Metastases and spread of cancer

●● Pathophysiology of cancer (molecular biolo-

gy of cancer)

●● Pharmacology and pharmacokinetics of can-

cer medications

●● Shared decision making

●● Site-specific cancers, e.g. lung, colorectal,

breast and prostate cancer

●● Staging/grading and diagnoses of cancer, tu-

mour markers, biomarkers

●● Treatment modalities: surgery, radiotherapy,

systemic therapy (e.g. standard chemother-

apy, hormone therapy, targeted therapy etc.).

TEACHING AND LEARNING METHODS Lectures, guided reading, clinical treatment cen-

tre visits, laboratory visits, case studies, debate

and discussion.

ASSESSMENT METHODS Subject knowledge: Analyse an article or write

a paper on an aspect of cancer treatment.

Grade: 50%

Practice: Provide health promotion or patient

education on cancer treatment. Grade: 50 %

BIBLIOGRAPHY AND RESOURCES BEATTY K,WINKELMAN C, BOKAR JA, MAZANEC P.

(2011) Advances in oncology care: targeted therapies. Adv

Crit Care;22(4):323-34; quiz 35-6

BENTZEN S & TROTTI A , 2007. Evaluation of early and

late toxicities in chemo-radiation Journal of Clinical On-

cology 25(26):4096-4103

DOGGRELL SA. (2011) Adherence to oral endocrine treat-

ments in women withbreast cancer: can it be improved?

[Review] Breast Cancer Res Treat;129(2):299-308

FAITHFULL S & WELLS M (2003) Supportive care in radi-

otherapy, Elsevier publications

GRAHAM DM, O’KEEFE M, DRAKE C, ISMAIL J, O’DEA

P, POWER DG Oral chemotherapy administration practic-

es in Ireland. (2011). Eur J Cancer 2011;47:S168

HANAHAN D, & Weinberg RA. (2011). Hallmarks of can-

cer: the next generation. (2011). Cell.144: 646-674.

HEMMINKI K, LIU H, HEMINKI A, SUNDQUIS TJ (2012)

Power and limits of modern cancer diagnostics: cancer of

unknown primary Ann Oncol;23(3):760e4

JEMAL, A., BRAY, F., CENTER, M., FERLAY, J., WARD, E.

& FORMAN, D. 2011. Global cancer statistics. CA Cancer

J Clin, 61, 69-90.

O’CONNOR SJ (2011) Review of the incidence, preva-

lence, mortality and causative factors for lung cancer in

Europe.. Eur J Cancer;47(3 Suppl):S346-7

KAGAN SH (2011) The global burden of cancer treatment:

reflecting clinical reality in cancer nursing research.. Can-

cer Nurs;34(5):343-4.

MCNALLY GA (2011) B-cell lymphoma, unclassifiable: a re-

view of the literature.Clin J Oncol Nurs 2011; 15(2):189-93.

MEENAGHAN T, DOWLING M, KELLY M (2012) Acute

leukaemia: making sense of a complex blood cancer.. Br J

Nurs ;21(2):76,78e83

MIASKOWSKI C, LEE K, DUNN L, DODD M, AOUIZER-

AT BE, WEST C, PAUL SM, COOPER B, WARA W, SWIFT

P ,2011. Sleep-wake circadian activity rhythm parameters

and fatigue in oncology patients before the initiation of ra-

diation therapy. Cancer Nurs. 2011 Jul-Aug;34(4):255-68.

NCI Common Terminology Criteria for Adverse Events

(CTCAE) v.4 .03 June 14 2010. National Cancer Institute

Common Toxicity Criteria. Available online at:http://evs.

nci.nih.gov/ftp1/CTCAE/About.html. Accessed 21st Au-

gust 2011

SMITH NZ (2012) Treating metastatic breast cancer with

systemic chemotherapies. Clin J Oncol Nurs;16(2):E33e43

SYMONDS,RP , 2001. Recent advances: Radiotherapy

BMJ 323 1107-10

WILSON FL, MOOD D, NORDSTROM CK.2010, The in-

fluence of easy-to-read pamphlets about self-care manage-

ment of radiation side effects on patients’ knowledge. On-

col Nurs Forum. 2010 Nov 1;37(6):774-81.

28




ECT credits: 9

MODULE SUMMARY This module provides the knowledge and skills

required to comprehensively assess an individ-

ual diagnosed with cancer. The ability to use

appropriate tools to assess specific symptom

problems or age-related issues is a necessity for

modern cancer care. Identifying patients’ needs

is essential if the management and intervention

is to be appropriate. Nursing interventions have

been shown to impact on patient outcomes and

their un-meet needs. This module enhances the

decision-making and communication module

and the practice skills are complementary in the

development of assessment.

LEARNING OUTCOMES 1. Demonstrate the principles of holistic as-

sessment in cancer practice.

2. Appraise decision making and how this im-

pacts on cancer nursing assessment using

both objective and subjective health problems

associated with cancer and its treatment.

3. Demonstrate an understanding of the com-

plex, changing, multiple health needs of

cancer patients and their families across the

disease trajectory.

4. Critically review the evidence base for

nursing management of cancer symptoms

and treatment side effects.

5. Demonstrate knowledge about the safe ad-

ministration of cancer therapies and the

nursing interventions necessary to manage

an adverse reaction to treatment.

6. Construct a care plan for a cancer patient

and document.

PRACTICE BASED SKILLS AND COMPETENCIES 1. Undertake a comprehensive nursing assess-

ment taking into account relevant physical,

social, cultural, psychological and spiritual

factors.

2. Monitor the patient’s health status for signs

and symptoms of deterioration and take steps

to document, intervene or refer appropriately.

3. Understand the importance of and possible

difficulties with oral drug management and

the possibility of non-adherence in cancer

patients.

4. Implement and critically evaluate a range

of evidence-based interventions to manage

the complex, multiple health needs of can-

cer patients and their families.

5. Work in partnership with the patient to

manage symptoms of cancer and subse-

quent consequences of cancer treatment.

6. Demonstrate knowledge of health and safe-

ty implications for cancer treatments that

Nursing Assessment and Interventions in the Management of People Affected by Cancer

29

impact on patients and other staff members.

Safely administers and monitors treatments

using the correct medical devices and/or

techniques.

7. Provide personalised care plans based on

individual risks, needs and preferences of

the patient.

CONTENT (in alphabetic order): ●● Assessment of information needs

●● Assessment tools for holistic care: including

physical, psychological, social and spiritual

●● Cancer-related signs and symptoms, treat-

ment-related, disease-related

●● Chemotherapy standards, patient safety

and safe working conditions

●● Communication skills in undertaking a

comprehensive assessment

●● Consultation styles and documentation of

assessment

●● Describing and interpreting data from com-

monly used assessment tools in cancer care

(e.g. pain, fatigue, nutrition etc.)

●● Differentiating between subjective and ob-

jective information

●● Frameworks for nursing assessment for ex-

ample nursing diagnosis

●● Importance of symptom documentation

and reporting

●● Potential environmental and communica-

tion barriers

●● Radiation safety

●● Recognition and management of oncologi-

cal emergencies

●● Symptoms and side effects of cancer treat-

ment modalities.

TEACHING AND LEARNING METHODS Demonstration, role-play, lectures, case study,

observed structured assessment in practice.

ASSESSMENT Essay: critically evaluate an assessment tool

used in cancer practice. Grade: 50%

Practice: Conduct a comprehensive assessment

of a patient with cancer. Grade: 50%

BIBLIOGRAPHY AND RESOURCES BAHRAMI M, ARBON P.2011, How do nurses assess

quality of life of cancer patients in oncology wards and

palliative settings? Eur J Oncol Nurs. 2011 Jul 19. [Epub

ahead of print]

DERBY S. 2011, Assessment and management of delir-

ium in the older adult with cancer. Clin J Oncol Nurs.

2011 Jun;15(3):247-50

DALY BJ. 2011, Caring for the critically ill patient with

cancer. Adv Crit Care 2011;22(4):321-2

FITCH MI. ,2011, Screening for distress: a role for oncol-

ogy nursing, Curr Opin Oncol. Jul;23(4):331-7. Review.

FONG DY, HO JW, HUI BP, LEE AM,MACFARLANE DJ,

LEUNG SS, et al, 2012.Physical activity for cancer sur-

vivors: meta-analysis of randomised controlled trials.

BMJ 2012;344:E70

GIVEN BA, SPOELSTRA SL & GRANT M , 2011. The

challenges of oral agents as antineoplastic treatments.

Seminars in Oncology Nursing, 27(2): 93-103

KELVIN JF,KROON L, OGLE SK. 2012. Fertility pres-

ervation for patients with cancer. Clin J Oncol Nurs

;16(2):205e10

MCLAUGHLIN L, MAHON SM ,2012. Understanding

taste dysfunction in patients with cancer. Clin J Oncol

Nurs;16(2):171e8

NELSON S (2011) Cancer cachexia. Nurs Stand; 25(39):59.

RALPH JL, VON AH D, SCHEETT AJ, HOVERSON BS,

ANDERSON CM. 2011. Diet assessment methods: a guide

for oncology nurses. Clin J Oncol Nurs;15(6):E114-21

RIDDERVOLD H, DAHLEN M, STENLING E, 2011. Re-

habilitation and treatment of skin reactions secondary

to radiotherapy: a result of evidence-based practice,.

Eur J Cancer ;47:S327

SPEKSNIJDER HT, MANK AP, VAN ACHTERBERG

T. 2011. Nursing diagnoses (NANDA-I) in hema-

tology-oncology: a Delphi-study. Int J Nurs Termi-

30




ECT credits: 9

MODULE SUMMARY This module provides the knowledge and skills

required to support patients through treatment

into survivorship and advanced disease. Cancer

is increasingly being managed over many years

therefore understanding co- morbidity and long

term consequences of cancer and its treatment

is essential to managing long term follow up.

Advanced cancer also provides challenges for

oncology nurses in managing symptoms, transi-

tions in care and palliative care issues.

LEARNING OUTCOMES 1. Demonstrate knowledge of the implications

of chronic illness and long-term survivor-

ship in those affected by cancer.

2. Understand the potential consequences of

long term and late effects of cancer treatment

3. Describe the principles of rehabilitation,

self-management and lifestyle interven-

tions for improving quality of life in those

affected by cancer.

4. Understand the importance of long-term

medicines management and the dangers of

non-adherence in cancer patients.

5. Demonstrate an understanding of the im-

portance of seamless transitions between

the acute and home care and from active

treatment to survival programs, palliative

and end-of-life care.

6. Describe the role of supportive, palliative and

end-of-life care, for patients and their family.


1. Appropriately considers co-morbidity, the

impact of chronic illness and long-term

survivorship on the health status of the pa-

tient with cancer and members of his or

nol Classif. Apr-Jun;22(2):77-91. doi: 10.1111/j.1744-

618X.2011.01183.x.

SIMCOCK R, SHIELDS P, 2011. Management of radiation

induced xerostomia in the UK. Clin Oncol, 23(3):S53

SPIROA, AHERN R,EMERY PW, BALDWIN C 2012. Oral

nutritional interventions in malnourished patients with

cancer: a systematic review and meta-analysis. JNatl

Cancer Inst;104(5):371e85

VOULGARIS E, PENTHEROUDAKIS G, PAVLIDIS N,

2011. Cancer and pregnancy: a comprehensive review.

Surg Oncol;20(4):E175-85

VAN CLEAVE JH, EGLESTON BL, MCCORKLE R. 2011,

Factors affecting recovery of functional status in older

adults after cancer surgery. J Am Geriatr Soc ; 59(1):34-43.

WHITE ID, ALLAN H, FAITHFULL S. 2011,Assessment of

treatment-induced female sexual morbidity in oncology:

is this a part of routine medical follow-up after radical

pelvic radiotherapy? Br J Cancer. Sep 27;105(7):903-10.

doi: 10.1038/bjc.2011.339. Epub Sep 6.

WOOD JM, CHAPMAN K, EILERS J 2011 Tools for as-

sessing nausea, vomiting, and retching: a literature re-

view. Cancer Nurs;34(1):E14-24

Cancer as a Chronic Illness / Supportive and Palliative Care

31

her family and implement appropriate re-

ferrals to other professionals and agencies

in respect of these.

2. Undertake a risk assessment and provides

appropriate help and advice in respect to

self-monitoring of long term consequenc-

es of cancer.

3. Undertake an assessment of the motivation

and capacity of the patient and members

of his or her family to self-manage their

condition and promotes a healthy lifestyle

during cancer rehabilitation.

4. Effectively evaluate patient adherence and

concordance when taking medication for

cancer or other long-term chronic con-

ditions and engages in patient education

about the benefits of adherence.

5. Engage in appropriate discharge planning

and co-ordinates care between different

health and social care providers including

voluntary and statutory care agencies.

6. Facilitate appropriate discussions between

health and social care professionals, patients

and their family members to elicit their pref-

erences with respect to the transition be-

tween active, palliative or end-of life care.

CONTENT (in alphabetic order): ●● Carer burden and distress in chronic illness

●● Caring for carers

●● Co-morbidity and other disease states in

cancer care (effects on the individual

with cancer)

●● Cultural approaches to death and dying

●● End of life care

●● End-of-life definitions and triggers for

assessment

●● Evidence-based management of symptoms,

pharmacological and non-pharmacological

●● Family support and bereavement

counselling

●● Home and family centred care

●● Life transitions and life events theory

●● Loss, grief and bereavement, spirituality

●● Managing complex and multiple health

needs in cancer care

●● Patient autonomy, agency and self-

management in chronic cancer care

●● Pharmacological changes of ageing and

their impact on cancer therapy

●● Poly-pharmacy, concordance and adher-

ence in chronic and long-term cancer man-

agement

●● Principles of health promotion and reha-

bilitation

●● Risk assessment of late effects

●● Role of different health and social care

agencies in supportive cancer care

●● Shifting perspectives model of survivor-

ship in cancer

●● The biology of dying (recognizing the

dying process, biological criteria for defin-

ing death at the end of the dying process)

●● Theories of chronic cancer disease

management.

TEACHING AND LEARNING METHODS:Lectures, guided reading, case studies, debate

and discussion.

ASSESSMENT Essay: Reflection on a critical incident related

to cancer as a chronic illness. Grade: 50%

Observed practice: Developing transfer plan

for the cancer patient back to their home af-

ter completion of cancer treatment or in mov-

ing into palliative stages of illness. Grade: 50%

BIBLIOGRAPHY AND RESOURCES BELLURY, L. M., BECK, S. L., STEIN, K., PETT, M. &

CLARK, J. 2011. Elderly cancer survivorship: An inte-

grative review and conceptual framework. Eur J Oncol

Nurs, doi: 10.1016/j.ejon.2011.03.008, 1-10

BREARLEY, S. G., STAMATAKI, Z., ADDINGTON-HALL,

32


J., FOSTER, C., HODGES, L., JARRETT, N., RICHARD-

SON, A., SCOTT, I., SHARPE, M., STARK, D., SILLER,

C., ZIEGLER, L. & AMIR, Z. 2011. The physical and prac-

tical problems experienced by cancer survivors: A rapid

review and synthesis of the literature. Eur J Oncol Nurs,

doi:10.1016/j/ejon.2011.02.005, 1 - 9.

COOLEY, C. 2010. Cancer survivorship 2: providing ad-

vice and support to those living with and beyond can-

cer. Nursing Times, 106, 17-18

DELGADO-GUAY MO, HUI D, PARSONS HA, GOVAN

K, DE LA CRUZ M, THORNEY S, et al.2011, Spiritual-

ity, religiosity, and spiritual pain in advanced cancer pa-

tients. J Pain Symptom Manage ;41(6): 986-94

FERRELL B. 2011. Advancing the psychosocial care of

patients with cancer at life’s end: a global nursing re-

sponse. Oncol Nurs Forum ;38(5):E335-40

GREER JA, PIRL WF, JACKSON VA, MUZIKANSKY A,

LENNES IT, HEIST RS, et al, 2012. Effect of early pal-

liative care on chemotherapy use and end of-life care

in patients with metastatic non-small-cell lung cancer. J

Clin Oncol 2012;30(4):394e400

HOWARD-ANDERSON J, GANZ PA, BOWER JE, STAN-

TON AL, 2012.Quality of life, fertility concerns, and

behavioural health outcomes in younger breast can-

cer survivors: a systematic review. J Natl Cancer Inst

;104(5):386e405

IVERSEN LH, 2012. Aspects of survival from colorectal

cancer in Denmark.. Dan Med J ;59(4):B4428

IRWIN, M., KLEMP, J., GLENNON, C. & FRAZIER, L.

2011. Oncology nurses’ perspectives on the state of

cnacer survivorship care: current practice and barriers

to implementation. Oncology Nursing Forum, 38, E11-9.

MAHER, J. & MCCONNELL, H. 2011. New pathways

of care for cancer survivors: adding the numbers. BJC,

105, S5-10.

PENGELLY, M. 2010. Championing patients’ cancer re-

habilitation. Cancer Nurs Pract, 9, 8.

RUSTOEN T, WENGSTROM Y, ZAVRATNIK B, RUND-

STROM C, WEISSE I, GEERLING J, et al. 2011. A Eu-

ropean survey of oncology nurse breakthrough cancer

pain practices. Eur J Cancer 2011;47:S302

SENKUS, E. & JASSEM, J. 2011. Cardiovascular effects of

systemic cancer treatment. Cancer Treat Rev, 37, 300-311.

WILKINS KL,WOODGATE RL, 2012. Taking care of sec-

ond cancer risk.Cancer Nurs;35(1):55-62

YANG P, CHEVILLE AL,WAMPFLER JA, GARCES YI,

JATOI A, CLARK MM, et al. 2012. Quality of life and

symptom burden among long-term lung cancer survi-

vors. J Thorac Oncol ;7(1):64-70

33




MODULE SUMMARY This module explores the impact that cancer

diagnosis and treatment has on the individual

and their family. It is recognised that a cancer

diagnosis can cause high levels of psychologi-

cal and physical morbidity, influencing quali-

ty of life, functional ability and employment.

The uncertainty of cancer survival, fear of re-

currence as well as how patients manage their

illness can impact on recovery for both indi-

viduals and their families.

LEARNING OUTCOMES 1. Demonstrate an understanding of the po-

tential psychosocial consequences of a can-

cer diagnosis and its treatment on individu-

als and their family members.

2. Recognise the differing care needs of patients

from disadvantaged or vulnerable groups.

3. Discuss the impact of inheritable, social or

lifestyle traits which predispose particular

individuals or families to cancer and con-

sider the impact of these on family health

and social wellbeing.

4. Describe the theories of supportive care and

how coping strategies impact on quality of

life of people with cancer and their families.

5. Consider the potential emotional stress of

caring for people who have cancer.

6. Consider his/her own attitudes, beliefs and

behaviours towards end-of-life care and ap-

praises the clinical value of bereavement

theories in palliative and end-of-life care.


1. Provide advice and support to enable peo-

ple to manage the impact of diagnosis and

treatment on their relationships with those

important to them.

2. Use evidence-based strategies to deal

with communication issues and refer ap-

propriately.

3. Undertake a family risk assessment and

discuss social, heritable or lifestyle factors

with at risk individuals whilst alleviating

anxiety and providing help and reassur-

ance to the worried well.

4. Assess the supportive care needs of pa-

tients and their families and refer patients

as appropriate to support services.

5. Recognise the social, financial and emo-

tional consequences of a cancer diagno-

sis for people with cancer and their family

members and responds appropriately mak-

ing suitable referrals if necessary.

6. Demonstrate tact, reflexivity and sensi-

tivity towards the needs of patients who

are dying, and demonstrate awareness of

Understanding the Impact of Cancer on the Individual, Families, and Healthcare Professionals

34


their psychosocial and spiritual needs, and

those of their family members.

CONTENT (in alphabetic order): ●● Concepts of supportive care, hope and cure

●● Costs of treatment, physical, psychological,

social, functional and spiritual

●● Experience of carers, children, friends and

non-traditional families

●● Financial costs

●● Impact of cancer across the lifespan: from

infancy to old age

●● Impact of cancer diagnosis, recurrence and

prognosis

●● Impact of cancer on ability to communi-

cate, coping, crisis intervention, grief

●● Impact of cancer on disadvantaged groups,

e.g. the elderly, immigrants, mentally ill,

those with learning disabilities and those

on low incomes

●● Impact of heritable traits, cancer families

●● Portrayal of cancer in art, media and liter-

ature

●● Sexuality, gender, altered body image, fer-

tility and relationships

●● Societal attitudes to cancer

●● Theories of coping behaviours.

TEACHING AND LEARNING METHODS Lectures, guided reading, case studies, debate

and discussion.

ASSESSMENT Critical analysis of a case study of a patient or

family with unmet needs. Grade: 50%

Practice: Observation of practice and care plan.

Grade: 50%

BIBLIOGRAPHY AND RESOURCES BEVANS M, STERNBERG EM, 2012. Caregiving bur-

den, stress, and health effects among family caregivers

of adult cancer patients. JAMA;307(4):398e40

HACK TF,CARLSON L, BUTLER L, DEGNER LF, JAKULJ

F, PICKLES T, et al.2011. Facilitating the implementa-

tion of empirically valid interventions in psychoso-

cial oncology and supportive care. Support Care Can-

cer;19(8):1097-105

HARDING M, 2012. Health-promotion behaviours and

psychological distress in cancer survivors. Oncol Nurs

Forum;39(2):E132e40

HARRINGTON JM, 2011. Implications of treatment

on body image and quality of life. Semin Oncol Nurs

2011;27(4):290-9

HARJU E, RANTANEN A, TARKKA MT, ASTEDT-KUR-

KI P, 2012. Perceived family health in persons with pros-

tate cancer and their family members. J Clin Nurs;21(3-

4):544-54

HENOCH I, LOVGREN M, WILDE-LARSSON B,

TISHELMAN C, 2012. Perception of quality of care:

comparison of the views of patients’ with lung cancer

and their family members. J Clin Nurs ;21(3-4):585-94

OHLSSON-NEVO E, ANDERSHED B, NILSSON

U,ANDERZEN-CARLSSON A, 2012. Life is back to nor-

mal and yet not: partners’ and patient’s experiences of

life of the first year after colorectal cancer surgery. J Clin

Nurs ;21(3-4):555-63

ROTEGARD AK, FAGERMOEN MS,RULAND CM, 2012.

Cancer patients’ experiences of their personal strengths

through illness and recovery. Cancer Nurs;35(1):E8-17

SAARNIO L, ARMAN M, EKSTRAND P, 2012. Power re-

lations in patient’s experiences of suffering during treat-

ment for cancer. J Adv Nurs ;68(2):271-9

WEITZ MV, FISHER K, LACHMAN VD, 2012. The jour-

ney of women with breast cancer who engage in mind-

fulness-based stress reduction: a qualitative explora-

tion.Holist Nurs Pract ;26(1):22-9

35



ECT credits: 9

MODULE SUMMARY This module provides the knowledge and

skills required to communicate effectively

with cancer patients. One of the criticisms in

cancer health care across Europe is that com-

munication is poor between health profes-

sionals as well as between patients and carers.

Good communication can aid decision mak-

ing and facilitate patient choice self manage-

ment and independence.

LEARNING OUTCOMES 1. Identify the information requirements of in-

dividuals with cancer during their cancer

diagnosis, therapy, after care and period of

supportive care.

2. Describe health promotion theories and ap-

ply the principles of teaching and learning

to patient education.

3. Reflect on communication skills and con-

sider theories of good communication in

supporting the individual and family affect-

ed by cancer.

4. Discuss how advocacy and disclosure in

cancer care can benefit and cause conflict

between individuals with cancer, families

and health care providers.

5. Identify how multidisciplinary team com-

munication can benefit patient care and

improve transitions between acute and

home care.

6. Differentiate between the different roles

information technology can have in im-

proving cancer documentation, remote

health management and in providing sup-

portive care.


1. Direct individuals and family members to

appropriate services and provide a plan or

prescription of information.

2. Assess the on-going and changing needs of

the patient and family members for edu-

cation, evaluating the individuals under-

standing of advice and information over

time.

3. Demonstrate the use of a range of commu-

nication techniques to promote well-be-

ing in a person with cancer. For example:

counselling skills, challenging behaviour

and active listening.

4. Recognise the ethical and legal dilemmas

as an advocate in providing informed con-

sent and support for cancer patients.

5. Provide information and advice within the

multidisciplinary team to support cancer

patient care.

6. Engage in electronic documentation and

in supporting e-health and telemedicine

within cancer care For example care plan-

ning and documentation systems, survi-

vorship care plan.

Information and Communication in Cancer Care

36


CONTENT (in alphabetic order): ●● Advanced communication skills

●● Advocacy in health care

●● Breaking bad news to cancer patients; factors

causing difficulty for healthcare workers

●● Care planning and case management

●● Decision making in the multi-

disciplinary context

●● Developing evidence-based patient

education materials

●● Effective and culturally sensitive

communication

●● Ethical decision making

●● EU data protection

●● Evaluation of existing informational

resources

●● Health promotion

●● Information technology tools in support of

communication

●● Online information and role of internet

shaping patient expectations

●● Optimising patient and family education

●● Patient’s autonomy, integrity

●● Professional / team communication

●● Survivorship care plans

●● Teachable moment (the time at which learn-

ing a particular topic or idea becomes possi-

ble or easiest)

TEACHING AND LEARNING METHODS Lectures, critical incident analysis, role-play.

ASSESSMENT Essay: Reflection on a critical incident related

to decision making and information provision.

Grade: 50% Observed practice: communicating

with a cancer patient. Grade: 50%

BIBLIOGRAPHY AND RESOURCES FITCH MI, HOWELL D, MCLEOD D, GREEN E. 2012.

Screening for distress: responding is a critical function

for oncology nurses. Can Oncol Nurs 2012;22(1):12e30

FUKI, S., OGAWA, K. & YAMAGISHI, A. 2010. Effec-

tiveness of communication skills training of nurses on

the quality of life and satisfaction with healthcare pro-

fessionals among newly diagnosed cancer patients: a

preliminary study. Psycho-Oncology.

JONES, J. M., PAPADAKOS, J., BENNETT, C., BLACK-

ER, S., CATTON, P., HARTH, T., HATTON-BAUER, J.,

MCGRATH, K., SCHWARTZ, F., TURNBULL, G., WAL-

TON, T. & JUSKO-FRIEDMAN, A. 2010. Maximizing

your Patient Education Skills (MPES): A multi-site eval-

uation of an innovative patient education skills training

course for oncology health care professionals. Patient

Educ Couns, doi:10.1016/j.pec.2010.07.039.

KINNANE NA, 2012. Evaluation of a hospital-based

cancer information and support centre. Support Care

Cancer; 20(2):287-300

KOMATSU H, NAKAYAMA K, TOGARI T, SUZUKI K,

HAYASHI N, MURAKAMI Y, et al. 2011. Information shar-

ing and case conference among the multidisciplinary team

improve patients’ perceptions of care. Open Nurs J;5:79-85

NESTEL D, COOPER S, BRYANT M, HIGGINS V, TAB-

AK D, MURTAGH G, et al. 2011. Communication chal-

lenges in surgical oncology. Surg Oncol ;20(3):155-61

SALSMAN JM, GRUNBERG SM, BEAUMONT JL, ROG-

ERS M, PAUL D,CLAYMAN ML, et al. 2012. Communi-

cating about chemotherapy-induced nausea and vomit-

ing: a comparison of patient and provider perspectives.

J Natl Compr Canc Netw 10(2):149e57

SCHOFIELD, P., DIGGENS, J., CHARLESON, C., MARI-

GLIANI, R. & JEFFORD, M. 2010. Effectively discussing

complementary and alternative medicine in a conven-

tional oncology setting: Communication recommenda-

tions for clinicians. Patient Educ Couns, 79, 143-151.

UITTERHOVE, R., BENSING, J., GROL, R., DEMULDER,

P. & VAN ACHTERBERG, T. 2009. The effect of com-

munication skills training on patient outcomes in can-

cer care: a systematic review of the literature. European

Journal of Cancer Care, 19.

37



ECT credits: 6

MODULE SUMMARY This module will enable the learner to facili-

tate team management and provide the nec-

essary skills to organise work and practice

development within a cancer setting. Multidis-

ciplinary team working is essential in cancer

care and developing skills in interpersonal re-

lationships, communication and workforce de-

velopment are essential for the future

LEARNING OUTCOMES 1. Consider the importance of legal, ethical and

professional issues in relation to the care and

management of patients with cancer.

2. Analyse and discuss the contribution made

by quality standards to the care of patients

with cancer.

3. Articulate the principles of risk assessment

and management in relation to the care of

patients with cancer.

4. Reflect on leadership styles and how differ-

ent models of clinical leadership can im-

pact on management of cancer care.

5. Discuss the strategies which might be used

to facilitate both their own, and others’

learning in clinical practice.

6. Discuss the importance of relevant re-

source management strategies in relation

to cancer care.


1. Demonstrate the application of legal, eth-

ical and professional principles in their

practice and seek to act as an effective can-

cer patient advocate at all times.

2. Provide leadership in the implementation

and evaluation of cancer quality standards

3. Assess risk and implement appropriate risk

management strategies in order to promote

patient well-being and safety in their prac-

tice area.

4. Apply appropriate leadership and manage-

ment strategies in their practice area and

evaluate the impact of these upon others in

the cancer care team.

5. Demonstrate evidence of their own contin-

uing professional development and actively

promote the learning of colleagues and oth-

ers in the clinical practice area.

6. Demonstrate the ability to plan, allocate,

coordinate and evaluate the use of health-

care resources in an appropriate manner

when providing care to patients with can-

cer and their families.

CONTENT (in alphabetic order): ●● Challenges of clinical leadership – balance

between support and challenge

●● Clinical audit and standards for practice,

quality improvement data

●● Definitions of leadership

Clinical Leadership and Resource Management of Cancer Nursing

38


●● Delegation and communication

●● Dimensions for change in practice

●● Economics (micro-local level/macro-

national level)

●● Managing human resources, lay carers, col-

leagues, inter-professional relationships

●● Multi-professional and interagency team

working in cancer care

●● Political and emotional intelligence,

self- awareness, social skills, social

awareness, self-management

●● Succession planning and resources

management

●● Theoretical and process management

●● Working as a multidisciplinary

team member.

TEACHING AND LEARNING METHODS Lectures, debates, case studies, reflection

ASSESSMENT Evaluate practice (using tools, audit scoping,

risk assessment and safety): planning change

and implementation, case management, budg-

eting and costing. Grade:50 %

BIBLIOGRAPHY AND RESOURCES FRIESE CR, 2012. Practice environments of nurses em-

ployed in ambulatory oncology settings: measure refine-

ment. Oncol Nurs Forum;39(2):166e72

KOUZES, J.M. AND POSNER, B.Z, 2007, The Leader-

ship Challenge. 4th Edition. San Francisco: Jossey Bass.

MERENDA C. 2011, Exploring the role of oncology

nurse navigators. ONS Connect ;26(10):8-12

OPEE, N. AND GALLOWAY J. 2009, Leadership and

Management in Healthcare. London: Sage.

MARINER TOMEY, A. ,2004, A Guide to Nursing Man-

agement and Leadership. 7th Edition, St. Louis: Mosby.

MARQUIS, B.L. AND HARRISON, C.J., 2006, Leader-

ship Roles and Management Functions in Nursing. 5th

Edition. Philadelphia: Lippincott, Williams and Wilkins.

PARKIN, P. 2009, Managing Change in Healthcare: Us-

ing Action Research. London, Sage.

PEDLER, M., BURGOYNE, J. AND BOYDELL, T.2007,

A Manager’s Guide to Self Development. London,

McGraw Hill.

ROSENZWEIG M, GIBLIN J, MORSE A, SHEEHY P,

SOMMER V, 2012. Bridging the gap: a descriptive study

of knowledge and skill needs in the first year of oncol-

ogy nurse practitioner practice. . Oncol Nurs Forum

;39(2):195e201

SULLIVAN, E.J. AND DECKER, P.J. 2005, Effective Leader-

ship and Management in Nursing. London: Prentice Hall.

WOODWARD S 2011. Patient safety: a core value of

nursing so why is achieving it

so difficult? [Review]. J Res Nurs;16(3):224-5

YUKL, G. 2002, Leadership in Organisations. Upper

Saddle River: Prentice Hall.

YAGASAKI K, KOMATSU H, 2011. Preconditions for

successful guideline implementation: perceptions of

oncology nurses.. BMC Nurs;10:23

39



ECT credits: 6

MODULE SUMMARY This module aims to develop the skills of the

nurse in being able to search, retrieve and cri-

tique evidence for cancer practice. These skills

require understanding of the research process

and the role of the cancer nurse in the develop-

ment of new therapies and cancer knowledge.

One of the difficulties of evidence-based prac-

tice is its implementation, and this module ex-

plores the barriers to change and dissemination.

LEARNING OUTCOMES 1. Evaluate the importance of cancer nursing

research to the field of cancer care.

2. Critically discuss the contribution of infor-

mation technology to the implementation of

evidence based practice in cancer nursing

3. Analyse different sources of information

and apply as appropriate to practice.

4. Describe the principles of cancer clinical

trials and the contribution which nurses

make to the safe conduct of multidiscipli-

nary research.

5. Discuss ethical principles in relation to the

conduct of cancer clinical trials.

6. Outline the use of health services re-

search in cancer service development and

explore the role of clinical audit in prac-

tice development.


1. Correctly identify the need for clinical ev-

idence and formulates appropriate clinical

questions when working in cancer settings.

2. Make appropriate use of information tech-

nologies when retrieving evidence upon

which to base cancer nursing interventions

in their practice area.

3. Demonstrate the ability to provide evidence

based rationale for the cancer nursing inter-

ventions implemented in their clinical area

4. Demonstrate the ability to participate in

clinical trials as part of a multi-profession-

al team and support more junior colleagues

in this role.

5. Demonstrate appropriate strategies to safe-

guard the interests and wellbeing of pa-

tients including the obtaining of informed

consent, maintaining patient confidentiali-

ty and dignity, documenting and reporting

drug interactions or other adverse events

where required.

6. Use specialist knowledge to contribute to

the development of evidence based policies

and procedures and practice development

for cancer nursing.

CONTENT (in alphabetic order): ●● Analytical and critical thinking

●● Clinical trials Research nurse and multidis-

ciplinary collaboration

Evidence Based and Applied Research in Cancer Care

40


●● Confidentiality and security of data/re-

cords. Identifying relevant clinical research

questions

●● Defining and appraising evidence levels

●● Documentation structure and standard-

isation

●● Ethical issues in research and evidence-

based change

●● Evaluation of research and evidence. Barri-

ers to implementing evidence-based prac-

tice,technical knowledge and organisation-

al barriers

●● Health care informatics (integrates comput-

er technology, information technology and

medical /healthcare information)

●● Health service evaluation and clinical audit

●● Identifying a researchable issue from

practice

●● Introduction to data analysis

●● Introduction to research methodologies

●● Research methods/measurement/outcomes

and data collection

●● Strategies for Internet and database,

library searches

●● Systematic and narrative reviews

●● What is evidence-based practice?

●● Writing reports, presentation of clinical

research/evidence.

TEACHING AND LEARNING METHODS Lectures, debates, case studies, reflection

ASSESSMENT Essay: Identify a research question and pro-

pose how this might be studied. Grade:50%

Practice: introduction of an area of putting evi-

dence into practice. Grade:50%

BIBLIOGRAPHY AND RESOURCES AVEYARD H. 2010 Doing a Literature Review in Health

and Social Care: A Practical Guide. Open University

Press, McGraw Hill Education

BOWLING A. 2009. Research Methods in Health: Inves-

tigating Health and Health Services. Open University

Press, McGraw Hill Education

BURNS N AND SUSAN K. GROVE SK. 2010 Under-

standing Nursing Research: Building an Evidence-based

Practice. 3rd edition Saunders

DELIN ERIKSSON A, 2011 Symptom management: let’s

do it evidence based. Eur J Cancer ;47:S327-8

GOUGH D, T JAMES, O SANDY (ed) 2012. An Introduc-

tion to systematic reviews, Sage publications

POLIT DF AND BECK C 2011. Nursing Research: Gen-

erating and Assessing Evidence for Nursing Practice:

Generating and Assessing Evidence for Nursing Practice

Wolters Kluwer Health/ Lippincott

Cochrane Handbook for systematic reviews of interven-

tions http://www.thecochranelibrary.com/view/0/About-

CochraneSystematicReviews.html accessed 7/1/2013

York centre http://www.york.ac.uk/inst/crd/pdf/System-

atic_Reviews.pdf

Bandolier summary accessed 7/1/2013 http://www.med-

icine.ox.ac.uk/bandolier/painres/download/whatis/

syst-review.pdf

41

The strategy for teaching and learning aims to

enable cancer nurses to feel confident in their

knowledge and in putting this knowledge into

practice. Research into the experience of learn-

ing shows that student learning is more com-

plex and fragile than the ‘delivery’ model rec-

ognises. Learners bring their own cultural and

life experiences as well as those from cancer

nursing practice that need to be extended. To

this end the EONS teaching and learning strat-

egy draws on four learning contexts:

●● The value of user perspectives

●● Learning from practice

●● Learning agreements

●● Appraising practice-based skills

and competences.

THE VALUE OF USER PERSPECTIVES Current health and social care policy with-

in the EU aims to place the users of servic-

es at the centre of service planning and de-

livery. Learners will be encouraged to focus

on the impact their practice has on individ-

uals (cancer patients, families) and groups

(including carers) or communities from both

user and professional perspectives. Such an

approach has implications for the type and

level of professional knowledge and skills re-

quired. The teaching and learning strategy

promotes the use of the user perspective as

a legitimate lifelong learning context for pro-

fessional knowledge development.

LEARNING FROM PRACTICE AND WITHIN PRACTICE Enquiry-based learning is learning which of-

fers an optimal method for developing the

learner’s critical analytical skills, communi-

cation and decision making skills in a variety

of cancer contexts. The initial starting point

of enquiry-based learning is a query or prob-

lem that the learner wishes to solve. This pro-

vides an individual focus to learning, provid-

ing experience and feedback to the learner.

Reflection, as a teaching and learning strat-

egy, ensures that learners think about what

they are going to do before they do it, for ex-

ample, reflecting on action before they re-

flect in action. Learners will be encouraged

to use a model of reflection to develop skills

and demonstrate how learning throughout

the programme has influenced their practice.

The connections between theory and prac-

tice are inherent within the EONS curricu-

lum but require the learner to reflect on prac-

tice experience that will then contribute to

their cancer nursing assessments.

LEARNING AGREEMENTS Profiling at the outset of the programme is es-

sential to develop individual learning and

work-based plans for developing competen-

cies. A learning agreement is viewed as a pro-

fessional development tool that demonstrates

the student’s development route to achieve his/

her intended outcomes.

Strategy for Teaching and Learning

42


The learning agreement will include state-

ments about:

1. the student’s learning needs in relation to

past experience, and the learning outcomes

he/she now seeks to achieve.

2. how the learner will achieve the desired

outcomes.

3. the resources the student will need to ac-

cess and utilise in order to achieve the

learning outcomes.

4. the ways in which the learner will monitor

and evaluate progress.

PRACTICE-BASED SKILLS AND COMPETENCIES The development of practice competen-

cies is a central part of the curriculum revi-

sions. Providing higher education that meets

health-related service needs through appro-

priate cancer-nursing skills is at the centre of

practice and development. The push for ac-

countability in health care has led to a great-

er emphasis on what the baseline standards

of performance are within nursing. Compe-

tencies have been defined as a way of setting

these standards and defining the speciality of

cancer nursing within Europe. Competency

in this context is defined as nursing skills for

safe and effective professional cancer prac-

tice. Assessment of practice-based skills is

necessary to evaluate the effective applica-

tion of knowledge and skills. A suitably qual-

ified cancer nurse should supervise cancer

nursing students’ clinical practice. Learn-

ers should experience caring for a number of

people with a variety cancers, across a range

of settings either through secondment, rota-

tions through units or through clinical visits.

Supervisors are responsible for guiding stu-

dents in practice as well as assessing learn-

ers’ competence to practise.

ASSESSMENT Learner assessment within courses using the

EONS post-basic curriculum in cancer nurs-

ing should be based on a selection of methods

of assessment reflecting the learning outcomes

and competencies of the programme. The as-

sessment tasks should include the wider goal of

requiring evidence of critical thinking, logical

argument, selection of relevant evidence, sys-

tematic problem solving, professional judge-

ment and action, and independent learning.

It is crucial that any learning strategy promotes

the notion of progressive learning that, at the

end point of the programme, produces a prac-

titioner who is able to practise from a sound

knowledge base. To be able to achieve this goal,

the integration of theory and practice is para-

mount. Fundamental to this goal is that prac-

tice is seen as a source of knowledge develop-

ment and is valued through assessment and

accreditation of practice-based learning. A va-

riety of assessment methods are suggested, in-

cluding essays, examinations, integrative as-

signments, projects, case study and research

proposals. The Assessment criteria for any

course will need to be clearly articulated to stu-

dents and should be assessed using published

criteria and applied consistently.

QUALITY CONTROL AND EVALUATION Internal and external audit is essential for eval-

uating the quality and level of the programme.

Higher education establishments and institu-

tions should have a policy and procedures in

place for the assurance of quality and stand-

ard of their cancer programme. This includes

a formal process of review of modules and pro-

grammes with periodic evaluation of student

feedback and achievements. Tutors and lec-

turers should be qualified and competent to

teach. Appropriate learning resources and stu-

dent support should be evaluated for adequa-

43

cy. Information on student pass and attrition

rates should be recorded and be used to in-

form the management of the modules and pro-

grammes. External audit and periodic review

should be undertaken. Information on recom-

mended standards for quality assurance with-

in higher education within Europe is available

from ENQA.

ECTS AND ACCREDITATION European Credit Transfer System (ECTS) is stu-

dent centred and based on the student work-

load required to achieve the objectives of the

module or programme. This is based on stu-

dent workload, learning outcomes and contact

hours. ECTS make study programmes easier

to compare and facilitate student mobility and

academic recognition. Student workload in

ECTS consists of the time required to achieve

all planned learning activities such as lec-

tures, seminars as well as independent study

and practice components. Credits are allocat-

ed to all educational elements including writ-

ten work and placements. To obtain the ECTS

label academic institutions need to apply. All

first and second cycle degree programmes are

eligible. The criteria for ECTS are individually

assessed but 60 ECTs is equivalent to a Higher

Education Institutions’ diploma. Accreditation

of courses through EONS provides recognition

of programme quality against the EONS nurs-

ing curriculum in cancer nursing. Further in-

formation on accreditation is available on the

EONS web site.

Produced by The European Oncology Nursing Society

Avenue E. Mounier 83, B-1200 Brussels, Belgium. www.cancernurse.eu [email protected]