Nursing & Democratic People’s Republic of Korea

This post is one of curiosity and interest in a socialist country that is largely a mystery of what occurs in everyday life. How is the healthcare system, what sort of technology and resources are available, what training do the nurses receive, is it hospital or university based? This post is not based on any knowledge other than searches from the internet and healthcare databases (Cinahl, Embase and Medline). It is also not a political post, so please add helpful and insightful resources focusing on healthcare into the comment’s section to build on the below resources. If anyone has any links to nursing schools in North Korea it would be amazing to hear about nurse training.

Search terms: Nursing and (North Korea or Democratic People’s Republic of Korea).

The formal searches yielded only one relevant article. Many articles exist but they focus on ethical and political viewpoints. Google search was more successful, but it is the unknown of the quality or true picture they provide. See below for resources.

WHO Stats:

  • Health System: Free access for all
  • Life Expectancy: Male 67/Female 74

Remember its very easy to get caught up in ‘our health system is the best’ mentality. When we look outside our own walls, there are some healthcare systems where the principles of ‘healthcare for all’ exist. An example is the Cuban healthcare system and also the work they do in training healthcare professionals in other nations. DPRK 360 provide a different perspective to North Korea, than portrayed in the media.

BBC Panorama: Inside North Korea (2017)


Barrett, J. (2011). The North Korean Healthcare System: On the Fine Line Between Resilience and Vulnerability.

Cha, J. (2015). Scenes from a North Korean Hospital. The Guardian.

DPRK 360. (2018) A different perspective to North Korea.

Kim, H. K., Lee, O. J., & Baumann, S. L. (2011). Nursing Practice with Families Without a Country. Nursing science quarterly, 24(3), 273-278. [abstract]

Kim, S. (2016). Comparison of North and South Korea Nursing Workforce Training System and Integration Plan. Advanced Science and Technology Letters. Vol.132 (Healthcare and Nursing 2016), pp.233-236.

Wikipedia (2017). Health in North Korea.

Wikipedia (2017). Pyongyang Maternity Hospital.

World Health Organisation. (2018). Democratic People’s Republic of Korea.

NNEC2018 Notes & Thoughts (Day 2)

Session: Changing World, Change in Clinical Practice

Focus: Overcoming the theory-practice gap

Research translation: slow process of change, translation of evidence

Deimplementation of Practice

The transition from hospital nurse education to Tertiary (university) sector.

Nurse researching and impact by Florence

Difficulty staying up to date through impact of information overload: volume of research, guidelines.

Value of systematic review- to make research manageable. Resources such as:


Donaldson, M. S., Corrigan, J. M., & Kohn, L. T. (Eds.). (2000). To err is human: building a safer health system (Vol. 6). National Academies Press.

Greenhalgh, T. (2014). How to read a paper: The basics of evidence-based medicine. John Wiley & Sons.

Greenhalgh, T., Howick, J., & Maskrey, N. (2014). Evidence based medicine: a movement in crisis?Bmj348, g3725.

Grol, R., & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients’ careThe lancet362(9391), 1225-1230.

McGlynn, E. A., Asch, S. M., & Kerr, E. A. (2003). Quality of health care delivered to adults in the United States-Reply. New England Journal of Medicine349(19), 1867-1868.

Niven, D. J., Mrklas, K. J., Holodinsky, J. K., Straus, S. E., Hemmelgarn, B. R., Jeffs, L. P., & Stelfox, H. T. (2015). Towards understanding the de-adoption of low-value clinical practices: a scoping reviewBMC medicine13(1), 255.


Session: Educating With The Brain in Mind

Sustainable transformational processes: thinking, practice and culture.

Neuroscience & collaboration (Rock & Cox, 2012): The SCARF® model stands for

  • Status,
  • Certainty,
  • Autonomy,
  • Relatedness and
  • Fairness

Challenge/support framework (Mariani, 1997).

The way the brain forms thoughts by Kahneman: System 1 and 2 (Thinking, fast and slow)


Kahneman, D. (2011). Thinking, fast and slow. Macmillan.

Mariani, L. (1997). Teacher support and teacher challenge in promoting learner autonomyPerspectives: A Journal of TESOL Italy, XXIII (2). 

Rock, D. (2010). The neuroscience of leadership (Doctoral dissertation, Middlesex University).

Rock, David, and Christine Cox. “SCARF in 2012: Updating the social neuroscience of collaborating with others.” NeuroLeadership Journal 4, no. 4 (2012): 1-16.

Session: Technology and online learning

  • CPD,
  • readiness to learn
  • core competencies
  • alignment between objectives and content (standardisation)


Blended Learning

Blended Synchronous Learning

Bower, M., Kenney, J., Dalgarno, B., Lee, M. J., Kennedy, G. E., Carter, H., … & Hedberg, J. (2013). Blended synchronous learning: Patterns and principles for simultaneously engaging co-located and distributed learnersElectric Dreams. Proceedings ascilite.

Prensky, M. (2001). Digital natives, digital immigrants part 1On the horizon9(5), 1-6.

Session:  Undergrad Systematic Review on Appraisal 

4 Themes of the review:

Systems Approach


Session: Preparing for Practice

  • Self efficacy

Babenko-Mould, Y., Andrusyszyn, M. A., & Goldenberg, D. (2004). Effects of computer-based clinical conferencing on nursing students’ self-efficacy. Journal of Nursing Education43(4), 149-155.

  • Preference for online learning & Task value

Artino Jr, A. R., & Stephens, J. M. (2009). Academic motivation and self-regulation: A comparative analysis of undergraduate and graduate students learning onlineThe Internet and Higher Education12(3-4), 146-151.

Some data analysis statistics: Cronbach’s alpha

Session: The Future of Nursing

Changing world of practice and graduate capabilities.

Missen, K., McKenna, L., & Beauchamp, A. (2014). Graduate nurse program coordinators’ perceptions of role adaptation experienced by new nursing graduates: A descriptive qualitative approachJournal of Nursing Education and Practice4(12), 134.

Missen, K., McKenna, L., & Beauchamp, A. (2016). Graduate nurse program coordinators’ perspectives on graduate nurse programs in Victoria, Australia: A descriptive qualitative approachCollegian23(2), 201-208.

Missen, K., McKenna, L., Beauchamp, A., & Larkins, J. A. (2016). Qualified nurses’ rate new nursing graduates as lacking skills in key clinical areas. Journal of clinical nursing25(15-16), 2134-2143.

End of day thought

Social Media: Low #SoMe engagement use across the conference, organisors and attendees included. Set up Symplur conference hashtag



NNEC2018 Notes & Thoughts (Day 1)

Session: Safer Care Victoria

Importance and power of storytelling and the narrative for learning in nursing.
Emojione 1F4D6





Aims and approaches for safer care:

  1. Targeting zero avoidable harm,
  2. Sharing excellence,
  3. Collecting and sharing data to improve patient care.


Session: Assessment & Learner Engagement

Impact of assessment- impact on learning, the need to make a positive impact.

Consider how can we use assessment for learning and for competency (rather than something that is merely done to us).

That assessment can influence the teaching focus and student behaviour just by the choice of assessment.

What assessment needs to do:

  1. Certify learners performance (summative assessment)
  2. Provide learners with info to aid learning (formative)
  3. Build students capacity judge their own learning (sustaniable assessment)

Build capacity to judge good work, and need to look at optomising the timing of assessments in courses (look at student workload), and to encourage good habits not rote learning.

Distractions can occur through a focus on marks or grades instead of focusing on achievements and the quality of work. Intended learning outcomes and the difficulty measuring by grades, instead mark by outcomes not numbers (what is the expectation for the minimum standard).

Feedback: What does or doesn’t the student do to meet the learning outcomes. Provide more descriptive assessment terms, not classified/standarsied rubric terms (such as good/satisfactory/excellent).

Emojione 1F649

Opportunities for feedback – be selective in what we do and when we do it.

Empower student to be more assertive and to seek feedback. Students to think about what they think is good criteria, think about how they did or did not meet the criteria.


Assessment Design Decisions

Assuring Learning

Boud, D., & Molloy, E. (2013). Rethinking models of feedback for learning: the challenge of designAssessment & Evaluation in Higher Education38(6), 698-712.

Boud, D., & Molloy, E. (Eds.). (2013). Feedback in higher and professional education: understanding it and doing it well. Routledge. [link to Ch. 13]

Cradle: Centre for Research in Assessment and Digital Learning

Feedback for Closing The Assesment Loop

Other Educational Ideas

  • Blended On-line and Digital (BOLD) Learning 

Develop curriculum and build critical thinking when using a blended online approach. Reduced face to face teacher time (online theory, but miss the applying critical thinking, apply theory into practice). Solution – innovative online lesson “apply your knowledge”, linked to learning content, relevant to the theory, instant feedback from case based scenarios.

Resource: Blended On-line and Digital (BOLD) Learning 

  • Steps towards Innovation 

    • Be courageous and embrace vulnerability. authenticity.
    • Be realistic.
    • focus on your goal.
    • think outside the triangle (content, educator, participant)
    • implement, assess, adapt – new ideas, feedback and evaluate

Resource: Brené Brown: The Power of Vulnerability

  • TRACS Video Resource Project 

Process in resource, planning and colaboration for a video resource.

  • key stakeholders,
  • logistical planning, learning objectives, cost, time frames,
  • real clinicians and patients (consent) in a real clinical setting (capture the experience of the patient journey),
  • story boarding key messages,
  • use of multi-media resources for video production,
  • ongoing project management, supporting facilitator guides,
  • Learning resources to go along with the video resources.

Resource: TRACS (TRAining Centre in Subacute care) videos

  • Teaching for 2020 and Beyond. 

Wicked health problems and how nursing education can influence and impact society.

  1. Inequality: rising social injustice.
  2. Empathy deficit: empathy in nursing (learning others experience, cultural skills)
  3. Robotic Nurses: healthcare technology
  4. Battling ourselves: workforce culture, budget, targets

The pedagogy (transformative learning)

  • students to become agents of change,
  • awakening empathy

Nurses as co-creators of healthcare environments. Nursing focus historical on health and well-being. Solution focused nursing being at the forefront of advancing health care with technology and the adaption of technology.

  • AI- clinical decision making
  • Telehealth
  • Digital capacity and technology.

Robo-nurse (Dystopian view of the future)


The Answer: Develop optimistic actions, change agents. Modelling of ethical, courageous, and admirable problem solving.

  • Open the VALT (Visually authentic learning tools) 

Simulation on a small budget and small space, following principles of:

  • authentic learning environments
  • immersion
  • sim on a budget,
  • hands on,
  • case scenario,
  • sim on the go,
  • transportable
  • Cost effective
  • Recyclable materials


Open the VALT

Tilbrook, V. A. (2017). Open the VALT™(Visually authentic learning tools): Using play to facilitate knowledge and collaborative practice. Women and Birth30, 39-40.





















Blog It: Free Open Access to Nursing Education (#FOANed)

This poster was submitted to the 17th National Nurse Education conference (#NNEC18) and is based around Free Open Access to Nursing education (#FOANed) and specialist online communities of practice (eCOP) that can develop with social media. The blog metrics to measure the global reach of Nursing Education Network, are a method for showing the impact of social media and the numbers of interactions related to the blog. Analytics from and Google analytics can be used to demonstrate analysis of post views, users, blog views, visitor city and country data to show the potential global reach.

This post has also been shared as part of the #WeNurses and #WeCommunities project #70nursebloggers & #70midwifebloggersThe aim is to inspire 70 nurses / student nurses / midwives / student midwives to blog in order to raise profile of what nurses and midwives do and nurses & midwives blogging and to celebrate 70 years of the NHS. If anyone wants to write a blog post, more than happy to upload into this site.


Rozenblum, R. and Bates, D. W. (2013). Patient-centred healthcare, social media and the internet: the perfect storm?. BMJ Quality & Safety.

DeCamp, M., Koenig, T. W., & Chisolm, M. S. (2013). Social media and physicians’ online identity crisisJAMA310(6), 581-582.

Carroll, C., Bruno, K., & Vontschudi, M. (2016). Social Media and Free Open Access Medical Education: The Future of Medical and Nursing Education? American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses, 25(1), 93-6.

Moorley, C. R., & Chinn, T. (2014). Nursing and Twitter: creating an online community using hashtagsCollegian21(2), 103-109.

Royal College of Nursing (RCN). (2016). Every nurse an e-nurse. Digital capabilities for 21st century nursing. Retrieved from

Digging For Dinosaurs: Change Idea

Presentation: Digging For Dinosaurs

Resource: Brown, C. E. (2012). Digging for Dinosaurs Contest: A Novel Strategy to Engage Nurses in Questioning Practice.

Change Management Strategy:  used a competition format to drive interest and engagement for ideas on removing ritualistic practices.

A strategy to engage nurses in practice change and the translation of evidence into practice.

Change ideas for nurses to reflect on clinical practice:

  • Why am I doing it this way????
  • Does it add value?
  • Improve quality of care?
  • Improve satisfaction?
  • Improve productivity?
  • Improve communication?
  • Improve motivation?

The aim was to aid nurses driving the change, engagement in research and evidence based practice.  Support is required from senior nurses to assist in the literature review process and any subsequent research projects. Setting up a project and completing ethics can be a time consuming process that the clinical nurse may require assistance.

This project is a great way to engage staff and encourage questioning of practice and aiding translation of evidence.


Brown, C. E. (2012). Digging for Dinosaurs Contest: A Novel Strategy to Engage Nurses in Questioning Practice.

Brown, G. H. (1993). The sacred cow contest. The Canadian Nurse89(1), 31-33.

Learning to Unlearn


To move into new domains of learning and knowledge there is a need for revolutionary thinking to be confident enough to rise to the challenge of moving into the unknown. Education from school to university and then into workplace, is normally planned and structured around a developmental trajectory as a persons skills, knowledge and experience increase. But what about the future and learning, if we don’t know the skills or knowledge that we will require, how do we unlearn any irrelevant information? This could be termed as a deimplementation process of learning. The process of unlearning becomes an important process in our learning skills repertoire.

From the organisation viewpoint comes the focus on becoming ‘learning organisations’, but maybe this could be supported with seeking new logic and a process of unlearning. “Unlearning is not about forgetting. It’s about the ability to choose an alternative mental model or paradigm” (Bonchek, 2016). The skill is recognising mental models that are no longer relevant or effective. This reflexivity of working with uncertainty could be benefited by utlising already well used practices such as self reflection, which could focus on considering any of our biases we hold and allowing change to occur as we move forward.

This post was inspired by the Twitter conversation below, thanks to @precordialthump.

Keywords: Unlearning; Reflexivity; Transformation; learning.


Bonchek, M. (2016).Why the Problem with Learning is Unlearning. Harvard Business Review.

Klein, E. J. (2008). Learning, unlearning, and relearning: Lessons from one school’s approach to creating and sustaining learning communitiesTeacher Education Quarterly35(1), 79-97.

McGregor, A. (2018). Unlearning: The key to the unlock 21st Century problems? International Teacher Magazine (ITM).

Mix It Up Book Club: The Classics

Inspiration and thought can come from an array of sources. I have recently tried to make a focused effort on adjusting the balance of healthcare and normal reading material that I read, incorporating the classics onto my ‘to do’ reading list. This approach is part of that work/life balance ethos that can become skewed when all your focus is on studies or completing a work based project. Avoiding that path to burnout is key.

Book Club:

  • Orwell, G. (1945). Animal Farm. New American Library.
  • Orwell, G. (1950). 1984. New American Library.








Avoiding the clear political messages, the importance of finding individuality and choice is very real when one considers the way social media platforms may track and direct our focus. Will future generations have a multitude of choice when engaging in life and work in the online world, or will only a handful of multinational corporations exist?

Keywords: Big Brother; Thought Police; Totalitarian Dystopia; Orwellian.


Orwell, G. (1945). Animal Farm. New American Library.

Orwell, G. (1950). 1984. New American Library.

Penguin Books (2018). Your Classic Books Reading Challenge.

Wikipedia (2018) Nineteen Eighty-Four.

Outliers: The Story of Success (Book Club)  

Book Club: Gladwell, M. (2008). Outliers: The Story of Success. Hachette UK. [sample here]

It’s More Than Just Talent

Outliers are “people who are invariably the beneficiaries of hidden advantages and extraordinary opportunities and cultural legacies that allow them to learn and work hard and make sense of the world in ways others cannot” (Gladwell, 2008).

Contributors To Success

    • Practice makes perfect- the 10,000 hours practice rule (Deliberate Practice).
    • The importance of cut off points in the calendar year in sport and schooling, related to age, development and subsequent opportunities.
    • Opportunity: the right time and place, what is happening to the wider world at the time of the person’s key development stages.
    • The impact of legacy.
    • Examples provided of the success stories of Bill Joy, Bill Gates & The Beatles.
    • IQ is not enough. The Terman IQ study of the gifted demonstrates that intelligence does not equal success (Terman, 1959).

Malcolm Gladwell Explains



Gladwell, M. (2008). Outliers: The story of success. Hachette UK. [sample here]

Kaufman, S. (2009). The Truth about the Termites. Psychology Today.

Nursing Education Network. (2017). Deliberate Practice: Practice like you play.

Terman, L. (1959). The Gifted Group at Mid-Life: Thirty-five Years Follow-up of the Superior ChildStanford University Press.

Wikipedia (2017) Outliers.

An Integrative Literature Review of Evidence-Based Teaching Strategies for Nurse Educators

Journal Club Article: Breytenbach, C., ten Ham-Baloyi, W., & Jordan, P. J. (2017). An Integrative Literature Review of Evidence-Based Teaching Strategies for Nurse Educators. Nursing Education Perspectives38(4), 193-197. [abstract]

Keywords: Evidence-Based Teaching; integrative review; teaching; nurse educator.


Evidence-based teaching strategies in nursing education are fundamental to promote an in-depth understanding of information. The teaching strategies of nurse educators should be based on sound evidence or best practice.


Integrative literature review of sixteen studies.


Eight teaching strategies were identified:

  1. E-learning
  2. Concept mapping
  3. Internet-based learning (IBL)
  4. Web-based learning
  5. Gaming
  6. Problem-based learning (PBL)
  7. Case studies
  8. Evidence-based learning (EBL)

The following three strategies of concept mapping, IBL and EBL provided the highest level increase in knowledge.


All teaching strategies enhanced the learning experience, but more research is needed. A multi-modal approach to teaching and delivering content is required to suit the content, situation and learner.


Breytenbach, C., ten Ham-Baloyi, W., & Jordan, P. J. (2017). An Integrative Literature Review of Evidence-Based Teaching Strategies for Nurse Educators. Nursing Education Perspectives38(4), 193-197. [abstract]

Journals For The Nurse Educator To Follow

Keeping up to date with the latest clinical nursing and healthcare developments is a challenging process, then throw in additional education focused literature and your into information overload territory.  To keep relevant and aware of current healthcare educational focused research, here are some resources that may help (no conflict of interest to report). As ever please add any suggestions of other resources you know about in the comments section at the bottom of this post and I will update the below resource list.

Journals To Follow: 

To organise your favourite journals or browse collections to keep up with the latest research:

A few predatory journals also exist out there in publishing land so beware.