Date of Award


Degree Name

Doctor of Nursing

Schools and Centres

Nursing and Midwifery

First Supervisor

Professor Selma Alliex


The provision of continuing professional development for nurses is necessary to support the delivery of safe patient care. Nurse education departments need to function as effectively and efficiently as possible, producing measurable outcomes to justify their cost in regard to the organisation’s financial bottom line. In reviewing the literature, three recognised models of nurse education services within hospitals were identified. These are described as centralised, decentralised and combination models. All of these models have advantages and disadvantages that can affect service delivery, quality of service and cost.

The purpose of this study was to investigate the different nurse education service models in use, to evaluate the efficiency and effectiveness of the different model types with a view to making recommendations for future nurse education service delivery within healthcare organisations.

This research study used a mixed methods approach comprising three phases. Phase one involved interviews and focus groups with nurse educators at one tertiary teaching hospital in Perth, Western Australia (WA). Phase two involved focus groups and interviews with nurse educators in acute care metropolitan hospitals in W.A. Phase three of the study consisted of a national survey of nurse educators in acute care metropolitan hospitals across Australia.

The results indicated that in comparing the centralised, combination and decentralised models, the type of model in use did not appear to affect the educators, visibility in clinical areas or the development of specialist knowledge and skills. However, significant results indicated that a centralised model:

  • has more senior educators involved in the selection and education of junior educators
  • requires educators to undertake less duties outside their role
  • gives educators a more organisational-wide view
  • makes educators feel less isolated
  • allows for more continuous awareness of learning deficits at ward level
  • uses less junior educators to fill staffing deficits
  • allows more autonomy
  • is more supportive of junior educators
  • supports more consistency of training across the organisation
  • has more coordinators as members of the executive or high-level committees.

The findings of this study demonstrate that a centralised nurse education service model undertakes more functions than, and delivers significant advantages over, the decentralised and combination models. The centralised nurse education service model encompasses the features of an ideal service model and was the model recommended by nurse educators across Australia.

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