1 │ Introduction

The process of aging is universally recognized as an inherent aspect of the human life cycle [1]. In contemporary times, the global incidence of old age has escalated in tandem with scientific advancements [2]. Projections indicate a substantial increase in the worldwide elderly population, reaching 1.5 billion by 2025 and surpassing 2 billion by 2050 (2). In Iran, the demographic aged 60 and above is anticipated to comprise around 10 million individuals by 2020 and exceed 26 million by 2050 [3]. The World Health Organization's report underscores a corresponding rise in the elderly population in Iran, attributed to an augmentation in the life expectancy index [4, 5].

Anticipating the impending challenges associated with an aging demographic, a lack of preparedness may lead to adverse consequences [6]. Consequently, education emerges as a pivotal strategy to address the multifaceted phenomenon of aging [7]. Educational programs, particularly those focusing on nursing during old age, stand out as instrumental in empowering and enhancing the quality of life for the elderly [8, 9].

By the World Health Organization's definition, geriatric nursing is characterized as the provision of specialized nursing care services to the elderly within a multidisciplinary health team in diverse clinical contexts [10]. This specialization involves a meticulous examination of the specific needs of the elderly population, aiming to design and implement nursing care to meet health requirements while assessing the efficacy of interventions to enhance the health of the elderly and their families [11]. Given the pivotal role of nurses in elderly care [12], it is regrettable that nursing education programs often fall short of adequately addressing the intricacies of elderly care [13].

In response to this gap, the geriatric nursing master's program was introduced, with the primary objective of scrutinizing the needs of the elderly and contributing to the enhancement of their quality of life [14]. The development of this program in Iran was tailored to align with the country's demographic shifts [15]. Recognizing the comprehensive nature of the educational system and its role as a sociopolitical, economic, and cultural tool, educational programs should be meticulously designed to meet societal needs [16]. The geriatric nursing master's program received approval as a specialized training course from the Supreme Planning Council of Medical Sciences in 2010 and commenced operations in 2011 with the admission of the inaugural student cohort [17].

Given the pivotal role of comparative studies in identifying curricular strengths and weaknesses, especially in nursing education, the examination of educational experiences from other countries becomes imperative [16]. Drawing upon comparative studies, Ghaffari et al., (2016) highlighted the emphasis on clinical and preventive issues in both Iranian and American geriatric master's programs, yet discerned clearer job opportunities in the United States [15]. Valizadeh et al., (2016) observed distinct goals and missions in the geriatric nursing master's courses in Iran and the United States, with the latter possessing more suitable training and clinical fields [7]. In the Iranian nursing master's program, Hasani Narenjbaghi et al., (2017) noted a lack of attention to the cultural differences within society [18]. Aghaei et al., (2018) underscored the emphasis on online education and electronic health development in Canada's educational program, an aspect notably absents in Iran's educational content [16].

Considering the aforementioned studies and acknowledging Canada's rich educational history, this study aims to compare the educational programs of the geriatric nursing master's course in Iran with the University of Alberta, Canada. The University of Alberta, as one of Canada's five distinguished universities and part of the global top 150 universities, particularly stands out with its Alberta School of Nursing, a pioneering institution in undergraduate nursing education in Western Canada [19].

2 │ Methods

2.1 │ Study design and subjects

The present review, undertaken in the 2022, adopts a comparative descriptive approach. Comparative analysis involves juxtaposing two or more phenomena, subjecting them to scrutiny to discern their differences and similarities [16]. A frequently employed model for such investigations is the Brady et al. model [20]. In the realm of comparative studies, Brady's model comprises four key stages: description, interpretation, contiguity, and comparison. The description phase involves the collection of pertinent information. Subsequently, in the interpretation stage, the amassed information undergoes analytical scrutiny. The contiguity stage entails a simultaneous examination of multiple systems to establish a comparative framework. Finally, in the comparison stage, the identification of the issue is followed by a comprehensive assessment and comparison of all factors about the education system of the respective countries [19, 21].

2.2 │ Data collection

During the description phase, the investigator initially scrutinized the titles pertinent to the field by referencing the approved title of Iran's geriatric nursing master's program and accessing the website of Alberta Nursing School, Canada. Additionally, a comprehensive collection of information was facilitated through the perusal of published articles in both internal databases (Magiran and Scientific Information Database) and external databases (Google Scholar, PubMed, and Scopus), utilizing Farsi and English keywords such as educational program, master's degree in geriatric nursing, nursing education system, Canada, and Alberta. In the interpretation stage, all gathered information concerning the historical background, course structure, philosophical underpinnings, mission, vision, overarching goals of the educational program, entry prerequisites, roles of students, post-graduation professional duties, course organization, educational strategies, and evaluation methods was systematically categorized and analyzed. Subsequently, a synthesis of the amassed data was performed to delineate differences and commonalities, thereby constructing a comprehensive framework. In a subsequent analytical step, the identified similarities and differences were scrutinized, compared, and interpreted to address the research inquiries.

3 │ Results

3.1 │ Participants’ characteristics

The findings of this study are presented in five distinct tables, each focusing on various elements of the curriculum, including the definition, historical background, course objectives, admission criteria, and course structure. Noteworthy temporal distinctions were observed between the geriatric nursing master's program in Iran, which has been established for approximately a decade, and the counterpart at the Alberta School of Nursing, boasting a nearly two-decade existence. An essential disparity lies in the program structure, where Iran's geriatric nursing master's program is singularly educational, while the University of Alberta offers two tracks, categorized as course-based and thesis-based. Furthermore, there is a quantitative discrepancy in clinical units, with the Iranian program exhibiting fewer clinical units than its Alberta counterpart. The overarching goal of the Iranian program is more generalized, whereas the University of Alberta's emphasis is on the specific goal of aiding families and patients in maintaining health (Table 1). An examination of the philosophy, mission, and vision of the respective programs reveals a greater level of specificity in Alberta, Canada, with a particular emphasis on globalization and cultural differences. In contrast, the Iranian program manifests a more general orientation (Table 2). The professional roles of students in the geriatric nursing master's curriculum exhibit distinct characteristics. In Iran, the roles are less defined, whereas in Alberta, and Canada, the curriculum's nature allows for more specific roles and positions (Table 3). Admission processes diverge between Iranian universities, which rely on entrance exams or exceptional talent, and Alberta College, where selection is based on interviews and a meticulous evaluation of applicants. In Alberta, significance is attributed to the quality of students, considering language proficiency, grade point average, and clinical experience as pivotal criteria for admitting nursing master's students (Table 4). Tuition fees also differ, with Alberta School of Nursing implementing private fees, while Iranian institutions accommodate both public and private sectors (Table 5). Teaching methodologies present variations, as Iranian instruction follows a traditional teacher-student paradigm, while Alberta adopts a problem-oriented approach. Notably, the absence of a dedicated internship environment in Iran's geriatric nursing master's program, coupled with the lack of specialized wards for the elderly in hospitals, leads students to seek elderly individuals in public spaces for practical experiences (Table 6). Lastly, the content of the geriatric nursing curriculum in Iran is characterized as general and inflexible, whereas in Alberta, the curriculum allows for specialization based on students' interests (Table 7).

4 │ Discussion

The primary objective of the present study was to undertake a comparative assessment of the master's degree curriculum in geriatric nursing within the educational systems of Iran and the Alberta School of Nursing in Canada. Notably, the Alberta School of Nursing exhibits a more clearly defined and community-tailored purpose, potentially attributed to the extended historical trajectory of the geriatric nursing master's program at the University of Alberta [19]. Given that the fundamental goal of any curriculum is to prepare learners for both personal and professional engagement within society, it is imperative for such programs to undergo periodic reviews and modifications aligned with the evolving health needs of the community, as highlighted in previous research [17]. This necessitates a comprehensive evaluation every few years, considering the dynamic changes in the demographic structure of the respective countries. One advantageous aspect of Iran's geriatrics master's program, in contrast to Alberta, is the inclusion of workshops addressing fundamental aspects such as principles of patient communication, clinical governance, patient safety, evidence-based nursing, promotion of health services, and infection control. These workshops contribute to a holistic educational approach, enhancing the skill set and knowledge base of learners in geriatric nursing.

The philosophy, mission, and vision delineated in the geriatric program at the Alberta School of Nursing exhibit a more focused and specialized orientation. Consequently, adherence to ethical and humanitarian principles, coupled with a commitment to supporting the elderly and their families while emphasizing societal needs, constitutes integral components of the values and beliefs inherent in every curriculum [7]. The presence of a distinct philosophy and perspective within each academic discipline underscores the influence of these ideological foundations on the formulation of policies within the respective field [22].

The roles and positions of the Master of Geriatric Nursing students in the Alberta School of Nursing are more specific. But there is no specific position in Iran. Some graduates work as lecturers in colleges after completing several educational units. However, in the program of the Alberta School of Nursing, graduates can work in the clinical environment based on their degree and expertise [19]. However, in Iran, there is no employment line for the graduates of this field in the academic and clinical departments [23]. 

Table 1. Comparison of course definition, history, and purpose in two universities of Iran and Alberta College of Nursing, Canada.

Table 2. Comparison of the definition of values and beliefs, mission and vision of two Iranian universities and the Canadian Alberta School of Nursing.

Table 3. Comparison of the role of professional tasks and expected competence of graduates in Iran and Canada.

Table 4. Comparison of conditions and methods of student admission in Iran and Canada.

Table 5. Comparison of course costs in Iran and Canada.

Table 6. Comparison of teaching and learning methods and educational strategies in Iran and Canada.

The duration of study at the University of Alberta surpasses that of Iran, with research suggesting that an extended educational period correlates with enhanced and more profound comprehension of the curriculum [22]. The comparatively brief duration of study in Iran raises concerns about the potential limitation of achieving deep learning experiences [17]. Admission criteria at Alberta College are rooted in interview-based selection processes, while in Iran, admission relies on entrance exam scores. Alberta College's policy of interview-based selection introduces subjective elements, potentially influenced by personal preferences and other factors, into the acceptance of learners [19].

In the admission process for students at the University of Alberta, there is a notable emphasis on clinical experience, a criterion not similarly considered in the recruitment of geriatric nursing students in Iran. Broadening the criteria and admission conditions for graduate students to include various skills and abilities is posited as a means to cultivate more proficient graduates [22]. While the University of Alberta prioritizes applicants with a clinical background, this aspect is not given due consideration in the admission process in Iran. Clinical experience has been shown to enhance critical thinking skills and accurate clinical judgment in nurses, making it a valuable factor in the education of nursing graduates [23]. Acknowledging and incorporating clinical history and experience are posited to play a pivotal role in elevating the quality of learning and clinical skills among nursing graduates. Moreover, in Alberta College's admission criteria for senior nursing students, a language degree is emphasized. Proficiency and mastery of English among postgraduate students are deemed advantageous, facilitating the utilization of nursing resources [19].

Table 7. Comparison of curriculum content of geriatrics master's courses in Iran and Canada.

The instructional approach employed in Iranian nursing schools adheres to a teacher-student model, whereas the Alberta School of Nursing adopts a problem-solving and comprehensive methodology. The inclusive teaching method, as applied in Alberta, engages students actively in the learning process, not only fostering learning opportunities but also establishing a conducive platform for real-world learning experiences [24]. The utilization of diverse educational methods, the introduction of authentic educational challenges, and the facilitation of reflective and deliberative processes through discussions and exchange of opinions, coupled with constructive feedback, collectively contribute to the enhancement of educational outcomes [25].

A notable deficiency in the geriatric nursing master's program in Iran is the insufficient availability of clinical space for student learning, coupled with a scarcity of specialized professors in the field of geriatric nursing at the master's level. Clinical education holds paramount importance in nursing education, serving as a crucial component in preparing learners to cultivate a professional identity [26]. The significance of clinical training is underscored by the understanding that possessing knowledge alone is insufficient for delivering safe care. Effective and competent individuals can only be nurtured through rigorous clinical training, and the absence thereof renders the task of training such individuals exceedingly challenging or, in some cases, impossible [27, 28]. In the realm of patient care, experiences gained and the application of acquired concepts occur through the dynamic interaction between the learner, the instructor, and the environment [28].

The content of the geriatric nursing master's program in Iran exhibits a more generalized nature, whereas the program at Alberta College is characterized by specialization aligned with societal interests and needs. The University of Alberta's master's course is distinguished by its thesis-based approach, wherein research topics are determined by individual interests, and the curriculum is structured around guided research projects. The outcomes of this approach are evidence-based and contribute to the enhancement of clinical care quality [19]. Furthermore, adapting the content to societal needs is deemed essential and should be a dynamic process in response to evolving societal requirements. The design and compilation of specialized training for various age groups ought to align with the dynamic needs of society, as current geriatric nursing master's programs in Iran manifest significant disparities with societal issues [29]. A prevalent criticism of Iran's geriatric nursing master's programs is the perceived gap and lack of alignment between the presented courses and the clinical care requirements of society [22]. Additionally, there is a notable absence of attention to cultural differences in Iran's geriatric nursing program [23].

In the reevaluation of Iran's geriatric nursing master's program, there has been an acknowledgment of the need for specific courses conducive to thesis research, including topics such as palliative care, telehealth, complementary medicine, and home care. An identified weakness in the geriatric nursing master's program in Iran pertains to the lack of autonomy in geriatric nursing educational groups, coupled with the provision of geriatric courses by professors from diverse disciplines [23]. A notable limitation of this study lies in the absence of comparable investigations utilizing a comparative descriptive approach within the country.

5 │ Conclusions

A comparison of the master's degree program in geriatric nursing across both academic contexts reveals both similarities and differences. It is crucial to underscore that the geriatric nursing master's program in Iran requires comprehensive revisions across multiple domains, including admission criteria, accurate delineation of roles and positions, teaching methodologies, and the training of students. Addressing these areas necessitates the establishment of foundational frameworks to facilitate these changes effectively. Furthermore, aligning the curriculum with anticipated responsibilities and labor market conditions emerges as a critical consideration in this endeavor.

Acknowledgements

Not applicable.

Authors’ contributions

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: MS; Drafting the work or revising it critically for important intellectual content: MS; Final approval of the version to be published: MS; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: MS.

Funding

Self-funded.

Ethics approval and consent to participate

Not applicable.

Competing interests

We do not have potential conflicts of interest with respect to the research, authorship, and publication of this article.

Availability of data and materials

The datasets used during the current study are available from the corresponding author on request.

Using artificial intelligent chatbots

None.