Curriculum Development In Nursing Education and How Forces, Issues, Social Context and Health Care Reforms Influence
Forces and Issues Influencing Curriculum Development In Nursing Education
Leaders in the nursing profession must remain vigilant to the forces and issues influencing the direction of professional education. In any dynamic organization, curriculum change is not a choice but a requirement. The magnitude, pace, and intensity of change within the health care arena affects providers, consumers, educators, and financers of health care.
As a result, nurse educators must continually work to develop and implement relevant curricula congruent with global trends, national events, advancements in science and technology, professional priorities, academic forces, the school’s mission, and faculty values.
Doing so ensures practitioners entering the workforce are prepared and equipped with relevant knowledge and competencies necessary to provide patient-centered care; effectively intervene in contemporary health care challenges; and advocate for delivery of safe, quality health care.
The ability to deliver meaningful curricula within the dynamic health care environment requires a close understanding of internal and external forces directing change. This topic and coming next topics describe the current social context for curriculum development, including issues and forces in the environment external to the nursing profession, the higher education environment, and the profession’s internal environment.
In addition, several strategies are presented that can assist faculty to identify forces and issues that influence the nursing profession and curriculum. Faculty with intimate and current knowledge of the forces and issues influencing nursing curricula are better positioned to navigate the political processes of building consensus and obtaining approval by all significant stakeholders.
Social Context for Curriculum Development to the Nursing Profession
Understanding issues external to the nursing profession form an essential piece of the foundation necessary to guide contemporary curriculum development. External issues like health care reform, global disasters and globalization, changing demographics, technology, and the environment provide the context for the world in which nurses learn and practice.
Collectively these same issues encompass risk factors for health and disease, contribute to the complex web of causation, and describe the current states of humanity and health. Health issues are increasingly related to the sociopolitical and economic characteristics of the communities where people live, work, and play.
Curriculum must acknowledge the broad determinants of health to prepare practicing nurses to effectively intervene in complex problems such as bioterrorism and other mass disasters, climate change, global and domestic violence, economic recession, homelessness, teen pregnancy, emerging infectious diseases, and increasing drug-resistant organisms.
The
following six trends, which capture significant developments and concerns for
society, are presented as the broad sociopolitical and economic context of
nursing practice and education. Although these trends are discussed separately,
their interconnectedness is undeniable.
Health Care Reform In Nursing Education for Curriculum Development
The passage and signing of the federal statue known as the Patient Protection and Affordable Care Act (PPACA) in 2010 has become a major force driving health care reform and ultimately curriculum development. Under this act and for the first time in America’s history all citizens have access to affordable health care insurance.
In conjunction with access to care, a national strategy known
as the “Triple Aim” has been implemented with the purpose of improving the
quality and access to health care while controlling costs (Institute for
Healthcare Improvement, 2009).
Nursing practice and education greatly benefited from the passage of the PPACA through amendments to Title VIII of the Public Health Service Act. As a result, funding priorities of the Nurse Education, Practice, Quality and Retention (NEPQR) program, administered by the Health Resources and Services Administration (HRSA) were shifted to support nursing education, practice, and retention.
For example, financial support for pursuit of advanced degrees by nursing students who have a desire to o teach increased, as did the amount nursing students from disadvantaged background or with limited financial resources could borrow to pay for their education.
In addition, more than $1 billion in new grants were authorized to increase home visits to mothers in high-risk communities and to establish a new grant that will fund nurse-managed health centers (U.S. Department of Human and Health Services, 2011; Wakefield, 2010).
In response to this anticipated reformed health care arena, nurse educators must ensure that prelicensure and graduate program nursing curricula prepare nurses to care for patients in ambulatory or community settings, possess skills to coordinate patient care, work as members of inter professional teams, provide quality as well as value based care, and develop leadership skills.
Nursing program curricula needs to increasingly focus on wellness, prevention, and palliative care versus management of acute patients in acute care settings (Institute of Medicine [IOM], 2010: Sherman, 2012). Nursing curricula should also seek to provide students with the opportunity to envision, create, or actively participate in the redesign of new or revolutionary models of health care delivery systems.
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