How to Define Curriculum and Development of Cotemporary Curriculum In Nursing Education

Cotemporary Curriculum In Nursing Education and How to Define Curriculum and Development

How to Define Definition of Curriculum, Developing Contemporary Nursing Curriculum

How to Define Definition of Curriculum

    The term curriculum was first used in Scotland as early as 1820 and became a part of the education vernacular in the United States nearly a century later. Over time, curriculum derived from the Latin word currere, which means “to run”—has been translated to mean “course of study” (Wiles & Bondi, 1989).

    In 1949 Tyler published a handbook on principles of curriculum and instruction that has been used for more than five decades (Tyler, 2013). Among other important concepts, Tyler proposed three major criteria for effective organization of a curriculum: continuity, sequence, and integration. Continuity is achieved through careful attention to “vertical reiteration of major curriculum elements” (Tyler, 2013, p. 84). 

    That is, key concepts and skills must be incorporated throughout the curriculum to support knowledge and skill acquisition. Sequence is related to continuity but incorporates attention to new learning experiences building on prior activities, while expanding breadth or depth of the content. Last, “integration refers to the horizontal relationship of curriculum experiences” (Tyler, 2013, p. 85). 

    Integration considers how students will develop appreciation for and the ability to apply skill sets across a variety of subjects and situations. An oft-cited example in nursing education is how the concept of mathematics is used across many topics and settings (e.g., medication calculations, disease prevalence, etc.).

    Doll (2002) originally described curriculum in relation to a shifting paradigm, moving from a formal definition to a focus on one’s multiple interactions with others and one’s surroundings. He defined curriculum as having five concepts: currere, complexity, cosmology, conversation, and community. 

  Currere was defined as the process of “negotiating passages” between teachers, students, and the text (pp. 45–46). The concept of complexity referred to curriculum as consisting of dynamic and complex interactions that eventually, through vision and perseverance of faculty, formed interconnections (p. 46).

    Cosmology was the term used to depict the “living” nature of the curriculum, evoking creativity and vitality (p. 48). The concept of conversation described the respect that faculty and students demonstrate for each other and how they “understand their own humanness” (p. 49–50), and community referred to the “ecological, global, and cosmological issues within which all humans are enmeshed” (pp. 51–52).

    In later work, Doll (2012) described an evolution in his thinking, noting the importance of integrating the rational, scientific approach (e.g., Tyler) with the aesthetic, spiritual view of education within the context of complexity science, in essence, “developing a different sense of curriculum and instruction—open, dynamic, relational, creative, and systems oriented” (p. 10).

    Because of the amorphous nature of the term curriculum, it has had a variety of definitions. Educators prefer particular definitions based on individual philosophical beliefs and the emphasis placed on specific aspects of education. 

    Two more recent conceptualizations of curriculum capture some of the most important evolutionary changes. Parkay, Anctil, and Hass (2010) proposed, “Curriculum is all of the educational experiences that learners have in an educational program, the purpose of which is to achieve broad goals and related specific objectives that have been developed with a framework of theory and research, past and present professional practice, and the changing needs of society” (p. 3). 

    Lunenburg (2011) recommended rethinking how to approach a curriculum to encompass “curriculum as content, as learning experiences, as behavioral objectives, as a plan for instruction, and as a nontechnical approach” (p. 1). 

    The nontechnical approach is described as a rejection of traditional curriculum planning and incorporates philosophical, aesthetic, moral and ethical, and other theories that are relevant to the world today.

Common elements found in many definitions of curriculum include the following:

1.  Preselected goals and outcomes to be achieved
2.  Selected content with specific sequencing in a program of study
3.  Processes and experiences to facilitate learning for traditional and adult learners
4.  Resources required to support curriculum delivery
5.  Extent of responsibility for learning assumed by the teacher and the learner
6.  How and where learning takes place
7. Interschool activities, including extracurricular activities, guidance, and interpersonal relationships
8.   Individual learner’s experience as a result of schooling

Developing Contemporary Nursing Curriculum

    Faculty need to consider many concepts when developing contemporary nursing curricula. For example, nursing curricula need to include concepts related to patient safety, coordination of care, self management, and health literacy, with emphasis on the burden of health problems on patient and family, strategies to decrease the gap between practice and evidence based practice, and strategies that are generalizable across populations (Finkelman & Kenner, 2009; Shattell et al., 2013). 

    Also important to nursing curricula are leadership and other skills to support achieving the stated goals from Healthy People 2020, including a focus on reducing disparities, preventable diseases, disability, injury, and premature death in improving health care for all (Healthy People 2020, n.d.).

    There are innumerable position statements, professional standards, recommendations, and guiding principles from various sources that faculty must be knowledgeable about and consider for inclusion in any curricula they are designing. 

    The recent 2014 global outbreak of Ebola demonstrates how quickly current events in health care can affect a curriculum, thus requiring rapid consideration and action from faculty. 

    It is important for faculty to find ways in which they can perform regular environmental scans with a goal of maintaining a curriculum that is dynamic, fluid, and contemporary. To develop relevant undergraduate and graduate nursing curricula for the future, faculty must consider the following questions:

1. Are students prepared to practice in a complex and changing health care environment, understanding that they will be required to engage in lifelong learning to have a sustained, relevant nursing career?
2.  Are students prepared as professionals to demonstrate the requisite knowledge and skills, including learning to think and make clinical decisions using principles of evidence-based practice within a culture of patient safety?
3.  Are students prepared to collaborate intra- and inter professionally, practice as leaders in health care, and demonstrate integrity in their practice within a legal and ethical framework?
4.  Are students learning essential multicultural and holistic concepts for culturally sensitive patient care within the context of global health needs and challenges?
5.  Are faculty working dynamically and productively to design curricula, including the design of innovative clinical models of instruction, that will most effectively prepare graduates for the workforce in a variety of settings?
6. Does the curriculum integrate a major focus on evidence-based research and practice, promoting faculty and student collaboration with inter professional colleagues in inquiry and improvement?
7.  Are curricula congruent with the goals of national and international health efforts (e.g., Healthy People 2020, World Health Organization [WHO] goals, and others) and in meeting the needs of older adults, women, children, and culturally diverse and other vulnerable populations?
8.  Will graduates be prepared to lead care teams in advocating for improved health care outcomes and services locally, nationally, and internationally?
9.  Are curricula being delivered using active learning strategies, including narrative pedagogies such as unfolding case studies, scenarios, and reflective thought, and are interactive technologies used that require students to engage with the topics and apply their knowledge?
10.  Are faculty designing learning experiences that will prepare learners for practice in transitional care settings? 
11.  Does the university or college provide programs that are high quality, accessible, and of good value, as compared to peer institutions?
12.  Are the curricula meeting the needs of the programs’ communities of interest and other relevant stakeholders?
13.  Do the curricula foster use of current and emerging instructional and patient care technologies, and are faculty adequately prepared to integrate these new technologies into their teaching?

    Additionally, the exponential expansion of knowledge, dramatically changing socio demographics and cultural diversity, an economically and consumer-focused political environment, and increasing acts of global terrorism will continue to challenge nursing faculty to critically review current curricula and methods of instruction with the goal of preparing graduates for the future. 

    Nursing education must address the myriad of issues affecting curriculum design and implementation and transform nursing education to prepare graduates at all levels of education for an increasingly complex workforce that has greater practice expectations and a heavier reliance on the use of advanced technologies across the entire health care continuum (Benner, Sutphen, Leonard, & Day, 2010; Valiga, 2012).