Outcomes and Competencies of a BSN Program Curriculum In Nursing Education

BSN Program Curriculum In Nursing Education ant Its Outcomes and Competencies

Outcomes and Competencies of Curriculum In Nursing Education, Identifying Curriculum Outcomes In Nursing Education, BSN Program Outcomes of a Designed Curriculum In Nursing Education, BSN Program the Graduate Will Be Able to By This Curriculum Design.

Outcomes and Competencies of Curriculum In Nursing Education

    If curriculum frameworks are the road maps to understanding the discipline of nursing, then outcomes can be equated with the trip’s destination and competencies with the mileage markers seen along the way. 

    Program outcomes (also referred to as learning outcomes or sometimes expected outcomes) then take the place of what was traditionally and more generally called terminal objectives as the outcomes represent the integrated knowledge, skills, and abilities or competencies students are expected to demonstrate at program completion.

    Outcomes, in the simplest of terms, are those characteristics students should display at a designated time, most often at the completion of the curriculum, and reflect a description of the ideal program graduate. Competencies are sometimes described as what students can do with what they know at designated points during and at the end of the educational program. 

    Each broader desired outcome may be linked with multiple competencies to achieve a meaningful level of specificity for student assessment and, in the aggregate, for program evaluation. The chapters in Unit V - Evaluation provide detailed information about assessment of student learning, program evaluation, and related topics.

Identifying Curriculum Outcomes In Nursing Education

    The movement to an outcomes orientation has developed over time in nursing education as it has in higher education. These resulting changes provide a strong focus on the quality and value of postsecondary education (K–12 has experienced a similar set of changes with a focus on competency testing). 

    Regional higher education accrediting bodies have fully embraced the idea that educational outcomes should prepare graduates to serve some aspect of societal need or improvement, resulting in strong, and some argue, prescriptive approaches to the assessment of student learning and enhanced review of program evaluation metrics.

    An example of this shift in ideology is reflected in a project titled The Future of Higher Education: Rhetoric, Reality, and the Risks of the Market by Newman, Couturier, and Scurry (2010). 

    One of the premises growing out of this project was the need for faculty to ask the right questions about educational goals and outcomes when engaged in curriculum development. The questions identified with relevancy to curriculum development include the following:

 • What knowledge and skills are needed by all graduates?

 • What requisite knowledge needs to be acquired by students to be productive in the workforce?

 • What is the gap between current knowledge and skills and those that are needed in the future?

 • What is the role of technology in facilitating the acquisition of the requisite knowledge and skills?

• How do we deliver the curriculum in a way that will maximize the outcomes?

    Over the past decade, the focus on outcomes in higher education has continued to increase. In response to the provocative questions raised when focusing on program outcomes, the NLN convened an advisory group to explore the outcomes and competencies needed at each educational program level, from licensed practical nurse to the clinical doctorate (National League for Nursing (NLN), 2010). 

    Similar efforts have occurred within the AACN, whose “Essentials” publications contain the expected outcomes and competencies for baccalaureate (2008), master’s (2011), and doctor of nursing practice (2006) programs in nursing.

    With the need for nursing educators to ensure that the curricula they design keep pace with the ongoing changes in health care and higher education, more emphasis will continue to be placed on the school’s ability to demonstrate success. Outcomes assessment has been seen as the key by which school programs can document strengths and weaknesses. 

    A comprehensive assessment program can help faculty determine what works and what does not in achieving academic quality and producing the desired program outcomes (Astin, 2012; McDonald, 2014; Oerrmann & Gaberson, 2014). 

    This logic is a significant departure from the predominantly process-oriented Tylerian approach to curriculum and evaluation, in which the emphasis was placed on detailed course objectives, the identification of content needed to meet course objectives, and the appropriate pedagogical approaches to complement the type of content needing to be taught. 

    Outcome assessment emphasizes what students have actually learned in their educational experiences, not merely the knowledge and experiences that were designed with the intent of achieving these results (Astin, 2012; McDonald, 2014; Oerrmann & Gaberson, 2014; Wittmann Price & Fasolka, 2010). 

    These differences, which may seem like nuances to many, are core to the changing focus in curriculum development and student learning assessment and evaluation that continues to evolve in higher education and nursing education.

    When moving to a curriculum that is more centered on the development of outcomes relevant to nursing practice, it is often easier to think about curriculum development as starting at a program’s end rather than its beginning.     

    Outcomes then become the critical focus of curriculum development. This method of curriculum development places a different emphasis on the need for organizing frameworks as a starting point for curriculum development.

    Approaching curriculum development beginning with the desired outcome or what the student needs to demonstrate at graduation to be a competent nurse and then working “backward” toward the beginning of the curriculum provides faculty with an opportunity to identify the essential outcomes and competencies that they wish to see their students demonstrate at the completion of the program. 

    It is important to note that development of outcomes should be significantly informed by the mission, vision, values, and philosophy of the program; an environmental scan that includes the perspectives of major external stakeholders; the use of best current evidence in nursing and health professions education; and internal stakeholder preferences from faculty, students, alumni, and appropriate others.

BSN Program Outcomes of a Designed Curriculum In Nursing Education

 Upon the completion of the program the graduate will be able to:

 1. Administer evidence-based, clinically relevant holistic care to individuals, families, groups and multi-dimensional populations with diverse demographic and cultural characteristics in a variety of settings.

 2. Communicate effectively using oral, written, and electronic methods, to transmit the analysis and integration of data required to provide safe quality care and inform nursing practice.

 3. Integrate critical reasoning and problem-solving methods to make effective nursing judgments and help patients make relevant decisions to improve their health and quality of life.

4. Implement interventions that integrate ethical, legal, and Christian principles and behaviors, consistent with the Catholic and Dominican Tradition, in all professional nursing activities in order to advocate for the health, well-being, and the best interests of nurses, patients, families, significant others, and the community.

 5. Integrate teaching strategies to assist individuals, families, and communities to achieve the highest level of health and well-being possible.

 6. Collaborate in partnership with other healthcare team members to promote, protect, and improve health of patients at any point on the illness/wellness continuum.

 7. Engage in leadership and management activities in a multidisciplinary healthcare environment to plan, implement, delegate, evaluate, and promote safe quality nursing care that is holistic and cost effective.

 8. Participate in the ongoing changes in the profession and actions that promote safe quality patient care and engage in ongoing preparation through continued learning and advanced practice education that advance the goals of the profession.

    The interrelationship between the organizing framework and the outcomes and competencies becomes clear with the organizing framework being shaped by the theories and concepts embedded in the outcomes and competencies. 

    For example, if faculty believe that students need to possess clinical reasoning, communication, teamwork, and leadership skills, these concepts will be evident in the organizing framework. In an outcomes-focused curriculum, the driver of faculty conversations is not what content must be taught but rather what KSAs (professional values) students need to demonstrate to meet expected curriculum outcomes. 

    Before they can think about curriculum from the outcome, or end stage, faculty first must identify the desired program outcomes using a stakeholder-informed and future-oriented picture of nursing practice (Sroczynski, Gravlin, Route, Hoffart, & Creelman, 2011). 

    Here are some examples of end o fprogram competencies that reflect evolving stakeholder priorities with an emphasis on transition care coordination across settings, emerging technologies, and culturally sensitive care.

BSN Program the Graduate Will Be Able to By This Curriculum Design 

 • Coordinate care and transitions across providers and settings

 • Apply communication and emerging technologies to nursing practice for optimal patient outcomes

• Deliver culturally sensitive care to patients and their families (Thomas Jefferson University College of Nursing, 2015)

    As faculty identify outcomes, it is important to embed these outcomes in actions that promote the practice of nursing. Using an outcomes perspective, it is important that faculty not only clarify and define the concepts they wish to use in the development of outcomes but also ensure that they have outcomes that are broad enough to incorporate all of the attributes desired.

    A common question is how many program outcomes are needed. There is no evidence based answer to this question; however, many programs strive for no more than eight to ten outcomes. Keep in mind that these should be broad-based outcomes that encompass a number of competencies that will evolve with changing practice. 

    If faculty are identifying a large number of program outcomes, it is likely that they have confused program outcomes with the knowledge, skills, or behaviors related to competencies. Program outcomes should not need to be frequently updated; they should stand the test of time. For example, consider the following BSN program outcomes (2 of 9). As a graduate of the BSN program you will be:

    A culturally sensitive individual who provides holistic, individual, family, community, and population-centered nursing care;

    An effective communicator who collaborates with inter-professional team members, patients, and their support systems for improved health outcomes (Indiana University School of Nursing, 2012). These outcomes are written broadly and will be contemporary for some time to come. 

    The knowledge, skills, and behaviors (competencies) that the graduate will need to acquire to demonstrate these outcomes will likely change, but the outcomes will remain current. The faculty can review and update the competencies as needed to stay current.

    Some of the criteria that will be useful in determining how many outcomes to include are ensuring that the major aspects of the organizing framework are included; that significant professional practice and accreditation standards are appropriately reflected; and that, when considering the outcomes as a collective whole, a clear picture of the major components of a practitioner who is engaged in safe, quality nursing care emerges.

    Consideration of a more ontological philosophical approach to defining outcomes adds the perspective of the learner on core characteristics. For example, in the work of Doane and Brown (2011), students are expected to demonstrate “self-initiating, self correcting and self-evaluating behaviors which they believe are at the core of skillful practitioners” (p. 24). 

    The authors indicate that developing skills of communication is critical and that it is the learners’ ability to identify what is not known that shapes the essential content within the curriculum. 

    The importance of reflection and reflective practice is increasingly recognized as a crucial strategy to develop professional identity, emotionally intelligent practitioners, and a commitment to lifelong learning and development (Sherwood & Horton-Deutsch, 2012).