Organizational Forces, Addressing Future Trends and Meeting Learner Characteristics Through Curriculum Design In Nursing Education

Curriculum Design In Nursing Education and Organizational Forces, Addressing Future Trends, Meeting Learner Characteristics Through 

Curriculum Design for Congruence with School and Organizational Forces In Nurse Educator, Curriculum Development Responding to Major Calls for Reform In Nursing Education, Meeting Learner Characteristics through Curriculum Design In Nursing Education, Addressing Stakeholder Expectations While Designing Nursing Curriculum, Addressing Future Trends in the Design of Prelicensure Curriculum In Nursing Education.

Curriculum Design for Congruence with School and Organizational Forces In Nurse Educator

    Schools of nursing operate in a myriad of different environments, each with a particular world view, set of implicit or explicit values, and encompassing a mission and vision. Faculty working to devise curricula should consider the values, mission, and vision of the parent organization as they develop courses, teaching learning strategies, and educational outcomes. 

    Mission and vision statements often encompass particular worldviews about the nature and importance of teaching, scholarship, and service; include statements about particular professional values; and also often delineate the scope and focus of areas and populations of interest such as a focus on the local community, statewide needs, and national and international areas of concern. 

Curriculum Development Responding to Major Calls for Reform In Nursing Education

    One of the ongoing challenges of curriculum development is staying abreast of the many different calls for reform from professional organizations, institutes, and research findings that have the potential to affect nursing practice. When creating nursing curricula for the twenty-first century, Glasgow, Dunphy, and Mainous (2010) recommend that curricula be focused on the integration of science and research and the influences resulting from health care policies. 

    Benner et al. (2010) work on transforming nursing education to some degree complements the recommendations of Glasgow and colleagues. Grown out of her research efforts, Benner and colleagues identified four “shifts” that should guide curriculum design based on the evidence she has collected: a shift toward teaching for a sense of the most important aspects of a situation and related key actions in particular situations; a movement toward integration of didactic and clinical education; a renewed focus on clinical reasoning and many ways of thinking that include critical thinking; and a renewed emphasis on professional formation, much more than simply functioning in a particular role.

    The guiding principles that the American Organization of Nurse Executives (AONE), (2010) identified are more prescriptive in nature than those proposed by Benner and colleagues, but also need to be taken into consideration when designing undergraduate curricula, especially those that lead to a baccalaureate degree. 

    The guiding principles are not focused on content, but rather how to access, synthesize, and manage the “knowledge work” of nursing, delivered in the context of a caring, patient-centered environment. The guiding principles also emphasize the importance of interdisciplinary and patient relationships in the delivery of care. 

    Quality and safety are considered to be core concepts to care delivery (American Organization of Nurse Executives, 2010).In translating some of the expectations of the Institute of Medicine [IOM] (2001, 2010) work into nursing curriculum operating principles, faculty will need to focus on improving the health and functioning of people; preparing students to deliver health care in a safe, effective, patient centered, timely, efficient, and equitable fashion; and developing competencies to establish care benchmarks and evaluate the outcomes of care according to these benchmarks. 

    The Quality and Safety Education for Nurses (QSEN) competencies have also taken a prominent place in the undergraduate nursing curriculum. Based on the work of Cronenwett et al. (2007) the QSEN Institute has developed competency statements for quality and safety knowledge, skills, and behaviors or attitudes (KSAs) across undergraduate curricula. 

    Many schools of nursing have used either the entire set of KSAs or have mapped their own curricula to this significant body of work. In another important call for action, the World Health Organization (WHO) published a key report, the Framework for Action on Interprofessional Education and Collaborative Practice (2010), issuing a global call for interprofessional health education with the stated goal of improving patient health outcomes worldwide. 

    The WHO asserted there is ample evidence showing that interprofessional education leads to interprofessional collaborative practice. Following this report, the Interprofessional Education Collaborative Expert Panel (2011) published a set of core competencies for interprofessional collaborative practice, including learning outcomes that apply to all health professionals.

  These two key reports have fostered an international movement toward interprofessional health education that has been endorsed by multiple professional organizations and has relevance for development of undergraduate nursing curricula. 

    Finally, as schools of nursing aim to graduate a workforce that is diverse and representative of the communities served, many have crafted programs aimed to attract and retain a diverse student body. Diversity is defined in a myriad of ways, including ethnic and gender diversity, as well as diversity in sexual and gender orientation, socioeconomic status, and even experience. 

    Achieving classes of students who are rich in diverse experience and who mirror the population who will be served by graduates is a focus for many schools of nursing today. 

Meeting Learner Characteristics through Curriculum Design In Nursing Education

    With the current emphasis on student learning and student engagement, it is important that curricula be designed to promote the development of individual students. This can be accomplished in part by encouraging interrelationships among the learners, faculty, and what is being learned. 

    Additional factors affecting program design and student development include focusing on health and well-being of society; grounding learning in contemporary evidence; creating a learning environment that is infused with experientially and culturally based learning opportunities; and supporting individual creativity especially as it relates to inquiry, problem solving, and reflection.

    For students in undergraduate programs, faculty designing curriculum should consider the particular population of learners that will be served. If there will be a predominance of learners with English as a second language (ESL), strategies for facilitating their success with reading, writing, and testing will be important. 

    If the students in an academic progression program are working in health care and seeking an additional degree (i.e., LPN to associate of science in nursing (ASN) or RN to BSN), learning activities and schedules should be conceived to meet learner needs being flexible, applicable to “real-world” applications and work experiences, and realistic in terms of pace of the number and type of assignments. 

    Students seeking a second degree appreciate recognition for prior learning, and respond well to a rigorous academic environment. When creating curricula for this population of learners, affording the learners the chance to draw connections between prior degrees and professional work experiences to the field of nursing creates a bridge to exemplary practice that is valued by participants. 

Addressing Stakeholder Expectations While Designing Nursing Curriculum

    The effect of stakeholder expectations on prelicensure nursing education cannot be overstated: state boards of nursing, nursing accrediting agencies, and the U.S. Department of Education have had tremendous influence on both design and delivery. Today, state boards of nursing are variable in how prescriptive they are relative to nursing curriculum but they do influence content taught, clinical requirements, and pedagogy. 

    Accreditation criteria are clear influencers regarding criteria to be met in curricular construction, and they are becoming more so as the U.S. Department of Education becomes more explicit in its emphasis on outcome data specified in its standards for recognizing professional accreditation bodies (U.S. Department of Education, 2010).

    Furthermore, although it is expected that nursing faculty will use professional standards to shape curricula, sometimes faculty rely on such standards without considering other sources for content and teaching methodology or without considering the unique mission of their own institution. 

    One can look to The Essentials of Baccalaureate Education for Professional Nursing Practice (American Association of Colleges of Nursing [AACN], 2013) and the Commission for Collegiate Nursing Education (CCNE) (2009) requirement that programs accredited by CCNE must incorporate them into the curriculum, as an example of how accrediting bodies can influence program development and curricula design.

    Professional standards offer critical guidance for nursing programs, but faculty should also attend to other factors relevant in their own institution’s mission, their own learners’ needs, and the needs of the health care agencies and communities served by the school’s graduates. 

Addressing Future Trends in the Design of Prelicensure Curriculum In Nursing Education

    Schools of nursing that are nimble and able to respond to future trends in nursing and health care will be able to maintain a curriculum that prepares learners for their future practice. Faculty who persist in monitoring and responding to identified trends, and who are able to revise curricula in a timely manner, will be rewarded with a curriculum plan that is future oriented and relevant.

    Numerous health care trends are predicted to have a major effect on nursing practice at the licensed practical and registered nursing level. Trends that are currently prevalent in health care and well on their way to becoming essential aspects of the nursing role include interprofessional practice competencies, understanding global health challenges, genetics, and genomics. 

    A focus on patient-centered outcomes and further integration of quality and safety concepts into the curriculum will continue. Tella et al. (2014) completed an integrative review of patient safety education practices and their outcomes in schools of nursing and found a wide variety of approaches in this focus area for nursing curriculum.

    Other current issues and trends in health care include providing nursing care that is veteran-centric; responding to new care roles to enhance care navigation, health coaching, and telehealth; and use of continuous quality improvement methodologies to enhance the efficiency and reliability of nursing and health care. 

    Kovner, Brewer, Fatehi, and Katigbak (2014) stated the employment patterns of newly licensed RNs is shifting from a heavy focus on acute care more toward care provision in the community; thus nursing curricula need to prepare graduates for this anticipated shift in the care environment. 

    Additionally, building curricula that address workplace readiness and promote healthy work environments (including issues such as civility, bullying, and readiness for practice) has taken on significance in recent years as the cost of high turnover among new nurses is realized the cost is high in patient safety outcomes, patient satisfaction, nursing job satisfaction, and cost.