Curriculum Development Project: Concept-Based Curriculum

This assignment is designed to assist the student to develop curricular components based on analysis of educational research of learners, the community, health care trends and accreditation standards. Part 1 is a scholarly paper, in which students select concepts for inclusion in a nursing curriculum. 

For Part 2, program and course objectives will be developed based on Bloom’s revised taxonomy.  

  1. Select three (3) concepts that should be incorporated into curriculum design and development, based on readings, trends in nursing, and the discussion of the issues in Weekly Guide Week 3.
  2. Provide support from the literature for the inclusion of each concept in curriculum design.
  3. Explain the relevance of these concepts in today’s nursing environment.  Include how these concepts fit with the each of these documents: Essentials of Baccalaureate Education (American Association of College of Nursing [AACN], 2008), Institute of Medicine (2010) Future of Nursing Focus on Education report and Pre-licensure KSAs (Quality and Safety Education for Nurses, 2014).
  4. The scholarly paper should be in a narrative format, 5 to 6 pages excluding the title and reference page.
  5. Include an introductory paragraph, purpose statement, and a conclusion.
  6. Include level 1 and 2 headings to organize the paper.
  7. Write the paper in the third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify, we, you, me, or may not be used. In addition, describing yourself as the researcher or the author should not be used.
  8. Include a minimum of three (3) professional peer-reviewed scholarly journal references to support the paper (review in Ulrich Periodical Directory) and be less than five (5) years old.
  9. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations).
  10. Make any revisions necessary based on the Originality Report

Concept-Based Curriculum

In recent years, there has been much academic and professional discourse on the effects of nursing education on patient satisfaction and quality of healthcare services (Wiltjer, 2017). Though there is weighty pragmatic evidence to prove that nursing education plays a major role on the outcomes of care, changes to curricula and effective approaches to teaching programs can improve their interpersonal skills, increase their critical thinking ability, improve their knowledge as well as boost their confidence.

As a result, and in a bid to improve course effectiveness many nursing institutions are considering the implementation of the concept-based curriculum in their programs (Lee & Willson, 2018). Significant literature discussed in this paper shows that as part of the program development procedure, the selection of applicable exemplars, competencies, and concepts to base content and build effective courses. This informative paper presents a benchmark method used to nursing educators to finalize and validate concept-based curriculum worldwide, through the identification of three key concepts that if well implemented into a nursing program could increase effectiveness.

The results will be used to facilitate the adoption process among other faculty groups considering changes in curricula, most importantly those seeking to incorporate conceptual curricula into their programs (Giddens, Keller & Liesveld, 2015). Finally, each of the concepts will then be looked at in terms of identifying how and why these are relevant in the context of the modern nursing environment drawing on literature such as the Essentials of Baccalaureate Education (American Association of College of Nursing [AACN], 2008), Institute of Medicine (2010) Future of Nursing Focus on Education report and Pre-licensure KSAs (Quality and Safety Education for Nurses, 2014).

Background

Conceptual learning started gaining traction in the nursing curricula during the late 1960s and the early 1970s. At that time, the norm was for each curriculum to be aligned to a specific nursing grand theory, including Jean Watson, Myra Levine, Peplau, or Virginia Henderson, to name but a few (Giddens, Keller & Liesveld, 2015). In these days however, concept-based curricula is not associated with a specific theory, but rather is informed by practice trends and reflects contemporary literature relevant in practice. The three concepts that are going to be considered in more detail here are: collaboration; clinical judgment/critical thinking as well as the use of technology as an asset within the nursing practice.

Collaboration

There is a growing need to enable collaboration across all levels of care delivery, and for collaborative efforts in providing safer and improved care. Collaboration is a key concept and value that is now inherent in the way that nurses and health care professionals are required to operate. Underpinning this concept is the recognition that health care professionals are now required to ensure that treatment they provide is focused on respect, autonomy and that patient’s form the first priority.

For example, while there may be clinical reasons to suggest that an individual would benefit from being hospitalized however where the patient is capable of making their own decisions they should be offered the opportunity to stay at home and receive home care. In order to provide this type of person-centric approach the curriculum must introduce this as a core concept and encourage those training within the health care professionals to start from looking at the patient and to work outwards.

This will naturally require collaboration amongst healthcare professions. Taking this approach does not come without challenges, for example as noted by Bosworth et al in 2011 there are concerns that there are simply insufficient resources available to provide an entirely client-centric approach at all times. There is also potentially a conflicting scenario where there is a robust medical reason that requires certain treatment but the patient feels that a different course of action is appropriate.

A primary example of this is seen in the on-going debate surrounding euthanasia. It is at this point that concept of collaboration and shared decision making become so critical. The process of decision making must necessarily look towards both the professionals and the patients. According to Friesen-Storms et al., (2015), the aim of a collaborative approach is: “to have the health professional and the patient jointly arrive at a health care choice that is based on the best available research evidence, clinical expertise, and the values of the informed patient.”

This core concept is recognized as being central in many of the standard setters in nursing. The American Association of Colleges of Nursing (AACN) on Essentials of Baccalaureate Education (2008) recommends that educators work collegially and in teams to enhance their professional practice. The same guide also goes further to encourage educators to collaborate with other educators to further their own learning.

A similar approach is recommended by Byssum & Carino (2014) in a study that sought to evaluate the performance of a collaborative measure to incorporation Quality and Safety Education for Nurses (QSEN) by the University of St. Francis Leach College of Nursing faculty. Study results showed that nursing program developed based on QSEN competence brought about collaborative efforts to improve positive patient experience (Byssum & Carino, 2014). Further, research shows that collaborative teaching practices that are student-owned, engaging, contextual, social, and active results in deeper learning experiences (Papathanasiou et al., 2014). Additional benefits of collaborative teaching include: it prepares students for real-life employment and social situations; it promotes easy understanding of diverse perspectives; it instils a sense of responsibility, increases self-esteem and develops retention practices among students; it promotes faculty-student interaction; and lastly, it leads to improved leadership skills, self-management, verbal communication, and promotes a higher level of thinking.

Clinical judgment and Critical Thinking

Another emerging concept influencing clinical education is that of Clinical judgment and critical thinking. Trossman (2015) identifies clinical judgment and critical thinking as indispensable skills for nursing students. Thus, once students have an understanding of this concept, they are able to transfer this knowledge easily into practice, meeting entry-level expectations for clinical judgment and critical thinking. In today’s health care setting, positive patient experience and engagement is an indispensable aspect of every hospital’s activity. To realize meaningful patient engagement, it is therefore important for nursing faculties to implement conceptual teaching methods that promote faster decision making in practice.

Critical thinking is a vital and highly relevant cognitive process that looks at the way that problem solving and decision making is undertaken. When considering the needs of nursing staff in the modern delivery of healthcare, it would seem reasonable that the curriculum should have critical thinking at its heart (Duncan & Schulz, 2015). One of the difficulties that emerge with this requirement is that it relies heavily on the ability of teaching staff to recognize the value of critical thinking and to prepare students in a way that encourages and supports such behaviours.

The Institute of Medicine looking at the Future of Nursing Focus on Education report of 2010 considered the overall question of how the future of nursing should interact with the education of nurses. Interestingly the focus here was almost exclusively on the level of education required and the way in which nurses entered the profession with the suggestion that there should be targets placed to ensure that more nurses obtain a baccalaureate degree within the sector.

While this does not directly note that critical thinking is a core component it is argued here that this standard has effectively created this situation. A health care professional who has greater and broader experience will naturally have better critical reasoning skills that have been developed. Similarly in the Quality and Safety Education for Nurses (2014), there is no specific core concept of critical thinking yet when the requirements are looked at it is reasonably easy to see that critical thinking is considered central to the needs of the healthcare sector.

For example, evidenced-based practice is seen as having the knowledge of a range of scientific processes and the ability to draw on a range of clinical opinions and different areas of evidence but this is this then combined with the skills of being able to identify what is relevant to each individual patient (Byssum & Carino, 2014). Attitudes are also noted in these standards and include the requirement for the learners to appreciate how important being up to date with information and to be looking towards continuous improvement in their work. Based on the above it is argued both theoretically and practically it is important for the curriculum to encourage and manage the level of critical thinking that learners develop throughout their time qualifying and beyond into their professional development.

Technological Capability

In today’s perfect storm of shifting patient expectations, stringent health regulations, and digital disruption, change in healthcare education is moving at a rapid speed as nursing faculties strive to adopt and implement conceptual teaching methods; such as the adoption of technology in the development of nursing curriculum. As technology continues to evolve and more practices are turning towards health IT, the healthcare sector is progressively concerned with rising patient expectations, cost-efficient, high quality and sustainable healthcare.

Thus, a well-designed technology education nursing program will enhance sharing and unification of information through innovative strategies that provide efficiency in the processing of content taught in class. While nursing faculties might weigh the costs of adopting and implementing technologically advanced learning methods, the overall benefits to the preparing nurse supersede the costs.

From where it stands, nursing faculties have made significant progress in supporting the use of technology in teaching. However, the proposed change in curriculum requires a renewed emphasis on ensuring a smoother exchange of healthcare information among all users. Recent research by Ajami & Bagheri-Tadi (2013) confirms the assertions that there is no shortage of evidence that by training nursing students on the use of modern technology in practice, they will be able to take advantage of the opportunities provided by the use of health technology to improve care delivery.

For instance, since hospitals these days have to efficiently manage large terabytes of data, they require tools that support fast information capture, allowing nurses to document care in a format that promotes patient engagement, enables easy access and data aggregation, as well as improves nurse-patient communication. Thus, the ultimate result for teaching students on the use of IT in nursing practice will be greater care continuity and a more consistent positive patient experience. The proposed changes in curriculum thus will help nursing students to provide better health care and manage care for patients by offering complete, up-to-date, and accurate information at the point of care; enhancing security and privacy of patient; reducing overall costs through improved health, reduced duplication of testing, improved safety, and decreased paperwork.

Conclusion

As conceptual methods and concept-based curricula to learning and teaching continue to take shape, more information on best adoption methodologies are needed. Also, by setting standards and goals, as well as measuring outcomes, nursing educators involved in the implementation of the curricula can determine if the overall objectives of the program are met. The program however must also align with the mission, vision, and philosophies of the parent institution, usually cantered on scholarship, services, or education (Lee & Willson, 2018).

The adoption of concept-based curriculum is the first step towards transformed care and meaningful use by improving all aspects of nursing education and patient care; including equity, efficiency, timeliness, education, communication, patient-centeredness, effectiveness, and safety (Byssum & Carino, 2014). By evaluating the evidence presented in this paper, it should be possible for nursing faculties to successfully implement concept-based nursing curriculums. This, in retrospect, will improve student transition into practice and promote patient outcomes, which is critical to the overall healthcare setting.

References

American Association of Colleges of Nursing. (2011). The Essentials of Baccalaureate

Education, 2008. Available at:

http://www.aacnnursing.org/portals/42/publications/baccessentials08.pdf

Bosworth, H. B., Granger, B. B., Mendys, P., Brindis, R., Burkholder, R., Czajkowski, S. M.,

& Kimmel, S. E. (2011). Medication adherence: a call for action. American heart journal, 162(3), 412-424.

Byssum, D. M., & Carino, J., L. (2014). Quality and Safety Education for Nurses Becomes

Collaborative: Out of the Silo. Journal of Nursing Education, 53(3): 59-60. doi:

10.3928/01484834-20140220-22.

Dolansky, M. A., & Moore, S. M. (2013). Quality and safety education for nurses (QSEN):

The key is systems thinking. Online Journal of Issues in Nursing, 18(3), 1.

Duncan, K., & Schulz, P. (2015). Impact of change to a concept-based Baccalaureate Nursing

curriculum on student and program outcomes. Journal of Nursing Education, 54: 16-S20.

Elliott, A. (2017). Professional values competency evaluation for students enrolled in a

concept-based curriculum. Journal of Nursing Education, 56: 12-21.

Giddens, J., Keller, T., & Liesveld, J. (2015). Answering the call for Bachelors prepared

nursing workforce: An innovative model for academic progression. Journal of

Professional Nursing, 3(1): 445-451.

Friesen-Storms, J. Bours, G. J., van der Weijden, T. & Beurskens, A., J. (2015) Shared

decision making in evidence-based decisions in chronic are in nursing: a discussion.

International Journal of Nursing Studies, 52(1): 393-402.

Lee, S., K. & Willson, P. (2018). Concept-based Curriculum Development, Implementation,

and Evaluation: A Systematic Review. International Journal of Nursing and Clinical Practices, 5: 271. doi: https://doi.org/10.15344/2394-4978/2018/271.

Papathanasiou, I. V., Tsaras, K., & Sarafis, P. (2014). Views and perceptions of nursing

students on their clinical learning environment: Teaching and learning. Nurse education today, 34(1), 57-60.

Swenty, C. L., & Titzer, J. L. (2014). A sense of urgency: Integrating technology and

informatics in advance practice nursing education. The Journal for Nurse Practitioners, 10(10), e57-e67.

Trossman S. (2015). A change in the air? Nurses discuss value of a concept-based approach

to education. American Nurse, 47(4): 1-10.

Wiltjer H (2017) Why collaboration should count as a core value of nursing. Nursing Times;

113: 12, 47-48

PART 2 – Student Program and Level Outcome Table

Student Program OutcomeSophomore Level Outcome (semesters 1, 2)Junior Level Outcome (semesters 3,4)AACN Essentials*Key Concepts
To be able to understand and collaborate across a range of health care professionals to provide a health plan that is patient centric and inclusive of all relevant healthcare professionals through multidisciplinary teamsAwareness of the various healthcare professionals that come together and how they interact. Understanding the concept of patient centric and how this operates in a healthcare setting  Establishing ideas of how multidisciplinary teams can be formed in the case of individual clients. Development of patient centric healthcare plans  2, 6, 7, 8, 9Collaboration
Full use and understanding of informatics within the health care setting to maintain robust notes and to keep up to date with patient developments as well as the appropriate safeguardingUnderstanding the basic information technology systems used in the healthcare setting and to be able to use them to maintain basic records  Be able to identify opportunities for greater use of information technology and to be able to ensure safety and evolution of IT policies within the healthcare setting  2, 4, 5, 6Technological Capability Communication and Collaboration  

*AACN Essentials

1Liberal Education for Baccalaureate Generalist Nursing Practice6Interprofessional Communication and Collaboration for Improving Patient Health Outcomes
2Basic Organizational and Systems Leadership for Patient Safety and Quality Care7Clinical Prevention and Population Health for Optimizing Health
3Scholarship for Evidence Based Practice8Professionalism and Professional Values
4Information Management and Application of Patient Care Technology9Baccalaureate Generalist Nursing Practice
5Health Care Policy, Finance, and Regulatory Environments  

Course Objective Table

 CourseCourse ObjectiveConceptBloom’s Domain
1Fundamentals of NursingBeing able to identify core health issues and signpost to other professionals as requiredCollaborationCognitive Domain of learning with particular reference to gathering basic and fundamental knowledge, moving to comprehension as the learner develops
2Medical -Surgical NursingBeing able to identify pain in a patient and to put in place a management plan for dealing with painCommunication Critical ThinkingAffective Domain – deals with the receiving of information and the valuing and organising this information to create a coherent plan
3Leadership  Be able to manage a team of healthcare professionals in a clinical setting to ensure complete care for patientsCollaboration CommunicationThe Psychomotor Doman – involves putting into action the skills learnt by identifying perceptions and responding with set mechanisms that then become habitual over time