Health Care Reforms Influence Curriculum Development In Nursing Education Forces and Issues Influencing Curriculum Development in Nursing Education
Nursing education leaders must remain vigilant to the forces and issues shaping professional education. In any dynamic field, curriculum change is not optional but essential. The magnitude, pace, and intensity of change in the health care arena affect all stakeholders, including providers, patients, educators, and health care financers.
Consequently, nurse educators must continuously develop and implement relevant curricula that align with global trends, national policies, advancements in science and technology, professional priorities, academic forces, institutional missions, and faculty values. This ensures that practitioners entering the workforce are equipped with the knowledge and competencies necessary for providing patient-centered care, addressing contemporary health care challenges, and advocating for safe, high-quality health care.
Delivering meaningful curricula in a dynamic health care environment requires a close understanding of the internal and external forces driving change. These include global health trends, societal issues, national health care reforms, technological advancements, and the evolving role of the nursing profession. Nurse educators must stay current on these issues to build consensus and secure stakeholder approval for curriculum changes.
This section explores the forces and issues influencing curriculum development, focusing on external and internal factors affecting nursing education. Faculty members who are well-versed in these influences are better positioned to shape and deliver educational content that prepares future nurses for the challenges they will face in practice.
Social Context for Curriculum Development in the Nursing Profession
Understanding external issues is essential for guiding contemporary curriculum development in nursing education. Key external issues include health care reform, global disasters, changing demographics, technological advancements, and environmental changes. These factors collectively shape the context in which nurses learn and practice. They also highlight the complex web of causation and describe the current states of health and humanity.
Health issues are increasingly linked to the sociopolitical and economic characteristics of the communities where individuals live, work, and play. Curriculum development in nursing must reflect this by addressing the broad determinants of health, such as socioeconomic status, environmental factors, and access to health care. This prepares nurses to intervene in complex health problems like bioterrorism, climate change, global and domestic violence, homelessness, and emerging infectious diseases.
In today’s interconnected world, nurses must be equipped to deal with health challenges that extend beyond traditional medical concerns. For instance, economic recessions impact public health by increasing rates of poverty and reducing access to essential health services. Similarly, globalization has contributed to the spread of infectious diseases across borders, requiring nurses to be familiar with global health protocols and practices.
Several trends in nursing education reflect the need to respond to these sociopolitical and economic factors:
- Health care reform
- Technological advancements
- Demographic shifts
- Global health challenges
- Environmental changes
- Ethical and legal concerns
Although these trends are discussed individually, they are deeply interconnected and influence each other. Together, they create a social context that informs how curricula in nursing programs must evolve to meet the demands of modern health care.
Health Care Reform in Nursing Education and Curriculum Development
The passage of the Patient Protection and Affordable Care Act (PPACA) in 2010 became a driving force behind health care reform, shaping the future of nursing practice and education. For the first time in U.S. history, the PPACA provided all citizens with access to affordable health insurance. This legislation introduced a national strategy known as the Triple Aim, which aims to improve the quality and accessibility of health care while controlling costs (Institute for Healthcare Improvement, 2009).
The PPACA significantly benefited nursing education by amending Title VIII of the Public Health Service Act, which supports nursing education, practice, and retention. As a result, programs like the Nurse Education, Practice, Quality, and Retention (NEPQR), administered by the Health Resources and Services Administration (HRSA), shifted their focus to improving nursing education and practice environments.
For example, financial support for nursing students pursuing advanced degrees increased, particularly for students from disadvantaged backgrounds or those with limited financial resources. The PPACA also allocated more than $1 billion in grants for initiatives like home visits to high-risk communities and the establishment of nurse-managed health centers (U.S. Department of Health and Human Services, 2011; Wakefield, 2010).
In response to these reforms, nurse educators must ensure that both prelicensure and graduate-level nursing curricula prepare students to work in community settings, coordinate patient care, and collaborate as members of interprofessional teams. The curricula must also focus on providing quality, value-based care, and leadership skills to future nurses.
Another critical shift in nursing education is the focus on wellness, prevention, and palliative care rather than the traditional emphasis on managing acute care patients in hospital settings. The Institute of Medicine (IOM, 2010) and Sherman (2012) highlight the importance of this shift, emphasizing that nurses must be prepared to deliver care in a variety of settings, including homes, clinics, and community health centers.
In addition to these adjustments, nursing curricula must provide students with opportunities to envision and participate in the redesign of health care systems. Nurses are not only caregivers but also innovators who can contribute to developing new models of health care delivery. As health care evolves, so must nursing education, with a focus on fostering creativity and leadership in the nursing workforce.
Technological Advancements and Their Impact on Nursing Education
Technology plays a transformative role in nursing education and health care delivery. Advancements in health informatics, telehealth, and simulation technology have reshaped how nurses are trained and how care is delivered. As these technologies continue to evolve, nursing programs must incorporate them into curricula to ensure that students are prepared to use cutting-edge tools in their practice.
Simulation technology allows nursing students to practice clinical skills in a controlled environment, giving them the opportunity to hone their abilities without risking patient safety. Similarly, telehealth enables nurses to provide care to patients in remote areas, expanding access to health care services and improving health outcomes.
Nursing curricula must be designed to prepare students for a technology-driven health care system. This includes not only teaching students how to use technology but also fostering a mindset of adaptability and continuous learning, as technological advancements will continue to shape the future of health care.
Conclusion
Curriculum development in nursing education must be responsive to the complex forces shaping the health care landscape. These forces include health care reform, social and economic changes, technological advancements, and the evolving needs of patients. By staying attuned to these influences and integrating them into nursing curricula, educators can ensure that future nurses are prepared to meet the demands of modern health care. As the nursing profession continues to evolve, so too must the education that prepares its practitioners.