Competency Based Education, Curriculum Elements, Organizing Frameworks Curriculum Design In Nursing

Organizing Frameworks Curriculum Design In Nursing Introduction to Competency-Based Education (CBE) in Nursing

Competency-Based Education (CBE) represents a transformative approach to curriculum design in nursing education. Defined formally, CBE is a framework that centers on the desired performance characteristics of health care professionals. It establishes clear, observable, and measurable performance metrics that learners must meet to be deemed competent (Gruppen, Mangrulkar, & Kolars, 2012). This stands in contrast to traditional education programs, which often employ less precise learning objectives and inconsistent methods of testing and measuring competency.

CBE offers several advantages over traditional models, including a systematic approach to assessing competencies and allowing students to progress at their own pace. This flexibility can be particularly beneficial in accommodating diverse learning styles and needs. However, implementing CBE fully poses challenges, such as accurately identifying community health needs, defining competencies, developing self-regulated learning options, and assessing learner competence. Additionally, the approach may not align with all learners’ preferences and capabilities.

In nursing education, CBE principles are increasingly incorporated due to accreditation and licensure requirements, although the extent and consistency of their application vary widely among programs.

Ordering or Constructing Knowledge in Nursing Curriculum

The structure of knowledge within a nursing curriculum is crucial for effective learning. Wiles and Bondi (2011) identify five patterns of ordering or constructing knowledge that can be used in curriculum design:

1. Building Blocks Design: This approach starts with foundational knowledge and skills, progressing to more detailed or specialized content. It assumes a logical sequence that facilitates learning and requires evidence-based decisions on content organization.
2. Branching Design: Similar to building blocks, this design starts with foundational knowledge but allows for varied learning pathways. It is often used in blocked curricula where students have options to explore different aspects of a subject.
3. Spiral Design: Knowledge is revisited at different points in the curriculum, with increasing depth and breadth. This design helps reinforce learning and address issues of forgetting or inadequate mastery of foundational knowledge.
4. Strand Design: Topics are organized into meaningful groups and repeated regularly throughout the curriculum. This approach builds better retention and achievement rates and is common in concept-based curricula.
5. Tasks or Skills Design: Specific tasks or skills are presented to achieve desired competencies. Students may follow different pathways based on their preferences or characteristics, and this design is prominent in CBE programs.
6. Process Design: Focuses on the process of learning rather than specific content. This approach emphasizes narrative pedagogy and strategies that reflect practical, real-world applications of knowledge.

Curriculum Elements in Nursing Education

Curriculum development in nursing is a complex and collaborative endeavor. Key elements of a nursing curriculum include:

• Curriculum Design: The overall framework of the curriculum, including its structure and content organization.
• Organizing Framework: A logical structure that guides the arrangement and integration of knowledge.
• End-of-Program Outcomes and Competencies: Clear objectives that define what students should achieve by the end of their program.
• Level Competencies: Competencies that are sequenced and progressively developed throughout the curriculum.
• Course Design: The structure of individual courses, including their content and delivery methods.
• Teaching Strategies and Learning Experiences: Methods used to facilitate student learning and engagement.
• Resources: The materials and support needed to implement the curriculum effectively.

Organizing Frameworks for Curriculum in Nursing Education

Organizing frameworks provide a structured approach to cataloging and retrieving knowledge within a curriculum. They offer a mental picture of what knowledge is essential and how it should be categorized and interconnected. These frameworks are not static; they evolve to reflect the changing needs of nursing practice and education.

Key concepts often incorporated into organizing frameworks include:

• Nursing Practice: Situated within caring relationships and health care systems.
• Health, Illness, and Healing: Understanding these phenomena in various contexts.
• Nursing’s Embeddedness: Within health care systems, social structures, and society.
• Judgment, Inquiry, Engagement, and Voice: Core themes that reflect the complexity and contextual nature of nursing practice.

Organizing frameworks guide curriculum development and help faculty design learning experiences that align with these concepts. They provide a blueprint for determining the scope of knowledge and structuring it in a meaningful way for both faculty and students.

The Penn Nursing Organizing Framework

The University of Pennsylvania’s School of Nursing exemplifies a structured approach to curriculum design through its baccalaureate curriculum. This curriculum aligns with the school’s mission, vision, and values, emphasizing nursing practice within caring relationships. It moves students toward deeper understandings of individuals, families, communities, and populations while addressing the complexities of health and illness.

The Penn Nursing framework focuses on four core themes: judgment, inquiry, engagement, and voice. These themes guide students through increasingly complex clinical experiences and care environments, reflecting the evolving nature of nursing practice. The framework also considers emerging roles in telehealth and retail clinics, ensuring that competencies remain relevant to current and future nursing practices.

Selecting and Designing an Organizing Framework

Choosing or designing an organizing framework is a critical task for faculty. It involves either selecting a single nursing theory or model or adopting a more eclectic approach that combines concepts from multiple theories. The choice depends on the specific needs and goals of the nursing program.

• Single Theory Approach: Some programs build their framework around a single nursing theory or model, providing a focused and cohesive structure.
• Eclectic Approach: More commonly, programs blend concepts from various theories to address the complexity of nursing practice and the health care environment.

This process offers an opportunity for faculty to foster teamwork and innovation, creating a framework that supports effective curriculum development and student learning.

Conclusion

Competency-Based Education (CBE) and thoughtfully constructed organizing frameworks play pivotal roles in modern nursing education. CBE ensures that students meet clear, measurable competencies, while organizing frameworks provide a structured approach to curriculum design. Together, these elements help nursing programs prepare graduates who are capable of meeting the demands of contemporary health care practice. By continually refining curriculum elements and frameworks, nursing education can adapt to the evolving needs of the profession and effectively prepare future nurses for the challenges and opportunities that lie ahead.