Curriculum Development In Nursing Education and How Forces, Issues, Social Context and Health Care Reforms Influence
Forces
and Issues Influencing Curriculum Development In Nursing Education
Leaders
in the nursing profession must remain vigilant to the forces and issues
influencing the direction of professional education. In any dynamic
organization, curriculum change is not a choice but a requirement. The
magnitude, pace, and intensity of change within the health care arena affects
providers, consumers, educators, and financers of health care.
As a result,
nurse educators must continually work to develop and implement relevant
curricula congruent with global trends, national events, advancements in
science and technology, professional priorities, academic forces, the school’s
mission, and faculty values.
Doing so ensures practitioners entering the
workforce are prepared and equipped with relevant knowledge and competencies
necessary to provide patient-centered care; effectively intervene in
contemporary health care challenges; and advocate for delivery of safe, quality
health care.
The
ability to deliver meaningful curricula within the dynamic health care
environment requires a close understanding of internal and external forces
directing change. This topic and coming next topics describe the current social context for
curriculum development, including issues and forces in the environment external
to the nursing profession, the higher education environment, and the
profession’s internal environment.
In addition, several strategies are
presented that can assist faculty to identify forces and issues that influence
the nursing profession and curriculum. Faculty with intimate and current
knowledge of the forces and issues influencing nursing curricula are better
positioned to navigate the political processes of building consensus and
obtaining approval by all significant stakeholders.
Social
Context for Curriculum Development to the Nursing Profession
Understanding
issues external to the nursing profession form an essential piece of the
foundation necessary to guide contemporary curriculum development. External
issues like health care reform, global disasters and globalization, changing
demographics, technology, and the environment provide the context for the world
in which nurses learn and practice.
Collectively these same issues encompass
risk factors for health and disease, contribute to the complex web of
causation, and describe the current states of humanity and health. Health
issues are increasingly related to the sociopolitical and economic
characteristics of the communities where people live, work, and play.
Curriculum must acknowledge the broad determinants of health to prepare
practicing nurses to effectively intervene in complex problems such as
bioterrorism and other mass disasters, climate change, global and domestic
violence, economic recession, homelessness, teen pregnancy, emerging infectious
diseases, and increasing drug-resistant organisms.
The
following six trends, which capture significant developments and concerns for
society, are presented as the broad sociopolitical and economic context of
nursing practice and education. Although these trends are discussed separately,
their interconnectedness is undeniable.
Health
Care Reform In Nursing Education for Curriculum Development
The
passage and signing of the federal statue known as the Patient Protection and
Affordable Care Act (PPACA) in 2010 has become a major force driving health
care reform and ultimately curriculum development. Under this act and for the
first time in America’s history all citizens have access to affordable health
care insurance.
In conjunction with access to care, a national strategy known
as the “Triple Aim” has been implemented with the purpose of improving the
quality and access to health care while controlling costs (Institute for
Healthcare Improvement, 2009).
Nursing
practice and education greatly benefited from the passage of the PPACA through
amendments to Title VIII of the Public Health Service Act. As a result, funding
priorities of the Nurse Education, Practice, Quality and Retention (NEPQR)
program, administered by the Health Resources and Services Administration
(HRSA) were shifted to support nursing education, practice, and retention.
For
example, financial support for pursuit of advanced degrees by nursing students
who have a desire to o teach increased, as did the amount nursing students from
disadvantaged background or with limited financial resources could borrow to
pay for their education.
In addition, more than $1 billion in new grants were
authorized to increase home visits to mothers in high-risk communities and to
establish a new grant that will fund nurse-managed health centers (U.S.
Department of Human and Health Services, 2011; Wakefield, 2010).
In response to
this anticipated reformed health care arena, nurse educators must ensure that
prelicensure and graduate program nursing curricula prepare nurses to care for
patients in ambulatory or community settings, possess skills to coordinate
patient care, work as members of inter professional teams, provide quality as
well as value based care, and develop leadership skills.
Nursing program
curricula needs to increasingly focus on wellness, prevention, and palliative
care versus management of acute patients in acute care settings (Institute of
Medicine [IOM], 2010: Sherman, 2012). Nursing curricula should also seek to
provide students with the opportunity to envision, create, or actively
participate in the redesign of new or revolutionary models of health care
delivery systems.