Curriculum Design In Nursing Education and Identifying, Leveling and Developing Competencies

Identifying
and Developing Competencies for Curriculum Design In Nursing Education

    After
the expected program outcomes have been established, the next step in the
curriculum development process is to identify the competencies that students
need to possess to attain these outcomes. Competency statements identify the
knowledge, skills, and professional attitudes and values that students need to
develop if they are to achieve the program outcomes. 

    Competency statements are
behaviorally anchored and student focused. Nursing faculty must approach
curriculum development from the premise that nursing knowledge and skills are
built on or interwoven with general education knowledge and skills. 

    Outcomes
should include those competencies that are specific to the nursing discipline,
as well as those competencies that establish a foundation for lifelong
learning. Students achieve the identified competencies, through acquisition of
necessary KSAs, leading to the achievement of the expected program outcomes,
whether as an undergraduate or graduate student. 

    Competency statements are
important in assessing student learning because they become the foundation that
drives evaluation. When identifying competencies, faculty should give attention
to determining the right student, the right behavior, the right level of
behavior, and the right context of the behavior. 

    Here, student refers to the
level of student from whom faculty are expecting these behaviors (e.g.,
pre nursing, nursing sophomore, nursing senior, master’s or doctoral level,
etc.); level of behavior refers to the level of learning or performance at which
the behavior is to be demonstrated (this is where learning taxonomies are
helpful); and context of the behavior refers to the environment in which the
behavior should occur. 

    For example, if faculty believe that it is essential for
students to exhibit a particular skill, knowledge, or attitude across a
continuum of health care settings or with a select population of patients, then
the competency statement should indicate the parameters in which the behavior
should be expressed. 

    It is equally important for faculty to remember not to be
so specific as to “paint themselves into a corner” from which there is no
escape (e.g., if faculty specify that a certain behavior will be demonstrated
with postoperative patients in an outpatient surgical setting, all students
must be guaranteed this type of experience for faculty to make an accurate and
consistent assessment and evaluation of student performance).

Leveling
Competencies for Curriculum Design In Nursing Education

    In
leveling, or specifying, competencies, faculty must recognize the level at
which the KSAs need to be demonstrated to obtain the outcome desired throughout
the curriculum. The learning environment will need to be designed to enable the
students to acquire knowledge at the level identified. 

    Evaluation measures also
need to be consistent with the level of learning identified to ensure
consistency in evaluation from the time of input of information through the
time of output of the expected competency. Learning occurs at various levels,
and the level of learning needs to be explicitly stated in the competencies
faculty generate for each level within the curriculum.

    Once
competencies have been leveled to a year or semester or academic level, faculty
must carefully examine these competencies and determine how courses can be
designed to contribute to the ongoing development of these competencies. 

    The
behaviors embedded in each competency become the focus for writing course level
competencies. Not all competencies will or should be included in all courses
that make up the curriculum. 

    Competencies at the course level are more concrete
and detail how the chosen competencies explicitly relate to the course. The
faculty will then need to identify what prerequisite and requisite knowledge
and skills students will need to possess to demonstrate this behavior.

    If,
for example, faculty believe that the individualization of a standard care map
is critical to a nurse practitioner student learning experience, then a
course level competency resulting in course objectives, learning activities,
and evaluation of learning will be included to reflect this behavior.

    Because
structured learning tends to be grounded in developmental theories, students
are expected to become more accomplished in applying knowledge to increasingly
more complex or new situations as they move through the curriculum. 

    Course
competencies (course expectations) then should be written to reflect the
placement of the course within the curriculum; the expectations of learning for
courses that precede, articulate, and follow each course; and how each course
can contribute to the development of program competencies. Precision is needed
when writing competency statements. 

    The language of the competencies must
reflect a continued sense of development. Development may take the form of
increasing complexity, differentiation, delineation, or sophistication.

Competency
Learning Progression Charts for Curriculum Design In Nursing Education

     As noted earlier in this chapter, outcomes are
typically measured through more specific competency statements that, in
aggregate, provide evidence that the outcome was achieved. 

    To maintain
curricula integrity, tracking competencies associated with each program outcome
is an important activity; however, tracking the numerous competencies
associated with all of the outcomes can become an onerous task. 

    Comprehensive
content grids are useful and necessary; however, they can be so voluminous that
they lose utility for depicting the building blocks of KSAs desired.

    Several
methods for documenting learning progression may be used; one exemplar is the
competency learning progression chart. 

    A competency learning progression chart
(Sullivan, 2014) can succinctly demonstrate the progression of learning (Table
6-3). Each program outcome is measured through multiple derived competencies
created to reflect learning achievement. 

    Each of the component competencies is
shown in a grid beneath the larger learning outcome, including information
regarding the course location, specific learning activities, and evaluation
criteria to assess student learning. 

    Once agreed on by faculty and included in
the competency learning progression chart, individual faculty may not
independently change the key learning activities and evaluation methods. 

    Further, selected assignment products may be used to create student portfolios
as an expression of their comprehensive achievement of the desired learning
outcomes. Finally, specification of key learning activities is an effective
tool to identify content duplication and gaps.

    In
one recent example within a nursing program, it was discovered that students
were asked to perform three community assessments in three different courses
using almost identical criteria. Faculty agreed that one community assessment
was sufficient and thus freed up precious time for other learning topics. 

  Competency learning progression charts can be reviewed on a regular basis to
incorporate new information and concepts, with the designated faculty group
making decisions regarding changes. This practice is an exemplar of how
curricular integrity can be balanced with the concept of academic freedom
discussed earlier.