Essentials In Curriculum Design Nursing Education Considerations for Curriculum Design
The Essentials framework, which includes key domains, competencies, and concepts, provides the foundation for curriculum design and program assessment in nursing education. This framework is intended to ensure consistency in the expected outcomes for nursing graduates. However, it is important to recognize that these elements, while essential to a nursing curriculum, do not represent the curriculum in its entirety.
In other words, nursing courses should not be designed to mirror the 10 domains and eight concepts explicitly. Instead, the Essentials’ components should be integrated throughout the curriculum, allowing for a scaffolded approach that introduces students to competencies in a variety of contexts with increasing levels of complexity. This ensures that nursing students encounter and apply competencies in diverse and authentic settings.
Nursing programs maintain flexibility in curriculum development, allowing each program to be unique or innovative. This flexibility supports institutions in creating curricula that reflect their mission and meet the needs of their student population while still aligning with the Essentials framework.
The term “outcomes” in this context refers to student learning outcomes, which are the desired achievements of nursing graduates upon completing the program. These outcomes encompass the attainment of all core competencies as well as any relevant specialty or role-specific competencies.
Course Design and Learning Outcomes
In the design of individual courses, student learning outcomes should be linked to both course competencies and end-of-program outcomes. This ensures a clear alignment between course objectives and the competencies outlined in the Essentials. Nursing curricula should include intentional teaching strategies that provide students with opportunities to learn and demonstrate their competencies across different contexts and with increasing complexity.
Incorporating diverse teaching methods and offering opportunities for practical application are essential in ensuring that students develop a deep understanding of the material. A minimum number of practicum experiences is also required, particularly for entry-level and advanced-level programs, to ensure consistent and high-quality preparation for professional nursing practice.
Assessment of Competencies
Assessment plays a crucial role in determining whether students are achieving the competencies necessary for professional practice. Nursing programs must establish a robust assessment plan to evaluate students’ progression through the curriculum. This plan may include progression indicators, which track learners’ achievements at specific points throughout their education.
Competencies should be assessed continuously, with students demonstrating their ability to integrate knowledge across multiple domains and apply it in complex clinical scenarios. Performance-based assessments are particularly valuable because they not only measure student learning but also serve as active learning experiences.
Performance assessment involves a multidimensional evaluation process where students’ skills are observed and judged based on explicit criteria. Feedback is provided to guide improvement and deepen competence. This method of assessment is particularly useful for evaluating practical skills and decision-making in clinical settings.
The Essentials Framework and Sub-Competencies
The Essentials framework supports two levels of professional nursing education: entry-level and advanced-level. Although the domains, competencies, and concepts are identical across both levels, sub-competencies are used to differentiate between the expectations at each stage. The next section will discuss the expectations for curricula at both levels of nursing education.
Level of Expectation in Nursing Curricula
The two levels of sub-competencies correspond to the educational stages of nurses as they enter the profession and as they advance their education. This approach is designed to guide nursing programs in structuring their curricula to meet the expectations for both entry-level and advanced-level nursing education. The following sections detail the specific curricular expectations for each level.
Entry-Level Professional Nursing Education
Entry-level professional nursing education encompasses programs that prepare nurses for initial licensure and entry into the nursing profession. These programs use Level 1 sub-competencies within the curriculum and are designed to prepare nurses for generalist practice across the lifespan, in a variety of settings, and with diverse populations.
Entry-level programs can include traditional pre-licensure programs, accelerated tracks, or degree completion pathways for nurses who originally earned an associate degree or diploma. Regardless of the pathway, these programs equip students with the knowledge and skills to meet the demands of professional nursing practice across four primary spheres of practice:
- Patient care delivery
- Healthcare systems and policies
- Health promotion and disease prevention
- Collaboration with interdisciplinary teams
Entry-Level Professional Nursing Degree Options
Entry-level nursing education is characterized by a variety of degree options, each designed to meet the regulatory and practical requirements for initial licensure as a registered nurse (RN). These include:
- Bachelor of Science in Nursing (BSN)
- Associate Degree in Nursing (ADN)
- Diploma Programs
Each of these degree pathways incorporates the Level 1 sub-competencies outlined in the Essentials. The goal is to ensure that nursing students gain foundational skills and competencies that prepare them to practice safely and effectively as professional nurses.
Pre-Licensure Programs
Pre-licensure nursing programs play a crucial role in preparing nurses for entry into the profession. These programs are often designed for students with no prior nursing education, offering pathways to initial licensure. The Level 1 sub-competencies apply across the curriculum for all entry-level programs, ensuring that students develop the skills and knowledge necessary for professional practice.
Content from prerequisite courses (such as biology, anatomy, and pharmacology) is incorporated into the learning and assessment of nursing sub-competencies. However, this does not mean that every sub-competency must be addressed in every course. Rather, sub-competencies should be revisited and reinforced throughout the curriculum, ensuring that students continue to build on their foundational knowledge as they progress through the program.
Outcome Measures in Entry-Level Nursing Education
Outcome measures in entry-level nursing education include:
- Attainment of Level 1 sub-competencies
- Pass rates on the NCLEX-RN, the national licensure examination for registered nurses
- Institutional requirements, such as successful completion of capstone projects or clinical practicums
These outcomes provide evidence that students have mastered the competencies necessary to practice as safe and competent nurses. Nursing programs must continually assess and improve their curricula to ensure that students are well-prepared for the challenges of modern healthcare.
Advanced-Level Professional Nursing Education
In contrast to entry-level programs, advanced-level nursing education focuses on developing specialized competencies for nurses seeking to expand their knowledge and skills in specific areas of practice. These programs incorporate Level 2 sub-competencies, which build on the foundational competencies acquired in entry-level education.
Advanced nursing programs allow students to specialize in areas such as:
- Advanced clinical practice (e.g., nurse practitioners, clinical nurse specialists)
- Nursing administration
- Public health and population health
- Nursing informatics
Advanced programs are designed to prepare nurses for leadership roles, specialized practice, and advanced certification. Like entry-level programs, advanced programs are required to assess students’ attainment of competencies through performance-based assessments and practical experiences.
Conclusion
The design and implementation of nursing curricula, as guided by the Essentials, aim to create consistency in the preparation of nursing graduates while maintaining flexibility for program innovation. Nursing programs must integrate competencies, domains, and concepts across their curricula, ensuring that students have opportunities to learn, practice, and demonstrate their abilities in various contexts.
By assessing students’ progression and outcomes throughout their education, nursing programs ensure that graduates are well-prepared to meet the demands of professional practice. Whether at the entry or advanced level, nursing education must remain adaptable and aligned with the evolving needs of the healthcare system, providing nurses with the knowledge, skills, and competencies they need to succeed.