Curriculum and Instruction in Nursing Education
Nursing Curriculum
Central to nursing education is curriculum
and instruction. Curriculum is the overall structure of nursing education
programs that reflects schools’ mission and philosophy, course of study,
outcomes of learning, and methods of program evaluation. Instruction is the
teaching and learning strategies and experiences faculty and students engage in
to achieve the elements of the curriculum. Throughout the history of nursing
education various trends and issues have influenced curriculum and instruction.
For example, advances in germ theory added to what students learned about
aseptic technique, progress in pharmacology changed what students learned about
drug therapies, and research in educational theory changed how teachers taught
as well as understandings of how students learn. What follows are examples of
some of the most prevalent trends and issues influencing curriculum and
instruction today. The areas listed are not all inclusive nor do they signify a
certain level of importance.
The purpose of the overview is to provide you with
an understanding of why you are learning what you are learning in your
curriculum (ie, important topics) as well as why teachers use particular
methods of teaching and learning (ie, important methods).
Important Topics in
Nursing Education Patient Safety
Patient safety has always been a priority
in nursing education. In recent years, due to widely publicized medical errors,
patient safety has taken on even greater importance. The book To Err Is Human:
Building a Safer Health System (Kohn, Corrigan, & Donaldson, 1999) brought
national attention to the issue of patient safety by discussing the number of
people who die each year from medical errors. This, in turn, sharpened the
focus of patient safety in nursing education.
Gregory, Guse, Dick, and Russell
(2007) urged nursing educators to begin the process of improving patient safety
by examining how curriculum and instruction are contributing to students making
errors and taking action to change teaching systems to reduce errors. Thus,
nursing students today and in the future may experience a system of nursing
education that prepares them differently than in the past to understand the
practices and principles of reducing medical errors. Chapter 8 provides a
further discussion of patient safety and creating a culture of safety in
healthcare systems.
Cultural Competence in Nursing Education
Cultural competence is the extent to which
a nurse understands and has the skills required to effectively address the
healthcare needs of individuals who hold cultural beliefs and values that are
different from his or her own. As society continues to become increasingly
diverse and global in nature, there is an increased emphasis on teaching
concepts related to cultural competence in nursing curricula. For example, the
US Census Bureau (2004) reported that Hispanic and Asian populations are
growing faster than the population as a whole.
Therefore, all nurses are likely
to work with healthcare providers and provide care to patients who have
cultural backgrounds with which they are not familiar. Nursing programs are
integrating coursework and clinical experiences related to cultural diversity
and global health care into the curriculum. These experiences can include, but
are not limited to, clinical experiences in other countries and learning with
nursing students who live in other countries (Fitzpatrick, 2007). Chapter 14
provides a comprehensive discussion of cultural issues that impact nursing
practice.
Gerontological Considerations In Nursing Education
According to the Centers for Disease
Control and Prevention (2007), by 2030 the number of people over the age of 65
will have doubled to 71 million, which will comprise 20 percent of the American
population. In a response to this trend, Thornow, Latimer, Kingsborough, and
Arietti (2006) have developed a guide for nursing faculty to assist them in
preparing nursing students to care for the elderly population.
The importance
of having a critical mass of nurses prepared to care for the growing population
of the elderly in the United States cannot be overstated. It is important for
gerontology concepts and experiences to be integrated throughout nursing
curricula to provide students with the skills required to care for both the
well and ill elderly.
Evidence Based Practice In Nursing Education
Evidence based practice is an approach to
nursing care where nurses draw on the best available evidence to make clinical
decisions. In nursing, evidence-based practice includes nurses’ use of research
studies and theory from within nursing and outside of nursing (eg, medicine,
psychology, sociology) to make clinical decisions. For example, a nurse caring
for a child with asthma draws on many sources of evidence to develop a
therapeutic care plan for this child.
Today’s nursing students can expect to
learn evidence-based practice through various activities where teachers provide
instruction in best practices for gathering, analyzing, and synthesizing
evidence. See Chapter 11 for a further discussion of evidence-based practice.
Technology and Informatics In Nursing Education
Regardless of the practice setting in which
students learn nursing care, it will include using various technologies and
knowledge of informatics to assist with patient care. These technologies can
include, but are not limited to, medical devices patients will use to provide
self-care, as well as information retrieval, clinical information management,
and documentation technologies. For example, students may have clinical
experiences where they need to understand the use of various insulin pumps or
pain management technologies that patients use at home, and that have patient
teaching implications.
Many schools of nursing are incorporating the use of
personal digital assistants (PDAs) into the curriculum to help students
immediately access information on medical terminology, laboratory values, and evidence-based
information. Students’ use of this device has important implications for
improving their clinical judgment (Newman & Howse, 2007). Students are also
being exposed to the use of a variety of clinical management systems.
For
instance, there are computerized physician order entry systems, tele-medicine
systems, and patient surveillance systems (Maffei, 2006), many of which have
implications for ensuring patient quality and safety. Chapter 20 further
addresses informatics and healthcare technology and their implications for
nursing practice.
Inter-Professional Education In Nursing
A major movement in healthcare education is
that of inter-professional education. It is defined as occasions when
professionals learn with, from, and about each other to improve collaboration
and quality of care (Barr, Freeth, Hammick, Koppel, & Reeves, 2006). The
need for such education originates from concerns about patient care quality and
safety and the overall importance of innovative ways to ensure good patient
care outcomes. Preliminary research on inter-professional education indicated
that it assists students in overcoming stereotypes about disciplines other than
their own, promotes understandings across disciplinary boundaries, and improves
students’ ability to engage in teamwork (Freeth et al., 2001).
Research on
inter-professional education continues. For instance, current studies are
investigating it as an approach to improving psychosocial care of oncology
patients (see, for example, the Interprofessional Psychosocial Oncology Distance Education
(IPODE) project at http://www.ipode.ca). Nursing students today will benefit
from being open to and actively participating in emerging models of
interprofessional education. Chapter 6 further explores the topic of
interprofessional research and practice.