Curriculum Design In Nursing Education and Organizational Forces, Addressing Future Trends, Meeting Learner Characteristics Through 

Curriculum Design for Congruence with School and Organizational Forces In Nurse Educator, Curriculum Development Responding to Major Calls for Reform In Nursing Education, Meeting Learner Characteristics through Curriculum Design In Nursing Education, Addressing Stakeholder Expectations While Designing Nursing Curriculum, Addressing Future Trends in the Design of Prelicensure Curriculum In Nursing Education.

Curriculum Design
for Congruence with School and Organizational Forces In Nurse Educator

    Schools
of nursing operate in a myriad of different environments, each with a
particular world view, set of implicit or explicit values, and encompassing a
mission and vision. Faculty working to devise curricula should consider the
values, mission, and vision of the parent organization as they develop courses,
teaching learning strategies, and educational outcomes. 

    Mission and vision
statements often encompass particular worldviews about the nature and
importance of teaching, scholarship, and service; include statements about
particular professional values; and also often delineate the scope and focus of
areas and populations of interest such as a focus on the local community,
statewide needs, and national and international areas of concern. 

Curriculum Development Responding
to Major Calls for Reform In Nursing Education

    One of the ongoing challenges of curriculum
development is staying abreast of the many different calls for reform from
professional organizations, institutes, and research findings that have the
potential to affect nursing practice. When creating nursing curricula for the
twenty-first century, Glasgow, Dunphy, and Mainous (2010) recommend that
curricula be focused on the integration of science and research and the
influences resulting from health care policies. 

    Benner et al. (2010) work on
transforming nursing education to some degree complements the recommendations
of Glasgow and colleagues. Grown out of her research efforts, Benner and
colleagues identified four “shifts” that should guide curriculum design based
on the evidence she has collected: a shift toward teaching for a sense of the
most important aspects of a situation and related key actions in particular
situations; a movement toward integration of didactic and clinical education; a
renewed focus on clinical reasoning and many ways of thinking that include
critical thinking; and a renewed emphasis on professional formation, much more
than simply functioning in a particular role.

    The guiding principles that the American
Organization of Nurse Executives (AONE), (2010) identified are more
prescriptive in nature than those proposed by Benner and colleagues, but also
need to be taken into consideration when designing undergraduate curricula,
especially those that lead to a baccalaureate degree. 

    The guiding principles
are not focused on content, but rather how to access, synthesize, and manage
the “knowledge work” of nursing, delivered in the context of a caring,
patient-centered environment. The guiding principles also emphasize the
importance of interdisciplinary and patient relationships in the delivery of
care. 

    Quality and safety are considered to be core concepts to care delivery
(American Organization of Nurse Executives, 2010).In
translating some of the expectations of the Institute of Medicine [IOM] (2001,
2010) work into nursing curriculum operating principles, faculty will need to
focus on improving the health and functioning of people; preparing students to
deliver health care in a safe, effective, patient centered, timely, efficient,
and equitable fashion; and developing competencies to establish care benchmarks
and evaluate the outcomes of care according to these benchmarks. 

    The Quality
and Safety Education for Nurses (QSEN) competencies have also taken a prominent
place in the undergraduate nursing curriculum. Based on the work of Cronenwett
et al. (2007) the QSEN Institute has developed competency statements for
quality and safety knowledge, skills, and behaviors or attitudes (KSAs) across
undergraduate curricula. 

    Many schools of nursing have used
either the entire set of KSAs or have mapped their own curricula to this
significant body of work. In
another important call for action, the World Health Organization (WHO)
published a key report, the Framework for Action on Interprofessional Education
and Collaborative Practice (2010), issuing a global call for interprofessional
health education with the stated goal of improving patient health outcomes
worldwide. 

    The WHO asserted there is ample evidence showing that
interprofessional education leads to interprofessional collaborative practice.
Following this report, the Interprofessional Education Collaborative Expert
Panel (2011) published a set of core competencies for interprofessional
collaborative practice, including learning outcomes that apply to all health
professionals.

  These two key reports have fostered an international movement
toward interprofessional health education that has been endorsed by multiple
professional organizations and has relevance for development of undergraduate
nursing curricula. 

    Finally,
as schools of nursing aim to graduate a workforce that is diverse and
representative of the communities served, many have crafted programs aimed to
attract and retain a diverse student body. Diversity is defined in a myriad of
ways, including ethnic and gender diversity, as well as diversity in sexual and
gender orientation, socioeconomic status, and even experience. 

    Achieving
classes of students who are rich in diverse experience and who mirror the
population who will be served by graduates is a focus for many schools of
nursing today. 

Meeting
Learner Characteristics through Curriculum Design In Nursing Education

    With
the current emphasis on student learning and student engagement, it is
important that curricula be designed to promote the development of individual
students. This can be accomplished in part by encouraging interrelationships
among the learners, faculty, and what is being learned. 

    Additional factors
affecting program design and student development include focusing on health and
well-being of society; grounding learning in contemporary evidence; creating a
learning environment that is infused with experientially and culturally based
learning opportunities; and supporting individual creativity especially as it
relates to inquiry, problem solving, and reflection.

    For
students in undergraduate programs, faculty designing curriculum should
consider the particular population of learners that will be served. If there
will be a predominance of learners with English as a second language (ESL),
strategies for facilitating their success with reading, writing, and testing
will be important. 

    If the students in an academic progression program are
working in health care and seeking an additional degree (i.e., LPN to associate
of science in nursing (ASN) or RN to BSN), learning activities and schedules
should be conceived to meet learner needs being flexible, applicable to
“real-world” applications and work experiences, and realistic in terms of pace
of the number and type of assignments. 

    Students seeking a second degree appreciate
recognition for prior learning, and respond well to a rigorous academic
environment. When creating curricula for this population of learners, affording
the learners the chance to draw connections between prior degrees and
professional work experiences to the field of nursing creates a bridge to
exemplary practice that is valued by participants. 

Addressing
Stakeholder Expectations While Designing Nursing Curriculum

    The
effect of stakeholder expectations on prelicensure nursing education cannot be
overstated: state boards of nursing, nursing accrediting agencies, and the U.S.
Department of Education have had tremendous influence on both design and
delivery. Today, state boards of nursing are variable in how prescriptive they
are relative to nursing curriculum but they do influence content taught,
clinical requirements, and pedagogy. 

    Accreditation criteria are clear
influencers regarding criteria to be met in curricular construction, and they
are becoming more so as the U.S. Department of Education becomes more explicit
in its emphasis on outcome data specified in its standards for recognizing
professional accreditation bodies (U.S. Department of Education, 2010).

    Furthermore,
although it is expected that nursing faculty will use professional standards to
shape curricula, sometimes faculty rely on such standards without considering
other sources for content and teaching methodology or without considering the
unique mission of their own institution. 

    One can look to The Essentials of
Baccalaureate Education for Professional Nursing Practice (American Association
of Colleges of Nursing [AACN], 2013) and the Commission for Collegiate Nursing
Education (CCNE) (2009) requirement that programs accredited by CCNE must
incorporate them into the curriculum, as an example of how accrediting bodies
can influence program development and curricula design.

    Professional
standards offer critical guidance for nursing programs, but faculty should also
attend to other factors relevant in their own institution’s mission, their own
learners’ needs, and the needs of the health care agencies and communities
served by the school’s graduates. 

Addressing
Future Trends in the Design of Prelicensure Curriculum In Nursing Education

    Schools
of nursing that are nimble and able to respond to future trends in nursing and
health care will be able to maintain a curriculum that prepares learners for
their future practice. Faculty who persist in monitoring and responding to
identified trends, and who are able to revise curricula in a timely manner,
will be rewarded with a curriculum plan that is future oriented and relevant.

    Numerous
health care trends are predicted to have a major effect on nursing practice at
the licensed practical and registered nursing level. Trends that are currently
prevalent in health care and well on their way to becoming essential aspects of
the nursing role include interprofessional practice competencies, understanding
global health challenges, genetics, and genomics. 

    A focus on patient-centered
outcomes and further integration of quality and safety concepts into the
curriculum will continue. Tella et al. (2014) completed an integrative review
of patient safety education practices and their outcomes in schools of nursing
and found a wide variety of approaches in this focus area for nursing
curriculum.

    Other
current issues and trends in health care include providing nursing care that is
veteran-centric; responding to new care roles to enhance care navigation,
health coaching, and telehealth; and use of continuous quality improvement
methodologies to enhance the efficiency and reliability of nursing and health
care. 

    Kovner, Brewer, Fatehi, and Katigbak (2014) stated the employment
patterns of newly licensed RNs is shifting from a heavy focus on acute care
more toward care provision in the community; thus nursing curricula need to
prepare graduates for this anticipated shift in the care environment. 

    Additionally, building curricula that address workplace readiness and promote
healthy work environments (including issues such as civility, bullying, and
readiness for practice) has taken on significance in recent years as the cost
of high turnover among new nurses is realized the cost is high in patient
safety outcomes, patient satisfaction, nursing job satisfaction, and cost.