BSN Program Curriculum In Nursing Education ant Its Outcomes and Competencies
Outcomes and Competencies of Curriculum In Nursing Education, Identifying Curriculum Outcomes In Nursing Education, BSN Program Outcomes of a Designed Curriculum In Nursing Education, BSN Program the Graduate Will Be Able to By This Curriculum Design.
Outcomes
and Competencies of Curriculum In Nursing Education
If
curriculum frameworks are the road maps to understanding the discipline of
nursing, then outcomes can be equated with the trip’s destination and
competencies with the mileage markers seen along the way.
Program outcomes
(also referred to as learning outcomes or sometimes expected outcomes) then
take the place of what was traditionally and more generally called terminal
objectives as the outcomes represent the integrated knowledge, skills, and
abilities or competencies students are expected to demonstrate at program
completion.
Outcomes,
in the simplest of terms, are those characteristics students should display at
a designated time, most often at the completion of the curriculum, and reflect
a description of the ideal program graduate. Competencies are sometimes
described as what students can do with what they know at designated points
during and at the end of the educational program.
Each broader desired outcome
may be linked with multiple competencies to achieve a meaningful level of
specificity for student assessment and, in the aggregate, for program
evaluation. The chapters in Unit V – Evaluation provide detailed information
about assessment of student learning, program evaluation, and related topics.
Identifying
Curriculum Outcomes In Nursing Education
The movement to an outcomes orientation has
developed over time in nursing education as it has in higher education. These
resulting changes provide a strong focus on the quality and value of
postsecondary education (K–12 has experienced a similar set of changes with a
focus on competency testing).
Regional higher education
accrediting bodies have fully embraced the idea that educational outcomes
should prepare graduates to serve some aspect of societal need or improvement,
resulting in strong, and some argue, prescriptive approaches to the assessment
of student learning and enhanced review of program evaluation metrics.
An
example of this shift in ideology is reflected in a project titled The Future
of Higher Education: Rhetoric, Reality, and the Risks of the Market by Newman,
Couturier, and Scurry (2010).
One of the premises growing out of this project
was the need for faculty to ask the right questions about educational goals and
outcomes when engaged in curriculum development. The questions identified with
relevancy to curriculum development include the following:
• What knowledge and skills are needed by all
graduates?
• What requisite knowledge needs to be
acquired by students to be productive in the workforce?
• What is the gap between current knowledge
and skills and those that are needed in the future?
• What is the role of technology in
facilitating the acquisition of the requisite knowledge and skills?
•
How do we deliver the curriculum in a way that will maximize the outcomes?
Over the past decade, the focus on outcomes in
higher education has continued to increase. In response to the provocative
questions raised when focusing on program outcomes, the NLN convened an
advisory group to explore the outcomes and competencies needed at each
educational program level, from licensed practical nurse to the clinical
doctorate (National League for Nursing (NLN), 2010).
Similar efforts have
occurred within the AACN, whose “Essentials” publications contain the expected
outcomes and competencies for baccalaureate (2008), master’s (2011), and doctor
of nursing practice (2006) programs in nursing.
With
the need for nursing educators to ensure that the curricula they design keep
pace with the ongoing changes in health care and higher education, more
emphasis will continue to be placed on the school’s ability to demonstrate
success. Outcomes assessment has been seen as the key by which school programs
can document strengths and weaknesses.
A comprehensive assessment program can
help faculty determine what works and what does not in achieving academic
quality and producing the desired program outcomes (Astin, 2012; McDonald,
2014; Oerrmann & Gaberson, 2014).
This logic is a significant departure
from the predominantly process-oriented Tylerian approach to curriculum and
evaluation, in which the emphasis was placed on detailed course objectives, the
identification of content needed to meet course objectives, and the appropriate
pedagogical approaches to complement the type of content needing to be taught.
Outcome assessment emphasizes what students have actually learned in their
educational experiences, not merely the knowledge and experiences that were
designed with the intent of achieving these results (Astin, 2012; McDonald,
2014; Oerrmann & Gaberson, 2014; Wittmann Price & Fasolka, 2010).
These
differences, which may seem like nuances to many, are core to the changing
focus in curriculum development and student learning assessment and evaluation
that continues to evolve in higher education and nursing education.
When
moving to a curriculum that is more centered on the development of outcomes
relevant to nursing practice, it is often easier to think about curriculum
development as starting at a program’s end rather than its beginning.
Outcomes
then become the critical focus of curriculum development. This method of
curriculum development places a different emphasis on the need for organizing
frameworks as a starting point for curriculum development.
Approaching
curriculum development beginning with the desired outcome or what the student
needs to demonstrate at graduation to be a competent nurse and then working
“backward” toward the beginning of the curriculum provides faculty with an
opportunity to identify the essential outcomes and competencies that they wish
to see their students demonstrate at the completion of the program.
It is
important to note that development of outcomes should be significantly informed
by the mission, vision, values, and philosophy of the program; an environmental
scan that includes the perspectives of major external stakeholders; the use of
best current evidence in nursing and health professions education; and internal
stakeholder preferences from faculty, students, alumni, and appropriate others.
BSN
Program Outcomes of a Designed Curriculum In Nursing Education
Upon the completion of the program the
graduate will be able to:
1. Administer evidence-based, clinically
relevant holistic care to individuals, families, groups and multi-dimensional
populations with diverse demographic and cultural characteristics in a variety
of settings.
2. Communicate effectively using oral,
written, and electronic methods, to transmit the analysis and integration of
data required to provide safe quality care and inform nursing practice.
3. Integrate critical reasoning and
problem-solving methods to make effective nursing judgments and help patients
make relevant decisions to improve their health and quality of life.
4.
Implement interventions that integrate ethical, legal, and Christian principles
and behaviors, consistent with the Catholic and Dominican Tradition, in all
professional nursing activities in order to advocate for the health,
well-being, and the best interests of nurses, patients, families, significant
others, and the community.
5. Integrate teaching strategies to assist
individuals, families, and communities to achieve the highest level of health
and well-being possible.
6. Collaborate in partnership with other
healthcare team members to promote, protect, and improve health of patients at
any point on the illness/wellness continuum.
7. Engage in leadership and management
activities in a multidisciplinary healthcare environment to plan, implement,
delegate, evaluate, and promote safe quality nursing care that is holistic and
cost effective.
8. Participate in the ongoing changes in the
profession and actions that promote safe quality patient care and engage in
ongoing preparation through continued learning and advanced practice education
that advance the goals of the profession.
The
interrelationship between the organizing framework and the outcomes and
competencies becomes clear with the organizing framework being shaped by the
theories and concepts embedded in the outcomes and competencies.
For example,
if faculty believe that students need to possess clinical reasoning,
communication, teamwork, and leadership skills, these concepts will be evident
in the organizing framework. In an outcomes-focused curriculum, the driver of
faculty conversations is not what content must be taught but rather what KSAs
(professional values) students need to demonstrate to meet expected curriculum
outcomes.
Before they can think about curriculum from the outcome, or end
stage, faculty first must identify the desired program outcomes using a stakeholder-informed
and future-oriented picture of nursing practice (Sroczynski, Gravlin, Route,
Hoffart, & Creelman, 2011).
Here are some examples of end o fprogram
competencies that reflect evolving stakeholder priorities with an emphasis on
transition care coordination across settings, emerging technologies, and
culturally sensitive care.
BSN Program the Graduate Will Be Able to By This Curriculum Design
• Coordinate care and transitions across
providers and settings
• Apply communication and emerging
technologies to nursing practice for optimal patient outcomes
•
Deliver culturally sensitive care to patients and their families (Thomas
Jefferson University College of Nursing, 2015)
As
faculty identify outcomes, it is important to embed these outcomes in actions
that promote the practice of nursing. Using an outcomes perspective, it is
important that faculty not only clarify and define the concepts they wish to
use in the development of outcomes but also ensure that they have outcomes that
are broad enough to incorporate all of the attributes desired.
A
common question is how many program outcomes are needed. There is no
evidence based answer to this question; however, many programs strive for no
more than eight to ten outcomes. Keep in mind that these should be broad-based
outcomes that encompass a number of competencies that will evolve with changing
practice.
If faculty are identifying a large number of program outcomes, it is
likely that they have confused program outcomes with the knowledge, skills, or
behaviors related to competencies. Program outcomes should not need to be
frequently updated; they should stand the test of time. For example, consider
the following BSN program outcomes (2 of 9). As a graduate of the BSN program
you will be:
A culturally sensitive individual who provides holistic, individual, family,
community, and population-centered nursing care;
An effective communicator who collaborates
with inter-professional team members, patients, and their support systems for
improved health outcomes (Indiana University School of Nursing, 2012). These
outcomes are written broadly and will be contemporary for some time to come.
The knowledge, skills, and behaviors (competencies) that the graduate will need
to acquire to demonstrate these outcomes will likely change, but the outcomes
will remain current. The faculty can review and update the competencies as needed
to stay current.
Some
of the criteria that will be useful in determining how many outcomes to include
are ensuring that the major aspects of the organizing framework are included;
that significant professional practice and accreditation standards are
appropriately reflected; and that, when considering the outcomes as a
collective whole, a clear picture of the major components of a practitioner who
is engaged in safe, quality nursing care emerges.
Consideration
of a more ontological philosophical approach to defining outcomes adds the
perspective of the learner on core characteristics. For example, in the work of
Doane and Brown (2011), students are expected to demonstrate “self-initiating,
self correcting and self-evaluating behaviors which they believe are at the
core of skillful practitioners” (p. 24).
The authors indicate that developing
skills of communication is critical and that it is the learners’ ability to
identify what is not known that shapes the essential content within the
curriculum.
The importance of reflection and reflective practice is
increasingly recognized as a crucial strategy to develop professional identity,
emotionally intelligent practitioners, and a commitment to lifelong learning
and development (Sherwood & Horton-Deutsch, 2012).