Organizing Framework for Curriculum Development In Nursing Education by Single Theory, Eclectic and Guiding Principles

Developing
a Single Theory Framework for Curriculum Development In Nursing Education

    A
traditional approach to constructing an organizing framework is to use a
particular nursing theory or model to help shape the visual image that is
consistent with the philosophy of the faculty. 

    For example, if faculty believe
that caring is at the core of nursing, a theory of caring (Hills & Watson,
2011; Swanson, 1999; Watson, 1997) might serve as the anchoring model when
explaining the discipline to students and cataloguing knowledge about the
discipline of nursing. 

    The advantage to building an organizing framework on a
single theory or model is the ability to use a single image with a defined
vocabulary that is shared by both the learner and the teacher. 

    Using a single
theory or existing conceptual model has limitations and poses challenges,
including that it may not reflect everybody’s view of nursing and nursing
practice. This becomes problematic when faculty have developed or been educated
in curricula that have used a different theory or orientation to the
discipline. 

    The use of only one theory in a framework may limit the ability of
faculty to pull together all elements of their curriculum, which provides a
rationale for moving away from this approach as does recognizing that the
practice of nursing is being transformed by a dynamic, evolving health care
system. Further, it is clear that nursing educators and practitioners will not
agree on a single theory. 

    Students educated in a curriculum driven by a single
theory are likely to experience frustration and confusion when they find
themselves in clinical practice settings that do not ascribe to the same
theory, or to any theory for that matter.

Developing
an Eclectic Framework for curriculum Development In Nursing Education

    Given
the challenges and limitations of using a single theory as an organizing
framework, faculty choice does not have to be constrained by a single theory or
model. 

    Those who believe that a combination of many theories or concepts are
more reflective of their beliefs about nursing may use an eclectic approach to
developing a curricular framework. Figure 6-1 shows an eclectic framework that
has been used to guide work in several nursing programs. 

    The Care Quality
Commission framework incorporates an updated use of traditional nursing role
concepts of care, cure, and coordination with the QSEN and IPE competencies as
the major guiding structures. The use of a more eclectic approach when
designing an organizing framework is not without its pitfalls. 

    Some view this
approach as an impediment to the development of a comprehensive nursing theory
and the development of a body of knowledge that is uniquely nursing. The
advantage to an eclectic approach is the ability to “borrow” concepts and
definitions that best fit the faculty’s beliefs and values from nursing and
non nursing theories. 

    The eclectic approach may also promote incorporation of
contemporary or evolving conceptualizations of nursing, health, the
environment, and other key concepts as well as better reflect the practice of
nursing across the continuum of settings and patient populations. 

    However, if
faculty develop an eclectic framework, where concepts and their definitions are
“borrowed” from a number of theories, they need to ensure that in the act of
borrowing they have not changed conceptual meaning. 

    It is important to clearly
show the relationships among the selected concepts. Therefore it is important
to clarify the meaning of concepts that will be used in an organizing framework
so that faculty and students are clear about the phenomena being studied.

Guiding
Principles for Developing Organizing Frameworks for Curriculum Development In Nursing Education

    Although there are no specific steps or “how
to’s” for developing organizing frameworks for curriculum, there are some
guiding principles that faculty can follow. D’Antonio et al. (2013) describe
the process used by one school of nursing to identify curricular concepts that
illustrates the use of many of these principles. 

    The first principle is to
choose those concepts that most accurately reflect the faculty’s beliefs about
the practice and discipline of nursing and how students learn. 

    The introduction
of contemporary, student centered approaches to learning, which stem from
constructivism theory , are becoming more evident in faculty
belief statements and are influencing curriculum development. 

    The concepts
identified should also reflect or complement the philosophy, mission, and goals
of the college or university in which the program is embedded. 

    By creating an
organizing framework that reflects concepts valued by both the discipline of
nursing and the parent institution, faculty have begun to articulate the
contributions their nursing program makes to all stakeholder entities.

     The most important aspect of choosing the
concepts that tie the curriculum together is relevancy. This means that the
concepts chosen need to be relevant and meaningful to the future practicing
nurse, consistent with the science and art of nursing, and the needs of the
populations served through health care delivery systems. During this phase of
the curriculum development, it is important to involve stakeholders in the
process. 

    Reading professional standards and recommendations; understanding
regulatory and accrediting criteria; and gathering input from practice
partners, s , students, community leaders, and other identified stakeholders
can all help faculty with selecting appropriate concepts.

The
selected concepts are often organized into a graphic representation to
facilitate understanding and recognition of the organizing framework. 

    The concepts included in the organization are further developed
through creation of end-of program outcomes and competencies. The requisite KSAs
are then further defined for each of the concepts and integrated throughout the
curriculum in course content and learning activities.

    The
second principle is to clearly define the major concepts underpinning the
curriculum framework. Consensus should be established in this process because
it will fall to the faculty to articulate these concepts to the students. 

    Consistency in terminology and definitions along with making the organizing
framework visible to faculty, students, practice partners, and other program
stakeholders will enhance the framework’s role in mastery of the desired level
of competency at program completion.

    The
third principle is to explain the linkages between and among the concepts
identified. This is critical because the linkages are the basis for how
students comprehend, apply, analyze, synthesize, and evaluate knowledge learned
throughout the educational process. 

    These principles are analogous to putting
together a jigsaw puzzle in which the concepts are the puzzle pieces and the
total picture is of high quality, contemporary nursing practice. Puzzles come
in various numbers of pieces. Usually the greater the number of pieces, the
greater the challenge in its construction. The outline and coloring of the
pieces are the definitions of the concepts. 

    The more clearly the puzzle pieces
are defined and the sharper the color delineations, the easier it is to fit the
puzzle together. It is critical that faculty and students grasp an
understanding of the framework without an intensive investment of time and
energy.

    Faculty
must decide on the major concepts that make up the organizing framework and
focus on illustrating the linkages among those concepts. It is not necessary or
desirable to identify each and every concept that students will be introduced
to. 

    The more faculty focus on minute concepts, the more likely it is that they
are defining facts (not concepts) that will quickly become irrelevant. It is
important to keep the work of concept identification, definition, and linkage
at a broader level involving concepts that will retain salience with safe,
quality practice.

    However
faculty decide to approach the work of developing a framework for their
curriculum, the framework eventually constructed must be consistent with the
school’s mission and philosophy statements, faculty values and beliefs, program
goals, professional standards, state and federal regulations, and current and
future nursing practice trends. 

    Faculty should have broad based agreement on
the curriculum framework because such agreement is fundamental to the
consistent interpretation, implementation, and evaluation of the curriculum in
meeting the expected program goals and outcomes. 

    If there is a disconnect among
philosophy, values, program expectations, professional practice expectations
and outcomes, and the framework, faculty need to raise significant questions as
to the utility of the created frameworks.

    Once
the work has been completed, faculty should share the completed framework with
various stakeholders, soliciting feedback on how the organizing framework is
interpreted by others. Such an exercise can help faculty determine if they have
been successful in publicly articulating their beliefs and values to others.