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CURRICULAR CONCEPTS


1







Module 3B: Identifying Key Curricular Concepts

California State University, Chico

Jennifer Denno, Katie Bedre, Margaret Ruch, Ruby Acojedo,
Siri Johnson

April 6
, 2012

Dr.
Irene
Morgan







CURRICULAR CONCEPTS


2


Influences on Key
Curricular
Concepts


Key curricular concepts
are the abstract ideas that form the substance of a curriculum. A
well
-
conceived curriculum is critical to the
baccalaureate
preparation of practicing nurses
(Boland &

Finke, 2009).
C
oncepts infused throughout the curricula are
often
influenced by
bodies such as the state board of nursing, accrediting bodies, institute
s

of higher education, and
even market and organizational forces. Typically, undergraduate nursing prog
rams focus on care
to individuals, families, groups, and communities in a variety of settings
,
management,
community health, nursing theory, research, group dynamics, and professional issues (Boland &
Finke, 2009).

Our challenge is to take the diffuse lis
t of knowledge and concepts required by
these bodies and infuse them into an imaginative, innovative new program with key curricular
concepts that will come together to create a body of knowledge that is both relevant and
futuristic for the nursing profess
ion.


Dillard and Siktberg (2009
, p. 80
)

believe

that components of
a

curriculum
should be
based on a
foundat
ion
, philosophy and mission,
organizing framework
,

and

expected
outcomes
.
As each of these
is

based on professional body requirements, they are
worth a quick review.
The
West Coast

Curriculum Committee (WCCC) had

established a
foundational goal

of reflecting
current Institute of Medicine
(IOM)
recommendations by using modern technology, an inventive
curriculum, standar
dized national clinic
al

stand
ards,
lifelong learning

strategies
, and local
healthcare organizations
. We aimed

to
produce professional nurses in

our
Baccalaureate

of
Science
In
Nursing (BSN) Program.
Our
philosophy

is derived from a synthesis of beliefs and
values shared among the faculty incorporating our values of persons, health, nursing, the
environment, and nursing education.
Our
mission

is
a

commitment t
o uphold academic
excellence and

provi
de a high quality b
accalaureate
level nursing education to students of
CURRICULAR CONCEPTS


3


diverse backgrounds in the greater Chico area
. We will accomplish this by

utilizing the latest
innovation
s

in technology to prepare nurses to be excellent clinicians, advocates, educators, and
leaders.
Ou
r
organizing framework

is a combination of Leininger’
s holis
tic care
theory
and
Benner’s novice to expert

theory
. These frameworks, along with the support of the
Commission
on Collegiate Nursing Education
’s BSN program essentials,

were the foundation for
our

anticipated
student learning outcomes

(SLOs)
:




Integrate a solid foundation in
liberal education

to enrich the baccalaureate level
nursing education (Essential I).



Assimilate
leadership

with quality improvement to deliver quality health care
(Essential

II).



Integrate
evidenced
-
based practice

in the delivery of safe, effective care across the
healthcare continuum (Essentials III, VI, VII).



Evaluate how
healthcare policies
, including financial and regulatory, to influence the
function of the healthcare sy
stem (Essential V).



Demonstrate effective communication and collaboration with various members of the
interdisciplinary healthcare team to promote the delivery of
quality healthcare

(Essential VI).



Utilize professional
health promotion

behaviors, including

the nursing process, at
each population and complexity level (Essentials VII, VIII, IX).



Integrate
technology

in nursing care to optimize the use of healthcare resources
inherent in caring for patients (Essential IX).



Exhibit commitment to
lifelong learni
ng

for continued personal and professional
growth.


CURRICULAR CONCEPTS


4


The
organization

of our program is based on a nursing model with an outcomes
approach.
By using an outcomes approach, we have shaped the program aro
und specific
identified outcomes. The student learning
outcomes will be used as

both a guide for development
of courses and
measurement of outcomes. Benner’s novice to expert theory
is
used to develop
experts,
Leininger’s caring theory
is used t
o
develop

a
caring

practice
,
and our program mission
of developing

expert clinicians, advocates, educators, and leaders

is used as a guide for
outcomes
of the program. An outcomes approach
promotes

ou
r foundational goal

of
using modern
technology, an inventive curriculum, standardized national clinic standards, lifelong
learning
strategies, and

local healthcare organizations
in the development of

these outcomes.
The
outcomes approach also allows for the integration of our philosophy with
persons, health,
nursing, the env
ironment, and nursing education throughout the progr
am.
We recognize the need
for communicating across disciplines and have incorporated this into our course work.

The West Coast School of Nursing has based its program goal, mission, philosophy
,
f
ramework, and SLOs on
regulatory
requirements for a BSN program.
For example, the Quality
and Safety Education for Nurses (QSEN) has identified six primary areas of required knowledge,
skills, and attitudes that are to be developed within
nursing pre
-
licens
ure programs according to
IOM re
commendations (QSEN, 2012). These essentials include patient
-
centered care, teamwork
and collaboration, evidence
-
based practice, quality improvement, safety, and
informatics, which
have been integrated
in
to
our program.

The California Board of Registe
red Nursing
(BRN)
requires that
all
BSN program
s

include
instruction in
critical thinking, personal hygiene, patient protection and safety, pain
management, human sexuality, client abuse, cultural diversity,

nutrition,
pharmacology, patient
advocacy, legal
, social and ethical aspects of nursing, and nursing leadership and management.

CURRICULAR CONCEPTS


5


Integrated throughout
the

curriculum are the nursing process, skills in preventive
,

remedial,
supportive, and rehabilitative nursing, p
hysical, behavioral, and soci
al aspects o
f human
development, and
k
nowledge and skills required to develop collegial relationships with health
care p
roviders from other disciplines

(BRN, 2012).

The Commission on Collegiate Nursing Education (CCNE, 2008) established nine
essentials that each BSN
program
meet to establish a quality program. These essentials include
d
critical thinking, patient protection and safety, quality improvement, nursing leadership and
management, evidence based practice, information technology, communication knowledge and
skills, culture and human development, nursing process and intervention
al skills, and human
development.
Each of these essentials have also been integrated into our BSN program.

Key Curricular

Concepts
,
Processes and Discussions

The
over
-
encompassing
expected outcomes

from
the West Coast School of Nursing

(WCSON)
program are

clinician, advocate, educator, and leader.

These
are

our

primary
key
curricular concepts
, or
innovative
ideas that form the substance of our curriculum.
They were
established by our outcomes approach, and are an innovative method to integrate nursing
education (without a medical focus) with an unfolding evolution of knowledge, thoughts, and
ideas

in a nursing program
.
Each
semester of

classes and experiences
focus on

the foundation
al

need

to develop

each of
these desired outcomes.
Infused with these co
ncepts are Benner’s novice
to expert theory
,

Leininger’s caring theory,
and

adult learning theory
, as well as
modern
technology, an
innovative

curriculum, standardized clinic
al

standards, lifelong learning
strategies, and
the involvement of
local
healthcare organizations in the development of these
outcomes
.

CURRICULAR CONCEPTS


6



After deciding on these key curricular concepts, o
ur group

focused on a few questions
that would help us to decide whether these concepts would be effective in a BSN program
.
The
answers help
ed guide us through the process of creating classes

and themes

that met

our
expected outcomes
, and would help us adapt to changes in the future
.
Q
uestions (McKimm,
2007
) and answers from our group
included:

Question

Answers






What sort of
healthcare
worker
do we
want to
produce?



A professional leader well versed in health policy, quality metrics, and
skilled in communication across disciplines.



A safe, effective, nurse leader who can collaborate with various
members of the health care team to provide

evidenced based, quality
care.



A driven nurse leader and advocate who effectively collaborates with
various members of the healthcare team to ensure the provision of safe,
quality, evidence based care.



All staff and students should implement safe,
efficient, quality care
which demonstrates the adoption and application of evidenced based
care. Nursing staff and graduates should understand and integrate the
nursing process within all components of patient care. Leadership roles
should be exhibited thr
ough patient advocacy and effective collaboration
with the various members of the interdisciplinary team.



Expert level nurse clinician, advocate, educator, and leader who has
developed caring and a novice to expert level within an educational
program that
includes liberal education, leadership skills, evidence
based practice, healthcare policies, quality, health promotion,
technology, and lifelong learning.




How will we
reflect health
service
changes and
demands


We will ascertain
the needs of the immediate area to meet the demands
of the community’s health. Being aware of the primary care needs of the
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Exhibit life
-
long learning and participation in the community that
incorporates healthcare policies, including financial and regulatory, to
influence the function of the hea
lthcare system and the BSN essentials.



Participate in an accreditation process to ensure continuous quality
CURRICULAR CONCEPTS


7


from external
agencies?

improvement.



Reflect current Institute of Medicine recommendations by using modern
technology, an inventive curriculum, standardized national clini
c
standards, lifelong learning strategies, and local healthcare organizations
to influence our curriculum. We also should continue to be an example
of lifelong learning as we continually adapt to these as they change over
time.





How will we
ensure
links
to
postgraduate
requirements
and training
(specialist
versus
generalist)?



We will offer a stream
-
lined process to ensure students can transition
into advanced studies with part
-
time options, on
-
line options and
pathways to specialize in specific area
s with residency programs in
conjunction with the local hospitals.



Establish partnership with a bigger university that offers postgraduate
studies utilizing the latest technology.



In addition to establishing partnership with universities, it is essential
that we also establish partnership with the surrounding healthcare
institutions. In order to move students from generalist to specialist we
need to provide them with the tools to develop into lifelong learners.
Instructors and learners should apply what th
ey learn, teach others what
they have learned, evaluate, reflect on experiences and explore the
answers to their questions. Research strategies should be understood and
applied in all course work.



A direct link to a post
-
graduate program would make this tr
ansition
seamless, and would encourage participation. Ensuring that the current
program meets all application requirements and gives the student
priority in this program would help as well. As our program progresses,
ensuring conversations about future pla
ns, direction, and
implementation requirements will assist the student in meeting specialist
versus generalist decision making and implementation.






How will we
identify and
overcome
barriers to


Implement a review process that regularly evaluat
es programs/courses,
solicit feedback from teachers and students every end of the semester
about courses offered, and maintain an open communication amongst
teachers to promote a constant flow of ideas on ways to improve.



Frequent assessment and evaluation is necessary to identify the driving
and restraining forces pertaining to change. Developing a collaborative
plan of action is key to overcoming barriers. Re
-
assessment is necessary
to determine if the implemented plan of

action effectively overcame the
identified barriers.



The National Institute for Health and Clinical Excellence (2007) states
that key strategies to identifying barriers include awareness and
knowledge, motivation, acceptance and beliefs, and understanding

CURRICULAR CONCEPTS


8


change?

skills, practicalities, and barriers that are beyond our control. We can
accomplish these by observing in clinical and educational settings,
brainstorming, running occasional focus groups, using questionnaires,
and keeping communication loops open between

students, instructors,
nurses, and with key individuals within the program. This will assist
with identification and current/modern solutions. Overcoming these
barriers could use solutions such as using educational materials that
support the change, leade
rship promotion, using clinical feedback or
audits as motivation, using student mediated strategies, reminder
systems, and educational outreach opportunities.


Ultimately
, the group
looked for a primary innovative set of concepts that support a state
-
o
f
-
the
-
art program with a focus on technology and tomorrow’s nurse. By answering these
questions, we identified issues that could arise with such a program, and solutions that we need
to keep in mind when implementing such a program. The following chart ide
ntifies key concepts
of the program, and how they
were

integrated

into our
innovative curriculum. E
ach semester
has
a theme related to each of the four outcomes we are looking for: clinician, advocate, educator,
and leader. As the chart shows, we then inco
rporate certain concepts in particular semesters, or
we infuse them throughout the program, taking them from novice to expert level as we go.
Leininger’s caring theory

and adult learning theory, as well as modern technology, an inventive
curriculum, standa
rdized clinical standards, lifelong learning strategies, and the involvement of
local healthcare organizations in th
e development of these outcomes are also infused throughout,
and can be considered our underlying curricular concepts.
Other concepts
infused:

Key Curricular Concepts:

Clinician

Advocate

Educator

Leader

Foundational Go
als



Modern technology



Inventive curriculum



S
tandardized
clinic standards



Lifelong learning strategies


X

X

X

X

X


X

X

X

X

X


X

X

X

X

X


X

X

X

X

X

CURRICULAR CONCEPTS


9




Local healthcare organizations


Philosophy



Persons



Health



Nursing



Environment



N
ursing education


X

X

X

X

X


X

X

X

X

X


X

X

X

X

X


X

X

X

X

X

Mission



Academic excellence



H
igh quality baccalaureate
level nursing education



Diverse students



Technology


X

X


X

X


X

X


X

X


X

X


X

X


X

X


X

X

Organizing Framework



Leininger’s Theory



Benner’s
Theory


X

X


X

X


X

X


X

X

Student Learning Outcomes



S
olid foundation in liberal
education to enrich the
baccalaureate level nursing
education (Essential I).



Assimilate leadership with
quality
improvement to
deliver quality health care
(Essential II).



Integrate evidenced
-
based
practice in the delivery of
safe, effective care across the
healthcare continuum
(Essentials III, VI, VII).



Evaluate how healthcare
policies, including financial
and regul
atory, to influence
the function of the healthcare
system (Essential V).



Demonstrate effective
communication and
collaboration with various
members of the

Pre
-
nursing




X




X





X





X





Pre
-
nursing




X




X





X





X





Pre
-
nursing




X




X





X





X





Pre
-
nursing




X




X





X





X




CURRICULAR CONCEPTS


10


interdisciplinary healthcare
team to promote the delivery
of quality healthcare
(Essential VI).



Utili
ze professional health
promotion behaviors,
including the nursing process,
at each population and
complexity level (Essentials
VII, VIII, IX).



Integrate technology in
nursing care to optimize the
use of healthcare resources
inherent in caring for patients
(Essential IX).



Exhibit commitment to
lifelong learning for continued
personal and professional
growth.







X






X





X









X






X





X









X






X





X









X






X





X




O
rganization



Nursing M
odel



Outcomes A
pproach


X

X


X

X


X

X


X

X

QSEN:
Knowledge, Skills, and
Attitudes



Patient centered care



Teamwork and collaboration



Evidence
-
based practice



Quality improvement



Safety



Informatics



X

X

X

X

X

X



X

X

X

X

X

X



X

X

X

X

X

X



X

X

X

X

X

X

BRN



C
ritical thinking



Personal hygiene



Patient protection and safety




P
ain management



Human sexuality



Client abuse



Cultural diversity



Nutrition



Pharmacology


X

X

X

X

X

X

X

X


X

X

X

X

X

X

X

X


X

X

X

X

X

X

X

X


X

X

X

X

X

X

X

X

CURRICULAR CONCEPTS


11




Patient advocacy



L
egal, social and ethical
aspects of nursing



N
u
rsing leadership and
management




Nursing process



S
kills in preventive remedial,
supporti
ve, and rehabilitative
nursing



P
hysical, behavioral, and
socia
l aspects of human
development



Knowledge and skills required
to develop collegial
relationships with health care
providers

X

X


X


X

X


X



X



X

X


X


X

X


X



X


X

X


X


X

X


X



X

X

X


X


X

X


X



X

CCNE Essentials



Critical thinking



Patient protection and safety



Quality improvement



N
ursing leadership and
mana
gement



Evidence based practice



Information technology



C
ommunication



C
ulture



Human development



Nursing process



Interventional skills


X

X

X

X


X

X

X

X

X

X


X

X

X

X


X

X

X

X

X

X


X

X

X

X


X

X

X

X

X

X


X

X

X

X


X

X

X

X

X

X

BSN Content



Individuals, families, groups,
and communities




Management



Community health



Nursing theory and research
Group dynamics



P
rofessional issues


X


X

X

X

X


X


X

X

X

X


X


X

X

X

X


X


X

X

X

X

Questions



Type of nurse worker



Reflect changes into future
curriculum (continual nursing
process)



Integrate continued education
concepts


X

X



X

X


X

X



X

X


X

X



X

X


X

X



X

X

CURRICULAR CONCEPTS


12




Overcoming barriers

X= covered during this semester



X
= extra focus during this semester


Overall, curricular concepts in our nursing program are designed to
evolve

as the student
progresses through the program, much like an evolving case study. Each semester the student
will integrate key concepts into th
eir education while progressing throughout the stages set
before them: clinician, advocate, educator, and leader.
Our SLOs are key curricular concepts that
will be infused through the program, as well as many others.


Our group finalized this process and began working on the curriculum matrix fairly
quickly, as we all agreed that the idea fit with our focus on outcomes, as well as using both
Benner’s novice to expert theory
and Leininger’s caring theory. The idea also s
upports the
evolving educational process that we envisioned, as you can see on the chart
, while using
Bloom’s taxonomy throughout the process.








eferences

CURRICULAR CONCEPTS


13


Board of Registered Nursing. (2012).
Title 16, California code of requirements.

Retrieved from

http://www.rn.ca.gov/regulations/title16.shtml#1423

Boland, D., & Finke, L.

(2009). Curriculum
designs. In D. Billings & J.
Halstead (Eds.),

Teaching in nursing: A guide for faculty

(3
rd ed., pp. 119
-
136). St. Louis,
MO: Saunders

Elsevie
r.

Commission on Collegiate Nursing Education. (2008).
E
ssentials of baccalaureate education

for professional nursing practice
.

Retrieved from
http://www.aacn.nche.edu/education
-

resources/BaccEssentials08.pdf

Dillard, N., & Siktberg, L. (2009). Curriculu
m development: An overview. In D. Billings & J.

Halstead (Eds.),
Teaching in nursing: A guide for faculty

(3
rd

ed., pp. 75
-
91). St. Louis,

MO:

Saunders Elsevier.

McKimm, J. (2007).
Curriculum design and development.

Retrieved from:

http://www.faculty.londondeanery.ac.uk/e
-
learning/setting
-
learning
-

objectives/Curriculum_design_and_development.pd
f


National Institute for Health and Clinical Excellence
.

(2007)
.
How to change practice:

Understand, identify, and overcome barriers to
change
. Retrieved from

http://www.nice.org.uk/media/AF1/73/HowToGuideChangePractice.pdf

Quality and Safety Education for Nurses.
(2012).
Competency KSA’s
,

pre
-
licensure
. Retrieved

from
http://www.qsen.org/ksas_prelicensure.php