Curriculum Development and Evaluation in Nursing Education 4th Edition pdf pdf
SARAH B. KEATING E STEPHANIE S. D BOOR E D I T O R S CURRICULUM HHHH DEVELOPMENT AND EVALUATION
Keating, EdD, MPH, RN, C-PNP, FAAN, retired as endowed professor, Orvis School of Nursing, University of Nevada, Reno, where she taught Curriculum Devel- opment and Evaluation in Nursing, Instructional Design and Evaluation, and the NurseEducator Practicum, and was the director of the DNP program. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission ofSpringer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copy- right Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, info@copyright .com or on the Web at www .copyright .com.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission ofSpringer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copy- right Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, info@copyright .com or on the Web at www .copyright .com. Keating and Stephanie S.
29 Felicia Lowenstein-Moffett and Patsy L. Ruchala
Nursing educators are recognizing the complexity of the health care systemand the health care needs of the population and moving advanced practice and leader- ship roles into the doctoral level, offering programs that create nursing researchers,scholars, and faculty to keep the profession current and ready for the future. For the pur- poses of the textbook, the definition is: a curriculum is the formal plan of study that provides thephilosophical underpinnings, goals, and guidelines for delivery of a specific educational pro- 2 of processes that are learner and consumer focused and at the same time, ensure excellence by building in outcome measures to determine the quality of the program.
HISTORY OF NURSING EDUCATION IN THE UNITED STATES
Lest the profession forgets, liberal arts and the sciences in institutions of higher learning play a major rolein nursing education and set the foundation for the development of critical thinking and clinical decision making so necessary to nursing care. The explosive growth of doctor ofnursing practice (DNP) programs in recent times and their place in defining advanced practice, nursing leadership, and education bring the past happenings into focus as theprofession responds to the changes in health care and the needs of the population.
CURRICULUM DEVELOPMENT AND APPROVAL PROCESSES IN CHANGING EDUCATIONAL ENVIRONMENTS
Following the curriculum plan results in anintact curriculum and at the same time provides the opportunity for faculty and stu- dents to identify gaps in the program or the need for updates and revisions. Such needsare brought to the attention of other instructors and the coordinators of the courses or levels for assessment and action through curricular review and change processes.
Othercatalysts for formal nursing education included the transition of hospitals from places for the destitute to arenas for the application of new medical knowledge and the indus-trial revolution that resulted in increased slums and disease (Rush, 1992). Hampton instigated an informal meeting of nursing superinten-dents that laid the groundwork for the formation of the American Society of Superinten- dents of Training Schools (ASSTS) in the United States and Canada, which later, in 1912,was renamed the National League of Nursing Education (NLNE).
MARCHING INTO SERVICE: NURSING EDUCATION IN WARTIME
With the backing of the NLNE and the ANA in addition to nursing leaders such asFrances Payne Bolton, the secretary of war approved the school and Annie Goodrich became its first dean. Thus, they signed on, despite the fact that hospitals had to establish a sepa- rate accounting for school costs, literally meet the requirements of their state boards ofnurse examiners to the satisfaction of the CNC consultants, and allow their students to leave for federal service during the last 6 months of their programs, when they wouldotherwise be most valuable to their home schools.
THE EVOLUTION OF CURRENT EDUCATIONAL PATHS FOR ENTRY INTO PRACTICE
Few voices actively campaigned for the alignment of nursing education with institutions of higher learning even as late as the 1930s, despite the rec-ommendation of the Rockefeller-funded Goldmark (1923) report, Nursing and Nursing Education in the United States, in the early 1920s. Political pressure for access to care, interacting with the shortage and maldistribution of physicians and recognition that nurses could competently do a subset of physicianwork, led to federal support for the spread of NP programs (B. Bullough, 1976; NationalCommission for the Study of Nursing and Nursing Education, 1971).
THE PROCESS OF CURRICULUM DEVELOPMENT
Roles in nursing continually develop to meet the needs of health care in order to better serve individuals, families, and the communities where they live (AmericanAssociation of Colleges of Nursing [AACN], n.d.; Institute of Medicine [IOM], 2010;Quality and Safety Education for Nurses [QSEN], 2014). The result was a major national initiative, QSEN, which centered on patient safety and quality topics, with a primarygoal to address the challenge of preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health caresystems in areas where they practice (NCSBN, 2016; NLN, 2017).
RESEARCH IN CURRICULUM DEVELOPMENT AND EVALUATION
A course coordinator canassume the responsibility for a new faculty member’s orientation to the course and its relationship to the curriculum and also to periodic assessment of the delivery of thecourse content to ensure its germaneness to the curriculum. It is widely noted in the literature that due to the complexities of today’s health care system andhealth care delivery, transformation of nursing education with a health systems frame- work is necessary to adequately prepare nurses to practice safely (AACN, 2017b; IOM, 37 the barriers that educational institutions impose upon themselves such as multilevel institutional hierarchies and lengthy committee processes to obtain approval of cur-riculum changes (Bellack, 2008; Coonan, 2008).
EXTERNAL AND INTERNAL FRAME FACTORS
All of these factors influence the curriculum in positive and negative ways and while they may not be in the control of the faculty, they are important to recognize and ana-lyze for their impact on the program. The same data collected for a needs assessment are in fact related to total quality management of the curricu- 46 planning; it is useful to incorporate the notion of evaluation as a process when con- ducting a needs assessment, not only in terms of the present plans for program start-upand changes, but also for planning for the future.
FINANCIAL SUPPORT AND BUDGET MANAGEMENT FOR CURRICULUM DEVELOPMENT AND EVALUATION
Therefore, the information from the assessment of the political climate is vital to plan- ning for the future and seeking assistance when the call comes for additional resourcesor for political pressure and support to maintain, revise, or increase the program. A review of the external frame factors provides a check with reality includ-ing the community in which the program is located, the industry for which the program prepares graduates, and the economic viability of the program.
INTERNAL FRAME FACTORS
The information related to these factors is analyzed for its relevance to the program and the findings are weighed as to their importance to the quality of the program, its exis- 56 institution as well as that of the nursing program to describe the hierarchal and formal lines of communication that guide the faculty in developing and revising programs. A majority of the population and the powers structurescompleted high school or higher levels of education and/or Within the population, what is the potential for acquiringthere is growing interest in and need for these levels of student, faculty, and staff for the program?education.
ROLE OF ADMINISTRATORS, STAFF, AND FACULTY IN FINANCIAL SUPPORT FOR CURRICULUM DEVELOPMENT ACTIVITIES
Chapter 5introduces the classic components of the curriculum and the process for its development fol- lowed by a chapter that describes the implementation of the curriculum through application oflearning theories, educational taxonomies, critical thinking concepts, and learner-focused, instructional strategies. A chapter with a proposed uni-fied curriculum summarizes the various educational pathways in nursing and the final chapter discusses the application of technology to the implementation of the curriculum through learn-ing strategies, distance education, and the burgeoning growth of Internet programs.
PURPOSE OF CURRICULUM DEVELOPMENT
The overall purpose of curriculum development in nursing education is to meet the learners’ needs by ensuring that it meets educational and professional standards andthat it is responsive to the current and future demands of the health care system. Chapter 5 discusses the components in detail and the pros and cons of frameworks to organize the curriculum plan including the useof nursing and other disciplines’ theories and concepts and professionally defined stan- dards or essentials of education.
DISTANCE EDUCATION AND TECHNOLOGY
Other high-tech devices and systems such as electronic record systems, smart phones, electronic tablets, and advanced communication systems add to the rapid changes in thedelivery of education and the need for students and faculty to keep abreast of the newer innovations. While curriculum development activities are quite the same across types of institutions, the differences arise whenexamining the overall purpose and mission of the institution and the financial and human resources that are available for revising or initiating new programs.
LEVELS OF NURSING EDUCATION
According to the National League for Nursing (NLN, 2014) Annual Surveyof Schools of Nursing 2014, diploma programs account for 4% of all nursing programs in the United States with most located in the Midwest and the East. For all types of programs, administrators and faculty should plan in advance for the financial support of curriculum development and evaluation activities and investigatepossible external resources such as grants for curriculum changes and program develop- ment activities.
THE FORMAL AND INFORMAL CURRICULA
Effects of Student–Faculty Interactions on the Curriculum Several studies have demonstrated the positive effects that student–faculty interactions have on the learning environment and ultimately, on the success of the curriculum’spurpose. The author offers specific strategies for orienting adjunct faculty to the challenges of teaching online and at the same time,maintaining contact with the institution, community, and colleagues.
THE CAMPUS ENVIRONMENT
Traditionally in higher education, the physical environment (campus) is important to the image of the home institution and plays a major role in building a sense of belonging forstudents and alumni alike. A description follows on how the organizational framework and/or concept analysis/map, overall goal or purpose of the curriculum, end-of-programobjectives/ student-learning outcomes (SLOs), and level objectives guide the implemen- tation plan that flows from the mission and philosophy statements.
THE MISSION OR VISION STATEMENT
Chief administrators (presidents) of institutions of higher learning assume much of the responsibility for ensuring that the mission and vision are current and reflect the 85 under assessment should be analyzed according to their specific roles in meeting the mission and vision of the institution. As with the presidents of universities and colleges, deans and directors of nursing education programs have a leadership role in developing program missions and visionsthat are not only congruent with the parent institutions, but look to the future.
ESSENTIALS FROM THE LIBERAL ARTS AND THE SCIENCES
The American Nurses Asso- ciation (2009) published the second consensus document on the Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines, and Outcome Indicators that is useful in planning for its content in nursing education. (2015) discuss the integra- tion of omics into doctoral level nursing curricula as recommended by the NationalCouncil for the Advancement of Nursing for nurse scientists to keep pace with emerg- ing scientific findings.
PROFESSIONAL VALUES, PROFESSIONALISM, AND NURSING PRACTICE
87 studies, graduates who represent the millennial generation do not advocate for their patients or assert themselves during moral conflicts. In order to evaluate the success of acurriculum in the preparation of ethical nurses, McLeod-Sordjan recommends the inte- gration of moral reasoning and social justice concepts into the program and the use ofvarious assessment tools to measure learning outcomes as they progress through the program and upon graduation.
INTERPROFESSIONAL COMMUNICATION AND COLLABORATION
Diversity is defined in its broadest sense not only in terms of race,ethnicity, culture, language, gender, and other differences from the dominant culture, 89 self-reported themselves as culturally aware; however, a review of the curricula found the concepts hard to find except in the community colleges where the concepts weremore explicitly expressed. In addition, faculty members identified race and ethnicity as part of the concepts of diversity and cultural competence but did not identify marginal-ized groups, isolated populations, elder groups, and so forth as part of the concerns for social justice and access to health care.
THE HEALTH CARE SYSTEM
Health insurance coverage contributes to therising costs of health care because of the need to distribute costs over younger, healthier populations; however, after ACA was implemented, the uninsured rates fell from 17.1%in the fourth quarter of 2013 to 12.9% in the fourth quarter of 2014. Nurses must keep abreast of the changes in the health care system in order to advocate for 90 good health; and to promote quality of life, healthy development, and healthy behav- iors across life stages (Office of Disease Prevention and Health Promotion, 2017).
PATIENT SAFETY AND QUALITY HEALTH CARE
In just 1 year, from 2012 to 2013, the number of articles doubled and the authors attributed the increase to the push by AACN for the integration of these con-cepts in its Essentials Series. Not only do technology and informatics apply to today’s nursing practice and to students to gain nursing competencies in the care of clients, they serve as platformsfor the delivery of nursing education programs such as web-based, hybrid, and web- enhanced courses.
SCHOLARSHIP, RESEARCH, TRANSLATIONAL SCIENCE, AND EBP
Scholarship and research concepts begin at the associate degree level and continue in complexity to the PhD where new knowledge istested and added to the body of scientific knowledge for the discipline. Ponte and Nicholas (2015) review the lit-erature on the use of these initials and their history pointing out that the majority of the doctorates carried research and dissertation requirements similar to the PhD and thatmany schools converted the DNS, DNSc, and DSNs to PhDs, some retrospectively for their alumni.
CRITICAL THINKING AND ITS APPLICATION TO NURSING
Development of critical thinking is essential to the preparation of nurses for clinical decision making and judgment and is part of the Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008). They didfind that the entire college experience results in the acquisition of critical thinking skills for all students but there is a paucity of studies to find differences among majors andalso, follow-up studies of graduates’ critical thinking skills.
ORGANIZATIONAL FRAMEWORKS AND CONCEPT ANALYSIS AND MAPPING
Learning Activities:Lecture, discussion, clinical practiceLocation of Content:Nursing theory classes, lab, andclinical settingsContent:Leadership characteristics andprocesses, collaboration theoriesand practice Interpersonal Collaboration 96 against them relate to the lack of freedom they provide for the learner and for the teacher whose role is to empower the learner. In addition to a choice of the format of the statement of purpose or goal for a nursing program, that is, global or behavioral, there are certain components belonging to pro-fessional nursing education that faculty may wish to consider and include, if not explic- itly, implicitly.
PROGRAM OF STUDY
Course objectives follow the course description, and are learner centered, based on the content of the course, their place in the curriculum plan, relationship to the level andend-of-program objectives, and relevance to the organizational framework. Organizing Frameworks/ConceptAnalysis/Mapping What is the organizing frameworkor concept map for the curriculum and how does it reflect the mission The curriculum has an organizing framework or concept map thatreflects its mission and 101Components Questions for Data Collection Desired OutcomesStudent-Learning Outcomes orEnd-of-Program and Level Objectives Are the mission, overall goal or purpose, and organizationalframework reflected in the objectives?
DEFINITION OF LEARNING
Since the concept of change is inherent in the concept of learning, any change in behavior implies that learning is taking place or has taken place. Learning that occurs during the process of change can be referred to as the learn- ing process.
In this theory, the role of the educator is to provide a stimulus, manipulate the environment,and merely transfer the information to the student. Attention requires students to identify whom they want to observe as their model; reten- tion occurs when students observe the behavior and the outcomes; reproduction occurswhen students are able to mimic the behaviors; and motivation occurs when students decide whether or not to continue the behavior based on the response they received (War-burton et al., 2016).
In the process of developing Bloom’s taxonomy, the group deter-mined that evaluation of learning must be considered through the domains of learning: cognitive—focused on knowledge; psychomotor—focused on hands-on learning andskills; and affective—focused on feelings, values, and beliefs (Halawi, McCarthy, &Pires, 2009). While this chapter briefly outlines Bloom’s work, a detailed account of the work can be found in the publication of The Taxonomy of Educational Objectives, Handbook 1: Cognitive Domain (Bloom, 1956).
CRITICAL THINKING CONCEPTS
In a scoping review of the literature, Zuriguel Pérez and colleagues (2015) con- cluded that critical thinking in the nursing profession is very different than criticalthinking in other professions. While critical thinking is often an umbrella term that includes a complex list of aspects necessary for nurses to possess both in and out of the clinical setting, expertsconclude that engaging students and using active learning strategies is an effective approach in teaching students to “think like a nurse” (Alfaro-LeFevre, 2013; Ward &Morris, 2016).
STUDENT-FOCUSED INSTRUCTIONAL STRATEGIES
All of these factors affectthe kinds of programs that are offered at schools of nursing, the content of the curricula, and the way that faculty teach in nursing education. The Tri-Council for Nursing (2010), a coalition of nursing organizations including the AACN,American Nurses Association (ANA), American Organization of Nurse Executives(AONE), and NLN issued a policy statement calling for a more highly educated nurs- ing workforce as a means to meet the nation’s need for safe and effective patient care.
ASSOCIATE DEGREE PROGRAMS
Haase (1990), in describing the sequence of events leading to the development of associate degree programs, states that in 1948, theCommittee on the Functions of Nursing made a recommendation that nursing practice consist of two tiers of nurses, one professional and the other technical. When developing or revising the mission and philosophy statements, the faculty and leaders of the nursingprogram should develop the program’s mission in relation to those of the institution.
The composition of the group that will be leading the work is of primary importance to the success of the endeavor, and the mem-bers should be selected with intention. A strong team includes a diverse group of tenured and untenured faculty members with various areas of expertise and backgrounds whoare committed to the goal, motivated to do the difficult work of curriculum develop- ment, and able to work collaboratively through the process of change (Robert Wood John-son Foundation, 2014).
COMPLETING THE CURRICULUM DEVELOPMENT PROCESS
THE INCLUSIVE CURRICULUM: PAYING ATTENTION TO DIVERSITY
Kellett and Fitton (2016) recommend a foun- dation of inclusive information systems and the creation of gender-neutral safe placesto promote a culture of inclusion for the transgender student. And finally, admissionand progression requirements for incoming students that support or, conversely, disad- vantage those who were educated in another country or are multilingual nonnativeEnglish speakers will shape the student body and affect the quality of learning for all the students.
INTERPROFESSIONAL EDUCATION: PREPARING FOR COLLABORATIVE PRACTICE
In response to safety and quality standards in health care and a vision for accessible, patient-centered care, AACN collaborated with leadership from other professional organi-zations to develop competencies for interprofessional practice (Interprofessional EducationCollaborative Expert Panel, 2011), which were integrated into the Baccalaureate Essentials(AACN, 2008). The World Health Organization (2010, p. 7) stated that interprofessional education (IPE) “occurs when students from two or more professions learn about, fromand with each other to enable effective collaboration and improve health.” Health profes- sions schools are developing models for IPE in classroom, simulation, and, more recently,clinical and community settings.
TRANSITION TO PRACTICE
The goal of transition programs is primarily to facilitate professional formation and socialization into the culture of the health care organization, assist the new graduate todevelop clinical competency, improve recruitment retention, and reduce orientation costs for the employer. Programs may be situated prior to graduation or following, and includeeducational and psychosocial support strategies such as mentoring, preceptor training, clinical coaching, expanded orientation, clinical and professional skill development,classes, and other learning and support activities targeted at the needs of the develop- ing professional (Hopkins & Bromley, 2016; Olson-Sitki, Wendler, & Forbes, 2012).