Innovations in community-based nursing education: transitioning faculty.

The health-care climate is changing rapidly and in ways that challenge the abilities of professionals who provide health care. Nursing educators are preparing professional nurses who can think critically, use sound clinical judgment, and participate as full partners in shaping health-care delivery and policy. Therefore, many schools of nursing, including five schools of nursing whose experiences are synthesized in this article, are revising their curricula to a community-based nursing perspective. Strategies to assist faculty in the transition to a community-based nursing curriculum include using change theory, creating a supportive environment, reducing tension and isolation, and evaluating. Potential challenges during transition include addressing grief and loss, overcoming the tedium of curricular development, moving the revision along while allowing opportunities for faculty input and consensus building, exploring alternative pedagogies, managing faculty workload and qualification issues, and preparing for transition. Outcomes include a more complete understanding of the community client as a partner in the delivery of health care, increased visibility and role modeling to potential future candidates for health careers, cultural transformations within a university, and promotion of the overall health of a community.     

Reconfiguring a curriculum for the new millennium: the process of change

Over the past decade, changing demographics, new technology, an increased focus on health promotion, and radical shifts in health care reimbursement have significantly impacted the nursing role. The purpose of this article is to review the process of change at one university as its curriculum evolved from an integrated acute-care focus to a community-based, health promotion framework. A review of the literature and survey data from students, alumnae, faculty, other universities, and curriculum consultants laid the groundwork for this process. Curriculum generation followed guided by data analysis, template design and revision, values clarification, sacrificing "sacred cows," and consensus building. Implications for nursing and nursing education are explored.     

Modular Curriculum Development in Community Health Nursing

Integrated curricula for baccalaureate education in nursing have many advantages but present problems for faculty. Several problems were identified in our community health nursing curriculum. For example, difficulty coordinating theory with clinical practice, lack of structural organization for the curriculum, inadequate coverage of key areas such as epidemiology and community assessment, and lecture format made it difficult to meet the learning needs of different student groups such as returning registered nurses and other adult learners. A modular community health nursing curriculum was developed. Not only were the instructional problems resolved, but satisfaction with the curriculum was expressed by both faculty and students.     

A conceptual model to support curriculum review, revision, and design in an associate degree nursing program

In light of declining NCLEX-RN first-write pass rates and the National League for Nursing call to transform nursing education, faculty at an associate degree nursing program in the southeastern United States began the process of intensive critique of its curriculum and program outcomes. Based on in-depth analysis and assessment of program outcomes, a conceptual framework was created to guide curriculum revision, development, and implementation processes. The framework serves as a guide for ongoing and systematic curriculum review and revision based upon evaluation findings. The basis of the conceptual framework was the result of an extensive literature review and an incorporation of the faculty-created philosophy.     

Leadership's role in curriculum revision

Often times, faculty are hesitant to make curricular revisions due to the many obstacles they may encounter. Varying levels of faculty expertise can also play a role in curriculum revision; seasoned faculty can fear change or believe change is not necessary and novice faculty are not equipped to be fully participatory in the process. It takes an effective leader to recognize the challenges, address the faculty, and have open, transparent communication throughout the process to ensure curriculum is kept current to reflect best practices.     

Teaching undergraduate students community nursing: using action research to increase engagement and learning

Nurses play a pivotal role in responding to the changing needs of community health care. Therefore, nursing education must be relevant, responsive, and evidence based. We report a case study of curriculum development in a community nursing unit embedded within an undergraduate nursing degree. We used action research to develop, deliver, evaluate, and redesign the curriculum. Feedback was obtained through self-reflection, expert opinion from community stakeholders, formal student evaluation, and critical review. Changes made, especially in curriculum delivery, led to improved learner focus and more clearly linked theory and practice. The redesigned unit improved performance, measured with the university's student evaluation of feedback instrument (increased from 0.3 to 0.5 points below to 0.1 to 0.5 points above faculty mean in all domains), and was well received by teaching staff. The process confirmed that improved pedagogy can increase student engagement with content and perception of a unit as relevant to future practice.     

Moving cemeteries: a framework for facilitating curriculum revision

The process of revising a nursing curriculum can be accompanied by self-oriented faculty behaviors such as inflexibility, indifference, and territoriality. The authors, who served as members of a curriculum revision task force, suggest the need for planned, intentional, and goal-directed approaches when revising an academic program. Lancaster's six components of research by committee are used as a framework to offer insights for enhancing.     

The clinical home community: a model for community-based education

BACKGROUND: Escalating health care costs, racial inequities and socioeconomic disparities have limited access for many to even the barest of health care services. The paradigm shift to a health promotion, disease prevention, and health restoration model within a community-based framework demands greater integrated learning experiences for nursing students that are centred where clients live, work, and play. AIM: To describe the process of developing, implementing and evaluating a rural New England University's experience of piloting a clinical home community model within its existing baccalaureate curriculum. CONTENT: The model describes how it is possible to break free from traditional acute care settings in hospitals and mental health institutions. Students are provided with maternal-child and adult mental health experiences that are available in a targeted clinical home community setting where consumers are increasingly seeking health care. The concepts that directed curriculum revision from a traditional to a community-based educational framework are discussed. OUTCOMES: Strengths and limitations of the model are presented within the context of student, faculty and consumer partnerships. Implications for global development of the clinical home community model in nursing are proposed.     

Order out of chaos: the use of a matrix to validate curriculum integrity

The rapid pace of change in the health care system now mandates that curriculum design be a dynamic, living process. A structural grid, or matrix, that lists the nursing courses and the major concepts identified in the philosophy and the theoretical framework was developed by the nursing faculty. The matrix is a visual representation of the curriculum concepts and how they are implemented in each course. The matrix serves as a reference point to validate that the essential knowledge for safe practice and new developments in nursing are being taught. The matrix is a living document, expected to evolve, that validates the integrity of the curriculum and confirms that faculty are "teaching what they say they are teaching."     

Using an admissions exam to predict student success in an ADN program

Nursing faculty strive to admit students who are likely to successfully complete the nursing curriculum and pass NCLEX-RN. The high cost of academic preparation and the nursing shortage make this selection process even more critical. The authors discuss how one community college nursing program examined academic achievement measures to determine how well they predicted student success. Results provided faculty with useful data to improve the success and retention of nursing.     

A new curriculum for a new millennium.

In the last few years of the 20th century, many factors converged at Auburn University School of Nursing, giving faculty the opportunity to explore beliefs about curriculum and the nursing profession's role in the 21st century. The result of this opportunity was the creation of a new curriculum that brings to life the conviction that nursing is not bound by the 4 walls of a hospital, but is a humanistic discipline that can be practiced anywhere. This article explains the intersection of variables that influenced the development of a new curriculum, including the call by nursing leaders for educators to drastically change their approach to the education of students. We describe the process of developing a community-based curriculum, with innovative examples of clinical and theory experiences on a semester-by-semester basis. Strategies to address obstacles to implementation of a community-based curriculum are included.     

Graduate home health education: a survey of home health educators and agency personnel.

To determine if there is a body of essential content that should be common to master's-level home care programs, a purposive sample of 200 nurses involved in home health or community health nursing was selected. The respondents (N = 118), including faculty and educational administrators (N = 61) and supervisors and administrators of home health agencies (N = 57), were asked their perceptions of the knowledge needed and their priorities for curriculum content for master's-prepared home care specialists in both clinical and administrative roles. There was agreement in most content areas, but significant differences were found between faculty and agency personnel in their priorities for community health concepts, and in their evaluation of nursing theory and epidemiology as essential content in both roles. We believe these results have important implications for nurse educators. As schools prepare students for leadership roles in today's home care environment, it is critical that pertinent content be well integrated into the curriculum.     

Education/community collaborations for undergraduate nursing gerontological clinical experiences.

In 2000, the American Association of Colleges of Nursing and the John A. Hartford Foundation Institute for Geriatric Nursing developed guidelines to help nurse educators incorporate gerontological nursing content into baccalaureate curricula. In 2001, the Hartford Foundation also provided grant monies to nursing programs to support gerontology curricular innovations and new clinical experiences. The funding allowed faculty to focus time, energy, and resources on gerontological nursing education. We, the authors, representing two funded schools of nursing, collaborated with community agencies to develop undergraduate gerontological clinical learning experiences and are encouraged by the results. This article describes the development of these collaborations and serves as a model for other schools of nursing. The education/community collaborations described here focus on clinical learning strategies, implementation activities, and outcomes/benefits of the experiences. Both educational programs had supportive administration, faculty willing to participate in curriculum change, organized plans to implement geriatric curricular enhancement, and long-standing community partnerships.     

Community health nursing clinicals: an examination of the present and ideas for the future.

As part of a curriculum revision for a baccalaureate school of nursing, a nationwide survey examined how schools of nursing structure community health nursing (CHN) clinical experiences. Results indicate that a wide variety of settings and agencies (public health departments, schools, clinics, home health, and many more) are being used. Use of preceptors, use of multiple and single agencies, observational visits, time scheduled, projects, and faculty philosophy of CHN were examined. Although many settings, courses, and projects are traditional, this study reveals that some nursing schools are responding to changes in health care and population needs and are structuring CHN clinicals accordingly. Ideas for clinical courses for the future are offered.     

Faculty as a community engaged with ongoing curricular development: use of groupware and electronic resources

This article describes how technology can facilitate faculty engagement in curriculum development, use faculty time efficiently, and ensure program quality. A plan to initiate an accelerated second-degree bachelor of science in nursing option was the impetus for use of groupware electronic strategies to support faculty as valued members of the academic community, engaged in the undergraduate program and its curriculum. This article describes the two Web-based applications (electronic-based strategies) developed: the curriculum development homepage as a collaborative communication tool, and a curricular tracking tool.     

Models of nursing as the basis for curriculum development: some rationales and implications

Within this paper the notion of a model of nursing as a basis for curriculum development is explored. Firstly the factors which a curriculum developer in nursing might take under initial consideration are discussed. It is then argued that a nursing faculty must identify and define its conceptualization of nursing and what it is to be a nurse. The process of conceptualizing nursing itself is examined. The paper goes onto argue that once a nursing faculty has reached a consensus view as to what constitutes nursing, then it either designs or selects a model of nursing which supports their particular conceptualization. Educational literature is cited to support the view that curriculum design, process and content are interrelated and that student learning is facilitated when the relationship between these three factors is coordinated. It is suggested that a nursing curriculum can achieve such an integration if a model of nursing is used as the conceptual framework. Finally some of the implications of adopting a model of nursing are stated.     

Capturing the curriculum: a curriculum maturation and transformation process

The author discusses an approach to successful curriculum revision that provides faculty with a renewed sense of individual and collective ownership of curriculum change. The framework for curriculum revision includes the components of commitment, change, collaboration, collegiality, consensus, communication, closure, and celebration, and the processes used to actualize these concepts.     

Planning nursing education for the 21st century

In looking towards the 21st century, the faculty at the Presbyterian Hospital School of Nursing, along with the Presbyterian Health Services Corporation and Queen's College, adopted a 1-2-1 programme The process of developing a new nursing curriculum is presented as the task force proceeded from the philosophy and goals to conceptual framework and curriculum objectives After discussions with nurse administrators and educators, extensive literature reviews and brainstorming sessions, concepts and subconcepts were chosen to form a philosophy The metaparadigm of nursing and other related concepts were then organized into a conceptual framework Ongoing communication and feedback from the faculty ensured group ownership of all documents The eclectic organizational scheme was a good fit for a large faculty with differing beliefs and values about a nursing curriculum The process of developing a future orientated nursing curriculum has been exciting, challenging and rewarding The faculty is committed to the new philosophy, goals and conceptual framework and believe that the 1–2–1 programme will educate future practitioners who are prepared to meet the challenges and changes in health care for the 21st century     

Changing to a conceptual base curriculum

The movement of undergraduate nursing education from the hospital to tertiary institution in Australia has highlighted the need for nursing to develop curricula that reflect a more rigourous academic basis and the universality of nursing care. This change demands that nursing faculty must articulate a philosophy and concept of nursing upon which to base a curriculum in order to meet present and future needs of society for health care. The faculty in the School of Nursing of Curtin University of Technology in Western Australia has responded to this challenge and is currently in the process of implementing its conceptual model of nursing.     

Concept mapping a baccalaureate nursing program: a method for success

The understanding of curricular design and development is paramount for faculty. For novice faculty, learning teaching methods commonly takes precedence over understanding curriculum development. Professional accrediting bodies of nursing programs require curriculum course content to be pertinent and flow logically. Baccalaureate nursing programs can choose to be accredited by the Commission on Collegiate Nursing Education. The purpose of this article is to describe an educational innovation that one College of Nursing implemented to orient new faculty to the curriculum and prepare for an accreditation renewal. Assigned faculty developed and implemented a concept mapping process aimed to evaluate and revise course content based on national standards and guidelines. Undergraduate faculty understanding and ownership of the curriculum was evident throughout the process. The concept mapping process proved to be an innovative approach to enhance the curriculum and equip faculty with an understanding of the relationship between concepts and course content.