Curriculum revision: making the process work

This paper presents the experience of one nursing faculty in revising a baccalaureate programme for registered nurses. Mechanisms used to facilitate the process of curriculum revision and to promote involvement of community agencies as well as faculty members and students are discussed. These mechanisms include use of a core co-ordinating group (curriculum co-ordinator, consultant in instructional development, administrative support person) to guide the process, acceptance of a draft of nursing theory content before proposing specific courses and student and community agency representation on course-development committees. The revision process is then analysed in relation to change theory. Particular attention is given to the concepts of involving all those affected by the change, maintaining open and effective communication and factors which minimize resistance.     

Is gerontological nursing included in baccalaureate nursing programs?

There is a significant effort to include gerontological nursing in baccalaureate nursing programs, but there needs to be continuous evaluation as to the nature and extent of this content. The four stages of the Curriculum Process Model (directive, formative, functional, and evaluative) provide a logical and systematic approach for developing or revising a curriculum. Although the status of gerontological nursing content, faculty preparation, and clinical settings for gerontological experiences have improved, they still do not provide the necessary educational background for students.     

Dual degree. Future preparation for nurse executives?

What is the best educational preparation for top-level nurse executives? Which educational degrees will improve marketability? These questions were asked of nurse executives and their chief executive officers in a national market survey. The authors discuss the results of the survey which provides information that may be useful in selecting educational programs and in planning and revising graduate curriculum.     

Integrating service learning into the RN to BSN curriculum with the application of QSEN competencies

To accomplish the goal of a more highly educated nursing workforce, academic nursing has supported a significant increase in the number of RN to BSN programs. The focus of educating practicing registered nurses is moving toward revising and designing curriculum that promote positive patient outcomes and supports contemporary healthcare practices. Facilitating a service-learning model for RN to BSN curricula and applying the Quality and Safety Education in Nursing (QSEN) competencies are two effective methods for enhancing professional practice. The purpose of this article is to promote the concept of integrating service learning into the RN to BSN curriculum and applying the QSEN competencies to learning activities to achieve improved quality and patient safety.     

Components of the doctoral curriculum that build success in the clinical nurse researcher role

Increasing numbers of hospitals and medical centers are creatively allocating positions for clinical nurse researchers. Since this type of position offers an outstanding opportunity to develop and test nursing theory, as well as to conduct and apply nursing research, it is important that doctoral programs provide students with the skills required to implement a research role within the context of a hospital organization. The purpose of this article is to demonstrate how doctoral programs in nursing can develop the foundation graduates need to implement the clinical nurse researcher role, not necessarily by revising the curriculum, but by adding occasional single seminars, guiding students to specific learning experiences, and deliberately emphasizing the links between course content and role applications.     

NCLEX-RN pass rate peril: one school's journey through curriculum revision, standardized testing, and attitudinal change

Processes used by a university to reverse the downward spiral of NCLEX-RN pass rates are described. Reasons for poor pass rates were found to be multifaceted and included gaps in curriculum content, student attitudes toward taking the licensure exam, delays in taking the exam following graduation, inadequate student preparation for taking standardized exams, and inappropriate and ineffective exit examinations. Various strategies for reversing the trend of the NCLEX failure rate included: addressing areas of weakness in the curriculum; revising courses; engaging students; changing standardized exit exams; employing a midcurricular and other standardized exams; and implementing remedial courses for poor performance on standardized exams. Change was effected and pass rates on the NCLEX-RN improved dramatically. Future possibilities and proactive measure are described.     

Pediatric Emergency Medicine Fellow Training in Ultrasound: Consensus Educational Guidelines

The importance of point‐of‐care emergency ultrasound (EUS) to the practice of emergency medicine (EM) is well established, and mounting research continues to demonstrate how EUS can benefit pediatric emergency department (ED) patients. As members of the EM community, pediatric EM (PEM) physicians should understand the potential value of EUS and seek opportunities to incorporate EUS into their daily practice. Currently, EUS education and training is at an early developmental stage for PEM fellows and varies greatly between programs. The goal of this article is to provide consensus education guidelines and to describe a sample curriculum that can be used by PEM fellowship programs when developing or revising their US training curricula. The authors recognize that programs may be at different stages of EUS development and will consequently need to tailor curricula to individual institutional needs and capabilities. This guideline was developed through a collaborative process between EUS educators and members of the American Academy of Pediatrics Section of EM Fellowship Directors Subcommittee. The guideline includes the following topics: important considerations regarding EUS in PEM, PEM US program framework, PEM US curriculum, PEM US education program, and competency assessment.     

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.     

Using video podcasting to enhance the learning of clinical skills: A qualitative study of physiotherapy students' experiences

BackgroundVideo podcasts, or vodcasts are increasingly used by a range of healthcare professions in the mastery of new skills. Little is known about the experiences of using vodcasts in physiotherapy education. Traditional pedagogic strategies have been employed in order to master those skills required for physiotherapy practice. There have been advances in the use of technology in medical education in the nursing, dentistry and medical fields. Vodcasts offer great versatility and potential when used as a pedagogical tool, embedded within a physiotherapy curriculum.AimTo explore students' experiences of using technology enhanced learning, namely vodcasts, in the Physiotherapy curriculum to develop the learning of clinical skills.MethodA series of focus groups were carried out with undergraduate and pre-registration physiotherapy students (n = 31).FindingsStudents valued the versatility and audio-visual nature of vodcasts; helpful in revising for practical examinations and practising their skills prior to, during and after taught skills classes. Watching and practising simultaneously allowed students to practice repeatedly and formulate a process for each skill. When learning a new skill, a combination of teaching and learning approaches was favoured, marrying traditional approaches with those that utilise technology.ConclusionsThis study's findings add to the existing body of evidence in skills based teaching and support a multi-media, blended approach in those disciplines involved in the learning and teaching of clinical skills.     

Web-based video and feedback in the teaching of cardiopulmonary resuscitation

Knowledge and skills relating to cardiopulmonary resuscitation tend to be lost over time. The combination of simulation sessions with online video records and online feedback allows for an enduring record of skills sessions to assist students in retaining and revising their learning. This paper reports a qualitative evaluation of such a combination used in inter-disciplinary sessions for volunteer nursing and medical students. Methods included focus groups and free text questionnaires; data were gathered from fourteen students and three teachers. Students had used the online material in a variety of personal ways, and found that the addition to their learning was significant. Their memories of the simulation sessions and of the feedback received immediately afterwards were incomplete, and repeated viewing enabled them to identify good and poor practice with more confidence, and to reflect more carefully on their own and others' practice. Teachers found it easier to give more detailed feedback when given the chance to watch the video than immediately after the session. All felt that the sessions would ideally be embedded in the curriculum.     

上海市康复护理床位外科患者入住、转出评估标准的研究

目的制定上海市康复护理床位外科患都入住、转出评估标准。方法采用质性访谈的方法对7名临床外科专家、1名康复学专家和2名护理学专家进行半结构式深入访谈;采用Delphi法对上海市15家综合医院105名外科专家就初拟的上海市康复护理床位外科患者入住、转出评估标准进行2轮专家函询。结果经过质性访谈,初步拟定上海市康复护理床位入住、转出评估标准。结论经过函询,对初拟标准进行修订,最终确定该评估标准。     

In-home obesity prevention in low-income infants through maternal and social transmission

BackgroundExtant obesity efforts have had a limited impact among low-income underserved children, in part because existing programs are limited in terms of their short duration and low dosage, limited accessibility and sustainability; and failure to address barriers faced by diverse low-income families.MethodsThis two-arm, parallel, randomized controlled trial (RCT) tests whether delivering obesity prevention, as part of an ongoing home visitation program (HVP), is an effective approach for primary (infants) and secondary (mothers) obesity prevention among low-income, underserved families. This RCT further examines the role of maternal and social factors as key mechanisms of transmission of infants' obesity risk, and the real-life costs of delivering obesity prevention as part of HVPs. Specifically, 300 low-income mothers/infants (6mo at baseline) participating in the Healthy Families America home visitation program in Antelope Valley (CA) will be recruited and enrolled in the study. Home visitors serving families will be randomly assigned to deliver the standard HVP curriculum with or without obesity prevention as part of their weekly home visits for two years. Anthropometric, metabolic and behavioral assessments of mothers/infants will be conducted at enrollment and after 6 and 18 months of intervention.DiscussionThis study addresses the need to develop interventions targeting at-risk infants before they become obese. The proposed research is timely as the Institute of Medicine, the United States Department of Agriculture, and the Department of Health and Human Services are revising their recommendations to address key factors influencing obesity risk in children from birth to 24 months of age.     

Conceptual frameworks and patterns of nursing curriculum

Common concepts of conceptual frameworks and curriculum patterns are identified by studying all 18 English-speaking, generic baccalaureate nursing programmes in Canada. Four identified curriculum patterns use client systems, health-illness, growth and development, and nursing roles as the primary curriculum organizer to sequence programme courses. The nursing programmes commonly use nursing process, followed by growth and development, human needs, and family as secondary organizers to structure contents of programme course. Identifying a curriculum by its organizers is useful to curriculum practice and research. Nursing faculty can use the identified organizers as primary or secondary organizers in designing, changing or evaluating their curriculum. It is also possible to use a nursing model with the identified organizers for an effective curriculum structure. Research studies on conceptual frameworks could use primary and secondary organizers to compare strength and weakness among different nursing curriculum structures.     

上海市康复护理床位外科患者入住、转出评估标准的研究

目的 制定上海市康复护理床位外科患者入住、转出评估标准.方法 采用质性访谈的方法对7名临床外科专家、1名康复学专家和2名护理学专家进行半结构式深入访谈;采用Delphi法对上海市15家综合医院105名外科专家就初拟的上海市康复护理床位外科患者入住、转出评估标准进行2轮专家函询.结果 经过质性访谈,初步拟定上海市康复护理床位入住、转出评估标准.结论 经过函询,对初拟标准进行修订,最终确定该评估标准.     

The Curriculum Blueprint: An Application to Nurse Practitioner Education

A psychometric model for the construction of examinations (the test construction process) is adapted as a conceptual framework for curriculum design. The outcome of the process, the curriculum blueprint, is proposed as particularly advantageous for nurse practitioner education, which is somewhat unique among nursing specialties in its need to accommodate the competing demands of several regulatory or educational approval bodies that influence the content of its curriculum. The curriculum blueprint provides a visual dimension and therefore is useful as a communication tool. An excerpted example of a curriculum blueprint is offered.     

Using research to establish protocols for practice: a statewide study of acute care agencies.

The purpose of the study was to examine research utilization practices relative to developing and revising practice protocols in acute care agencies in Delaware. Nurse leaders in 13 acute care agencies identified resource nurses most familiar with the development and revision of agency protocols. Thirty-two resource nurses from 11 agencies, representing critical care, emergency, general medical, general surgical, obstetric, and psychiatric nursing, were interviewed. Interviews were tape-recorded and transcribed. Examples of research-based protocols, defined as those supported by research citations, were obtained. The authors found that the majority of protocols submitted, although referenced, were not research-based. Most institutions used textbooks and standards to support nursing practice protocols. The authors concluded that nurses who are responsible for developing and revising agency protocols were not familiar with the use of research findings to guide the development or revision of protocols and were unsure what constituted the "use of research."     

Designing a Patient Safety Undergraduate Medical Curriculum: The Telluride Interdisciplinary Roundtable Experience

Purpose: Patient safety has emerged as a global concern in the provision of quality health care, and yet, to date, few medical schools have created and/or implemented patient safety curricula. The purpose of this article is to introduce readers to one model of a patient safety undergraduate medical curriculum, as designed by a group of experts attending an annual interdisciplinary roundtable assembled for this purpose. Summary: The Annual Telluride Interdisciplinary Roundtable met in 2005 and 2006 to design what it considered to be a comprehensive patient safety curriculum for medical students. Invited members included stakeholders from a variety of fields, including health care providers, senior health care administration, students, residents, patient advocacy leaders, and curriculum development/assessment experts. The group developed a list of general curricular principles, followed by 11 specific elements felt to be essential to an effective patient safety curriculum for undergraduate medical education students. It also identified a number of challenges to implementing such a curriculum. Conclusions: A patient safety curriculum, developed by a group of experts for an undergraduate medical education population, was successfully developed over a two-year period of time. Future meetings of the Telluride Roundtable group have centered on evaluation and refinement of these curricular elements as pilots occur in a number of medical schools, and new curricular ideas continue to be developed. Continued interprofessional dialogue and collaborative research will enable the development and implementation of a standardized longitudinal patient safety student curriculum.     

骨科健康教育临床路径内容的研究

目的 提高骨科健康教育的有效性,使骨科患者早日康复。方法 通过成立骨科健康教育临床路径小组,采取书写、修改、临床应用、再修改、定稿的方式完成了共性与专病健康教育临床路径表及落实检查登记单。结果 经临床试用,每种疾病的路径表针对性强,既有文字又有图片,有利于患者的学习,也对护士的工作起指导作用,一方面提高教育的知晓率,另一方面提高护士的工作效率。结论 研制科学、统一的骨科健康教育临床路径内容,能够为护士提供一条有效的教育途径,为骨科患者提供更优质的服务。     

Integrating what is taught with what is practised in the nursing curriculum: a multi-dimensional model

The discrepancy between nursing as it is taught in the classroom (theory) and nursing as it is experienced by students in the clinical setting (practice) has long been a source of concern to teachers, practitioners and learners This paper provides an overview of the literature on the theory-practice gap, exploring some of the many reasons cited for its existence as well as suggested ways of bridging the gap Drawing upon the findings, a comprehensive and multidimensional model designed to integrate theory and practice of nursing is proposed for use by curriculum planners Fundamental to the model is the notion of collaboration between education and service staff at all stages of the curriculum process The model highlights eight key areas for the curriculum team to consider the curriculum model to be used, sequencing of taught content and clinical practice, the content of the course, teaching methods to be used, assessment criteria, the role of tutors in the learning process, the contribution of service staff, and the influence of the hidden curriculum It is argued that only through such a comprehensive model can integration of theory and practice within the curriculum be achieved Adoption of the model, however, will require considerable individual and organizational commitment