A curriculum is a methodical arrangement of the total summation of experiences tailored by a school for a specific group of students to achieve the aspirations of a particular educational program. In other words, a curriculum is a runway for achieving pre-determined educational goals, and it is seen as an outline for an educational program. Nursing curriculum means the learning prospects as well as the learning activities that include clinical experiences and practices that the teaching staff plans and puts into practice in diverse settings for the nursing students, for a specific time frame to achieve specific objectives. Apart from defining the nursing curriculum, the paper will discuss the impacts of current societal attributes as well as student attributes and needs on the current nursing curricula.
Definition and Conceptualization of Nursing Curriculum
Definitions of a curriculum have existed since about the 1820s. They were first used in Scotland, then later adopted professionally in the USA a century later. The word itself originates from Latin currere, to run a course. Initially, it meant the knowledge passed from generation to the next. A common understanding of a curriculum is a series of studies with precise courses, leading to academic certification that might either be a diploma or a degree. The scope and interpretation of the curriculum have greatly expanded due to many definitions as a response to social forces, creating uncertainty and discrepancy in the meaning of the original word. Nonetheless, definitions are significant since they express educators’ view that will affect how a curriculum is applied. Furthermore, the definitions detail the range of work to be completed by the curriculum developers. Regardless of the different definitions and conceptions, a nursing curriculum is implemented with the intention that learning takes place.
The nursing curriculum can be conceptualized as either evidence-informed, context-relevant, or unified. In this context, a nursing curriculum is defined as the entirety of the theoretical methods, the curriculum goals, overall plan, policies, resources, and evaluation methods. The curriculum encompasses all matters within the authority of school that affect learning and progression of nursing students. An evidence-informed nursing curriculum is based on methodically and resolutely collected evidence about the context of the subject matter offered, students, learning, teaching, nursing education, and practice as well as clients and their responses to health situations. The evidence collected is interpreted by curriculum developers who will then create and appraise plans to the realities of the school. An evidence-informed curriculum is ever- changing and developing as new evidence emerge. The curriculum remains up to date due to continuous modification.
A context-relevant nursing curriculum is one that is responsive to the present and expected societal, health, and community circumstances of the nursing students as well as the present and expected essentials of the nursing profession. It also aligns with the mission, viewpoint, and goals of the school of nursing, and it should be feasible within the realities of the institution as well as the community. This type of nursing curriculum is characterized by and based on the forces that influence society, health care system, learning, nursing students, and the school of nursing. Although the nursing curricula of many schools will appear comparatively similar, those that are strongly context-based will have distinct characteristics that reflect their local circumstances.
A unified curriculum contains components that are theoretical, reasonably, cohesively, and visibly relaxed. Philosophical methods and professional abilities, as well as curriculum concepts, are apparent in the curriculum goals. The level and course learning objectives are drawn from the curriculum goals. Moreover, the course title reflects the practical methods and curriculum concepts, and the learning strategies are in line with the goals, and the practical and educational methods. All the three models of a nursing curriculum are based on evidence regarding nursing education, practice, and nursing students as well as societal and institutional circumstances.
Stakeholders for a Nursing a Nursing Curriculum
Involvement of stakeholders in developing a nursing curriculum helps to minimize the gap between the practicing professional nurses and the demands of stakeholders. In most cases, the stakeholders require to be involved in the curriculum development process to ensure that nursing students are educated well enough to meet their demands.
There are many stakeholders involved in a nursing curriculum, and they include the nursing school, the government, the nursing students, the Nursing Council, protective associations, and patients as well as the practicing nurses and other healthcare providers. The patients are part of the stakeholder group because they contribute to the nursing practice and they are the end users of the system.
The nursing school or nursing faculty is the main stakeholder of a nursing curriculum as it utilizes it directly. The development of the nursing curriculum is also influenced by various institutional factors such as its mission, philosophical approaches, and the school culture. The nursing students are also significant stakeholders. They are affected by the curriculum directly and they represent the future professionals of the nursing discipline. The nursing council regulates the nursing profession through legislation and it can give self-regulatory powers to licensing entities. It also establishes and maintains educational, professional, and practice standards for the nursing profession. Through the Ministry of Health, the government is responsible for the national health care system and its agencies. There are numerous agencies that fall under the Ministry of Health. The practicing nurses and other healthcare providers are other groups of stakeholders mostly referred to as ‘Frontline’ workers in the system as they work directly with the patients.
Institutional and College/Program Mission and Vision Statements vs Curriculum Goals
Typically, nursing schools have a mission and a vision statement since it is required from them by most of the accrediting entities. The school’s mission statement should communicate its purpose and goals to the stakeholders, both internal and external ones. An institution's mission statement plays an important role in the development of a nursing curriculum and the subject-matter offered, selecting appropriate performance measure and achieving the desired learning objectives. An effective mission statement is key to the success of a nursing school. The mission statement should align with the institution’s values, create proper strategies and learning approaches, and address the necessity of changing society. The mission statement also steers the nursing school towards identified needs and encompasses a vehicle to help bring together the staff around common goals.
The mission statement, viewpoint, and the conceptual framework of the school, as well as the nursing curriculum goals and objectives, should be in line with the mandate of the nursing school and reflect present professional nursing practice values and entry level qualifications as consented by the nursing council. The mission statement should be clearly stated and should serve as a foundation for developing a nursing curriculum, applying it, and evaluating the programs through its goals and objectives. It should also be reviewed regularly and revised appropriately to reflect societally, nursing learning and practice trends both at the local, national, and the global level.
The nursing curriculum goals and objectives should be compatible with the mission and vision statements of the institution. This means that at the end of the learning process, the nursing students achieve what leads to the institutional mission. The curriculum goals and objectives also determine the learning approaches as well as the school’s culture. As such, the school mission, learning approaches, and the institutional culture are the key essentials of an educational framework for the implementation of a nursing curriculum. Curriculum goals are an expression of what successful nursing students will be able to demonstrate after completing the course, and they are also in line with the educational vision.
Philosophical Approaches/Learning Theories
Nursing is a dynamic, ever-changing discipline. As the intricacy of the patients and their perception increases, nurses play a rather all-inclusive role in the healthcare leadership as well as the patient outcomes. As the nursing practice has evolved so has the curriculum for educational programs, shifting from being based on a specific philosophical approach to a general meta-paradigm. The current approach allows focusing on meeting the content standards provided by the nursing council. The standards provided include an emphasis on values such as professionalism, continuing education, and use of EBP that tend to focus on the general roles of practicing nurses. The focus on the general roles and actions of practicing nurses provides room for curriculum metacognitive development based on critical and constructivism theories.
The Metacognitive theory is seen as a tri-part construct that encompasses self-knowledge and self-evaluation as well as applied knowledge. Research has shown that inability to practice self-evaluation leads to lower literacy abilities and teaching nursing students metacognitive skills can enable them to transfer their self-evaluation across their life experiences in the future.
Critical reflective theory, when used, gives a nursing curriculum a theoretical framework that meets various requirements of nursing education. For instance, there is a necessity to produce critically reflexive graduates who are able to engage in professional roles that include ethical activities. Critical reflexivity results from one being able to connect internally with predispositions of the postulation that often influences decision-making and nursing care. Critical theory also offers an opportunity in which the rich history of the nursing profession can be incorporated into the curriculum.
Constructivism theory is also used in the nursing curriculum. According to this theory, nursing students are able to engage in the use of applicable knowledge and link newly acquired knowledge to their past experiences. Then, they are able to connect the acquired knowledge to the nursing practice. Learning takes place as they internalize and then rebuild their realism on the basis of the gained knowledge. A good nursing curriculum is the one that applies several theories cohesively rather than focusing on a single theory.
Strands and Threads in a Nursing Curriculum
A strand or a thread in the nursing curriculum is a consistent theme studied through a course offered irrespective of its subject content and it can be grouped into two major classes, horizontal and vertical strands. Both the horizontal and vertical strands converge to form the content of a nursing curriculum. Despite that, a course can fail to integrate all strands or rather be determined by only the horizontal strand or vertical or even neither. Horizontal strands are the concepts taught in all courses, and they vary only according to factors in a given situation. Moreover, they can be viewed as the theme of a semester by some institutions. In nursing, the horizontal strands include caring, nursing process, client, and culture. Caring is a fundamental practice in nursing of looking after and attending to the needs of a person. The nursing process is a five-step procedure used to guide nurses in providing their services to patients while a client is the recipient of nursing services, such as individuals, families, and communities. Lastly, there is the culture that is the customs and practices followed by the community, within which the nursing services are being offered.
Vertical strands are the subject matter contained in the nursing courses that expand in complexity as the level advances. Normally, vertical strands are the academic ideas of a course being studied in a semester. There are several vertical strands that can be incorporated into a nursing program, and among them are critical thinking, health, communication, and professionalism. Critical thinking is a way of self-assessment, whereby the learned information is used in making knowledgeable decisions. Then, health is the constant change in the well-being of an individual throughout his or her lifetime. Communication, on its part, is the techniques used to exchange information between the nurse and the client being attended. Finally, professionalism is the competence and abilities of a nurse or the capabilities of a nurse to be an educator, activist and a care provider to the patient.
A curriculum is the methodical arrangements of all the experiences put together by an institution for a specific group of students to achieve the objectives of a given educational program. It is a way of achieving educational goals and objectives. The nursing curriculum encompasses the plans and the learning activities such as clinical experiences and practices that are applied to nursing students to achieve the learning objectives. It can be conceptualized as either evidence-informed, context-relevant or unified nursing curriculum. Nursing curricula in most institutions are relatively similar but they have distinct features that reflect their locality. Stakeholders play a very important role and they are involved in the process of curriculum development. The stakeholders in the nursing curriculum include the nursing school, the government, the nursing students, the nursing council, protective associations, and patients as well as the practicing nurses and other healthcare providers. The school’s mission and vision statements also influence the process. The philosophical theories used in a nursing curriculum include metacognitive development based on critical and constructivism theories. The curriculum also has strands and threads that are either vertical or horizontal.