1. Nursing Education and the Curriculum Revolution

2. Overview The Problem: Content Saturation in Nursing Education The Problem: Content Saturation in Nursing Education Themes from the literature Themes from the literature Causes and Contributing Factors Causes and Contributing Factors The Solution: A Conceptual Approach The Solution: A Conceptual Approach Concept-based Curriculum and Concept-based Curriculum and Conceptual Learning Conceptual Learning

3. What is the Problem? Health sciences education is experiencing content saturation; there is more content than can possibly be taught in any given curriculum. Health sciences education is experiencing content saturation; there is more content than can possibly be taught in any given curriculum.

4. Themes from the Literature AACN (1998) “…is it possible to “prepare beginning level professional nurses for the future in a four-year time frame” (p.19). AACN (1998) “…is it possible to “prepare beginning level professional nurses for the future in a four-year time frame” (p.19). Tanner (1998) questioned if the expectations set forth in Essentials was a “blueprint for 21-year curriculum” p. 383 Tanner (1998) questioned if the expectations set forth in Essentials was a “blueprint for 21-year curriculum” p. 383

5. Themes from the Literature Diekelmann (2002) “….textbooks are thicker and course content more complex. Students complain of ‘too much content’ as they appear to have reached their limits with memorization.” Diekelmann (2002) “….textbooks are thicker and course content more complex. Students complain of ‘too much content’ as they appear to have reached their limits with memorization.” IOM (2003) specifically cites “overly crowded curricula” as one of many challenges in health education reform (p. 38). IOM (2003) specifically cites “overly crowded curricula” as one of many challenges in health education reform (p. 38).

6. Themes from the Literature NLN (2003) “…..reform efforts in nursing rarely change the substance of the curriculum itself but merely ‘switch, swap, and slide content around’….” NLN (2003) “…..reform efforts in nursing rarely change the substance of the curriculum itself but merely ‘switch, swap, and slide content around’….” Ironside (2004) “The dilemma nurse educators are increasingly facing is not what to include in a course, but what to leave out” Ironside (2004) “The dilemma nurse educators are increasingly facing is not what to include in a course, but what to leave out”

7. Themes from the Literature Faculty with expertise in nursing education should “take the lead in promoting innovation and moving away from a focus on content coverage” (NLN 2005) Faculty with expertise in nursing education should “take the lead in promoting innovation and moving away from a focus on content coverage” (NLN 2005) “Generalist education at the baccalaureate level is foundational to specialty practice” (AACN 2006) “Generalist education at the baccalaureate level is foundational to specialty practice” (AACN 2006)

8. Causes of Content Saturation Information Age Information Age Changes in Health Care Delivery Changes in Health Care Delivery Teacher-centered Pedagogy Teacher-centered Pedagogy Academic-Practice gap Academic-Practice gap

9. How much information is there? The National Library of Medicine’s Medline archives 31,000 new citations per month. It is estimated that a clinician would need to read 17 articles a day every day of the year simply to remain current in their field of practice (Hall & Walton, 2004). The National Library of Medicine’s Medline archives 31,000 new citations per month. It is estimated that a clinician would need to read 17 articles a day every day of the year simply to remain current in their field of practice (Hall & Walton, 2004).

10. Changes in Health Care Delivery Shift in focus from inpatient/acute care to community focused care. Shift in focus from inpatient/acute care to community focused care. Problem not in change in focus, but the failure of nursing education to eliminate content. Problem not in change in focus, but the failure of nursing education to eliminate content.

11. Conventional Pedagogy “Filling the Pot” Ongoing “love affair” with teacher centered learning (makes us look and feel really smart!) Ongoing “love affair” with teacher centered learning (makes us look and feel really smart!) Teacher is responsible to ensure all content is delivered (passive learning experience). Teacher is responsible to ensure all content is delivered (passive learning experience). Focus is on content. Focus is on content. “If I don’t cover the content, students won’t learn it” “If I don’t cover the content, students won’t learn it”

12. Academia – Practice Gap Nursing practice wants graduates who are prepared to enter specialized settings. Nursing practice wants graduates who are prepared to enter specialized settings. “Core Competencies” for undergraduate nursing education have been recommended from many nursing practice specialty groups. “Core Competencies” for undergraduate nursing education have been recommended from many nursing practice specialty groups. Some faculty groups feel these should be added to curricula. Some faculty groups feel these should be added to curricula.

13. More is Not Better! When focus is on content, the volume of content covered is high, but the retention of information is low……… When focus is on content, the volume of content covered is high, but the retention of information is low………Why? Because of a failure to accomplish deep learning/deep understanding.

14. Covering too much content tends to cover the concept! CONCEPT

15. Solutions: Conceptual Approach Concept-based Curriculum Concept-based Curriculum Conceptual Learning Conceptual Learning

16. What is a Concept? A concept is an organizing principle or a unifying classification of information. A concept is an organizing principle or a unifying classification of information. CONCEPT

17. Concept-Based Curriculum: What is it? Concepts provide organizational structure for curriculum and are the focus within courses. Concepts provide organizational structure for curriculum and are the focus within courses. Concepts drive content. Concepts drive content. Important that concepts are not too vague to be useful. Important that concepts are not too vague to be useful.

18. A Recycled Idea? Concept curriculums of the past Concept curriculums of the past Concepts vague and not useful Concepts vague and not useful Lack of specific exemplars Lack of specific exemplars Failure to show inter-relationship of concepts Failure to show inter-relationship of concepts Concepts did not bridge into clinical courses Concepts did not bridge into clinical courses

19. Benefits of Concept-based Curriculum Focus on concepts as opposed to content Focus on concepts as opposed to content Emphasis on recognition of concepts across populations and multiple situations Emphasis on recognition of concepts across populations and multiple situations Emphasis on interrelationships of concepts Emphasis on interrelationships of concepts Fosters conceptual learning* Fosters conceptual learning* Stimulates critical thinking Stimulates critical thinking Meets needs of diverse learners Meets needs of diverse learners

20. Challenges of Concept-based Curriculum It is different It is different Faculty lack understanding Faculty lack understanding Faculty resistance to change Faculty resistance to change Requires different level of coordination Requires different level of coordination Lack of literature detailing steps Lack of literature detailing steps What about NCLEX? What about NCLEX?