NURS FPX 6108 Assessment 3 Curriculum Theory, Frameworks, and Models

Student Name

Capella University

6108

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Submission Date

Curriculum Theory, Frameworks, and Models

Development of a successful nursing curriculum requires good theory and curriculum design. Theoretical foundations have an impact on the structuring, delivering, and evaluating of nursing knowledge content in the curriculum. The University of Pittsburgh’s Bachelor of Science in Nursing Program is structured based on AACN (2021) Essentials, a competency-based curriculum. Kumar and Rewari (2015) have suggested the need for incorporating institutional missions and learner needs in the curriculum design. The following article will delve into the organizational, theoretical, and conceptual design of Pitt’s BSN curriculum.

Description of the Selected Health Care Curriculum

The context of the institution and the community served by a program informs a description of a nursing curriculum. For instance, the University of Pittsburgh School of Nursing has offered baccalaureate nursing education since 1939 and is one of the oldest nursing schools in the U.S. (University of Pittsburgh, 2024). It’s in Pittsburgh, PA, part of the Victoria Building, which also holds a contract with UPMC, a local health system that offers a variety of clinical education for its students. As a result, the rich academic resources in research-active faculty members and many different ways in which to experience real-world clinical practice make this institution and program particularly well suited for preparing nurses.

The Bachelor of Science in Nursing (BSN) degree program is a complete pre-licensure nursing program. Nurses who attend the program should be from various work settings in healthcare. This will be for traditional graduate students who have been accepted into the program and for current students who are transferring from other universities. A nursing student will complete more than 1,200 hours of supervised clinical practice in hospitals, clinics, and in the community as part of this education program. The research findings indicated that students who had been exposed to many opportunities for valuable hands-on learning in clinical education were able to develop their nursing competency better than students with limited clinical education opportunities during the nursing education period.

Fundamental Organizing Design and Theoretical Framework

Knowing the structure of a curriculum enables us to see how learning experiences are designed so that we can improve the nurse’s capability as a nurse. The Pitt BSN program is organized around the AACN (2021) “The Essentials: Core Competencies for Professional Nursing,” a professional nursing competency model. It leads to the establishment of measurable professional competencies for all courses, assessments, and clinical experiences. Programs in the health professions in which students need to demonstrate skills are believed to be best suited to competency-based education (CBE).

The BSN program at Pitt should be competency-based due to the fact that there is a need for students to be able to demonstrate and standardize their skills upon exiting the BSN program. CBE frameworks have the added benefit of making nursing graduates more clinically prepared as well as reducing the amount of time for a graduate to become competent in the hospital environment. The domains of the AACN Essentials align with the 10 domains of the licensing requirements of the Pennsylvania State Board of Nursing and the national exam, the NCLEX-RN.

Simple-to-Complex Curriculum Sequencing

The Pitt BSN program employs a competency-based design in addition to a simple-to-complex model over four academic years. First year/Second year focuses on providing a basic foundation in virtually all the sciences related to health assessment; Third year/Fourth year are more challenging clinical scenarios with increasingly complex multi-systems. This is a staged strategy that helps foster the confidence of learners who are exposed to higher levels of cognitive and clinical demands, according to Faber et al. This enrolment system/facilitation is staged and perfectly suitable since it comes from high school to rigorous, task-driven nursing practice.

History and Major Concepts of the Organizing Design and Theoretical Framework

An understanding of how CBE developed in the 1970’s evolution will aid in the comprehension of its current existence and usage in designing nursing degree programs. CBE emerged in health professions education in the 1970s when the gap between the knowledge learned in school and that used in the clinical environment was identified. In 1986, the AACN published its first Essentials of Baccalaureate Education, a discipline-specific competency-based set of expectations for nursing schools; and in 2021, AACN released an updated version of the Essentials, now based on a competency model using a domain-based approach as the standard across all practice settings.

The evolution of Competency-Based Education (CBE) relates to the nursing profession’s adaptation to increasingly complex and technologically driven care they deliver in a constantly changing healthcare system. The changes to CBE in 2021 were developed from national workforce data, which showed that there was a gap in the readiness of new graduates in providing interprofessional care, the use of evidence in the provision of care, and care for the population. The historical context of this is very important for the Pitt BSN Program as it recently made changes to its BSN curriculum to better align with the framework of the 2021 Essentials. Graduation rates of students from programs that abide by the 2021 Essentials have far better results on national examinations.

Major Concepts of the AACN Essentials Framework

The 10 core competency domains outlined in the AACN Essentials are the roadmap for building the profession of nursing as a baccalaureate-level career, with five of them identified as key: knowledge for nursing practice, patient-centered care, population health, scholarship/practice, and quality/safety. The remaining four cover the following areas: interprofessional collaboration, system-based practice, informatics and technology, and professionalism and personal and professional leadership. These ten domains of nursing represent the nursing practice of today and line up with all levels of the Pitt BSN program curricula.

Each of the Domains can have a sequence of “sub competencies” that programs can follow with a student as the learner progresses from novice to program exit. An example of this is that in the field of informatics, students should move from simply using the electronic health record (EHR) to understanding how to use it to analyze health data and then give an appropriate foundation for how to enhance the quality of care that can be given to the patients. Those students who graduated from programs where the technology competencies were explicitly linked to patient outcomes had significantly higher decision-making scores on the study as a whole than those who graduated from programs in which the technology competencies were not mapped. The students who graduated from programs in which technology competencies were mapped explicitly to patient outcomes had significantly higher scores on decision-making as compared to the students who graduated from programs in which the technology competencies were not mapped to patient outcomes. These are overarching concepts that direct the integration of the simulation laboratories, electronic clinical systems, and interprofessional practice experiences into the Pitt BSN Program.

Demonstration of the Organizing Design and Framework Within the Curriculum

An operationalized theoretical framework adds meaning to a whole curriculum; it becomes physical, it becomes content. Each of the Pitt BSN curricula integrates the competency domains found in the American Association of Colleges of Nursing’s (AACN) 2014 BSN Standards into the content of each course to help ensure the content of learning activities meets the standards for professional practice. For example, in the course NURS 4040 Evidence-Based Practice and Research, the course is directly tied in with the “Scholarship for Practice” domain since the students review research articles for merit. In NURS 4030: Nursing Leadership and Management, the course connects with the two strands “Professionalism” and “Interprofessional Relationships” with scenarios that are based on teams of students.

How the AACN framework is integrated throughout the Pitt BSN program is illustrated in course examples. Person-Centered Care (PCC) competencies are introduced to students in NURS 1020 during Year 2 by engaging in structured patient interaction and cultural awareness training. At Year 4, NURS 4050 integrates the 10 BACN domains in combination with a clinical immersion experience with supervision. Furthermore, Billings & Halstead demonstrate the value of a good capstone in providing compelling witness to the effectiveness of putting a school’s theoretical perspective into practice (what is learned in courses into action).

Simple-to-Complex Design Demonstrated Through Curriculum Sequencing

The simple-to-complex structure of the program is evident in the clinical and didactic curriculum in each year of the program. Science skills taught in Year 1 and Year 2 are basic sciences in biology, chemistry, nutrition, and health assessment, which give the scientific foundation for nursing. In Years 3 and 4, the courses are increasingly clinical, and students are introduced to more complex nursing courses that demand advanced-level clinical reasoning skills, such as Adult Health Nursing II, Community Health Nursing, and Leadership. The content of these courses is based on developmental learning, which means that the competency for nursing is built up in steps from the concrete knowledge to the abstract one: the clinical judgment.

The integrated NCLEX preparation activities, which are threaded throughout the entire program, serve to further demonstrate the scaffolded, outcomes-based design of the program’s curriculum. A foundational mastery Diagnostic Prep exam is administered in Year 3, and subsequently, a 3-day NCLEX review and Predictor Exam are administered at the end of the program. Mani determined that programs with NCLEX checkpoints throughout the curriculum have significantly higher first-time pass rates of the NCLEX exam than programs that have no checkpoints. Therefore, the overall characteristics of the Pitt BSN program demonstrate that the simple-to-complex sequence of the BSN curriculum is well supported by theory and is implemented effectively.

Conclusion

Theories and organizing designs give coherence, direction, and purpose to a nursing curriculum. The University of Pittsburgh’s BSN program seems to have a strong alignment with the AACN Essentials framework as well as its competency-based, simple-to-complex organizing approach. It can be illustrated by the extent to which all three aspects of the curriculum (course sequencing, learning outcomes, and clinical experiences and how they are assessed) bear evidence of decisions that are evidence-based and are made on purpose. This program has been so well matched that it is a good example of what nursing education in the United States should look like in baccalaureate programs and a good indicator of the quality of the programs.