Concept-Based Curricula

Transcription

1 TREND PERSPECTIVE Concept-Based Curricula Preparing students to thrive in the ever-changing healthcare environment EXECUTIVE SUMMARY recognizes the value of concept-based nursing curricula to help manage content saturation and aid students in learning to apply concepts across multiple contexts. The highlight of this non-traditional learning model is that it equips tomorrow s nurses with the critical thinking skills that are essential to practicing safe and effective care in the clinical environment.

2 s Perspective on: Concept-Based Curricula The concept-based nursing curriculum focuses on the foundational principles, or concepts, that can be applied across patient settings, the life span, and the health-illness continuum. Perspective Traditional nursing education has been under considerable strain for years, as changes in healthcare delivery have resulted in ever-expanding knowledge demands for the student nurse. In response, the conceptual approach to nursing education has emerged as an innovative curricular framework designed to manage information overload, engage students in an active learning environment, develop their clinical reasoning skills, and fully prepare them for an increasingly collaborative field of practice (Giddens, 2007). The conceptual approach reflects a departure from the standard medical model, which emphasizes disease processes and task-based interventions for specific population groups or settings (e.g., pediatric, maternity, medical-surgical, mental health, and so on). Instead, a concept-based nursing curriculum focuses on the foundational principles, or concepts, that can be applied across patient settings, the life span, and the health-illness continuum (Giddens, 2007). supports the idea that a concept-based nursing curriculum provides an effective framework for managing content saturation and helping students learn to apply concepts in multiple contexts; thereby, it also equips student nurses with the critical thinking skills that are essential to thriving in a fluid and everchanging healthcare environment. Background Concept-based curricula are not a new phenomenon, nor are they unique to nursing. Early attempts to use concepts as high-level content organizers in education (instead of discrete topic areas) can be linked to the work of curriculum theorist Hilda Taba in the 1950s and 1960s. Similar models began to emerge in the field of nursing in the 1970s and 1980s when Dorothea Orem s Self-Care Framework introduced grand theories, or concepts, as a curricular mechanism to distinguish nursing from other healthcare disciplines (Giddens, 2015). These earlier attempts at introducing concept-based teaching models were useful forerunners in addressing how learners acquire complex knowledge. However, they fell short in providing clear and consistent definitions of concepts and in being able to link concepts to practical applications. 2

3 s Perspective on: Concept-Based Curricula In recent decades, the call for dramatic reform in nursing education has been resounding in academic literature. In 1998, the American Association of Colleges of Nursing (AACN) released The Essentials of Baccalaureate Education for Professional Nursing, which outlined the core standards for curriculum development. However, with the abundance of knowledge and competencies identified in The Essentials, the report s authors questioned whether it is even possible to prepare beginninglevel professional nurses for the future in a four-year time frame (AACN, 1998). Another academic remarked that the report was a blueprint for the 21-year curriculum (Tanner, 1998). In 2003, the Institute of Medicine (IOM) cited the overly crowded curriculum as one of the major hurdles that needed to be overcome in improving healthcare education. That same year, the National League for Nursing (NLN) called for a complete paradigm shift to address outdated teaching models, noting that despite significant changes in the healthcare system and in nursing practice, many nurse educators continue to teach as they were taught and for a healthcare system that no longer exists (NLN, 2003). The IOM s 2010 report on The Future of Nursing echoed this sentiment, noting 3

4 s Perspective on: Concept-Based Curricula that nursing education largely focuses on acute care, although chronic conditions account for much of the care provided by today s nurses. As a result, the report suggested that nursing curricula needed to be updated to reflect advancements in science and technology and changes in patients needs. The report also cited that fundamental concepts that can be applied across all settings and in different situations needed to be taught to account for the rapid growth of health information (IOM, 2010). In response to these academic pressures, in addition to moves by several state boards to reduce credit-hour requirements for graduation, nursing programs across the country have been implementing or investigating concept-based curricula to replace the traditional paradigm (Goodman, 2014). Concepts and Conceptual Learning Explained Concepts, broadly defined, are the building blocks used to organize the key competencies, skills, and knowledge areas in nursing education. These may include patient profile concepts (such as culture, development, or functional ability), health and illness concepts (such as perfusion, inflammation, or gas exchange), and/or professional concepts (such as leadership, ethics, or care coordination). The specific instances or clinical situations that best represent the concept in context are known as exemplars (Giddens, 2015). For example, in a concept-based curriculum, a course may focus on the concept of infection the risk factors, physiological mechanisms, assessment tests, and clinical management principles of infection. Then, based on prevalence and incidence, exemplars such as pneumonia, otitis media, and surgical wounds may be chosen to illustrate infection principles across ages, populations, and care settings. In an effort to manage content saturation, not every possible instance or exemplar of infection will be explicitly covered in class. However, the goal of conceptual learning is to foster a deep understanding of concepts and how they interrelate. So, by building on prior knowledge and making connections with similar exemplars, students should be able to transfer ideas to new situations (Giddens, 2015). 4

5 s Perspective on: Concept-Based Curricula To bridge the gap between didactic courses and clinical experiences, both simulation activities and case studies can focus on the chosen concepts and exemplars in a controlled environment to give students hands-on opportunities to apply their learning (Bristol, 2013; Giddens, 2008). Effects The adoption of concept-based models is occurring most commonly at the ADN program level, followed by BSN, with some LPN/LVN programs experimenting with this new approach (Sportsman, 2014). Since most of these programs are still in the initial stages of implementation, there currently is not a large amount of data available to draw on for research. However, early studies show promising results. Lisa S. Lewis (2014) reported a small but positive improvement in program completion, retention, and on-time graduation rates, as well as a slight increase in NCLEX-RN Examination pass rates within an ADN program that implemented a concept-based curriculum. Kathleen Duncan (2015) found little difference in first-time NCLEX-RN Examination pass rates between traditional and concept-based programs. It bears noting, however, that the ultimate goal of conceptual learning is not simply to improve test scores but rather to improve the clinical reasoning and critical thinking skills that a nurse needs to thrive and adapt in today s healthcare system. As more programs switch to a concept-based model, and as those programs continue to refine and mature in this approach, we can expect to see more studies conducted on the efficacy of this educational framework. Elsevier Products and Services that Support a Concept-Based Curriculum The success that concept-based nursing programs are experiencing today compared to earlier prototypes in the 1970s can largely be attributed to well-organized and clearly defined concept textbooks like Concepts for Nursing Practice (Giddens, 2013) as well as the advancement of ebooks and other digital resources that make it easier to search, access, and synthesize information from a multitude of sources all at once (Bristol, 2013). provides a variety of products and services, including texts like Concepts for Nursing Practice, that are specifically designed to support the goals of concept-based teaching and learning. Concepts for Nursing Practice is an interactive text that defines and analyzes 53 different nursing concepts. Written by conceptual learning expert Jean Giddens, this groundbreaking text will help students easily apply what they learn in the classroom to what they encounter in the clinical setting. Nursing Concepts Online is a fullyintegrated resource that combines all of Elsevier s top conceptual learning tools into one easy-to-use course format. Through a single access code, students can take advantage of pre-loaded simulation scenarios, concept-based case studies, a functional EHR, adaptive mastery quizzes, priority exemplar links, and loads of nursing skills all organized around the 53 nursing concepts found in the Concepts for Nursing Practice text. The ultimate goal of conceptual learning is not simply to improve test scores but rather to improve the clinical reasoning and critical thinking skills that a nurse needs to thrive and adapt in today s healthcare system. 5

6 s Perspective on: Concept-Based Curricula Elsevier s Academic Consulting Group offers expert, unbiased guidance on every facet of developing, executing, and evaluating a concept-driven curriculum. Some of the services and tools they offer programs and faculty include: custom curriculum design, faculty training conferences and customized workshops, continuing education credit opportunities, strategies for teaching conceptually, recorded webinars, and much more. Mastering Concept-Based Teaching is a remarkable reference for educators that offers all the strategies and guidance needed to plan, develop, and deliver an effective concept-based curriculum (whether it s for an LPN, ADN, BSN, or MSN program). Renowned authors Dr. Jean Foret Giddens, Dr. Linda Caputi, and Dr. Beth Rodgers walk readers through the background and benefits of using a concept-based learning approach, how to apply a research-based approach to teaching concepts, how to improve and evaluate student learning with concepts, and more to ensure educators are ready to successfully bring concepts into their nursing program. Concept-Driven HESI Preparation Products include case studies, patient reviews, and practice tests that are each mapped to the concepts found in Gidden s Concepts for Nursing Practice text. Concept-Centered HESI Testing Options encompass a variety of exam types including HESI Exit Exams, Specialty Exams, and Custom Exams that can be assembled to meet individual school or state concept-based curriculum requirements. Simulation Learning System for RN 2.0 is an extensive collection of evidence-based scenarios, organized by concept, that give nursing students hands-on practice applying what they learn in the classroom to a clinical setting. SimChart for Nursing is an electronic health record that has been specifically developed as a learning tool for nursing students. SimChart can be used in both the classroom and simulation lab to give students a meaningful way to apply the concepts they are learning to patient documentation. 6

7 s Perspective on: Concept-Based Curricula Conclusion While the amount of knowledge related to every illness and treatment intervention is potentially limitless, the amount of time available to teach nursing students is not. Therefore, there is a need for a learning model that can help educators manage content and help students learn to think more critically about nursing concepts. is committed to providing its customers with the industry s best and most effective tools for developing, executing, and evaluating a concept-based curriculum, so that today s students can learn to think more critically and better prepare for whatever tomorrow s healthcare climate has in store. Works Cited American Association of Colleges of Nursing. The Essentials of Baccalaureate Education for Professional Nursing Practice (1998). Washington, DC: Author. Bristol, T.J., & Rosati, L.J. Successful Concept-Based Learning through the Integration of Technology. Teaching and Learning in Nursing, 8 (2013): Duncan, K. & Schulz, P.S. Impact of Change to a Concept-Based Baccalaureate Nursing Curriculum on Student and Program Outcomes. The Journal of Nursing Education, 54.3 Suppl. (2015): S Giddens, J.F., & Brady, D.P. Rescuing Nursing Education from Content Saturation: The Case for a Concept- Based Curriculum. Journal of Nursing Education, 46.2 (2007): Print. Giddens, J.F., et al. A New Curriculum for a New Era of Nursing Education. Nursing Education Perspectives, 29.4 (2008): Print. Giddens, J.F., Caputi, L., & Rodgers, B. Mastering Concept-Based Teaching: A Guide for Nurse Educators. (2015). Goodman, T. Nursing Education Moves to a Concept-Based Curriculum. AORN Connections, 99.6 (2014): C7-C8. Institute of Medicine. Health Professions Education: A Bridge to Quality. (2003). National Academies Press. Institute of Medicine. The Future of Nursing: Focus on Education. (2010). National Academies Press. Lewis, L.S. Outcomes of a Concept-Based Curriculum. Teaching and Learning in Nursing, 9 (2014): National League for Nursing. Position Statement: Innovation in Nursing Education: A Call to Reform. (2003). Retrieved from org/aboutnln/positionstatements/ innovation.htm. Sportsman, S. Concept-Based Curricula in Nursing: Perceptions of the Trend. (2014). Elsevier Academic Consulting Group. White Paper. Tanner, C.A. Curriculum for the 21st Century Or is it the 21-Year Curriculum? Journal of Nursing Education, 37 (1998): Additional References Caputi, L. (Ed.) Teaching Nursing: The Art and Science. (2nd ed.). Glen Ellyn, IL: College of DuPage. Dailey, J.L. The Concept-Based Curriculum: Key Points for a Transition. (2014). Elsevier Academic Consulting Group. White Paper. Erickson, H.L. Concept-Based Curriculum and Instruction for the Thinking Classroom (2007). Thousand Oaks, CA: Corwin Press. Giddens, J. F. (2013). Concepts for nursing practice. St. Louis: Elsevier. Giddens, J.F.. Wright, M., & Gray, I. Selecting Concepts for a Concept- Based Curriculum: Application of a Benchmark Approach. The Journal of Nursing Education, 51.9 (2012):

8 For more information on concept-based curricula, including how it is used and how to begin implementing it in your classroom, visit