Curriculum Philosophy 2013 Vision Global leaders in nursing excellence Mission Our mission is to educate professional nurses who promote health for individuals and communities Program Outcomes At the end of the curriculum, graduating students will be able to synthesize principles from nursing, biological and behavioral sciences, humanities, leadership, management and liberal education to plan, deliver and evaluate nursing care (rational, technical and emotive elements) for individuals, families, groups, or populations. To achieve this they will: 1. Practice in a professional caring manner. This includes: exemplifying professional values and ethics. committing to providing client centered care as a service to the public. fostering contexts that promote, protect, maintain and restore health of human beings through the life span to its end. 2. Develop partnerships that enable human beings to engage actively in health decisions thereby assuming control of their health. This includes: valuing cooperation and sharing responsibility, risk and power inherent in partnerships. using professional communication skills. 3. Use processes of systematic inquiry, including critical thinking, decision making and research. This includes: using critical thinking as a process of inquiry. using decision making as a reasoning process to make connections and judge information. investigating relevant literature, critiquing research studies, identifying researchable questions.. 4. Assume responsibility for own professional growth and continuing competence, based on CRNBC entry-level competencies. 5. Integrate leadership skills into practice. This includes:
coordinating health services. nourishing a common vision and focusing activity towards the common goal. implementing exemplary followership roles appropriately in the situation. 6. Implement technology as practice to enhance client/patient care. Our Beliefs Nursing Nursing, as relational practice, involves the provision of professional caring to promote, protect, maintain, and restore the health of human beings through the lifespan. Nursing is also the prevention, treatment and palliation of illness and injury, primarily by assessing health status, planning and implementing interventions, and coordinating health services (College of Registered Nurses of British Columbia, 2013). As a vital member of the health care team, nurses focus holistically on human beings responses to their experience of health in whatever context they find themselves. Nurses must also meet changing health needs of populations. Nursing Education Nursing education includes educational processes and strategies that teach nursing students to integrate nursing knowledge, skills, and professional and ethical conduct into nursing practice. Learner centered nursing education in the curriculum is based in experiential and situational learning and incorporates critical reflection. The curriculum is taught for relevance and salience to ensure students are prepared to manage the rigors of professional nursing practice (Benner, Sutphen, Leonard & Day, 2010). We believe teachers foster the development of self-directed learning in nursing students. Clinical learning in the BCIT BSN program occurs in a context relevant to nursing practice and within an established health care team. Clinical learning involves the application of nursing knowledge to nursing practice. Clinical learning is experiential and situational. Experiential learning provides students with opportunities to expand their understanding, while situational learning allows students to explore the unique qualities of each learning experience. Clinical teachers facilitate both of these learning experiences by assisting students to focus on the salient aspects of providing nursing care to patients, clients, families, communities, or populations. Partnership In the curriculum, partnership is a complex interpersonal relationship between both students and the individuals they care for, and between students and teachers. These partnerships facilitate achievement of optimum health and learning outcomes. It is the intention that partnerships are based on professional communication, empowerment, and negotiation. Partners negotiate roles, responsibilities and actions so mutual needs are met. They achieve consensus on the goals to work towards and implementation of nursing care. Nursing partnerships enable individuals to engage actively in health decisions thereby 2
assuming control of their health. This sense of empowerment develops an individual s competence and confidence and promotes self-reliance. Students and teachers value each other s worth and uniqueness in this relationship and they value cooperation and commitment to their roles in the partnership. They believe in the capacity of each other as they engage in the learning process (Gallant, Beaulie & Carnevale, 2002). Philosophical Foundations Phenomenology The curriculum is based on a phenomenological foundation. Using phenomenological inquiry, students and teachers explore the nature of human experiences in an effort to understand the deeper meaning for individuals which may include patients, clients, families, groups and communities. This inquiry is free from unexamined assumptions and causal theories. For example, students examine the meaning that diagnoses and situations have for each person. Teachers explore the meaning a learning experience holds for students. Critical Social Theory Critical Social Theory directs students and teachers to examine human conditions within social and political contexts. Students and teachers critique power structures and risks for oppression to minimize power constraints that may exist. They promote emancipation and empowerment in individuals. For example students and teachers share responsibility for evaluation of learning; students encourage independence and decision making regarding an individual s health issues. Humanism Humanism in nursing has been a well-established value within the profession for many years and is still relevant in the current day. The central idea of humanistic nursing is one of connection that involves a relationship between two people (Peplau, 1965). Humanism provides a frame of orientation that places the center of the nurses universe at the nursepatient relationship (Paterson & Zderad as cited in Kleiman, 2005) ). In the nurse-patient relationship, each person recognizes the other as a subjective human being like themselves. Regardless of the economic, social, and technological context, nurses place priority on the imperative of the human relationship (Kleiman, 2005)). Humanism focuses students on learning opportunities that are meaningful to them, and although this may be challenging for students it can facilitate personal growth. Learning is a joint responsibility of the learner and teacher where both bring expertise to the learning situation. Students actively engage in learning and teachers facilitate meaningful learning and reflection related to experiences. Nurses provide care to patients depending on where they are at, and teachers facilitate learning based on where the students are at. 3
Curriculum Framework Arising directly from our beliefs and the philosophical foundations are the content and process threads of the curriculum. These content and process threads collectively reflect the faculty s shared beliefs about what is important to nursing practice. Nursing knowledge taught within our curriculum is focused within these content threads. Processes threads describe the key attributes students develop enabling them to become nurses. Content threads Caring Caring is the unique contribution of nursing which helps human beings identify, determine and act upon their life experiences relevant to their health. Caring has both scientific and humanistic components. Scientific caring refers to those judgements and acts of helping others based upon tested or verified knowledge; whereas humanistic caring refers to the subjective experiential feelings and acts of assisting others (Leininger, 1988). Context Context is the set of circumstances or facts that surround or are relevant to a particular event or situation. Context is dynamic and time sensitive and comprised of physical, emotional, ideological, environmental, social, cultural, economic, political, and spiritual aspects. Context influences beliefs, perceptions, attitudes and decisions of human beings and may be modified to promote health and meaning. Human Being Human beings may refer to a person, group, family, community or population. Human beings have unique beliefs, intentions, capacities, and perspectives on and experiences of health and health care, as well as differing resources to meet health needs. Human beings interpret their experiences and create meaning. Human beings influence and are influenced by the social context of their lives. Human beings have intrinsic worth, and are deserving of respect, trust, dignity, and choice. All have potential and each is unique Health Health is a state of being and a process of becoming all of which one is capable in one s life situation. The World Health Organization defines health a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (World Health Organization, 2006). Thus, health is a resource for everyday living that enables human beings to realize aspirations and to interact with a changing context. Health can be seen from both an individual and population perspective. Global health is the optimal well-being of all humans and is considered a fundamental human right, which should be accessible to all (CNA, 2009). The perception of health is influenced by personal meaning and awareness of what influences personal health practices and also the ability to perceive what is possible in each situation. Change in perceived health status may provide the impetus for growth. 4
Health is determined by social, economic, cultural, and political context and other determinants of health. Process threads Professionalism Professionalism is a process that evolves throughout professional life. It develops when there is a learning partnership between nurses, nursing students and nursing instructors and they commit to using reasoning and reflection in the pursuit of professional nursing attitudes, judgments, knowledge and skills. Professionalism means making the client the primary focus of nursing and committing to providing a service in the public interest. Professionalism contributes to independent and interdependent nursing practice, with registered nursing a self-regulated profession in Canada. Communication Communication is a process embedded in multiple relational contexts by which meanings are exchanged among people to develop shared understanding. There is a rhythm between the participants in the process that creates a whole experience. Communication involves written, verbal, and non-verbal skills including the appropriate use of informatics. Professional communication in nursing establishes shared meaning and partnership in order to develop capacities. Systematic Inquiry Systematic inquiry includes three evolving processes: critical thinking, decision making, and research. Critical thinking is a process of inquiry that includes challenging assumptions, considering the importance of context, imagining alternative perspectives, and remaining reflectively sceptical (Brookfield, 1987). Reflection within the individual or through dialogue with others facilitates critical thinking. Reflective questioning, careful consideration, and the search for evidence are part of a continual cyclic process. Decision making is a reasoning process that uses thinking to make connections and judge information that allows nursing students to make the best decision possible with the information they have at the time (Johnson & Webber, 2005). The decision making process is an essential component of a nurses clinical judgment. Research is a diligent, systematic inquiry or investigation to validate and refine existing knowledge and generate new knowledge (Grove, Burns, & Gray, 2013). For nurses, research involves investigating appropriate and relevant literature to expand their body of knowledge; critiquing research studies to assess evidence for practice; identifying researchable questions and participating in clinically focused research projects. Professional Growth Professional growth is a process of self-inquiry and self-direction that facilitates lifelong learning. It is achieved through assessing one s practice, identifying learning needs, evaluating self and others, reflecting, and critical appraisal (Patterson, Crooks, & Lunyk- Child, 2002). Nurses are committed to professional growth as a way of enhancing their knowledge, skills, attitudes, and judgments. Professional growth requires self-discipline, 5
initiative, commitment to the profession and passion for the practice. Professional growth and personal growth impact each other. Leadership Leadership is an evolving process that can be learned and is implemented by nurses in all clinical settings and roles. Leadership enhances and supports potential within followers by nourishing a common vision and focusing activity towards the common goal (Grossman & Valiga, 2009). Leadership is based on achieving self-knowledge to transcend self-interest, establishing meaningful and genuine connections with stakeholders, challenging the status quo, incorporating nursing ethics into practice, implementing systems thinking, supporting self-direction and risk-taking, and recognizing the contribution of others (Cameron, 2002). Technology-as-Practice Technology as practice, or the way nurses are, know, and do, links technological innovations to the culture in which they are developed and used. Technology-as-practice influences and is influenced by cultural and social practices and processes (Franklin, 1990). Technology involves organization, procedures, symbols, new words, equations and a mindset (Franklin,1990, p. 12). As technology evolves, nurses examine how to best integrate technology into nursing practice and critically analyze its impact on patients and the health care system. 6
Framework Schematic 7
Glossary Alternate Clinical Experiences All clinical learning contributes to course outcomes. When alternate clinical learning experiences are offered to students the following guidelines provide direction for meaningful learning to occur: Objectives are clearly identified and reflect course outcomes Alternate experiences are planned, prescheduled, and organized by the clinical teacher Preparation will be required by students prior to the alternate experience The student s role and activities are clearly identified and discussed with the student and are within the student s scope of practice Students are expected to debrief their experience and share their learning according to the activity expectations Alternate Clinical Experiences 8
References Benner, P; Sutphen, M; Leonard, V; & Day, L. (2010). Educating Nurses: A call for radical transformation. San Francisco: Jossey-Bass. Brookfield, S. (1987). Developing critical thinkers: Challenging adults to explore alternative ways of thinking and acting. San Francisco: Jossey-Bass. Cameron, G. (2002). Transformational leadership for a health promotion practice. In L.E. Young & V Hayes (Eds.), Transforming health promotion practice: Concepts, issues, and applications (pp. 99-111). Philadelphia: F.A. Davis. Canadian Nurses Association (2009). Position Statement: Global health and equity. Ottawa: Author. College of Registered Nurses of British Columbia, (2013). Glossary. https://crnbc.ca/glossary/pages/default.aspx (retrieved May 11, 2013 11:42) Franklin, U. (1990). The real world of technology. Toronto, ON: CBC Enterprises. Gallant, M.H., Beaulie, M.C., & Carnevale, F.A. (2002). Partnership: An analysis of the concept within the nurse-client relationship. Journal of Advanced Nursing, 40(2), 149-157. Grossman, S.C., & Valiga, T.M. (2009). The new leadership challenge: Creating the future of nursing (3rd). Philadelphia: F.A. Davis. Johnson, B.M., & Webber, P.B. (2005). An introduction to theory and reasoning in nursing (2nd ed.). Philadelphia: Lipincott Williams & Wilkins. Grove, S.K., Burns, N, & Gray, J.R. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St. Louis, MO: Elsevier Saunders. Kleiman, S. (2005). http://www.humanistic-nursing.com/humanism-43.htm (retrieved May 8, 2013 9:47) Leininger, M. (1988). Leininger's theory of nursing: cultural care diversity and universality. Nursing Science Quarterly, 1 (4): 152-60. Patterson, C., Crooks, D., & Lunyk-Child, A. (2002). A new perspective of competences for self-directed learning. Journal of Nursing Education, 41(1), 25. Peplau, H. E. (1965). The heart of nursing: Interpersonal relations. Canadian Nurse, 61, 273-275. World Health Organization. (2006). Constitution of the World Health Organization - Basic Documents, 45th edition, Supplement. Author. This document was prepared on behalf of the BCIT BSN Program Curriculum Committee by Shannon Elliott, Susan Rowe-Sleeman, and Eileen Shackell. May 2013. 9