2. Objectives
• The educator will be able to describe the
converging societal forces providing the impetus
for curricular reform in nursing education.
• The educator will be motivated to examine the
current nursing curriculum for compliance with
the inclusions suggested here.
• The educator will be able to evaluate the need
for modification of the current curriculum.
• The educator will be able to advocate effectively
for nursing curriculum restructuring.
3. The Push for Change in Nursing
Education
• We need to address the gap in developing and
translating pedagogic research to nursing
education
• We need to commit to the implementation of
evidence-based teaching practices
• We need to commit to developing the science
of nursing education
• We must transform our educational
paradigms
4. Key Reports Advocating for Change
• Institute of Medicine (IOM, 2001, 2003),
• National League for Nursing (NLN, 2003,
2005, 2008)
• American Association of Colleges of Nursing
(AACN, 2008),
• Technology Informatics Guiding Education
Reform (TIGER) Initiative (2007)
• Quality and Safety Education for Nurses
(Cronenwett et al., 2007).
5. “Crossing the Quality Chasm: A New
Health System for the 21st
Century”
• Increasing complexity of health care increasing
complexity of health care
• No finite body of knowledge for practice
• Need to help our students:
– learn how to learn,
– learn how to build a body of knowledge for
themselves, and
– learn how to find and apply appropriate knowledge to
their practice.
(Institute of Medicine, 2001)
6. “Health Professions Education: A
Bridge to Quality”
• Need for collaboration among health
professionals
• Need appropriate application of technology
• Practice must be evidence based
• Shift to patient-centered care
• Focus on quality improvement and safety
(Institute of Medicine, 2003)
7. Innovation in Nursing Education:
A Call to Reform
• Develop the science of nursing education
• Form partnerships between:
– Students
– Teachers
– Clinicians
– Researchers
(National League for Nursing, 2003)
8. “Transforming Nursing Education “
• Faculty must focus on student learning and create
appropriate educational environments.
• Objectives for reforms:
– Developing the science of nursing education to emphasize
evidence-based education;
– Identifying nurse educators as specialty practitioners;
– Providing financial resources for faculty development and
curricular reforms;
– Identifying and responding to changes in the complex
practice environment; and
– Developing efficient and effective uses of educational
resources.
(NLN, 2005)
9. “Preparing the Next Generation of
Nurses to Practice in a Technology-Rich Environment: An
Informatics Agenda”
• Healthcare environment is technology and
information laden
• Increasing sophistication of healthcare
technology
• Both faculty and students must achieve
informatics competency
(NLN, 2008)
10. “Essentials of Baccalaureate Education for
Professional Nursing Practice.”
• Report contains curricular elements and Framework
for 21st
Century practice
• Nine Essentials of baccalaureate nursing education:
– integration and inclusion of liberal education in nursing
curricula;
– knowledge and skills in leadership quality care and patient
safety;
– knowledge and skills necessary to translate evidence into
practice;
– mastery of information management and patient care
technology skills;
(American Association of Colleges of Nursing, 2008)
11. Essentials of Baccalaureate Education,
cont.
• knowledge of content related to healthcare policy, and
finance and regulation;
• skills in collaboration and communication across
healthcare disciplines;
• considerations for disease prevention and the
promotion of the health;
• development of professionalism and professional
values including ethics of practice; and
• preparation to provide care across the lifespan and in
multiple complex healthcare environments.
(AACN, 2008)
12. Technology Informatics Guiding
Education Reform (TIGER)
• Nursing must bridge, “the quality chasm with
information technology, enabling nurses to use
informatics in practice and education to provide
safer, higher-quality patient care” (TIGER, 2007, p.
4).
• Pillars of the Tiger vision:
– Management & Leadership: Revolutionary
leadership that drives, empowers and executes
the transformation of health care.
– Education: Collaborative learning communities
that maximize the possibilities of technology
toward knowledge development and
dissemination.
13. Pillars of the TIGER Vision, cont.
• Communication & Collaboration: Standardized, person-centered,
technology-enabled processes to facilitate teamwork and relationships
across the continuum of care.
• Informatics Design: Evidence-based, interoperable intelligence systems
that support education and practice to foster quality care and safety.
• Information Technology: Smart, people-centered, affordable
technologies that are universal, useable, useful and standards-based.
• Policy: Consistent, incentives-based initiatives (organizational and
governmental) that support advocacy and coalition-building,
achieving…an ethical culture of safety.
• Culture: A respectful, open system that leverages technology and
informatics across multiple disciplines in an environment where all
stakeholders trust each other to work together towards the goal of
high quality and safety. (TIGER, 2007, p. 4)
14. Quality and Safety Education
for Nurses (QSEN)
Defined core competencies for nursing education as:
• Patient-centered care: Recognize the patient or designee
as the source of control and full partner in providing
compassionate and coordinated care based on respect for
the patient’s preferences, values, and needs (p. 123).
• Teamwork and collaboration: Function effectively within
nursing and inter-professional teams fostering open
communication, mutual respect, and shared decision-
making (p. 125).
• Evidence-based practice (EBP): Integrate the best current
evidence with clinical expertise and patient/family
preferences and values for delivery of optimal health care
(p. 126).
(Cronenwett et al, 2007)
15. Core Competencies, con’t.
• Quality improvement (QI): Use data to monitor the
outcomes and processes and use improvement
methods to design and test changes to continuously
improve the quality and safety of health care systems
(p. 127).
• Safety: Minimize the risk of harm to patients and
providers through both system effectiveness and
individual performance (p. 128).
• Informatics: Use information and technology to
communicate, manage knowledge, mitigate error, and
support decision-making (p. 129).
(Cronenwett et al, 2007)
16. Preparing for Contemporary Practice
• Constructivist learning approaches encourage
learners to build and continuously refine a
knowledge base (Peters 2000)
• Students should be taught to engage in reflective
practice to build a transformative and
translational knowledge base (Noveletsky 2007)
– Redman (2008) termed this mindfulness
• Nursing faculty must model knowledge building
and commit to evidence-based teaching as well
as evidence-based clinical practice.
17. Tips for Developing a Student-
centered learning environment
• Encourage students to foster the integral relationship
between their personal and professional selves.
• Create the space for learners to see how who they are
as a person shapes who they are as a nurse.
• Encourage the examination of particularities (i.e. what
is unique, significant, similar, different).
• Pay attention to how you are taking up and expressing
knowledge and how that is shaping you in particular
moments of your teaching practice.
Brown and Doane (2007, p. 117)
18. Role of Technology for Transforming
Nursing Education
• Global integration of technology in nursing
education can help technology use become
seamless, painless, transparent and ubiquitous.
• We cannot expose our students to every possible
type of technology they might encounter in
future practice, we can help them to become
proficient users of various technologies that
currently support the delivery of quality, safe,
and effective healthcare.
19. Sample Content to Support
Technology Competency
• Use of patient care technologies (e.g., monitors,
pumps, computer-assisted devices)
• Use of technology and information systems for clinical
decision-making
• Computer skills that may include basic software,
spreadsheet, and healthcare databases
• Information management for patient safety
• Regulatory requirements through electronic data
monitoring systems
• Ethical and legal issues related to the use of
information technology, including copyright, privacy,
and confidentiality issues
20. Content Con’t.
• Retrieval information systems, including access,
evaluation of data, and application of relevant data to
patient care
• Technological resources for evidence-based practice
• Technology and information systems safeguards (e.g.,
patient monitoring, equipment, patient identification
systems, drug alerts and IV systems, and barcoding)
• Information literacy
• Electronic health record/physician order entry
• Decision support tools (AACN, 2008, pp. 19–20)
21. Learning Activities
1. Review the article by Noveletsky (2007) and identify areas in the
curriculum where you can implement reflective practice techniques
for your students.
2. Next, consider developing a process for reflective practice as an
educator using a blog to document your successes and areas where
you can improve.
3. Divide faculty into three groups. Assign group A to read the 2008
AACN “Essentials of Baccalaureate Education for Professional
Nursing Practice” and create a grid identifying where each of the
essentials is covered in the curriculum. Assign Group B to review
the 2007 TIGER initiative recommendations and create a similar
grid. Finally, assign Group C to the QSEN initiative and to create a
similar grid. Allow 3 weeks for this activity and reconvene the
groups. What areas of improvement have you identified in the
curriculum? How will you address these needed improvements?
4. Assign faculty to read Giddens et al. (2008) and consider the pros
and cons of a concept-based curriculum.
22. References
• American Association of Colleges of Nursing. (2008, October 20). The essentials of baccalaureate education for professional
nursing practice. Available at http://www.aacn.nche.edu/Education/pdf/BaccEssentials08.pdf. Accessed June 16, 2009.
• Brown, H. & Doane, G. (2007). From filling a bucket to lighting a fire: Aligning nursing education and nursing practice. In L. E.
Young & B. L. Paterson (Eds.), Teaching nursing: Developing a student-centered learning environment (pp. 97–118).
Philadelphia, PA: Lippincott, Williams & Wilkins.
• Coonan, P. (2008). Educational Innovation: Nursing's Leadership Challenge. Nursing Economics, 26(2), 117-21.
• Cronenwett, L., Sherwood, G., Barnsteiner J., Disch, J., Johnson, J., Mitchell, P., et al. (2007). Quality and safety education
for nurses. Nursing Outlook, 55(3), 122–131.
• Giddens, J. Brady, D., Brown, P., Wright, M., Smith, D., & Harris, J. (2008). A new curriculum for a new era of nursing
education. Nursing Education Perspectives, 29(4), 200–204.
• Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Available at:
http://books.nap.edu/html/quality_chasm/reportbrief.pdf. Accessed January 27, 2009.
• Institute of Medicine. (2003). Health professions education: A bridge to quality. Washington, DC: National Academies Press.
• National League for Nursing. (2003). Innovation in nursing education: A call to reform (Position statement). Available at:
http://www.nln.org/aboutnln/PositionStatements/innovation082203.pdf. Accessed October 20, 2009.
• National League for Nursing. (2005). Transforming nursing education (Position statement). Available at:
http://www.nln.org/aboutnln/PositionStatements/transforming052005.pdf. Accessed October 20, 2009.
• National League for Nursing. (2008). Preparing the next generation of nurses to practice in a technology rich environment:
An informatics agenda (Position statement). Available at:
http://www.nln.org/aboutnln/PositionStatements/informatics_052808.pdf. Accessed October 20, 2009.
• Noveletsky, H. (2007). Reflective practice. In M. J. Bradshaw & A. J. Lowenstein (Eds.), Innovative teaching strategies in
nursing and related health professions. (4th ed., pp. 141–148). Sudbury, MA: Jones and Bartlett.
• Peters, M. (2000). Does constructivist epistemology have a place in nurse education? Journal of Nursing Education, 39(4),
166–172.
• Redman, R. (2008). High reliability organizations: Implications for nursing knowledge development. Research and Theory for
Nursing Practice, 22(3), 165–167.
• Technology Informatics Guiding Education Reform. (2007). Evidence and informatics transforming nursing: 3-year action
steps toward a 10-year vision. Available at: http://www.aacn.nche.edu/Education/pdf/TIGER.pdf. Accessed February 3,
2009.
