Curriculum Development

Expanding Geriatric Education in Undergraduate Nursing EducationGroup:Siobhan McMahonGail ProtheEbere UmeEllie Lacabral

Mission and GoalsMission: The College of Nursing within the XXXX University is a learning organization that prepares students to provide and lead evidence based nursing practice that optimizes health and well-being of diverse older adult populations.

Goals: • Maintain a curriculum that is contextually relevant • Prepare nurses to practice in a complex and continually

changing health environment• Prepare professional nurses to care for individuals across

the life span, including older adults.

 PhilosophyThe College of Nursing integrates the philosophy of XXX University that is dedicated to the exchange of knowledge and pursuit of wisdom within and atmosphere of intellectual honesty and freedom

Nursing PhilosophyThe faculty within the College of Nursing also believe the central concepts within nursing practice include: • Client/ Person• Nursing • Environment• Health, • Teaching and Learning Environment • Nursing Education

Curriculum Scope

  Objectives: • Enhance the knowledge and skill of nurses to care for

older adults and their families across diverse settings and specialties. 

• Enhance the sensitivity of nurses caring for older adults and their families across diverse settings and specialties.

 

 

Curriculum ScopeSetting: University

Time Frame: 18 Months. o All undergraduate faculty involved in some way o Curriculum leader and steering committee o Working groups 

Data collection   Philosophical approaches  Goals   curriculum matrix course development  Course Development

 

Curriculum Defined

A curriculum is a framework  upon which specifics are added. Like a house, the foundation is the philosophy, values and mission for the house. Upon this foundation, the outer framework, curriculum, is built. Inside the framework then are specific rooms and these rooms are representing the specific courses. Each course has more detail added. Curriculum, therefore, is a structured framework.

Rational and Needs for Development

—Aging Population and their diverse health care needs—Patient Protection and Affordable Care Act 2010—Health Care Trends—Current Educational Deficits

Aging Population• Baby Boomers will be crossing the age of 65 in record

numbers starting in 2011.• Average life expectancy at age 65 is an additional 17 to 19

years• Average life expectancy at age 75 is additional 12 years• Proportion of US Population over the age of 65

2010: 40.2 million (12%) 2030: 72 million (20%) 2050: 88.5 million

Aging Population and Health

• 80 % of people over 65 have at least one chronic condition• 50% of people over 65 have at least two chronic conditions• Proportion of older adults (John A. Hartford):

o 50% of persons in acute care settings. o 70% of persons receiving home care serviceso 90% of persons living in long term care settingso  34% of all prescriptions

Aging Population and Health

• Health status of older adults is diverse and often complex. influenced byo income level, o living arrangements, o need for physical and psycho/social supports.

• A major focus of health promotion is to minimize loss of independence associated with functional decline and illness. (CDC, 2010).

• Fewer than  40 % of adults r are up-to-date on potentially life-saving clinical preventive services such as screening for breast, cervical, and colorectal cancers, and vaccinations against influenza and pneumococcal disease (CDC, 2010).

Health Care Reform• Patient Protection and Affordable Care Act 2010

o Increased Subsidies for 32 million of Americanso Created National Health Care Workforce Commission o Nursingo Increased funding for the National Health Service Corpso Creates grant programs for nursing retentiono Increases loan amounts for Nursing Student Loan

programo Expands Nurse Loan Repayment and Scholarship

Programo Geriatric Nursing Career Incentives

Health Care TrendsInstitute of Medicine(2008, 2010)

•Retooling for America (2008)• Older Americans account for a disproportionate share of

professional health care services but the number of geriatric specialists remain low.

• Many generalists treat geriatrics without specialty training• The Future of Nursing (2010)• Competencies needed to practice have expanded,

especially in areas such as geriatrics

Health Care Trends

• Chronic Diseaseo 82%of older adults  have at least one chronic     illnesso  Specialty treat Over 65 population

• Aging of Nursing Workforceo 73,000 RN’s leave profession annuallyo Average age of Nursing Faculty  55.2

Current Education Deficits• BSN program 

o In 2005 1/3 Nursing programs had required geriatrics course

o  In 2003 34% had any  free standing geriatric program and 23% had an integrated geriatric education

• Geriatric Educationo Often presented during Fundamentals or during

Medical Surgicalo Clinical experience at Nursing Homes at

beginning of education

Barriers to Curriculum Development• Full curricula • Lack of interest in geriatrics • Limited faculty• Limited funding and time • Limited evidence supporting the best methods

by which to accomplish this (IOM, 2008)•  Reluctance to change (philosophical views,

roles, relationships, teaching-learning approaches, evaluation approaches)

Full Curricula

Examine current teaching-learning styles and provide workshop about newer methods that move away from the quantity of content to the

Faculty without interest or knowledge in geriatrics

Faculty development resources    Updated baccalaureate competencies (2010)    Evidence Based Nursing Resources    Assessment Series    Teaching Workshops    Curriculum Mapping Tool    End of Life Training     Review Courses "Faculty should partner with health care organizations to develop and prioritizecompetencies so curricula can be updated regularly to ensure that graduates at all levelsare prepared to meet the current and future health needs of the population." (IOM, 2010)                             

                   

Limited Faculty

Recommendation 5: Double the number of nurses with a doctorate by 2020. Schools of nursing, with support from private and public funders, academic  administrators and university trustees, and accrediting bodies, should double the number of nurses with a doctorate by 2020 to add to the cadre of nurse faculty and researchers, with attention to increasing diversity.        

Limited Funding and Time

Limited evidence supporting the best methods by which to accomplish enhanced Geriatric Education Across the Curriculum

 

Curriculum Philosophical Approach

  

Synergy Model of Nursing Education??• Originally developed to link patient outcomes with certified

critical care nurses• Learner center stage• Continuum with opposing end points to describe both

educators and learners.• Matching the needs of the learner and competency of the

educator optimizes learning.orConstructivism plus collaborative inquiry (Iwasi, pp. 179)• Meaning and knowing are constructed; learning is

connected; new understandings occur between among students teachers and clients. 

• generation of new knowledge from reflection, shared power, active learning and decision making

Curriculum Philosophical Approach

Educator Competencies

Clinical JudgementAdvocacyCaring PracticesCollaborationSystems thinkingResponse to diversityClinical inquiryFacilitator of learning

Learner Characteristics

ResiliencyReadinessExperiencesVulnerabilityResource AvailabilityParticipation in learning    & decision makingPredictability

Curriculum Philosophical Approach

 

Curriculum Philosophical Approach

Cognitive Apprenticeship: Mentoring

Curriculum Design

See Matrix

Curriculum Evaluation Plan

Definition: 

Thoughtful, organized appraisal of  the central elements 

of the course of study  

     

Curriculum Evaluation Plan

Purpose: 

• To ensure relevant, internal consistency 

• Implementation fidelity• Outcomes congruency• Student/faculty satisfaction

    

     

Curriculum Evaluation Plan

Reasons: 

• Ensure standards • Justify fiscal/resources requests

and allocation • Obtain data for maintenance or

modification or discontinuation    

     

Curriculum Evaluation Plan

Types  

oInternal:  Program-based • External:  Accrediting/Regulatory

bodies (CCNE, NLNAC)      

Curriculum Evaluation Plan

Frequency based 

• Formative:  Regular intervals for feasibility and effectiveness

 • Sumative:  At the end of a course

or the program.      

Curriculum Evaluation PlanPlanning of curriculum evaluation (Iwasiw, Goldenberg, & Andrusyszyn, 2009  1.Determine purpose and audience2.Consider internal vs external consistency and

fidelity3.Individual or committee responsible for

coordination of the CE4.Evaluate the CE Model to be used5.Evaluate the CE questions to be addressed

(small bites)6.Consider the standards or criteria to be used

Curriculum Evaluation Plan cont.1.Decide the data essential to answer the CE

questions2.Methods and timing of data collection

(Include person responsible for obtaining 3.and providing data4.Repository for the data collected5.Individuals to interpret, judge the evidence

and formulate recommendations for moving forward.

6.Process for reporting the CE results to the relevant audience

7.Deadline for the completion of CE

Curriculum Evaluation Plan Components of curriculum Evaluation:1.      Philosophical approaches2.      Curriculum outcome statements3.      Curriculum design4.      Curriculum outcomes5.      Courses6.      Teaching-learning strategies7.      Strategies to evaluate student                achievement8.      Human and physical resources9.      Learning climate10.    policies

Curriculum Implementation

 

BibliographyAmerican Association of College of Nursing (2010). Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older adults. Retrieved from http://www.aacn.nche.edu/education/pdf/AACN_Gerocompetencies.pdf Center for Disease Control [CDC] (2010).  Healthy AgingRetrieved from www.cdc.gov/aging Institute of Medicine  (2008). Retooling for an aging America building the health care workforce. Washington DC: The National Academies Press.