Implementing a Concept-Based Nursing Curriculum: A Review of the Literature

Planned Approach and Implementation of Pharmacology Teaching in the Bachelor's Veterinary Nursing Programme in Sweden

Veterinary Nurses play a key role in handling drugs and perform medication treatments, thus pharmacological knowledge is essential. The veterinary nurses' role varies widely worldwide but does not include the prescription of drugs. Nevertheless, pharmacology is a complex subject within veterinary nursing education and for the registered veterinary nurse in practice. In this article, we describe and discuss the pedagogical questions "what, why, and how" of teaching pharmacology to undergraduate veterinary nurses implemented in the Veterinary Nursing programme in Sweden. The program has undergone vast changes with classes increasing from 40 to 120 students during the last decade. The progression in the program is presented as intended learning objectives, the teaching and learning activities, and the assessment tasks in each course concerning pharmacology. The procedure of several student-activating pedagogical methods is presented. The use of students' evaluations to assess the education, in line with student-centered education, is described. This information can be useful for veterinary nursing program directors, course leaders, administrators, or teachers considering undertaking curricular changes.

Nurse educators' experience in implementing concept-based curriculum: a phenomenology study

OBJECTIVES

This study explores the experiences of nurse educators in Qatar implementing the Concept-Based Curriculum (CBC), identifying barriers and facilitators to improve strategies and support.

METHODS

A phenomenological approach based on Van Manen was used. Data from semi-structured interviews with 18 nurse educators were transcribed and analyzed using Colaizzi's method with NVivo software.

RESULTS

Three key themes emerged: Challenges in CBC Implementation, Institutional Support, and Practical Integration and Adaptation. Educators encountered obstacles such as insufficient training, transition difficulties, and resistance to change. However, strong leadership and collaboration eased the transition. Over time, resistance diminished as educators observed enhanced critical thinking and clinical judgment in students.

CONCLUSIONS

Effective CBC implementation requires comprehensive training and strong institutional support. Continuous adaptation of teaching methods to meet diverse student needs is essential. These findings provide valuable insights for future curriculum reforms and emphasize the importance of strategic educational approaches to improve CBC outcomes.

Integrating Faith and Learning Using a Biblical Concept-Based Curriculum

ABSTRACT

The integration of faith and learning (IFL) in nursing has deep historical roots. However, barriers have developed to successful IFL in Christian higher education. A biblically based concept curriculum (BBCC) is proposed that emphasizes deep learning, critical thinking, and student-centered learning. Examples are provided of BBCC curricular integration, pedagogical methods, and assessments related to the IFL. Results of student evaluations before and after implementation of the BBCC identified an increase in students' perceptions of IFL in nursing courses.

Nursing educational framework: A new nurse-driven, conceptually guided approach

PURPOSE

The aim of this article is to present the Nursing Educational Framework (NEF) as an opportunity to integrate core elements of a humanistic person/family-centered view and as guidance in structuring a relationship-based curriculum.

DATA SOURCES

Empirical and theoretical literature studies were reviewed to define the framework rationale and its components.

DATA SYNTHESIS

A deductive/inductive collaborative expert-informed approach was undertaken to develop this evidence-based codesigned framework. Its mission, along with unique components, implementation strategies, and outcomes, were successively integrated into the framework to guide nursing knowledge, learning, and curriculum development. A hermeneutic collaborative process of circular reflection was used in the development process.

CONCLUSIONS

The NEF contains central guiding principles and concepts that are intended to provide structural consistency across its included programs from a humanistic person/family-centered approach.

IMPLICATIONS FOR NURSING PRACTICE

This comprehensive theory-guided framework allows educators to suggest specific directions for nursing practice within the nursing discipline and articulate nursing's unique and specialized approach to promoting excellent patient care outcomes. It can assist students to develop critical lens from a person/family-centered relationship-based practice approach.

Call to Action: Bolstering the Diminishing Pediatric Nursing Workforce

BACKGROUND

Pediatric workforce shortages became more apparent with coronavirus disease 2019 (COVID-19) and the rise in other viruses. Among factors affecting these shortages are undergraduate and graduate curricula that include pediatric content and clinical experiences.

METHOD

A narrative review was conducted to examine the state of the pediatric nursing workforce, describe curricular models in undergraduate and graduate programs, and determine the effects of these models on pediatric content and clinical experiences as well as subsequent employment in pediatric nursing.

RESULTS

Curricula affect knowledge of pediatric content and clinical ability to practice, potentially resulting in direct care pediatric workforce shortages and subsequently the number of pediatric nurse practitioners, nurse scientists, and faculty.

CONCLUSION

Research is needed on specific shortages in the pediatric workforce, standardization of required pediatric content and clinical hours, and simulation versus in-person clinical experience to prepare graduates for practice, as well as practice perspectives of new graduates' ability to practice. [J Nurs Educ. 2024;63(12):806-812.].

Outcomes of Concept-Based Curricula: An Integrative Review

BACKGROUND

Complexity and change in health care environments, the rapid pace of knowledge generation, and changing education policy have led to national calls for change in nursing education. Many nursing programs have adopted a concept-based curriculum (CBC) to address these challenges. Yet, much is still uncertain about the outcomes and effectiveness of CBC, which requires large scale, time-consuming, and resource-intensive change.

METHOD

This integrative review assesses the outcomes of CBC in nursing higher education with a focus on the comparison of CBC to traditional curricula.

RESULTS

The four relevant themes that emerged after an extensive literature review were critical thinking/clinical judgment, NCLEX-RN© (National Council Licensure Examination for Registered Nurses) pass rates, graduation rates, and student satisfaction scores. Overall, the evidence base is not robust. A valid and reliable tool to measure clinical judgment is needed. The review specifically addresses CBC effects on student critical thinking and clinical judgment, traditional outcome metrics, (NCLEX-RN success, graduation rates, and student satisfaction), and other perceived benefits.

CONCLUSION

The authors found promising results on the effect CBC may have on critical thinking and clinical judgment and other perceived benefits. Findings were inconclusive on traditional outcome metrics. [J Nurs Educ. 2024;63(11):725-729.].

Integrating innovation and competency-based education in the development of a new direct-entry master of science in nursing program

There has been a call for nursing programs to shift to Competency-based education (CBE). Competency-based education has numerous benefits in nursing education. A curriculum that includes both concepts and competencies helps students and stakeholders understand what new nurse graduates will be able to do with the knowledge they construct throughout the program. Competency-based education is student-centered, flexible, and dependent on students actively engaging in their learning. A small faculty team developed a new direct-entry MSN program, based on essential components of CBE. This article describes the process of incorporating CBE into the development of the program, as well as challenges and barriers to fully implementing CBE into the curriculum.

The effects of introducing virtual reality communication simulation in students' learning in a fundamentals of nursing practicum: A pragmatic randomized control trials

AIM

This study was conducted to examine the effectiveness of a virtual reality communication simulation (VRCS) in teaching communication skills in fundamentals of nursing practicum.

BACKGROUND

Effective communication skills are an integral part of the nursing profession and the foundation of high-quality nursing care. Effective communication not only addresses the needs of patients but is also necessary for maintaining patient safety. Many studies have reported the inadequacy of nursing students in communicating with patients. Nursing students often experience stress due to their lack of adequate skills to communicate effectively with patients and their family members.

DESIGN

A pragmatic randomized controlled trial research with four within-subjects assessments (at the baseline (T0), 1st week (T1) and 3rd week (T2) of the clinical practice and 1 week after the end of the clinical practice (T3)) and between-subjects assessments.

SETTINGS AND PARTICIPANTS

Eighty-four nursing students at a university of Science and Technology in central Taiwan.

METHODS

The students were randomly assigned to an experimental group (n = 42) and a control group (n = 42). The experimental group received a VRCS, whereas the control group received the nurse-patient communication teaching video. The data were collected from April 2022 to August 2022. The Kalamazoo Essential Element Communication Checklist, Communication Self-Assessment Scale, Learning Satisfaction Questionnaire and Stress Scale for Nursing Students in Clinical Practice were used for data collection.

RESULTS

At baseline, the control group had higher scores on communication ability and confidence compared with the experimental group (t = -3.91, p <.001; and t = -2.35, p =.021). In the first week of clinical practice, the experimental group had significantly higher mean scores for communication ability compared with the control group (β = 15.99, 95 % confidence interval [CI] 13.79, 18.18) and communication confidence and learning satisfaction compared with controls at T1, T2 and T3 of the clinical practice (all, p <.001). The clinical practice stress scores of the experimental group were significantly lower than those of the control group at T1, T2 and T3 of the clinical practice (all, p <.05).

CONCLUSIONS

The newly developed VRCS is acceptable and worthwhile for training nursing students to develop communication abilities. This study suggests that VRCS practice should be arranged as early as possible in fundamentals of nursing practice courses and before the fundamentals of nursing practicum so as to facilitate the learning of effective communication. Follow-up research is needed to evaluate the long-term effects of virtual reality education in nursing practice.

Developing an international concept-based curriculum for pharmacology education: The promise of core concepts and concept inventories

Over recent years, studies have shown that science and health profession graduates demonstrate gaps in their fundamental pharmacology knowledge and ability to apply pharmacology concepts in practice. This article reviews the current challenges faced by pharmacology educators, including the exponential growth in discipline knowledge and competition for curricular time. We then argue that pharmacology education should focus on essential concepts that enable students to develop beyond 'know' towards 'know how to'. A concept-based approach will help educators prioritize and benchmark their pharmacology curriculum, facilitate integration of pharmacology with other disciplines in the curriculum, create alignment between universities and improve application of pharmacology knowledge to professional contexts such as safe prescribing practices. To achieve this, core concepts first need to be identified and unpacked, and methods for teaching and assessment using concept inventories developed. The International Society for Basic and Clinical Pharmacology Education Section (IUPHAR-Ed) Core Concepts of Pharmacology (CCP) initiative involves over 300 educators from the global pharmacology community. CCP has identified and defined the core concepts of pharmacology, together with key underpinning sub-concepts. To realize these benefits, pharmacology educators must develop methods to teach and assess core concepts. Work to develop concept inventories is ongoing, including identifying student misconceptions of the core concepts and creating a bank of multiple-choice questions to assess student understanding. Future work aims to develop and validate materials and methods to help educators embed core concepts within curricula. Potential strategies that educators can use to overcome factors that inhibit adoption of core concepts are presented.

Nursing Graduates' Preparedness for Practice: Substantiating the Call for Competency-Evaluated Nursing Education

Practice readiness continues to be a challenge in healthcare. This was especially evident during the COVID-19 pandemic. This focused descriptive-correlational study examined nurses' perceived preparedness for practice during the pandemic. One hundred and eighty-four registered nurses (RN) responded to Qualtrics survey questions addressing the competencies they perceived they had and the competencies they felt they needed that would have better prepared them to care for patients during the COVID-19 pandemic. The results demonstrated that although these nurses felt competent in certain areas, they perceived that they needed more education in those same areas to feel better prepared. Bivariate correlations and linear regression analysis indicated that institutional competency development, education, and work experience influenced perceived competency.

Should the concepts chosen to guide concept-based curricula be threshold concepts?

In this paper we propose that the concepts guiding concept-based curricula should be threshold knowledge concepts. We briefly discuss some of the hurdles of current concept-based curricular designs and describe how the concepts themselves, paradoxically, might perpetuate the continued emphasis on content in nursing courses. Until now, threshold concept theory has not been part of the mainstream conversation about concept-based curricula. Threshold concepts act as portals to professional identity development and are recognized by their troublesome and transformative potential to enhance knowledge acquisition and change worldviews. This feature differentiates them from the core concepts often described within concept-based curriculum literature. The identification of threshold concepts in existing nursing courses might help structure curricular revision with the goal of enhancing transfer of learning and decreasing faculty resistance to the concept-based curricular approach.

Identifying important conceptual areas in a nursing education programme to meet future demands, using group concept mapping

A nursing programme in southern Sweden was revised to meet future demands. The aim of this study was to explore important conceptual areas to be included in a nursing programme in order to meet long-term societal and health care requirements. Group concept mapping (GCM), a mixed-methods approach, was used. Thirty-four experienced teachers participated. Data was collected during brainstorming sessions in focus groups. Following editing and removal of duplicates, 101 statements remained to be sorted into piles that had similar conceptual representation in nursing education. The final step was then to rate each statement from 1 to 5 (higher values = more important/more feasible). Quantitative analysis using non-metric multidimensional scaling and hierarchical cluster analysis resulted in 11 clusters. Assessment and treatment and Person-centred care were rated as the most important and Scientific theories and methods, Basic caregiving in nursing and Person-centred care had the highest feasibility ratings. Further analyses suggested that the content of nursing education can be seen from a systems theory perspective, represented by the macro, meso, and micro levels. These levels may increase the understanding of the complexity of nursing care. Furthermore, the cluster analysis can facilitate the development of a concept-based curriculum for nursing education.

A Rapid Transition to Virtual Simulation: The Creation of Virtual Simulation Doulas

ABSTRACT

Following COVID-19-related closures of clinical and simulation learning sites, a Jesuit college of nursing made a two-week pivot from in-person to virtual clinical learning. In response, the simulation team reinvented their role to provide extensive support in the Jesuit pedagogical tradition. These self-titled "simulation doulas" removed all nonteaching tasks from faculty, remained available for questions and concerns, and became experts on the simulation platforms. The simulation doulas' success in facilitating such rapid transition relied on remaining transparent in communication, anticipating needs, embracing adaptability, and conveying a spirit of empowerment to stakeholders.

Application of the Threshold Concept Framework in Nursing: An Integrative Review

BACKGROUND

The shift to concept-based curricula requires nurse educators to be selective with disciplinary content to avoid overburdening curricula. Although educators strive to make these concepts explicit, some learners find them troublesome. These troublesome concepts are often threshold concepts, which are critical to understanding disciplinary knowledge.

PURPOSE

The purpose of this integrative review was to examine how the threshold concepts framework has been applied within nursing to facilitate student learning of troublesome knowledge.

METHOD

Whittemore and Knafl's integrative literature review methodology was used.

RESULTS

Twenty articles were included representing a diverse selection of literature. Data analysis resulted in 3 themes: framing difficult knowledge, developing pedagogical strategies, and designing nursing curricula.

CONCLUSION

The threshold concepts framework aids in redesigning pedagogy to engage students at critical points in the learning process, helping them successfully navigate encounters with troublesome knowledge. The framework also provides guidance for identifying and sequencing concepts critical to the discipline to avoid overcrowded curricula.

Faculty's experience in developing and implementing concept-based teaching of baccalaureate nursing education in the Chinese context: A descriptive qualitative research study

BACKGROUND

Nursing education faces daunting challenges in preparing graduates to think critically in the context of the complex healthcare system of practice. Concept-based teaching (CBT) is an effective approach used in curriculum reform to cultivate critical thinking and active learning abilities in nursing students.

OBJECTIVES

This research aims to investigate faculty's experiences while developing and implementing CBT, and clarify barriers to and facilitators of CBT reform in China.

DESIGN

A descriptive qualitative study.

SETTING

A university in middle China.

PARTICIPANTS

Full-time teachers teaching in a four-year undergraduate nursing program that offers CBT.

METHODS

This study used a purposive sampling method and collected data through semi-structured interviews. The researchers digitally recorded and transcribed each interview verbatim. The conventional content analysis method was used to examine the faculty's experiences while developing and implementing CBT. Theoretical saturation was achieved using ten educators due to the group's high homogeneity.

RESULTS

Through the data analysis process, five themes emerged from the participants' descriptions: questioning themselves, taking responsibility, struggling with conflict and stress, recognizing support, and feeling worthwhile. Thirteen subthemes were also identified. The overarching themes extracted from the participants' experiences were struggling with conflict and stress and feeling worthwhile.

CONCLUSION

The faculty's CBT experiences ranged from curiosity and expectation at the initial stage to confusion in the face of challenges at the middle stage. The faculty ultimately believed that their time and energy were well-invested. Faculty faced significant challenges due to students' resistance, peer maladjustment, and inner conflict during the reform process, but the administrators supported their transition and helped them overcome difficulties through change theory-based workshop training. Developing effective strategies was indispensable to reduce both faculty's and students' resistance and negative reactions.

Patient safety educational interventions: A systematic review with recommendations for nurse educators

Aim

This study identified and evaluated tested patient safety educational interventions. This study also described the content, curricular structures and teaching strategies of the educational interventions and determined the methods used for evaluating patient safety learning outcomes.

Design

The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines directed this review.

Methods

Searches for articles describing and evaluating patient safety educational interventions were conducted using four scholarly databases. Study quality was assessed using the McMaster Critical Review Form.

Results

Seven studies met the inclusion criteria. Educational interventions were either presented as stand‐alone courses or as lessons embedded in an existing course. All studies employed a mixture of various teaching modalities and several evaluation methods and outcomes. Mixed results were observed in terms of the effects of educational interventions. Future researchers should continue to develop patient safety curricula and examine their effect on student competencies with stronger methodological rigour.

Sustaining a Concept-Based Curriculum: Beyond the Launch

BACKGROUND

Many schools of nursing are transitioning to a concept-based curriculum (CBC) to better prepare students to practice across complex practice settings.

PROBLEM

Current literature focused on transitioning to a CBC lacks discussion on how to sustain a CBC once it is implemented.

APPROACH

In this article, the authors emphasize the importance of intentionally sustaining a dynamic CBC and provide strategies to accomplish this aspect of the curriculum trajectory.

CONCLUSION

The authors recommend a multipronged approach to sustainability that takes into account the dynamic nature of curricular change, implementation, and evaluation. Strategies are centered around themes of promoting effective use of a dynamic curricular model, stakeholder engagement, and leadership.

Educational Interventions for Nursing Students to Develop Communication Skills with Patients: A Systematic Review

INTRODUCTION

Nursing students establish therapeutic relationships with their patients and as future nursing professionals, they should be trained to be effective communicators. The objective of this systematic review was to know the impact of educational interventions on nursing students to develop their communication skills with patients.

METHODS

A systematic review of literature was carried out. The following databases were consulted: CINAHL, PubMed (Ovid Medline), SCOPUS and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. As for inclusion criteria, published articles in English from 2000 to 2020 were included. The methodological rigor of the included articles was evaluated with the JBI Critical Appraisal Checklist for Randomized Controlled Trial or Quasi-Experimental Studies. Changes in communication skills with the patient after the implementation of an intervention were analyzed.

RESULTS

Of the included studies in this systematic review (N = 19), two studies were randomized controlled trials, others were single group quasi-experimental studies (N = 11) and two group quasi-experimental studies (n = 6). The majority of the studies were carried out in the USA (n = 7). The most frequent educational intervention was simulation (n = 11). As for the improvement of communication skills, 13 of the 19 articles found statistically significant differences in patient-centered communication skills of nursing students.

CONCLUSIONS

This systematic review provides preliminary evidence of the effectiveness of interventions used to train nursing students in patient-centered communication. Although all the interventions obtained significant results in communication skills, it has not yet been determined which methodology is more effective.