Nursing Curriculum Development and Evaluation

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Table of Contents

Competency Statements and Learning Objectives
Strategies of Learning Outcomes Evaluation
Criterion-Referenced and Norm-Referenced Tests
Advantages and Disadvantages of True-False and Multiple-Choice Test Items
A Multiple-Choice Item
Cultural and Societal Factors in Students’ Learning
Facilitating Learning Through Learning Activities
Critical Thinking Strategy
Best Feedback Practice in the Clinical Setting
References

Competency Statements and Learning Objectives

Four competencies and their alignment with standards

Competency statement 1: Identify the values, preferences, and needs of a patient and effectively explain them to other members of the health care team. This competency complies with a skills requirement listed by Quality and Safety Education for Nurses (QSEN) (“QSEN competencies,” 2014) under the Patient-Centered Care section; particularly, the skill of providing care with sensitivity and respect.

Competency statement 2: Demonstrate awareness of their strengths, weaknesses, opportunities, and threats as a member of a health care team and construct a plan for self-development in the area of collaboration. This competency complies with the first requirement of QSEN in the Teamwork and Collaboration section; particularly, the attitude of recognizing the potential to make contributions to the team.

Competency statement 3: Summarize own clinical experience, construct evidence-based guidelines, and apply them to actual clinical situations. This competency complies with various QSEN’s requirements in the Evidence-Based Practice section, particularly, the attitude toward EBP as an integral part of establishing better clinical operation.

Competency statement 4: Evaluate the impact of care provided to patients in clinical conditions on population-wide developments and processes. This competency complies with the QSEN’s requirements in the Quality Improvement section; particularly, the skill of finding data on care outcomes, analyzing it, and using it in the process of designing care improvement initiatives.

Learning objectives for competency 1

Judge the importance of the patient, family, and community dimensions of patient-centered care.
- Learning resource: Patient feedback.
- The criterion for selecting appropriate learning resources: Appeal.
Evaluate how diverse backgrounds, including social and cultural backgrounds, affect different values, preferences, and needs of patients.
- Learning resource: Instructional media.
- The criterion for selecting appropriate learning resources: Width of the diversity range.
Critique clinical practices and approaches to care for compliance to provide optimal comfort and support to a patient.
- Learning resource: Guidelines.
- The criterion for selecting appropriate learning resources: Applicability.

3. Combining contemporary and traditional approaches, blended approaches can be seen as concessions made to fit progressive educational strategies and practices into limited classroom conditions with the considerations of “class size, agreements with clinical agencies, and policies of the educational institution” (Iwasiw, Andrusy, & Goldenberg, 2009, p. 244). However, blended approaches can also be seen as optimal combinations of different aspects of curriculum development that are designed to fit particular educational conditions, which is why these approaches are appropriate for a Fundamentals course.

Strategies of Learning Outcomes Evaluation

The papers and essay strategy and the oral questioning strategy will be used to evaluate how well curricular aims are achieved. An advantage of the papers and essays strategy is that it promotes writing skills and critical thinking along with encouraging creativity in a student (Billings & Halstead, 2012). An advantage of the oral questioning strategy is that it allows an instructor to see if learning outcomes are successful in real-time, i.e. if a student can demonstrate what he or she has learned without consulting a textbook or notes.
A disadvantage of the papers and essays strategy is that it is time-consuming for both learners and educators. A disadvantage of the oral questioning strategy is that it can be stressful and overwhelming for a student to answer questions in front of a teacher (Billings & Halstead, 2012).

Criterion-Referenced and Norm-Referenced Tests

Criterion-referenced tests set absolute standards for evaluating students’ performance (Billings & Halstead, 2012), which is why they will be used in the Fundamentals course to evaluate how well such areas of nursing education as drug dosage are understood by students.
Norm-referenced tests are designed to generate relative ranking, which is why they will be used in the Fundamentals course to grade papers and answers.

Advantages and Disadvantages of True-False and Multiple-Choice Test Items

The advantages of true-false test items are that they can contain larger amounts of diverse information than other test items; students can be given more items like this because their completion is less time-consuming, and evaluation is convenient.
The disadvantages of true-false test items are that they can be completed by guessing; they are limited to two choices (while real-life situations can be considerably more complicated), and they may not always test actual knowledge—if a student chooses the false option, it does not mean that he or she knows what is true in the given context.
The advantages of multiple-choice test items are that they allow educators to fit a lot of studied materials in one test; the scoring is convenient, and guessing is less likely to affect the results than in true-false tests.
The disadvantages of multiple-choice test items are that creating them can be time-consuming for educators—a major complication is a creation of “plausible distractors” (Billings & Halstead, 2012, p. 428); reading and comprehending these items can take a lot of learners’ time, too; creativity is not encouraged, and these items test the ability to recognize a correct answer rather than to produce it.

A Multiple-Choice Item

A multiple-choice item for learning objective 1: Judge the importance of the patient, family, and community dimensions of patient-centered care.

The daughter of a 75-year-old male patient receiving palliative care asks you how her father is doing. You should:

Tell her to talk to her father;
Tell her to talk to her father’s physician;
Tell her everything you know about her father’s state;
Tell her she is not supposed to know the answer to her question.

When constructing the stem of a multiple-choice question, it is important to consider that the question should be clear enough for a student to provide an answer without even looking at the multiple options.
When developing response options, it is important to make them plausible and make them sound equally valid. Also, it is useful to make sure that the response options are of approximately the same length because students tend to choose longer, more elaborate answers over short and general ones, which is a guessing technique that can affect scores.
Posttest reviews can be beneficial because they not only provide correct answers to students who were not sure which answer was correct but also enable discussions. Students can discuss not only why the correct answer is correct but also why the incorrect ones are incorrect.

The correct answer to the multiple-choice question above is a. Telling the patient’s daughter to talk to her father first follows the principle of patient autonomy (Burkhardt & Nathaniel, 2013); the answer d. indicates a failure to meet the learning objective of promoting family involvement in care.

Cultural and Societal Factors in Students’ Learning

There are various possible ways in which a student’s cultural, societal, and personal backgrounds can affect his or her learning experiences in the classroom (Bastable, 2014). For example, in some cultures, it is more encouraged to be active during a lesson, i.e. talk to the teacher and express opinion. In other cultures, on the contrary, it is acceptable to stay silent and not participate in discussions until you are specifically asked to do so by a teacher. This can create barriers to interactive learning and equal participation, which is why cultural norms should be taken into consideration by educators.

Facilitating Learning Through Learning Activities

Learning activity for learning objective 3: Critique clinical practices and approaches to care for compliance to provide optimal comfort and support to a patient.

A group of students will be asked to approach the whiteboard and write in different parts of it as many factors as they can come up with that could cause a patient’s discomfort. A different group of students will be then asked to write under each factor a possible solution or several solutions that a nurse can initiate.

The activity helps meet the learning objective because students receive an opportunity to critically discuss in the classroom what clinical practices can contribute to better care, comfort, and support for a patient upon identifying together what can cause discomfort.

The proposed activity corresponds to the visual learning style, which is the most widespread learning style (Bastable, 2014). Many students will be able to memorize the image of the whiteboard with discomfort factors and solutions for them on it; students will also be able to refer to this image in test-taking as well as actual clinical practice.

Critical Thinking Strategy

The critical thinking strategy that will best facilitate the development of self-reflection skills in the suggested Fundamentals course design is concept mapping. The learning activity suggested above is the first step to concept mapping: assigning solutions to each formulated problem allows further reflection on the connections among concepts. Concept mapping is a hierarchical approach (Billings & Halstead, 2012) that allows structuring large amounts of knowledge a student receives into intelligible and applicable systems. This approach contributes to critical thinking because learners need to establish which concepts are primary, which ones are secondary, which ones are tertiary, and so on, i.e. thorough evaluation is required.
With concept mapping, self-reflection is promoted by providing valuable feedback to a student about his or her thinking process. If performed in groups or by the entire class in the classroom, concept mapping is a collective effort, in which a student can compare his or her critical thinking process and outcomes to those of other students, which promotes self-reflection. If performed individually, concept mapping assignments should be provided with feedback from a teacher or peers to let a student know the strengths and weaknesses of his or her critical and structural thinking.

Best Feedback Practice in the Clinical Setting

An example of a best practice for providing feedback to learners in the clinical setting is authorizing a clinical mentor to provide regular feedback based on observing the behavior and performance of a student. The effectiveness of this method has been confirmed (Anderson, 2012), but what needs to be necessarily ensured is that the mentor does not perform an evaluation, i.e. summative assessment in which the performance of a student is described and compared to standards, but provides feedback, i.e. formative assessment in which it is recommended how behaviors and practices may need to be changed for improvement.

References

Anderson, P. A. (2012). Giving feedback on clinical skills: Are we starving our young? Journal of Graduate Medical Education, 4(2), 154-158.

Bastable, S. B. (Ed.). (2014). Nurse as educator: Principles of teaching and learning for nursing practice (4th ed.). Sudbury, MA: Jones and Bartlett.

Billings, D. M., & Halstead, J. A. (2012). Teaching in nursing: A guide for faculty (4th ed.). St. Louis, MO: Elsevier.

Burkhardt, M. A., & Nathaniel, A. (2013). Ethics and issues in contemporary nursing. Boston, MA: Cengage Learning.

Iwasiw, C., Andrusy, M., & Goldenberg, D. (2009). Curriculum development in nursing education (2nd ed.). Boston, MA: Jones & Bartlett.

QSEN competencies. (2014). Web.

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