Running head: ASSIGNMENT 2 1

Assignment 2

Evaluation of Curriculum through Application of National Guidelines

Stephany Villacres

SUNY Delhi

NURS 602: Curriculum Development and Instructional Design

Dr. Kirsty Digger

September 22, 2017

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Rationale for Student Outcomes Aligning With Program Outcomes

The goal of student learning outcomes (SLO) is to define a set of objectives of what

students will learn in that specific course. The program that the students are participating in also

set goals that students are expected to achieve upon program completion. The College of New

Rochelle (CNR) have asked educators to align their student learning outcomes with those of the

program outcomes for the Baccalaureate in Nursing degree. In this manner the college is assured

that the program outcomes are being met in each undergraduate course in nursing. Therefore,

when students graduate from the BSN program, they have met the program outcomes along with

complying with CCNE Standards.

Student Learning Outcome #1 and Program Outcome #1

For this course, NUR 314: Nursing II Synthesis: Acute Health Problems, students will

meet five learning outcomes, and each one clearly states how the outcome will be achieved.

Program outcome #1 states that the student will be able to, Synthesize concepts and theories

from the liberal arts and sciences and professional studies as the foundation for nursing practice

within an interdisciplinary, holistic, caring-healing framework (CNR, 2017). In this course the

professor has aligned SLO #1 with this specific program outcome. The nursing student will be

expected to utilize their background education (pre-requisite coursework) in the liberal arts and

sciences, and apply it to adult health nursing practice. For example, two of the pre-requisite

courses at CNR are general psychology and developmental psychology. What was learned from

these courses can be applied when conducting a psychosocial assessment of the patient. The

prior knowledge obtained from these psychology courses will not only help with this aspect of
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nursing but will be seen throughout the undergraduate curriculum in therapeutic communication,

family and patient teaching, implementation of care plans, etc.

Another pre-requisite before beginning nursing courses at CNR are chemistry, biology,

and anatomy & physiology. One of the student learn outcome objectives is for students to use

this background and apply their knowledge from these courses when formulating a teaching plan.

A teaching plan can consist of many parts, however it is especially important to have some

familiarity in the sciences when educating the patient on their illness. These background courses

are the foundation on which we learn nursing and it also aids the student in developing their

critical thinking skills.

Student Learning Outcome #2 and Program Outcome #2

Program outcome #2 states, Use clinical and critical reasoning and other ways of

knowing as a basis for providing safe, ethical, and evidence-based client care (CNR, 2017).

This aligns with NUR 314 student learning outcome #2 in which students are expected to apply

their critical reasoning skills in order to care for the adult patient in a healthcare setting. The

student will evidence these outcomes being met by utilizing the comprehensive assessment in

order to care for the patient adequately. He/she will learn the value of a comprehensive

assessment when diagnosing, planning care, and evaluating patient outcomes. The student will

be expected to prioritize their care according to the patients condition and their response to care.

This will allow the student to further understand the principle dynamics underlying nursing care.

Along with this foundation the student is expected to deliver safe and ethical care by adhering to

the ANA Standards of Clinical Nursing Practice. These standards guide our clinical practice and

provide a framework in which to practice safely within our scope. Its important
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Student Learning Outcome #3 and Program Outcome #3

Use effective communication and information literacy as a foundation for professional

nursing practice and interdisciplinary collaboration (CNR, 2017) is program outcome #3 for the

Bachelor in Science of Nursing at CNR. This program outcome aligns with student learning

outcome #3 in which students are to use effective communication in their professional practice.

In this course the student will use therapeutic communication skills when engaging with adult

patients. Therapeutic communication in nursing is essential in order to provide safe and

competent care.

Effective communication does not only pertain to direct patient communication but also

indirect, such as charting, collaborating with other disciplines, providing hand-off, and most

importantly anticipating our patients needs. Students will document in the patients chart

according to hospital policy, legal, and ethical principles learned throughout this course. Students

will further demonstrate effective communication when providing discharge education to their

patients utilizing an appropriate evaluation tool such as teach-back. These are all forms of

communications that are used to direct and enhance our patient care.

Student Learning Outcome #4 and Program Outcome #4

One of the hallmarks of a CNR nursing education is providing holistic care. Program

outcome #4 embodies this principle because the focus is to, Care for clients from diverse,

multicultural, and evolving global environments within a holistic, caring-healing, evidence-

based, ethical framework (CNR, 2017). Throughout this course, students will learn a variety of

concepts and techniques and be able to apply what theyve learned in a holistic manner in order

to care for the adult population. Student learning outcome #4 focuses on the clinical aspects of
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nursing while still emphasizing the need for nursing interventions that are appropriate for each

individual patient; taking into account the patients background and culture. Initially the student

will be taught how to safely and competently administer medications in all forms, practice

standard precautions when delivering nursing care, and conduct a basic physiological

assessment. Once, the student is proficient in these areas, students will apply these interventions

in conjunction with the patients own beliefs and values. Student will learn how to adapt their

practice and formulate an action plan in order to productively care for the patient while still

taking into consideration their own personal belief system. All of these interventions allows us to

care for our patients in a holistic caring manner.

Student Learning Outcome #5 and Program Outcome #5

Lastly, program outcome #5 states that the student will be able to, Demonstrate

commitment to leadership and professional development, including healthcare policy advocacy,

self-care management, reflective learning, and service to society (CNR, 2017). Throughout this

course, Nursing II Synthesis: Acute Health Problems, students will demonstrate commitment to

professional role development by being self-aware of their professional interactions and

behaviors when interacting with the adult population.

Professional role development does not only apply to how one carries themselves

personally but also how one relates and cares for others. Students will need to deliver evidence

based care to their adult population, this will demonstrate a commitment to competent nursing

skills and professional development. Students will also be responsible for their patients in the

clinical setting and demonstrate accountability and reliability during clinicals hours.

Furthermore, students will demonstrate a personal commitment to role development by utilizing

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the code of ethics to guide the students practice with the adult population. The code of ethics is a

statement of ethical obligations and principles that promote a safe and caring environment in

which to treat patients. Applying the code of ethics to ones work allows for not only holistic

care to be provided but also allows the student to grow as a professional.

Rationale for Student Outcomes Aligning with CCNE Standards

The Commission of Collegiate Nursing Education (CCNE) evaluates nursing programs to

ensure that quality and professional education is being given to students who attend CCNE

accredited universities. It is important to highlight that accreditation by the CCNE is based on the

institutions voluntary participation to partake in continuous self-assessment and quality

improvement of their program. It is a process institutions willingly choose to partake in order to

demonstrate to the public and other organizations their commitment to producing quality

registered nurses.

The CCNE has developed a set of standards used to evaluate baccalaureate nursing

programs. These standards measure program quality and effectiveness of the baccalaureate

nursing program. This course is unable to measure all four of the CCNE standards. However,

standard III which measures program quality: curriculum and teaching-learning practices can be

met in three different areas.

Standard IIIA

Standard IIIA focuses on the curricular objectives that the course outlines and ensures

that they are related to the student learning outcome. In the course syllabus the professor outlined

the student learning outcomes that will be achieved in the course along with a specific set of

objectives. These objectives are further related to the role and practice of a professional nurse.
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More importantly the CCNE requires that all student learning outcomes are congruent with the

institutions program outcomes. As I mentioned previously CNR has prearranged that all student

learning objectives be congruent with the baccalaureate in nursing program outcomes. Therefore,

ensuring that IIIA is met.

Standard IIIC

Another standard that is able to be met by this courses student learning objective #1 is

IIIC. Standard IIIC emphasizes the importance of how non-nursing courses are incorporated into

not only the curriculum but nursing practice. If we look at SLO #1 in which students are

expected to utilize their background in other courses, there are well-defined goals within that

learning outcome that are associated with role of a professional nurse. Furthermore, not only is

the student learning and program outcome met but the objective is related to the professional

practice of a registered nurse. By implementing theoretical knowledge from the non-nursing

courses students will be able to integrate this with nursing knowledge and care for the adult

patient efficiently.

The Institute of Medicine recommended that the nursing workforce should be more

prepared and knowledgeable in order to effectively care for patients from diverse and evolving

health care conditions and backgrounds (IOM, 2010). This recommendation triggered many

institutions to reevaluate their programs, including the prerequisites needed for a baccalaureate in

nursing degree. Giddens & Meyer (2016), formed a workgroup to discuss pre-requisite

coursework needed prior to entry into a nursing program. Their goal was to standardize pre-

requisite courses and propose a set framework for all baccalaureate in nursing programs.

Unfortunately, no specific coursework was determined but four categories for pre-requisite
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coursework was agreed upon, general education, basic sciences, social sciences, and human

sciences. These categories are to serve as the foundation on which nursing education is taught.

Therefore, the rationale of the CCNE setting a standard in which baccalaureate programs

demonstrate how non-nursing courses can be merged with nursing education is appropriate and

essential.

Standard IIIE

Lastly, standard IIIE is met by student learning outcome #4 which emphasizes

competency in the technical skills nurses use regularly when caring for patients. Standard IIIE

proposes that the curriculum should include planned clinical practices in order for the student to

be able to demonstrate competent nursing skills. In this course students are expected to attend

their clinical sites once a week for eight hours at a time for a total of 14 weeks. During this

clinical times students are expected to achieve SLO #4. Student learning outcome #4 lists a

number of nursing interventions that the student must be competent in upon completion of the

course. A few of these nursing interventions are conducting vital signs, administering

medications, administering tube feedings, performing trach care, hanging IV tubing and bags,

cardiac monitoring, etc. These nursing interventions are consistent with clinical experiences that

are needed in order to practice safely as a registered nurse. Once again the SLO is congruent with

the program outcomes and directly related with the role of the professional registered nurse.

QSEN

The Quality and Safety Education for Nurses Institute (QSEN) has composed a set of

competencies that prelicensure programs such as the baccalaureate in nursing should meet in

order to produce quality nurses upon graduation. Six competencies have been established as
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essential to nursing education, patient-centered care, teamwork and collaboration, evidence-

based practice, quality improvement, safety, and informatics. Each competency proposes

objectives to be met in three distinct domains: knowledge, skills, and attitudes. These three

domains are known as KSAs which serve as a guide for institutions to be able to identify gaps in

their teaching between the classroom, clinical practices, and upon graduation the performance of

the graduate as a registered nurse. In this course the student learning outcomes can be associated

with four of the six QSEN competencies.

Student Learning Outcomes Related to Achievement of QSEN Competencies

Patient-Centered Care

In patient-centered care the client is the focal point of our care and commitment. The

patient is regarded as a partner throughout their entire experience. The patient will be the one

providing us with important information regarding their personal belief system, values, and

needs. In this course there was one student learning outcome that was directly related to this

QSEN competency. SLO #4 specifically stated that one of the goals of the course was to care for

the patient in a holistic manner, taking into account his/her diverse and dynamic background.

More specifically one of the objectives of this SLO stated that the student nurse will assume

responsibility for including the patient in all decisions regarding his/her care that would directly

affect their health.

Teamwork & Collaboration

Teamwork and collaboration is an important dynamic in our healthcare system. This

competency underlines the importance of interdisciplinary communication when caring for a

patient to provide the best care possible. SLO #3s objective is to use effective communication
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throughout a students nursing practice. Throughout the course the student nurse will learn how

to gather information from other disciplines through direct and effective communication. The

student nurse will demonstrate how the information collected will be utilized in the patients

assessment, treatment, and discharge planning. When the student nurse communicates with other

disciplines certain KSAs will be fulfilled. Through experience and direct communication the

student nurse will be able to identify if effective communication is taking place and/or identify

any barriers to collaboration that might exist. The student nurse should feel empowered to seek

help and support in order to maximize a patients comfort and treatment. The student nurse will

eventually develop the skills to initiate requests on behalf of her patient care from other disciples

and this will help the student nurse grow as a professional. SLO #3 not only emphasizes the need

for communication across disciplines but it also shines a light on teamwork among the patient

and nurse. One of the objectives is for the student nurse to be able to provide the patient with

appropriate information regarding their health and when ready discharge plan.

Evidence-based Practice

In QSEN this competency is essential to providing quality care to a patient because it

emphasizes the need for evidence-based care to be implemented at every step of treatment. SLO

#1 and #2 achieve this QSEN goal because there is evidence to support the need for these two

learning objectives. SLO #1 focuses on synthesizing what was learned in non-nursing courses in

order to deliver appropriate patient care. There is evidence to support that these non-nursing

courses are essential to the baccalaureate program and more so, serve a direct purpose in

providing patient care. Giddens & Meyer (2016), attempted to standardize the pre-requisite

courses needed for nursing and although this was unable to be done it was very clear that the

need for these courses was essential to nursing practice. One of the reasons why nursing
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educators were unable to agree on exact courses to be used as pre-requisites is because too many

courses were viewed as necessary and valid.

SLO #2 outlines the significance of critical thinking in every aspect of patient care. In

nursing school one develops critical thinking skills as a result of first learning the rationale

behind how things are done. Our critical thinking skills were consistently challenged by

encouraging us to ask why assessment, treatments, and educations were done a certain way. In

nursing, the answer to the why question was almost always evidence-based. Therefore, critical

thinking skills and evidence-based practice go hand in hand because one without the other would

be difficult to do. Knowing about research and evidence enables the student nurse to provide

evidence-based nursing care. Applying this type of nursing care allows us to prioritize our care

with patients, evaluate a patients response to treatment, and challenge/identify any changes that

need to be made in practice.

Quality Improvement

Quality improvement are ongoing evaluations and improvements that are conducted to

strengthen the healthcare system. SLO #5 concentrates on developing a commitment to

professional role development. The student nurse will demonstrate that they are dedicated to

growing not only as an individual and prospective nurse but as a leader in the nursing field. The

student nurse will be able to steadily advance their knowledge and skills, therefore impacting

practice and improving the quality of care for patients.

The course has developed a framework that allows for baseline leadership to be achieved

throughout clinicals, by slowly building on previous knowledge and experience. This will enable

the student nurse to grow as leader as they complete the nursing program. And once out on the
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field empower him/her to seek leadership positions in which they are able to conduct quality

improvement projects to advance and develop our healthcare system. Scott & Miles (2013)

directly correlating the need for advancing leadership capacity in nursing to quality improvement

projects. They suggested that leadership in nursing should be implemented early on in nursing

education, preferably at the bachelor level in order to ensure that newly graduated nurses are

aware of the possibilities of leadership positions. Subsequently once students engage in these

leadership positions it will allow for quality improvement to take place in their respective

positions.

Student Learning Outcome Not Met

In this course one of the requisites is to develop a nursing care plan and teaching plan for

an adult patient at the students clinical site. This assignment often causes confusion and in this

particular class many students were unable to achieve a passing grade. According to the syllabus,

student learning outcome #1 is at risk for not being met because this particular assignment

belongs to that section.

A nursing care plan is composed of the nursing diagnoses, goals for the patient,

interventions, and evaluation of the overall patient and interventions. The nursing care plan will

also set a date of when the goals are to be achieved. A teaching plan is part of the nursing

interventions but it details what the patient will be taught and how. The teaching plan should also

incorporate how the patient will be evaluated after receiving the information/education.

One of the possible causes for students failing this assignment could be not enough time

was spent on the instructors behalf educating the students about nursing care plans and teaching

plans. A few templates could have been handed out but each plan is individualized to the patient
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and therefore, if proper instruction was not given the students perhaps were unable to gather all

the necessary information they needed on their patient. Another possible cause could be since

this is a second semester nursing course, the instructor might have assumed that nursing care

plans were reviewed in the foundations course thoroughly and therefore did not see the need to

re-educate the students. Lastly, the students could have possibly believed that they knew exactly

what was being asked of them and didnt question the assignment. Students could have briefly

listed or bulleted interventions without rationales and this could have affected their grades if the

instructor was keen on providing rationales throughout the assignment. This could definitely

occur is a detailed rubric was not provided to the students. A number of reasons can cause

miscommunication among students and professors. However, it is important to note that

miscommunication or a lack of communication could inadvertently affect an assignment and

subsequently be a threat to certain standards/competencies not being met by the institution and

student.

SLO #1 could possibly not be met because this particular assignment uses information

from non-nursing courses, the patients medical record, and requires the collaboration among the

interdisciplinary team to synthesize everything into the nursing care plan and teaching plan. As a

result CCNE standard IIIC is at a high risk of not being met because this standard focuses on the

baccalaureate nursing curriculum building on the foundations of non-nursing courses in the

sciences and liberal arts. If the student is unable to fulfill this assignment as directed than there is

no evidence to show that they are capable of appropriately employing non-nursing course

education into nursing practice.

There is also the potential for the QSEN competency Evidence-based practice to not be

met. However, unlike the CCNE standards it would be easier to identify other aspects of the
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nursing curriculum that meet this competency. Evidence-based practice is used across

undergraduate nursing education and many tools are used to assess competency in this area. For

example, when a student is found to be competent in placing a foley catheter accurately, it could

be said that the student followed evidence-based protocol to insert the foley. Therefore, it would

be easier to find another assignment/project that would prove the nursing curricula to be

evidence-based.

In order to tackle why this learning outcome was unmet, its first important to speak with

the students to find out where the miscommunication or misunderstanding occurred. After

identifying the cause behind why so many students were unable to achieve a passing grade

interventions should be put into place to attempt to redeem the assignment. I dont see the

assignment itself as a problem, quite the opposite I believe assignments like these stimulate

critical thinking in students and allow them to grow as professionals.

Marchigiano, Eduljee, & Harvey (2011), analyzed students perceptions on clinical

assignments and their development of critical thinking skills. The study proved what many nurse

educators already believe to be true which is that these types of assignments stimulate critical

thinking and allow for the student to feel more confident in their delivery of care. Therefore, in

this case I believe the assignment itself does not need to be revised. Instead the instructor should

focus on revising the instructions given to the students as well as where they can get

supplemental material to help with the assignment. The students can then be asked again to redo

the assignment. If time does not permit for such an extensive assignment to take place then the

teaching plan component can be removed because there will be other opportunities for the

students to demonstrate their teaching skills. In any case, it is essential to attempt to complete
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this assignment because it will be difficult to create another assignment that incorporates all of

the fundamentals needed to achieve the set standards/competencies.

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References

Barnsteiner, J., Disch, J., Johnson, J., Mcguinn, K., Chappell, K., & Swartwout, E. (2013).

Diffusing QSEN competencies across schools of nursing: the AACN/RWJF faculty

development institutes. Journal Of Professional Nursing, 29(2), 68-74.

doi:10.1016/j.profnurs.2013.03.003

College of New Rochelle (CNR). (2017). School of nursing: baccalaureate program student

learning outcomes. Retrieved from http://catalog.cnr.edu/content.php?catoid=15&navoid

=415

Commission of Collegiate Nursing Education (CCNE). (2013). Standards for accreditation of

baccalaureate and graduate nursing programs. Retrieved from http://www.aacnnursing.

org/Portals/42/CCNE/PDF/Standards-Amended-2013.pdf?ver=2017-06-28-141019-360

Giddens, J. L., & Meyer, D. (2016). Foundational courses for the baccalaureate nursing degree:

enhancing efficiency for academic progression. Journal Of Nursing Education, 55(7),

373-378. doi:10.3928/01484834-20160615-03

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health.

Washington, DC: National Academies Press.

Marchigiano, G., Eduljee, N., & Harvey, K. (2011). Developing critical thinking skills from

clinical assignments: a pilot study on nursing students' self-reported perceptions. Journal

Of Nursing Management, 19(1), 143-152. doi:10.1111/j.1365-2834.2010.01191.x

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Quality and Safety Education for Nurses (QSEN). (2017). QSEN competencies. Retrieved from

http://qsen.org/competencies/pre-licensure-ksas/

Scott, E., & Miles, J. (2013). Advancing leadership capacity in nursing. Nursing Administration

Quarterly, 37(1), 77-82. doi:10.1097/NAQ.0b013e3182751998