Nursing Curriculum Implementation

The complexity of health care today requires nursing graduates to use effective thinking skills. In order for nurses to have a foundation of nursing education to support the ever-changing social and healthcare environments, a nursing curriculum must offer development of nursing education to create learning opportunities that will build students professional knowledge, skills, values, identity, and confidence nursing programs (Iwasiw et al., 2020). Many nursing programs are revising the curricula to include concept-based learning that encourages problem-solving, effective thinking, and the ability to transfer knowledge to a variety of situations (Baron, 2017). Iwasiw et al., (2020) states that upon graduation professional nurses must practice safely and competently.

By nursing programs implementation of revised curriculums, academic institutions continue redesigning goals and objectives to overcome such obstacles. The revision of curriculum will require nurse educators to modify their teaching styles and methods to promote student-centered learning. Changing from teacher-centered learning to student-centered learning requires a major shift in thinking (Baron, 2017). In 2023, the state of Illinois average pass rate of the NCLEX was 85% and the national average was 89%. With this deficit, revised curricula is needed to meet the ever-changing needs.

When implementing a revised nursing curriculum, nurse educators must consider numerous factors including resources, timeline for implementation, leadership responsibilities, and benchmarking. Utilization of a change theory, an educational framework, and alignment with the state board of nursing will help guide the curriculum implementation. For this blog, the focus will be utilizing Eric Havelock's change theory that is pulled from Lewin's Theory of Planned Change. Havelock's theory acknowledges the importance of planning and resistance to change for curriculum development. Lewin’s Theory of Planned Change includes the following change stages (Barrow, 2022):

• Unfreezing: Understanding the need for change

• Moving: Initiating the process of change

• Refreezing: Establishing a new status quo

Lewin's Theory of Planned Change

The acronym CREATER can be used to remember the steps in Havelock's theory (Baptiste, 2018):

• C: Care (Attention to need for change)

• R: Relate (Build relationships)

• E: Examine (Diagnose the problem)

• A: Acquire (Resources)

• T: Try (Choose solution)

• E: Extend (Gain acceptance)

• R: Renew (Stabilize and sustain)

Outline for Implementing a New or Revised Curriculum

Model of Eric Havelock's change theory based on Lewin’s Theory of Planned Change

I. Analyze the data regarding the need for change- Assistant Dean of Nursing Education

A. Review current drivers for implementing change

B. Conduct SWOT analysis

C. Gain support for curriculum development

II. Appoint a curriculum leader- Assistant Dean of Nursing Education

A.   Knowledgeable of curriculum development

B.    Possess managerial skills for coordination of logistics

C.    Have the support of faculty and other stakeholders.

III. Form advisory committee for curriculum development- Curriculum Leader

A. Committee to consist of leaders including the Curriculum leader, a Clinical Learning Resource Center liaison, an Interprofessional Education committee liaison, one faculty member representative from each campus, and two upper classmen to serve as student representatives. The following non-voting member(s) will include the Assistant Dean of Nursing Education who will serve in an advisory capacity when needed.

B. Nursing faculty to be included for benchmarking new/revised curriculum

IV. Committee to organize for curriculum development- Advisory Committee

A.   Establish timeline for curriculum change

B.    Submit to Board office for approval at least three months prior to implementation

V. Gather, research, and analyze the data on internal and external contextual factors- Advisory Committee

A. Review current mission, goals, philosophy

B. Assess current culture, demographics, environment, and healthcare system.

VI. Establish philosophical and educational approaches- Advisory Committee

A. American Association of Colleges of Nursing (AACN) The Essentials: Core Competencies for Professional Nursing Education

B. Lewin’s Change Theory model

VII. Evaluate the current goals/outcomes- Advisory Committee

A.   Determine new goals

B.    Determine new outcomes to fit the curriculum change.

VIII. Design the new/changed curriculum- Advisory Committee/Nursing Faculty

A. Develop plan for implementation

B. Develop plan for evaluation

C. Conduct benchmarking via feedback loops, surveys

D. Develop syllabus

E. Determine resources needed such as additional staff, technology, human resources, infrastructure, etc.

F. Perform budget review and determine financial needs.

IX. Create Courses- Advisory Committee/Nursing Faculty

A. Conduct Crosswalk Comparison to ensure alignment with Illinois Board of Nursing requirements and the AACN The Essentials: Core Competencies for Professional Nursing Education

B. Develop plan for implementation

C. Develop plan for evaluation

D. Conduct benchmarking via feedback loops, surveys

V. Implement the curriculum- Nursing Faculty

A. Conduct formative evaluation via 360-degree feedback survey

B. Revise as needed.

XI. Conduct summative curriculum evaluation- Advisory Committee

A. Perform internal curriculum evaluation such as graduates’ success rates

B. Perform external curriculum evaluation such as NCLEX pass rates

Crosswalk Comparison
Illinois Board of Nursing	AACN The Essentials: Core Competencies for Professional Nursing Education	Benchmarking Tools and Methods in Implementation Plan
Illinois Administrative Board
225 ILCS 65/Art. 60 heading
Nursing curriculum must contain all applicable requirements established by rule, including both theory and clinical components. Program curriculum that meets all State requirements. The applicant has successfully completed a licensure examination approved by the Department.	Domain 1: Knowledge for Nursing Practice Descriptor: Integration, translation, and application of established and evolving disciplinary nursing knowledge and ways of knowing, as well as knowledge from other disciplines, including a foundation in liberal arts and natural and social sciences. This distinguishes the practice of professional nursing and forms the basis for clinical judgment and innovation in nursing practice (AACN, 2021).	Curriculum to use Domain 1-Knowledge for Nursing Practice Tool Kit, which incorporates integrative learning strategies, resources, recommended content, recommended assessment strategies, and references (AACN, 2022). Methods in implementation plan will consist of using the Lewin's Theory of Planned Change Model (Iwasiw et al., 2020).
Clinical learning experiences shall include actual hours of practice in nursing skills and computer laboratories; simulated clinical experiences; faculty supervised hands-on clinical care; clinical conferences; debriefing; and observation experiences. Observation experiences provide supplemental learning experiences to meet specific learning objectives	Domain 8: Informatics and Healthcare Technologies Descriptor: Information and communication technologies and informatics processes are used to provide care, gather data, form information to drive decision making, and support professionals as they expand knowledge and wisdom for practice. Informatics processes and technologies are used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practice and professional and regulatory standards (AACN, 2021).	Curriculum to use Ethics Concepts Across Multiple Program Types and Domains which encompasses all domains and incorporates integrative learning strategies, resources, recommended content, recommended assessment strategies, and references (AACN, 2021). Methods in implementation plan will consist of using the Lewin's Theory of Planned Change Model (Iwasiw et al., 2020).
Instruction shall be provided in nursing roles; biological, physical, social, behavioral, and nursing sciences, including body structure and function, microbiology, pharmacology, nutrition, signs of emotional health, human growth and development; and nursing skills .	Domain 2: Person-Centered Care Descriptor: Person-centered care focuses on the individual within multiple complicated contexts, including family and/or important others. Person-centered care is holistic, individualized, just, respectful, compassionate, coordinated, evidence-based, and developmentally appropriate. Person-centered care builds on a scientific body of knowledge that guides nursing practice regardless of specialty or functional area (AACN, 2021).	Curriculum to use Domain 2 Person-Centered Care Tool Kit which incorporates integrative learning strategies, resources, recommended content, recommended assessment strategies, and references (AACN, 2022). Methods in implementation plan will consist of using the Lewin's Theory of Planned Change Model (Iwasiw et al., 2020).

References

225 ilcs 65/ nurse practice act. (n.d.). https://ilga.gov/legislation/ilcs/ilcs4.asp?DocName=022500650HArt.%2B50&ActID=1312&ChapterID=24&SeqStart=13100000&SeqEnd=14800000

American Association of Colleges of Nursing. (2021). Domain 1: Knowledge for nursing practice. https://www.aacnnursing.org/Portals/42/AcademicNursing/Tool%20Kits/Essentials/Domain-1-Knowledge-for-Nursing-Practice-Feb-2022.pdf?ver=MRswM382SU6tuvxjU3ONGQ%3d%3d

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf

Baptiste, D. L. (n.d.). Application of Havelock’s theory of planned change for increasing Sigma chapter membership and Retention. stti.confex.com. https://stti.confex.com/stti/lc18/webprogram/Paper90222.html

Baron K. A. (2017). Changing to Concept-Based Curricula: The Process for Nurse Educators. The open nursing journal, 11, 277–287. https://doi.org/10.2174/1874434601711010277

Barrow, J. M. (2022, September 18). Change management in health care. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK459380/

Board of Nursing Licensure Requirements. NCSBN. (n.d.). https://www.ncsbn.org/nursing-regulation/education/board-of-nursing-licensure-requirements.page

Iwasiw, C. L., Andrusyszyn, M.A., & Goldenberg, D. (2020). Curriculum development in

nursing education (4th ed.). Jones & Bartlett Learning.

NATIONAL COUNCIL LICENSURE EXAMINATION SUMMARY DATA. Illinois Department of Financial and Professional Regulation. (2023, December). https://nursing.illinois.gov/content/dam/soi/en/web/nursing/documents/pdf/ilapnursingedprogpassrates.pdf

Neville-Norton, M., Cantwell, S., & b. (2020, January 2). Implementing a concept-based nursing curriculum: A review of the literature. Teaching and Learning in Nursing. https://www.sciencedirect.com/science/article/abs/pii/S1557308719302239