Exploring Nursing Education Curriculum Changes: Why, What, and Best Practices

Healthcare is an ever-evolving profession, and nursing colleges are well aware that they must evolve alongside it in order for their graduates to be successful. Still, change for change’s sake won’t help today’s students become well-equipped professionals, so much thought has to go into how nursing students are taught. That certainly includes curriculum which is the base of every program and must be comprehensive and relevant, says Belmont University’s Cathy Taylor.

“Today’s nursing students, and Millennials in general, are dealing with information overload, or content saturation,” Taylor says. “That’s true for the rest of society as well, so this is an issue that’s front and center for both students and faculty. As we listen to nurse leaders, as well as nursing students, we see the need for new skill sets and new ways of teaching them.”

Belmont got out ahead of the issue, with nursing school faculty beginning an in-depth study of their curriculum in 2014. After compiling what was being taught and looking at it through the lens of recommended skills from nurse leaders, as well as standards of care, they were able to identify some shortfalls.

“Between 2014 and 2016, they worked really hard to design a new concept-based curriculum to address those gaps,” Taylor says. “We just admitted our first cohort of undergraduate students who will benefit from all this hard work, which is geared toward concept-based learning, concept-based models that stimulate deep thinking. Students learn big ideas and how to organize information into categories. This is in contrast to traditional models where students learn facts and then they work to apply them in a clinical setting. In concept-based teaching, students build on previous learning and actively work to integrate knowledge from other disciplines.”

Integrated styles of learning will produce well-rounded grads           

The goal is to allow students to link concepts to solve problems, hard-wiring the flexibility to think on their feet. Taylor is quick to add, however, that concepts haven’t taken the place of content.

“Students still have to master basic skills, so the new curriculum includes more clinical simulation and virtual practice time,” she explains. “Some of the big concepts that we will incorporate into every course in the new curriculum include, certainly our Christian perspective, which is compassionate and relationship-based, and inclusive, and that de-marginalization for patients in our charge.”

Elements that Belmont’s curriculum will hone in on include:

• Care Management
• Teamwork
• Collaboration
• Inquiry
• The Importance of Curiosity
• The Ability to Ask the Big Questions
• Leadership
• Population Health
• Professional Identity Formation

Teaching concepts like flexibility, critical thinking, and resiliency sounds complicated, because taking a skill vs. a practice, and creating curricula around it, is new territory. Still, Taylor says, it’s doable.

“We know that these skills are important to the patient experience and that they indeed can be learned,” she says. “We practice and model a lot at Belmont. As an example of additional learning, and with support from the Healing Trust, we recently worked to infuse empathy into our aging-adult curriculum. This involved active listening, case studies and having the students role play by assuming different perspectives. We saw significant increases in empathy scores on an established measurement tool, the Jefferson Empathy Scale.”

When the students become the teachers

Another goal of concept-based learning is enabling the nursing students to pass along what they’ve learned to patients. Some of the newest work in this area takes place around ACEs, or Adverse Childhood Experiences.

“We all know intuitively that a safe nurturing environment is the best for infants and young children, but now we actually have the science and the technology to see differences in developing brains of children exposed to different environments,” Taylor says. “We can teach parents and other caring adults to respond to infants in a way that actually builds brains and sets them up for future success and better health. This includes laying down foundations for reasoning, impulse control, and empathy later in life. Strategies for minimizing negative effects of childhood adversity are now sprinkled throughout our entire curriculum, not just in our pediatrics courses.”

A major tool of the new learning methodology is simulation, she adds, where students provide care in a realistic environment, then watch the video playback and debrief the experience. That’s paired up with another concept, the dedication education unit, where students are assigned to a staff nurse so they work one-on-one with a staff nurse. The student actually works the same shift, Taylor says, so [he or she] definitely gets a realistic experience.

The end goal, she says, is to ensure collaboration and communication with “people with the boots on the ground who tell us that students have got to know more about what the workplace is like, and they've got to make the connections better and faster.”         

About Cathy Taylor

Cathy R. Taylor, DrPH, MSN, RN, is dean and professor, Gordon E. Inman College of Health Sciences and Nursing at Belmont University in Nashville, Tennessee. She has held faculty and administrative positions with the Tennessee Department of Health, Vanderbilt University School of Nursing, Alvin C. York VAMC and several Tennessee hospitals. Taylor has consulted with the U.S. Department of Health and Human Services, as well as China’s Ministry of Health.