Foundations of Nursing Education

Foundations of Nursing Education

A. Justification

The executive team of Hartford Community College has decided to change the current associate
degree nursing program to a bachelor of science in nursing (BSN) program. As opposed to the
current program that runs for two years, the new curriculum is expected to take four years. A
new BSN program must be designed for the proposed change to be implemented effectively. The
change from an associate degree nursing program to a BSN program has been influenced by both
social and institutional factors. According to Institute of Medicine (2010), the increasing
complexities in healthcare needs of today’s society can effectively be met by highly trained
nurses who have a better understanding of patient safety, health care quality improvement
methods, care management, and system care management. Therefore, for student nurses to fit in
the job market after graduation, they only join academic institutions that offer degree programs
that will enable them to master core skills and competencies required for nursing practice
(Institute of Medicine, 2010). By changing from the current associate degree nursing program to
a bachelor of science in nursing (BSN) program, Hartford Community College will become an
institution of choice for many student nurses, and it will be able to produce graduate nurses who
can effectively compete for jobs in the market.
The decision for a BSN program has been informed by the Institute of Medicine (IOM)
report 2010 entitled, “The future of nursing: Leading change, advancing health.” The report
points out that nursing education, as well as nurse roles and responsibilities, should change to
effectively meet the increasing demand for care in today’s society. In part II section 4 of the

FOUNDATIONS OF NURSING EDUCATION 3
report, nurses are advised that they should seek to achieve higher levels of education from
academic institutions with improved systems of education for them to survive in the ever-
changing health care system (Institute of Medicine, 2010).

B. Quality and safety initiatives: Recommendation

  1. Rationale
    Rising cases of medical errors in today’s health care organizations undermine the quality
    of care received by patients. Cases of medical errors can be reduced significantly if student
    nurses are taught on how to maximize quality during care delivery. The IOM’s report of 1999
    entitled, “To err is human: Building a safer health system” provides the right recommendations
    that health care organizations can implement to maximize quality and patient safety. One of
    these recommendations will be used to guide the integration of safety and quality initiatives in
    the new BSN program. One of the recommendations emphasizes the need to raise performance
    standards for health care practitioners through a collaborative effort of professional
    organizations, oversight organizations, and patients (Institute of Medicine, 1999). As guided by
    this recommendation, the institution will set performance standards for quality and safety that all
    student nurses in the BSN program will be required to meet before graduating. By changing the
    current associate degree nursing program to a bachelor of science in nursing (BSN) program,
    Hartford Community College will be in an excellent position to teach students about quality and
    patient safety. Consequently, graduate nurses from the institution will contribute positively in
    minimizing cases of medical errors (Institute of Medicine, 2010).
  2. Possible barrier

FOUNDATIONS OF NURSING EDUCATION 4
The possible barrier that might prevent successful implementation of the quality and
safety recommendation is limited funds. To successfully implement the recommendation, the
institution will have to purchase the right materials for teaching students about health care
quality and patient safety. Furthermore, it will be compelled to employ qualified and experienced
professionals to teach students matters related to patient safety and health care quality. The
institution must have adequate finances to put the right training resources in place, without which
it will be unable to implement the recommendation. Proper planning is therefore required before
the proposed change is initiated (Wakefield, 2008).

C. Learning theory

The development of critical thinking skills in the new BSN program would substantially
be supported by constructivism learning theory. Constructivism is a learning theory that assumes
that students individually develop knowledge and understanding of new concepts through
experience and reflection (Aliakbari, Parvin, Heidari, and Haghani, 2014). This means that
learning takes many forms depending on the way a student constructs his or her knowledge and
on the nature of experience they have. The institution will have to consider the advantages and
disadvantages of constructivist learning theory before incorporating it into the program.
One of the advantages of using constructivism learning theory in the program is that
Hartford Community College will have a curriculum that will allow learners to relate their
previous ideas and experiences with the newly acquired knowledge and to assess its relevance. In
this manner, learners will make appropriate decisions to either replace the old ideas with new
ones or to discard it all together (Aliakbari et. al, 2014). Using constructivism learning theory in
the BSN program is also advantageous in the sense that, it will allow the institution to transform
students from passive information holders to active learners. Transforming students into active

FOUNDATIONS OF NURSING EDUCATION 5
learners is very important in the learning process because it enables them to put whatever they
have learned into practice. This way, Hartford Community College will become a modern
academic institution that effectively develops critical thinking skills of learners (Aliakbari et. al,
2014).
However, using constructivism learning theory to support the development of critical
thinking skills in the new BSN program may be disadvantageous in the sense that, it may make
the institution to design instructional strategies that focus more on the learner than on the concept
being taught (Aliakbari et. al, 2014). This may prevent students from perfectly applying
previously known ideas into practice. For instance, constructivists believe that the teacher should
use experiments to help students acquire additional knowledge about a given concept. However,
experiments are only meant to build on already existing conceptions, but not on helping the
learner to integrate new concepts. Another disadvantage associated with using constructivism
theory in the new BSN program is its ability to prevent learners from acquiring knowledge
wholesomely. This is because, using constructivism theory makes learners to view knowledge
independently without because a concept can have a different meaning other than the one
attributed to experience (Aliakbari et. al, 2014).

D. Educational philosophy: Multiple bits of intelligence

The development of the new BSN curriculum can be informed by the key components of
multiple bits of intelligence as an educational philosophy. Proposed by Gardner in 1983, the
theory of multiple bits of intelligence assumes that learners can develop an understanding of new
knowledge by applying different levels of acumens (Gardner, 1999). Specifically, students can
acquire new knowledge through logical mathematical assessment, musical thinking,
understanding others, spatial representation, the use of language, using the body to solve

FOUNDATIONS OF NURSING EDUCATION 6
problems, self-understanding, and by developing an understanding of the natural world (Gardner,
1999). According to Gardner (1991), everyone has got eight bits of intelligence which usually
operate in a very sophisticated manner. Also, people can be intelligent in various ways, and they
often strive to develop specific intelligence to the best of their abilities.
Using multiple bits of intelligence in the new BSN program has some advantages and
disadvantages. The main advantage of using multiple bits of intelligence in the program is that it
will enable Hartford Community College to design an educationally effective curriculum that can
allow all students to explore and develop their skills in individual bits of intelligence. However,
using multiple bits of intelligence in the BSN program may not be feasible at the moment
because the program is new and integration of the philosophy involves relatively complex
logistical issues (Gardner, 1999).

E. Delivery of instruction

Being a modern institution, Hartford Community College can choose current modalities
to deliver the new BSN program. The most appropriate modalities for instructional delivery are
online education and competency-based learning. The institution must be conversant with
potential barriers that may be faced during implementation of each one of these modalities to
ensure a free flow of learning once the new BSN program becomes operational. Online
education is a contemporary method of learning where instruction is delivered through the
internet. By using online education to deliver instruction, Hartford Community College will
have an opportunity to integrate information technology into its system. This way, it will be
able to attract a large volume of learners located in different regions and who will be able to
access online courses using their home computers. The main barrier that the institution may face

FOUNDATIONS OF NURSING EDUCATION 7
when implementing an online educational system is limited resources (Avey, Cohen and
Walker, 2008).
Competency-based learning is a method of delivering instruction that involves teaching,
testing, issuance of grades, and reporting of students’ performance. It gives learners an
opportunity to demonstrate that they have understood and integrated the taught concepts.
Competency-based learning is an appropriate method of delivering the new BSN program
because it will help to produce graduate nurses who are competent enough to apply acquired
knowledge into practice. The main barrier that the institution may face in the process of
competency-based learning implementation is small staff that can effectively assist students to
incorporate taught concepts into nursing practice (Pillay, 2010).

F. Assessments

  1. Formative assessment
    The new BSN program will be supported by assessments aimed at evaluating whether
    students have integrated the taught concepts. Both formative and summative assessments will be
    used in the new BSN program. The two benefits of using formative assessment in the new BSN
    program are; development of a training program that encourages improved understanding of
    taught concepts by students, and ability to hire trained personnel who can effectively meet
    students’ academic needs (Sundberg, 2002). However, using formative assessment in the
    program may prevent instructors from teaching concepts in detail, especially when assessments
    are conducted during lessons. Moreover, students may not take formative assessments seriously,
    and this may compel the instructor to repeat concepts time and again. This will result in wastage
    of time and resources (Sundberg, 2002).

FOUNDATIONS OF NURSING EDUCATION 8

  1. Summative assessment
    Using summative assessment in the new BSN program will be advantageous in the sense
    that, it will enable Hartford Community College to know whether students have understood the
    taught concepts. This knowledge will guide the institution to select the right evaluation method
    that matches the needs of individual students. Another benefit of summative assessment is that it
    will allow the institution to measure students’ performance over time. This will enable the
    institution to know learners’ areas of weaknesses that need to be strengthened before graduation.
    Two limitations of using summative assessment in the program are; disruptive learning, and
    reduced reliability of results due to an inadequate inclusion of all the taught content (Sundberg,
    2002).
  2. Classroom assessment techniques (CAT)
    Classroom assessment technique is a form of formative assessment that can greatly
    increase student success in the new BSN program. Using this technique, the institution will
    provide ongoing assessments to students to monitor their learning progress. The teacher will
    ensure that he uses assessment approaches that target specific needs of individual students.
    Students will rely on the teacher’s guidance to integrate new knowledge about the taught
    concepts. Classroom assessment technique can, therefore, help to increase students’ success in
    the new BSN program by stimulating critical thinking skills of learners and their abilities to
    solve problems as they continue to learn (Davidson, 2009).

G. ANA Code of Ethics

Nurses are increasingly faced with complex issues that require them to make informed
decisions. Some of these issues may influence the nurse to make decisions that may end up

FOUNDATIONS OF NURSING EDUCATION 9
harming the patient. To regulate nurses’ activities during practice, the American Nurses
Association prepared a Code of Ethics which all student nurses are expected to be conversant
with before leaving institutions of higher learning. Like any other academic institution that offers
nursing related courses, Hartford Community College will have to incorporate and apply the
ANA Code of Ethics in the new BSN program. In order to come up with a program that complies
with the requirements of the ANA Code of Ethics, the institution will integrate four legal
accountabilities in nursing education namely; Family Education Rights and Privacy Act
(FERPA), Americans with Disability Act (ADA), Health Insurance Portability and
Accountability Act (HIPAA), and Copyright laws (Zahedi, Sanjari and Dastgerdi, 2013).
Hartford Community College will demonstrate compliance with the Family Education
Rights and Privacy Act (FERPA) by maintaining the maximum privacy of learners’ education
records. As far as Americans with Disability Act (ADA) is concerned, the institution will apply
similar enrollment and assessment standards to all students irrespective of their disability status.
Furthermore, Hartford Community College will demonstrate compliance with the Health
Insurance Portability and Accountability Act (HIPAA) by ensuring that all students’ data that is
exchanged among institutions or individuals for educational purposes are protected and kept
confidential. Most importantly, Hartford Community College will integrate copyright laws into
the new BSN program by designing a unique curriculum that is not a verbatim resemblance of
another program which is already in use by another institution (Zahedi, Sanjari and Dastgerdi,
2013).

H. Accreditation

Hartford Community College will have to incorporate and apply at least one accreditation
method in the new BSN program to enhance its credibility. The most appropriate accreditation

FOUNDATIONS OF NURSING EDUCATION 10
method that the institution should incorporate and apply is the Accreditation Commission for
Education in Nursing (ACEN). ACEN plays a significant role in ensuring that institutions of
higher learning offer quality education that can equip graduate nurses with relevant knowledge
and skills. Hartford Community College will incorporate and apply ACEN by designing a BSN
curriculum that meets the accreditation standards documented by the commission. The specific
standards that the institution will have to meet in order to be accredited by ACEN to offer the
new BSN program include; sufficient administrative capacity, sufficient staff and faculty
members, relevant and achievable student policies, a curriculum that supports result into positive
student outcome, sustainable and adequate learning resources, and effective program evaluation
techniques (ACEN, 2017).

I. Conclusion

To develop a good BSN program, Hartford Community College should ensure that the
new BSN program matches societal, economic, and institutional trends, and can meet the
academic needs of student nurses. Moreover, the new BSN program should integrate quality and
safety initiatives based on recommendations documented in the IOM’s 1999 publication.
Furthermore, Hartford Community College should use constructivist learning theory to support
the development of critical thinking skills in the new BSN program. Again, it should rely on the
key components of multiple bits of intelligence to inform the development of the new BSN
program. Being a modern institution, Hartford Community College should use online education
and competency-based learning to deliver the new BSN program. The institution should use both
formative and summative assessments to examine whether students have integrated the taught
concepts in the new BSN program. Most importantly, the new BSN program should articulate

FOUNDATIONS OF NURSING EDUCATION 11
integration of ANA Code of Ethical Conduct as well as the desired learner outcomes as
documented by the Accreditation Commission for Education in Nursing (ACEN).

References

ACEN. (2017). Standards and criteria: Baccalaureate. Retrieved from
www.acenursing.org/accreditaion-manual/
Aliakbari, F., Parvin, N., Heidari, M. & Haghani, F. (2014). Learning theories application in
nursing education. Journal of Education and Health Promotion, 4:2. Doi:10.4103/2277-
9531.151867. Retrieved from PubMed Central.
Avey, M., Cohen, B. & Walker, J. (2008). Evaluation of an online graduate nursing curriculum:
Examining standards of quality. International Journal of Nursing Education Scholarship,
5(1):44.
Davidson, J. E. (2009). Preceptor use of classroom assessment techniques to stimulate higher-
order thinking in the clinical setting. The Journal of Continuing Education in Nursing,
40(3):139-43.
Gardner, H. (1999). Intelligence reframed: Multiple bits of intelligence for the 21st century. New
York, NY: New York.
Institute of Medicine. (1999). To err is human: Building a safer health system. Retrieved from
the National Academies Press website: http://www.nap.edu/catalog.php?record_id=9728
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health.
Washington, DC: National Academies Press

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Pillay, R. (2010). Towards a competency-based framework for nursing management education.
International Journal of Nursing Practice, 16(6): 545-54. Doi:10.1111/j.1440-
172X.2010.01880.x.
Sundberg, M. D. (2002). Assessing student learning. Cell Biology Education, 1:11-15. Doi:
10.1187/cbe.02-03-0007.
Wakefield, M. (2008). The quality chasm series: Implications for nursing. In R. G. Hughes (Ed),
Patient Safety and Quality: An evidence-based handbook for nurses. Rockville MD: U.S
Department of Health and Human Services.
Zahedi, F., Sanjari, M., Dastgerdi, V. (2013). The code of ethics for nurses. Iranian Journal of
Public Health, 42(1): 1-8.

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