Objective #2. Discuss the development of curricula using the NLN Education Competencies Model

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1 Objective #2 Discuss the development of curricula using the NLN Education Competencies Model

2 Describe how the following curriculum components are developed from the outcomes: philosophy, program outcomes, course outcomes, unit objectives, learning activities and evaluation methods.

3 CORE VALUES Core Values of the NLN Caring Diversity Integrity Excellence

4 Additional Core Values Holism Ethics Patient Centeredness

5 The core values resonate with our nursing program's philosophy. Yes No

6 Before we go further What concepts do you believe will be essential to nursing practice in 2017?

7 Integrating Concepts Context and Environment Knowledge and Science Personal/Professional Development Quality and Safety Relationship-Centered Care Teamwork

8 Question to Ponder How are the apprenticeships of knowledge, practice and ethical comportment realized for each of the six integrating concepts identified in our nursing program?

9 Program Outcomes The expected culmination of all learning experiences: Includes mastery of essential core nursing practice competencies Builds on core values Builds on six integrating concepts

10 Program Outcomes The outcomes reflect the culmination of complex, multifaceted learning, which can be demonstrated at the time of graduation.

11 Program Outcomes Human flourishing Nursing judgment Professional identity Spirit of inquiry

12 Program Outcomes And Core Competencies Core competencies are the discrete, measurable skills essential for the practice of nursing, that are developed by the faculty to meet the program outcomes

13 Program Outcomes And Core Competencies Expected culmination of all learning experiences that occur during the academic program The over-arching outcome is nursing practice

14 Program Outcomes And Core Competencies Competencies increase in complexity as students move through the various types of nursing education programs

15 Implications for Nursing Education Incorporate in all levels of the curriculum Philosophy Framework Outcomes Program, Course, Unit Learning Activities, Evaluation

16 To consider What should be gained in one s preparation as a nurse that will not be available after graduation? Hall, 2004

17 The Hidden Curriculum What are the unintentional outcomes of the curriculum or, what are students learning when you aren t looking?

18 Curriculum Components Philosophy Framework Program Outcomes Course Outcomes Caring Diversity Relationship-Centered Care Relationship-Centered Care Human Flourishing Professional Identity Human Flourishing Ethics Personal & Professional Development Professional Identity Excellence Knowledge & Science Professional Identity Spirit of Inquiry Holism Context & Environment Nursing Judgment Integrity Personal & Human Flourishing Professional Professional Identity Development Patient-centeredness Quality & Safety Nursing Judgment Professional Identity Spirit of Inquiry Teamwork Human Flourishing Professional Identity Human Flourishing Professional Identity Professional Identity Spirit of Inquiry Nursing Judgment Human Flourishing Professional Identity Nursing Judgment Professional Identity Spirit of Inquiry Teamwork

19 Developing a Philosophy The first step in curriculum development is development of your program philosophy. The core values form the basis of your philosophy.

20 Questions to Ponder How might we recognize, develop, and fully integrate the identified core values across our nursing education program(s)? To what extent are these core values congruent with the values expressed in our educational institution s mission statement?

21 Developing a Program Framework The second step in curriculum development is identifying those concepts that you would like to embrace in your program. Many programs place these concepts into a framework or model that then leads to the program s outcome competencies.

22 Questions to Ponder What concepts are intentionally and progressively developed across the current curriculum at our school of nursing? In what ways might our nursing program examine, re-organize, and appropriately incorporate the six integrating concepts?

23 Developing Outcomes The third step in curriculum development in determining the program outcomes you would like graduates to achieve.

24 Questions to Ponder What outcomes are formally identified for our school of nursing? How congruent are the articulated outcomes for our school of nursing with the four outcomes espoused in this model?

25 Question The majority of our learning activities focus on the application of nursing judgment and not the delivery of facts. Yes No

26 Learning Activities These can be as simple as a drug calculation scenario and as complex as a simulation requiring prioritization and delegation Numerous resources are available on the QSEN & IHI websites:

27 Learning Activities Unfolding case studies such as those available through the ACES (Advancing Care Excellence for Seniors) initiative ACES: acultyresources/aces/index.htm

28 Learning Activities Simulation The bridge between theory and practice allowing students to apply theory to practice and practice to theory

29 Evaluation Methods Moving beyond the multiple-choice exam

30 HUMAN FLOURISHING

31 Outcome: Human Flourishing Defined: An effort to achieve self-actualization and fulfillment within the context of a larger community of individuals, each with the right to pursue his or her own such efforts.

32 Human Flourishing Encompasses the. Uniqueness Dignity Diversity Freedom Happiness Holistic well-being.of the individual within the larger family, community and population

33 Human Flourishing: Competency for ADN Graduates Advocate for patients and families in ways that promote their selfdetermination, integrity, and ongoing growth as human beings.

34 Human Flourishing Program Outcome: Advocate for patients and families in ways that promote their self-determination, integrity, and ongoing growth as human beings. Course Outcome: NUR 201 Concepts of Care II: Promote the selfdetermination, integrity, and ongoing growth as human beings of patients and families when providing care in the acute care setting.

35 KPEs : Knowledge Effective strategies for communication with different members of the health care team, including patients and families, nurses, and other health professionals (TW) The role of family, culture, and community in a person s development (RCC) Health care approaches of other disciplines and other cultures; power inequities across health care professions (RCC)

36 KPEs: Practice Respect different styles of communication used by patients, families and health care providers (TW) Promote and accept the patient s emotions; accept and respond to distress in patient and self; facilitate hope, trust and faith (RCC) Act with integrity, consistency and respect for differing views (TW)

37 KPEs: Ethical Comportment Show respect for others values; appreciate diversity; be civil during relationships and work; value community empowerment and social justice; work to improve social conditions affecting health; adopt inclusive language (C&E) Be aware of personal beliefs, values and biases (P&PD) Respect the patient s dignity, uniqueness, integrity, and self-determination, and his or her own power and self-healing processes (RCC)

38 Human Flourishing Learning Activity Case Study 70 y/o Lakota Elder Hospitalized Diagnosed with Type 2 Diabetes 400 miles from home and family members

39 Learning Activity Nursing Judgment First a word about Nursing Judgment Nursing judgment encompasses three processes; namely, critical thinking, clinical judgment, and integration of best evidence into practice.

40 Question In your nursing program, which of the following terms do you currently use? a. Critical thinking b. Clinical reasoning c. Clinical judgment d. Nursing judgment

41 Clinical Judgment Clinical judgment refers to a process of observing, interpreting, responding, and reflecting situated within and emerging from the nurse s knowledge and perspective (Tanner, 2006).

42 Question We use Tanner s Model of Clinical Judgment along with the traditional nursing process. Yes No

43 The Tanner Model of Clinical Judgment Noticing Expectations Initial Grasp Interpreting Analytic Intuitive Narrative Action Responding Reflecting Outcome Reflection on Action Reflection in Action

44 Review of Competencies for ADN Graduates Nursing Judgment Make judgments in practice, substantiated with evidence, that integrate nursing science in the provision of safe, quality care and promote the health of patients within a family and community context.

45 KPEs Knowledge: Demonstrate ability to manage conflicting information (C & E) Integrate knowledge from nursing and other disciplines (K & S) Describe sentinel events and root cause analysis (Q & S) Identify scope of practice, roles, and responsibilities of health care team members, including overlaps (TW)

46 KPEs Practice Use databases for practice purposes (K & S) Identify problems (P & PD) Contribute to assessment of outcome achievement (Q & S) Retrieve research finding and other sources of information. ( K & S)

47 KPEs Ethical Comportment Value evidence-based approaches to yield best practices for nursing (K & S) Accept multiple right answers in patient care and other professional situations (P & PD) Recognize the risks across transitions in care and during handoffs among providers (TW)

48 Course Outcomes Nursing Judgment Nursing 101 Fundamentals Describe the nursing process as it relates to making nursing judgments in the provision of safe, quality care in long-term care, rehabilitation and acute care settings.

49 Activities/Strategies Noticing Reflective journaling

50 Respond to the following: Select a brief patient care interaction with a patient you have not seen before. Immediately after leaving the patient s room, make a list of everything you remember about the patient and the room environment. Include observations of the patient, equipment, family members present and the condition of the room.

51 After you have made the list, go back into the patient s room with paper and pencil and make another list of the same type of observations. When you have time to compare the list and reflect on your observations, answer the following questions:

52 What was the greatest difference in your 2 lists? What was the most significant observation you made on your second list that you omitted from the first list? Why do you think this was a significant omission?

53 What will you do to increase your observational skills during your next patient interaction?

54 PROFESSIONAL IDENTITY

55 Outcome: Professional Identity Defined: Professional identity involves the internalization of core values and perspectives recognized as integral to the art and science of nursing. These core values become self-evident as the nurse learns, gains experience, and grows in the profession.

56 Outcome: Professional Identity The nurse embraces these fundamental values in every aspect of practice while working to improve patient outcomes and promote the ideals of the nursing profession. Professional identity is evident in the lived experience of the nurse, in his or her ways of being, knowing and doing.

57 Professional Identity Competency for ADN Graduates Implement one s role as a nurse in ways that reflect integrity, responsibility, ethical practices, and an evolving identity as a nurse committed to evidence-based practice, caring, advocacy, and safe, quality care for diverse patients within a family and community context.

58 Professional Identity Program Outcome Implement one s role as a nurse in ways that reflect integrity, responsibility, ethical practices, and an evolving identity as a nurse committed to evidence-based practice, caring, advocacy, and safe, quality care for diverse patients within a family and community context. Course Outcome NUR 202- Nursing Care Management and Leadership: Act as a nurse committed to evidence-based practice, caring, advocacy and safe, quality care for diverse patients within a family and community context.

59 KPEs Knowledge Scope of practice, roles and responsibilities of health care team members including overlaps. (TW) Impact of team functioning on safety and quality of care, and how authority gradients influence teamwork and patient safety. (TW) Factors that contribute to a systemwide safety culture; the importance of reporting hazards and adverse events; the just culture approach to system improvement (Q&S)

60 KPEs Practice Stay current in professional health care knowledge (Q&S) Apply decision making skills, particularly in the context of uncertainty and ambiguity (P&PD) Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care (Q&S)

61 KPEs Ethical Comportment Appreciate the influence of systems on health care outcomes. (C&E) Engage in lifelong learning to keep professional knowledge current (Q&S)) Value the influence of system solutions in achieving effective team functioning (TW) Recognize the risks across transitions in care and during handoffs among providers (TW)

62 Learning Activity Providing Patient Centered Care Through Teamwork and Collaboration by Pamela M. Ironside

63 Learning Activity Spirit of Inquiry

64 Review of Competencies for ADN Graduates Spirit of Inquiry Examine the evidence that underlies clinical nursing practice to challenge the status quo, question underlying assumptions, and offer new insights to improve the quality of care for patients, families and communities.

65 KPEs Knowledge Describe quality improvement processes. Describe the steps of research and the role of the staff nurse in research.

66 KPEs Practice Demonstrate a questioning pattern of thought (C & E) Reflect on practice as a basis for generating questions regarding practice (K & S) Develop a plan to continue learning and attain additional degrees and professional advancement (RCC)

67 KPEs Ethical Comportment Analyze ethical challenges presented by clinical situations (C & E) Maintain a questioning mind and spirit of inquiry; be open to new ideas and approaches (K & S)

68 Course Outcomes Spirit of Inquiry Nursing 204 Nursing Care Management & Leadership Examine the evidence that underlies clinical nursing practice to challenge the status quo, question underlying assumptions, and offer new insights to improve the quality of care for patients, families and communities.

69 Activities/Strategies CLINICAL GROUP CHANGE PROJECT DESCRIPTION: Consistent with the philosophy and organizing framework of the nursing program, the writing component of this assignment is designed to promote written communication skills as well as effective group process and the use of evidence-based practice.

70 Purpose: To utilize change theory and evidence-based information to implement a change on a nursing unit. The group will identify a needed change on the nursing unit, plan how the group will accomplish the change, implement the change, and evaluate the results.

71 PLEASE CALL! DON T FALL!

72 Osteoporosis and Falls Osteoporosis is bone loss associated with an increased risk of fractures. The term osteoporosis means porous or brittle bone. Diagnosis can be made by your doctor completing a medical history, physical exam, x-rays, lab work and other tests. Osteoporosis is a major health problem. 28 million Americans have osteoporosis contributing to about 1.5 million bone fractures per year. One in two women and one in five men older than 65 years will suffer bone fractures caused by osteoporosis. Many of these are painful fractures of the hip, spine, wrist, arm, and leg, which occur as a result of a fall. However, even simple household tasks can result in a fracture of the spine if the bones have been weakened by osteoporosis. The most serious fracture from osteoporosis is a hip fracture. Most patients who experience a hip fracture and previously lived alone will require help from their family or home care. Hip fractures are expensive. Health care costs from a hip fracture total more than $35,000 per patient. Source: American Academy of Orthopaedic Surgeons Remember: Please ask the nurse or patient care technician for help when getting up.

73 How to Start the Journey and Get Others to Come on the Trip! NLN Curriculum Assessment: Report Card yresources/toolkit_innovation_curriculum _Design/index.htm 1. The curriculum is flexible and reflects current societal and health care trends and issues, research findings, and innovative practices, as well as local and global perspectives.

74 2. The curriculum provides experiential cultural learning activities that enhance students 3. The curriculum emphasizes students values development, socialization to the new role, commitment to lifelong learning, and creativity.

75 4. The curriculum provides learning experiences that prepare graduates to assume roles that are essential to quality nursing practice, including but not limited to roles of care provider, patient advocate, teacher, communicator, change agent, care coordinator, user of information technology, collaborator, and decision maker.

76 5. The curriculum provides learning experiences that support evidencebased practice, multidisciplinary approaches to care, student achievement of clinical competence, and, as appropriate, expertise in a specialty role.

77 6. The curriculum is evidence-based. (Programs should ask themselves how the current curriculum is evaluated based on outcome evidence.)

78 7. The design and implementation of the program is innovative and seeks to build on traditional approaches to nursing education.

79 How to Start the Journey and Get Others to Come on the Trip! Assign relevant reading materials Retreat! Focused brainstorming Develop consensus (a shared vision) Start development Regroup and check-in Allow adequate time

80 Take one of the course level objectives and write one unit and one clinical objective and then develop one learning activity

81 Q/A - Discussion

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