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PubMed1994

Curriculum issues related to nurse turnover.

The problem of turnover rates among registered nurses has implications for nursing curriculum and for continuing education programs. After a brief presentation of turnover issues, curriculum implications will be discussed under three broad areas: (a) content about turnover included in nursing management textbooks; (b) nursing curriculum issues that influence the survivability of graduates of schools of nursing and thereby affect turnover rates; and (c) continuing education needs of registered nurses. This paper is not a summary of solutions for turnover. The problem of turnover is complex and poorly understood. The curricular issues provide challenges to traditional nursing education that would increase the likelihood of the development of "hardy" nurse graduates who have survival skills for the practice environment.

Curriculum↗

PubMed1995

Education and practice collaboration: a strategy for curriculum development.

Five schools of nursing in British Columbia formed a collaborative partnership in 1989; four represented diploma programs, and one a post-RN program. Their partnership benefited each in the development of a baccalaureate nursing curriculum. Committed to the principle of a curriculum being driven by practice, rather than the reverse, the collaborative partners employed a variety of strategies to include nurses from practice in the development of the curriculum. One strategy used by the partnership was a Delphi survey of nurses in practice. This article describes the results of this survey and their implications for nursing curricula.

British Columbia↗

PubMed1999

Information literacy in an undergraduate nursing curriculum: development, implementation, and evaluation.

With the increasing complexity of nursing practice and health care delivery, developing information literacy in students for lifelong learning is a vital element of nursing education. The San Francisco State University School of Nursing has developed, implemented, and evaluated an integrated program of information literacy in its undergraduate curriculum. The curriculum strand includes a variety of instructional strategies woven through all semesters of the nursing program. To evaluate the information literacy program, an exploratory descriptive approach was taken using two different cohorts of students. Baseline testing prior to implementation of the information literacy program and posttesting after implementation of the program revealed selected positive occurrences in students' use of bibliographic databases and journal literature. However, students did not perceive they were more successful in accessing information, and faculty assessment of students' ability to evaluate information did not change from 1992 to 1996. These and other evaluation findings have implications for the development of an information literacy curriculum and its integration with other facets of student learning.

Computer Literacy↗

PubMed2000

Reconfiguring a curriculum for the new millennium: the process of change.

Over the past decade, changing demographics, new technology, an increased focus on health promotion, and radical shifts in health care reimbursement have significantly impacted the nursing role. The purpose of this article is to review the process of change at one university as its curriculum evolved from an integrated acute-care focus to a community-based, health promotion framework. A review of the literature and survey data from students, alumnae, faculty, other universities, and curriculum consultants laid the groundwork for this process. Curriculum generation followed guided by data analysis, template design and revision, values clarification, sacrificing "sacred cows," and consensus building. Implications for nursing and nursing education are explored.

Community Health Nursing↗

PubMed2000

Toward a narrative-centered curriculum for nurse practitioners.

This paper discusses various alternative and nontraditional teaching strategies currently used in nurse practitioner curricula. These instructional strategies include case-study analysis (Ryan-Wenger & Lee, 1997) and problem-based learning/practice-based learning (Barrows, 1994). We suggest a further evolution, using principles and practices of a narrative pedagogy (Diekelmann, 1995) to allow convergence of these several narratively-focused inductive and interpretive approaches. This combination of ways of learning has led us toward a narrative-centered curriculum for family nurse practitioners (FNPs). Specific ways to use narrative in the FNP curriculum are presented to demonstrate how to take the curriculum beyond traditional ways of teaching and learning.

Curriculum↗

PubMed2000

A practice-based genetics curriculum for nurse educators: an innovative approach to integrating human genetics into nursing curricula.

The practice-based genetics curriculum has been revised based on feedback from field-testers and is available for nurse educators. Powerpoint materials have been added to the curriculum. Further information about the curriculum can be found at the website: www.fbr.org. The practice-based modules complement the growing number of genetic resources available for nursing faculty and support incorporation of genetics concepts into all levels of nursing education. This educational effort helps ensure that nurses entering practice are prepared to help their clients understand genetic aspects of themselves and their health and available gene-based testing and treatment options.

Curriculum↗

PubMed2002

Violence-related content in the nursing curriculum: a follow-up national survey.

Appropriate educational preparation about violence prevention, assessment, and treatment provides critical knowledge and skills that enable nurses to provide competent care to violence survivors. This follow-up national survey examined changes in the extent, placement, and faculty responsible for violence-related content in baccalaureate nursing curricula since the original 1995 survey was conducted. This national study used a 31-item mailed questionnaire that requested demographic information; data related to course content, clinical experiences, curriculum and faculty development, and curriculum evaluation; and recommendations. Usable questionnaires were returned from 395 (61%) of 648 programs surveyed. Findings indicated content related to women, children, and suicide and self-destructive behavior was taught primarily in 2 to 4 hours; 46% of schools presented sexual and elder abuse content in 1 hour or in readings only; and related clinical experiences were primarily coincidental. The majority of schools (63%) reported no violence-related faculty development activities during the past 4 years despite previous indication of need. More than two thirds of programs (68%) did not systematically evaluate violence content, and 75% had not developed violence-focused student competencies. Although small gains were found in hours of presentation in some content, little has changed in the nursing curriculum overall. The significance of this study is related to the relevance of nursing education to preparing students and faculty to address the social and health problems of increasing violence and abuse.

Aged↗

PubMed2004

A facilitative approach to learning about curriculum development.

Graduate students have high ambitions and desire excellence in their work. Creating learning opportunities that capture this drive and help them achieve and exceed their goals is a challenge for educators. This article describes two teaching approaches, group process and an adaptation of Bensusan's escalator model, which were used in a graduate nursing course to help students learn about curriculum development. Students participated as a faculty group, submitting successive iterations of their work as they developed hypothetical curricula. Benefits students identified from course faculty's critiques of their submissions included experiencing enhanced self-direction, self-esteem, and mutual respect among students and between students and course faculty, as well as authentic curriculum development in a safe, caring, and supportive context. This article discusses the strengths and limitations of this pragmatic and productive learning approach to preparing future nurse educators for their role as curriculum developers.

Attitude of Health Personnel↗

PubMed2006

Environments of care: a curriculum model for preparing a new generation of nurses.

This article provides a perspective on the community-based curriculum model that has guided undergraduate education for the past decade, discusses some of the problems that have emerged with the community-based approach, and proposes an alternative approach for consideration and discussion. The community-based model is discussed in relation to three major areas of concern: faculty and preceptor implementation of the curriculum, entry into practice and hiring pattern disjunctions, and trends and unexpected consequences of changes in the health care system. The Environments of Care Model, proposed as an alternative curriculum approach, conveys a broad perspective on health and illness, based on a multiple determinants of health paradigm and a systems framework.

Community Health Nursing↗

PubMed1990

The Curriculum Directors: influencing occupational therapy education, 1948-1964.

This paper depicts an important story in the history of occupational therapy. The story concerns a small group of women, known as the Curriculum Directors, whose influence prevailed in the growth and development of occupational therapy throughout the 1950s. The account is synthesized from both written history sources and oral history interviews with group members and their contemporaries. It characterizes the Curriculum Directors and describes their influence on the profession as well as others' perceptions of their accomplishments. This paper also chronicles the forces that emerged in reaction to the Curriculum Directors' authority and briefly details the dissolution of their power.

Curriculum↗

PubMedDate not supplied

Outcomes of selected cases from the American Occupational Therapy Foundation's curriculum mentoring project.

This study investigated the outcomes of a yearlong formal curriculum-mentoring project sponsored by the American Occupational Therapy Foundation. Five occupational therapy faculty groups were selected through a competitive application process and paired with mentors to assist in curriculum change. The experiences of each of the teams were studied using multiple methods of data collection, including semistructured interviews conducted in person and via telephone, a mailed questionnaire, and bimonthly electronic journal entries. The process and outcomes of two representative cases are reported in this qualitative, critical case study analysis. Overall, the faculty groups in each of the two teams seemed to benefit from mentoring in differing degrees as a result of their participation in this curriculum mentoring project. An important finding was that a well-focused mentoring plan with clearly outlined expectations needs to be established at the onset of any formal mentoring project. Additionally, a systematic, strategic plan agreed on by both mentors and participants, with a clear outline of responsibilities, will enhance the outcomes of a mentoring relationship.

Curriculum↗

PubMed1984

The medical interview: a core curriculum for residencies in internal medicine.

A core curriculum for teaching medical interviewing is presented that enhances the internist's skills in a broad range of interactions with patients. Learning these skills is now left to chance and is often deficient. Four objectives are developed: patient-centered interviewing and treatment; an integrated (biopsychosocial) approach to clinical reasoning and patient care; personal development of humanistic values; and psychosocial and psychiatric medicine. Teaching options include real and simulated encounters with patients, observation with discussion, and use of groups. A general strategy for implementing the curriculum at the local level requires the intellectual and financial support of the dean and department chairman, and a multidisciplinary faculty committed to developing, implementing, and evaluating the curriculum. At many programs, faculty development will be necessary.

Curriculum↗

PubMed1992

Internal medicine practice in transition. Implications for curriculum changes.

The curriculum for internal medicine needs to be changed to eliminate the dichotomy between training and practice. At the same time, changing medical needs and the actual conditions of medical practice must be taken into account. The new curriculum, at the very least, needs to emphasize the central position of general internists in health care delivery. To accomplish this, several subjects must be added to the curriculum, including additional training in ambulatory care, management of chronic disease, medical procedures, and the doctor-patient relationship. Learning to direct a coordinated health care team should also be included. A more definitive restructuring would require reorganizing medical centers around three major departments: primary care, subspecialty medicine, and surgery.

Attitude of Health Personnel↗

PubMed1992

What is a curriculum?

Dissatisfaction with the current internal medicine residency experience has led to proposals for various new curricula. Unfortunately, the more basic question of "What is a curriculum?" or more accurately, "What curriculum model is most appropriate for clinical training?" has remained largely unexamined. The dominant curriculum model, although valuable, may not be adequate for the task. In its place we propose an experimental model that is more congruent with the realities of graduate medical education.

Curriculum↗

PubMed1992

Roles of various organizations in internal medicine curriculum reform.

The curriculum in internal medicine for medical students and residents is being driven increasingly by the service demands of our teaching hospitals and is badly in need of fundamental reform. In reasserting the primacy of education as the driving force for the curriculum, numerous tasks must be done to achieve successful reform. These tasks are well within the scope of the several organizations that command leadership positions in the discipline of internal medicine and that represent the spectrum of activities required to discharge the specialty's public responsibility. These organizations include the Association of Professors of Medicine (APM), the Association of Program Directors in Internal Medicine (APDIM), the Society of General Internal Medicine (SGIM), The Residency Review Committee for Internal Medicine (RRC-IM), the American Board of Internal Medicine (ABIM), the American College of Physicians (ACP), the American Society of Internal Medicine (ASIM), and the Federated Council of Internal Medicine (FCIM). The challenge posed by the need for curriculum reform is to rouse these organizations to concerted action. Each of the seven organizations must assume a specific role and a unique set of responsibilities in the epic reforms envisioned.

Curriculum↗

PubMed2004

The effect of a 13-hour curriculum to improve residents' teaching skills: a randomized trial.

BACKGROUND: Although resident physicians often teach, few trials have tested interventions to improve residents' teaching skills. A pilot trial in 2001-2002 found that 13 trained resident teachers taught better than did untrained control residents. OBJECTIVE: To determine whether a longitudinal residents-as-teachers curriculum improves residents' teaching skills. DESIGN: Randomized, controlled trial from May 2001 to February 2002 (pilot trial) and March 2002 to April 2003. SETTING: 4 generalist residencies affiliated with an urban academic medical center. PARTICIPANTS: 62 second-year residents: 23 in the 2001-2002 pilot trial and 39 more in 2002-2003; 27 of the 39 participants were medicine residents required to learn teaching skills. INTERVENTION: A 13-hour curriculum in which residents practiced teaching and received feedback during 1-hour small-group sessions taught twice monthly for 6 months. MEASUREMENTS: A 3.5-hour, 8-station, objective structured teaching examination that was enacted and rated by 50 medical students before and after the intervention. Two trained, blinded raters independently assessed each station (inter-rater reliability, 0.75). RESULTS: In the combined results for 2001-2003, the intervention group (n = 33) and control group (n = 29) were similar in sex, specialty, and academic performance. On a 1 to 5 Likert scale, intervention residents outscored controls on overall improvement score (post-test-pretest difference, 0.74 vs. 0.07; difference between intervention and control groups, 0.68 [95% CI, 0.55 to 0.81]; P < 0.001) by a magnitude of 2.8 standard deviations and on all 8 individual stations. The intervention residents improved 28.5% overall, whereas the scores of control residents did not increase significantly (2.7%). In 2002-2003, 19 intervention residents similarly outscored 19 controls (post-test-pretest difference, 0.83 vs. 0.14; difference between intervention and control groups, 0.69 [CI, 0.53 to 0.84]; P < 0.001). Twenty-seven medicine residents required to learn teaching skills achieved scores similar to those of volunteers. LIMITATIONS: The study was conducted at a single institution. No "real life" assessment with which to compare the results of the objective structured teaching examination was available. CONCLUSIONS: Generalist residents randomly assigned to receive a 13-hour longitudinal residents-as-teachers curriculum consistently showed improved teaching skills, as judged by medical student raters. Residents required to participate improved as much as volunteers did.

Curriculum↗

PubMed1996

Curriculum goals for the training of osteopathic family practice residents for the year 2000.

The osteopathic family practitioner of the future will play a larger role in the delivery of healthcare under managed care. To prepare for this role, osteopathic family practice residents must develop skills in direct medical care, medical education, and healthcare administration. Likewise, these residents need to become familiar with the clinical setting in which these skills are needed, specifically, ambulatory, rural, hospital, and minor emergency care environments. We propose the development of a curriculum designed to promote these skills and clinical experiences. This curriculum would expand family practice experiences; replace the current required rotations in specialty medicine with longitudinal rotations designed to develop specific family practice skills; include block rotations in hospital care, minor emergency care, and rural medicine; develop model case assignments to teach residents to integrate their roles as provider, educator, and administrator; and entail clinical experiences in medical administration and education. An evaluation process that reflects the goals of the family practice curriculum is key to the success of such a program.

Clinical Competence↗

PubMedDate not supplied

A curriculum for SHO training--what is it and why has it changed?

The Royal Colleges of Physicians have revised the core curriculum for SHOs in medicine and the medical specialties to make it objective based. The objectives, knowledge, skills and attitudes for 'core skills' use ward based and outpatient clinical scenarios in specialty areas. There are also important sections on 'generic skills' including communication skills, team-working skills etc., cross-specialty areas, training in practical procedures and selection of investigations. Only in up to 41% of posts do SHOs in medicine get regular appraisal. A new appraisal replacing the personal training record has been designed to help SHOs reflect on their experience and identify gaps in their training using the revised curriculum. The new edition of the core curriculum should also allow the RCPs to set standards on the assessment of competence of SHOs to inform the postgraduate deans' SHO RITA process.

Clinical Competence↗