Curriculum Development in Nursing

Process and Innovations Education for nurses and allied health professionals is being radically overhauled both in the UK and overseas. Curriculum Development in Nursing offers nurse educators a single text that covers curriculum development processes, and highlights case study examples of innovation in approaches to nurse education. The book has been written by internationally well-known authors, who take a truly international perspective looking at education in the UK, Europe and the US, as well as in Africa and the Middle East.

This book will be an essential guide to curriculum development and will be an invaluable resource for nurse educators and postgraduate nursing students internationally.

Leana R.Uys is Deputy Vice Chancellor of the University of KwaZulu-Natal, South Africa and also Head of the College of Health Sciences at the same university.

Nomthandazo S.Gwele was Professor and Head of the School of Nursing, University of KwaZulu-Natal, South Africa during the preparation of this book, but is currently Executive Dean of Health Sciences at the Durban Institute of Technology in South Africa.

Curriculum Development in Nursing Process and Innovations

Leana R Uys and Nomthandazo S Gwele

LONDON AND NEW YORK

First published in 2005 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

Simultaneously published in the USA and Canada by Routledge 29 West 35th Street, New York, NY 10001

Routledge is an imprint of the Taylor & Francis Group This edition published in the Taylor & Francis e-Library, 2005.

“ To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to http://www.ebookstore.tandf.co.uk/.”

© 2005 selection and editorial matter, Leana R Uys and Nomthandazo S Gwele; individual chapters, the contributors.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanlcal, or other means, now known or hereafter invented, including

photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data A catalogue record for this book has been requested

ISBN 0-203-31334-8 Master e-book ISBN

ISBN 0-415-34629-0 (hbk) ISBN 0-415-34630-4 (pbk)

Contents

Preface v

Contributors vii

Abbreviations ix

Glossary x

1. Education philosophy and the curriculum 1 2. An overview of the process of curriculum development 20 3. Establishing the context and foundations 30 4. Developing a macro-curriculum 40 5. Developing a micro-curriculum 61 6. Implementing a new curriculum 82 7. Curriculum evaluation 98 8. A problem-based learning curriculum 112 9. A case-based curriculum 128

10. Developing problem scenarios and cases 140 11. Developing a community-based nursing education 153 12. Developing an outcomes-based curriculum 176 13. A curriculum for interprofessional learning 195 14. Conclusion 204

Index 207

Preface

Nurse educators always have a dual role—they are both nurses and educators. As nurses they often have a specialty, such as psychiatric nursing or nephrology nursing, and they need to keep up with developments in that specialty, both in terms of the literature and the practice. When such nurses become educators, they also have to master the field of education, and keep up with what is new in the field of education, both in terms of theory and practice. We therefore believe that such nurse educators need constructive, stimulating and up-to-date texts to assist them in their task as educators of the new generation of nurses.

Nursing and midwifery are facing increasing demands the world over, but especially in developing countries. Healthcare quality is often dependent on the quality of nurses and midwives, since they provide the bulk of the human resource capacity. Their traditional hospital-based, lecturer-dependent and narrowly focused training often does little, however, to prepare them for the realities they face in practice in under-served areas, where they need to work and think independently, and where they need to lead the health team and the community. The fact that resources are often scarce, and support for nursing education compares poorly with that for medical education, does not help. The challenge is therefore often how to do more with less.

We, Leana and Thandi, have been active in our own country, and internationally, assisting nurse educators to interrogate their own curricula, their own teaching practice and their own views on nursing education. In many places we have found enthusiastic colleagues who want to deliver quality nursing education, but who are caught in old paradigms, and outdated methods. Often they have had limited exposure to higher education settings, but are expected to develop new nursing schools in universities. In such circumstances they often carry poor educational practices from other settings into new programmes and schools. Under pressure to develop new curricula fast with limited resources, and implement these curricula for groups of students used to traditional teaching/learning, they fall back on what they have been used to in their own school and nursing education.

As we worked in such settings over time, we often felt the need for a book that we could leave with them to assist them when we had left. We could find nothing that articulated our belief in innovative process-outcome curricula, based on solid preparation of the curriculum, staff and students. There was nothing that gave the simple information one needs when leading a nursing programme: how you plan for clinical learning experiences, how you decide how much clinical learning is enough, how you balance process with content and outcomes.

The purpose of this book is to offer nurse-educators a single textbook that brings together two aspects:

• the generic process, outlining each step carefully to support faculty who actually have to develop a curriculum, and

• innovative approaches which have developed over the last 20 years, and are still new to most nurse-educators.

This book gives enough detail to enable a group of nurse educators to use it to work through the process of developing a curriculum. It is a ‘how to’ guide, but it outlines adequately the theoretical and philosophical reasoning behind the decisions made. It also gives more detail of specific types of innovative curricula, to support groups who want to implement such models. Since most of the authors are second-language English speakers, the writing is usually easy to understand, and is also illustrated with examples, both in the text and in the form of recommended readings.

Chapter 1 provides a philosophical basis for the process of curriculum development, and anchors the more practical chapters which follow.

Chapters 2–7 deal with the process of curriculum development, implementation and evaluation. In each chapter one step of the process is described, explaining what it entails, and how the educators should go about completing the tasks.

Chapters 8–13 give examples of the more common types of innovative curricula. In each case the author deals with the characteristics of the specific type of curriculum, the advantages and disadvantages, and then describes the specific tasks involved in developing such a curriculum. The specifics about the implementation of each kind of curriculum are also given, and often the author refers to a real life curriculum as an example. Since more than one type of curriculum uses cases of problem-scenarios, one chapter (Chapter 10) is dedicated to the development of such components. Problem- based, case-based, outcomesbased, community-based and interprofessional learning are all innovations that have built up some credibility over the last 20 years, but can still all be seen as innovative.

At the end of each chapter we recommend a few readings which give examples of either research done in the topic covered by the chapter, or give a description of implementation of the topic of the chapter. For instance, at the end of Chapter 6 on the implementation of a new curriculum, one article describes an example of such an implementation process, while the other describes a research project on staff concerns during the implementation project. We also list one or two points for discussion, to assist groups to engage around the issues raised in the chapter. Having read and studied the chapter the reader might be stimulated by these points to apply the new knowledge, or search further for answers.

Curriculum development is something all the authors of this book feel passionately about. We hope that the book will stimulate readers to create something new in nursing and midwifery education, and to facilitate the creation of a new cadre of nurses and midwives who can confidently lead us towards the ideal of ‘Health for All’.

Leana Uys and Nomthandazo Gwele Durban, March, 2005

Contributors

Henry Y Akinsola is a registered nurse and a registered nurse tutor. He trained in Nigeria as a diploma nurse in 1973. He did his first degree (B.Sc. in Nursing, 1978) and PhD in Community Health (1991) at the University of Ibadan, Nigeria. He holds the degree Master of Science in Community Medicine from the University of Manchester, England (1983). He has been involved in the training of nurses and doctors for the past 21 years, having worked in Universities in several African countries, including Nigeria, Kenya and Botswana. Currently he is the team leader of project designed to integrate quality assurance principles in the nursing training curricula of the College of Nursing and Health Technology, Ministry of Health, Asmara, Eritrea.

Nomthandazo S Gwele (Thandi) is a registered nurse and midwife, and a registered nurse educator. She started her nursing career in a Diploma programme at Frere Hospital in East London, South Africa. While working as a midwife and a community health nurse, she obtained her BA (Nursing) in 1984 from the University of South Africa. In 1985 she travelled to the USA on a bursary, and obtained both the M Education and the MS (Nursing) at the University of Missouri-Columbia before returning to South Africa. Having worked at the University of Transkei, she joined the staff of the University of Natal (now KwaZulu-Natal) in 1992, where she obtained her PhD in 1994. Over the last 10 years she has acted as curriculum consultant to numerous nursing colleges and universities in South Africa, she also worked closely with the Nursing Institute of the United Arab Emirates. She was Head of the School of Nursing at the University of KwaZulu-Natal, Durban, South Africa.

Marilyn R Lee began her nursing career in 1971 as a Staff Nurse after completing her Diploma in Nursing at the Barnes Hospital School of Nursing in St. Louis, Missouri, USA. She was Head Nurse, Clinical Nurse and Inservice Instructor there over the next 10 years. She subsequently obtained BSN (1976) and BA (1975) from the University of St. Louis and her M Nursing (1982) from the University of South Carolina. In 1983 she taught in the School of Nursing at McMaster University, where for the next 16 years she taught nursing students using problem- and case-based approaches to learning in Canada and later in Pakistan. While in Pakistan, she was coordinator and team leader in two projects in nursing education and leadership development. She received her PhD in Nursing from Wayne State University, Detroit, Michigan, USA in 1996. In 1999 she moved to the University of Botswana (in Gabarone), where she is currently the first Deputy Director in the new Academic Programme Review Unit.

Fikile Mtshali is a registered nurse and midwife, and also registered operating room nurse, nurse educator and nurse administrator. She has worked in a range of clinical

settings for many years before embarking on an academic career. She obtained her PhD in 2003 with a study on Community-based Education in nursing in South Africa. She has been working as a consultant in different African countries, including Rwanda and Tanzania, as part of the work of the School of Nursing at the University of KwaZulu-Natal. She is currently Post-graduate Programme Director in the School of Nursing, University of KwaZulu-Natal, Durban, South Africa.

Mouzza Suwaileh graduated from the B.Sc Nursing programme in the College of Health Sciences in 1987, and also has a qualification in health professional education from the same institution. She obtained an M.Sc in Adult Health Nursing from the University of Texas Medical Branch in Galveston in 1990 and then a PhD in Nursing from the University of Texas in Austin, USA. She also did a Diploma in Health Care Management from Royal College of Surgeons, Ireland in 2002. She worked in various units in Bahrain hospitals, and is a certified haemodialysis nurse. She is currently the Chairperson of the Nursing Division at the College of Health Sciences, Kingdom of Bahrain, and the Director of WHO Collaborating Center for Nursing Development, Kingdom of Bahrain.