This paper examines the process of developing a nursing curriculum, focusing on three interconnected areas: the foundational steps required to implement an RN-to-BSN degree completion program, and two case studies involving nursing schools facing distinct curricular challenges. Case One analyzes Meadowvale, a school confronting declining licensure examination pass rates and the need for urgent curriculum reform. Case Two examines Rosemount, an institution with a fragmented faculty development system and resistant senior leadership. Drawing on Iwasiw et al. (2009) and Keating (2011), the paper identifies key facilitators of change, strategies for managing resistance, appropriate timelines, and leadership models suited to each institutional context.
The first required step before initiating an RN-to-BSN degree completion program is determining the need for such a curricular change. This determination will ultimately require an application for accreditation in this area, meaning that the demanding process of change must be warranted within the community. The initial step, therefore, is to explore the apparent need for professional development in the research and academic capacities of nursing. If it can be determined that adding a Bachelor's program to the community's offerings would substantially address the field's demand for appropriately educated nurses, it would be appropriate to proceed with new curriculum development.
Resources required for making this a reality include funding for achieving accreditation, faculty support for developing a proper course of education, and the means for preparing faculty to administer the newly advanced path of learning. It is expected that roughly two years of application and development would be required before a new curriculum could be put into place.
Once completed, the positive outcome would be a more attractive range of course offerings for prospective students and a stronger skill set for graduates entering the job market. The only anticipated negative consequence would be the demand to bring new and differently skilled personnel on board. With an appropriate adjustment period, this drawback could be quickly addressed.
The most immediately pressing factor for Meadowvale is the apparent lack of alignment between the current curriculum and the professional standards reflected on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). A 20% failure rate, combined with broadly voiced discontent among the school's graduates, suggests that the current curriculum has become outdated relative to the demands and expectations of actual professional practice. Meadowvale is therefore propelled by its declining performance to bring major change to a long-standing curricular orientation.
The primary sources of support will be those personnel with whom the lead instructor has established a strong and positive working relationship. According to the case history, the instructor benefits specifically from successful working relationships with faculty members, university administrators, and clinical and professional colleagues. This provides a significant opportunity to make inroads into development by selecting key faculty members to help drive the new curriculum forward among colleagues. According to Keating (2011), supportive faculty will be the most important resource both for developing curriculum and for working against the inevitable resistance that is likely to arise. Keating notes that "in a study of faculty perceptions of implementation of curriculum change, Powell-Cope, Hughes, Sedlak, and Nelson (2008) found that administrators, other faculty, and students who were 'champions for curricular change' were also identified as facilitators of successful implementation of the new curriculum" (Keating, p. 34). This is especially true in a case where change has been necessitated by a 15-year curricular holding pattern, during which many faculty members may have grown too comfortable with the existing system and are likely to prove a source of resistance.
For many faculty members, the philosophical orientation of the curriculum change is likely to be a determining factor. As the case history indicates, there is little central guidance on the philosophy of the nursing curriculum currently in place; as a result, patient-centered, feminist, and social justice perspectives all influence educational approach. Those who are aligned with the centrally selected philosophical orientation of the new curriculum will most likely be its strongest advocates and most stable personnel.
According to Iwasiw et al. (2009), the twin failures of high licensure exam failure rates and general graduate dissatisfaction serve as a significant impetus for immediate change. As the Iwasiw text indicates, this urgency "is influenced by the factors that prompted consideration of curriculum development initially. If, for example, two successive groups of graduates have had a high failure rate on licensing examinations, then there is pressure to improve the curriculum quickly" (Iwasiw et al., p. 19). In the present case, the results of this year's testing must be responded to quickly in light of an approaching accreditation review. A suitable timeframe for curriculum development would therefore be three months, spanning the slowest enrollment quarter — presumed to coincide with the summer months. The fall semester would then correspond with a pilot period, with refinement and full implementation following the spring semester.
Evaluation of acceptance and readiness should take the form of close consultation. Because the positive working relationship between the instructor and the faculty will be critical to effecting positive change, assessment should also be an open process of ongoing consultation. Bi-weekly conferences with faculty can help identify flaws and opportunities in the curriculum going forward.
"Rosemount's fragmented faculty development and resistant leadership"
In spite of the obstacle created by a few decidedly out-of-touch leaders, there is a clear need for all faculty to remain effective by staying current with changes in the broader industry. As Iwasiw et al. note, "continuing shifts in health and healthcare systems, technologies, population profiles, expectations, and demands have led to the realization that the education of nurses, and therefore nursing curricula, must be subjected to evaluation, revision, and maybe even dramatic change. The magnitude, intensity, and pace of societal and healthcare dynamics challenge nurse educators to develop relevant, evidence-based curricula to prepare nurses for new roles and responsibilities consistent with evolving healthcare systems. A curriculum 'not only reflects but is a product of its time'" (Iwasiw et al., p. 17).
Strategies for encouraging participation should include professional recognition for meaningful contribution. Rosemount might consider developing its own internal certification program centered on participation, performance, and completion in a faculty development program. Development activities could remain voluntary, allowing faculty members to retain flexibility or to pursue professional advancement. Naturally, career opportunities and recognition would be more forthcoming for those who achieve internal certifications.
The primary goal of undertaking this program would be to ensure that faculty continually possess the knowledge, skills, and understanding at the cutting edge of the industry. Shared knowledge of medical practices, the legal conditions surrounding them, and the nursing environments in which they will actually be implemented are all constantly shifting. Development activities such as participation in internal certification programs can ensure ongoing currency.
Faculty members resisting change should be encouraged to take part in open discussion about what could or should be improved in an evolving curriculum development program. As Iwasiw et al. indicate, "challenges about the accuracy of information that illustrates the need for curriculum development, or the conclusions drawn, can be anticipated. This may reflect an honest, intellectual disagreement, a deeply held belief in the value of the current curriculum, a general response to change, or opposition to those proposing curriculum development" (Iwasiw et al., p. 23). Open dialogue can help determine which of these motivations is at play and redress it through compromise. Indeed, this may be the only way to bring objecting senior leaders into the process of change without allowing them to control its momentum.
At Rosemount, a Transformative Leadership orientation is required. In particular, the need to designate implementation champions suggests that this transformative approach should lead to a distributed leadership model wherein all participating faculty become drivers of change. By combining open dialogue, voluntary internal certification, and recognition-based incentives, Rosemount can build the kind of broad faculty engagement necessary to move beyond its current fragmented approach and develop a sustainable, evidence-based curriculum development program.
Iwasiw, C., Goldenberg, D., & Andrusyszyn, M. (2009). Curriculum Development in Nursing Education. Jones and Bartlett Learning.
Keating, S. B. (2011). Curriculum development and approval processes in changing educational environments. In Curriculum Development and Evaluation in Nursing.
You’re 91% through this paper. Sign up to read the remaining 1 section.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.