Curriculum Levelling in Nursing Education

Discussion board post for NURS624 Teaching in Health Disciplines, posted on May 23 2023. Post is in response to discussion about how nursing education is levelled and organized, and ultimately achieved throughout the curriculum.

Thank you for this overview on curriculum development around entry to practice requirements for nurses. I would like to expand upon your introduction by delving into specifics of the CNO entry to practice guidelines, and include my personal experience teaching in a nursing program in Ontario.

I believe one of the most significant areas where levelling and consolidation of knowledge shines is in clinical practicums. In clinicals, students are required to synthesize their knowledge, apply it to real-life situations, question it as they come across inconsistencies or incongruencies between theory and practice, and co-construct knowledge with their colleagues in the clinical setting. I teach clinicals, and I find that, not only is a progressive humanist approach most appropriate and effective to facilitate a space where students can apply critical thinking and organize their learning according to their own needs, but also clinicals offer a practical, meaningful space for students to create connections between all of the distinct information they have gathered throughout their theory courses.

The CNO entry to practice framework breaks down the practice of nursing into categories: clinician, professional, communicator, collaborator, coordinator, advocate, leader, and educator (CNO, 2018). Often, no single course (except perhaps the pregrad consolidation practicum in the final semester) addresses each and every one of these outcomes, nor is it realistic to expect as much. The reality is that some of these outcomes -- especially related to professional, advocate, and leader -- rely on the accumulation of experience over time, rather than unidirectional flow of knowledge from teacher to student, so it stands to reason that these would be developed over the course of an entire educational program, with pearls of wisdom gleaned along the way. Other outcomes are more tangible and directly teachable, though they also rely on layering of knowledge, or levelling, as nurses think from lower levels of knowledge to higher levels (which I discussed in a previous discussion board post related to Bloom's taxonomy).

Examples from CNO entry to practice guidelines (2018) and related course levelling:

In my view and experience, the best curriculums offer students opportunities to directly gain skills and knowledge, followed quickly by opportunities to process, consolidate, question, evaluate, and appraise that learning through constructive methods. This process should repeat itself indefinitely over the course of a nurse's career, but if it is initiated early in the education process, it will become natural for students to engage in this, and it will inspire them to continue using this methodology of knowledge acquisition and analysis throughout their profession. After all, nursing is a profession of life-long learning, so we must be continually engaging in this process.

References

College of Nurses of Ontario. (2018). Entry-to-practice competencies for registered nurses. Retrieved on May 23, 2023, from: https://www.cno.org/globalassets/docs/reg/41037-entry-to-practice-competencies-2020.pdf