November 12th to 19th, 2007

Yesterday, I attended a university student committee meeting. In 2008, there will be a diversity task force forming to address the needs of diverse students on campus. For example, the Muslims students have requested a 24 hour prayer room on campus. Many of our diverse students have problems and there is no one on campus who they can discuss their needs with. We will be hiring a counselor to specialize in counseling students with problems related to diversity.

Since we are increasing the student diversity on our campus, I wanted to look at how I could make some curriculum changes in the courses that I teach to meet the needs of these students. These are some suggestions that Amaro, Abriam-Yogo, & Yoder (2006) mentioned in their research study:

1. Ask for tutoring with English. The university does not provide English tutors to students. Honestly, I do not know where I could refer students for an English tutor. I need to bring this issue up at the next committee meeting.

2. Have papers edited by English-proficient classmates or family members. We provide a writing center at the University so this option would work.

3. Take a medical terminology class. We require a mandatory medical terminology class in the fall semester of the sophomore year for ALL students.

4. Record lectures. We do not allow students to tape lectures in the classroom because we discuss confidential information related to patients and clinical sites. If students want to tape lectures, they need to require special permission from the University.

5. Participate in study groups. I strongly encourage my students to participate in study groups in the courses that I teach.

6. Ask faculty to provide more time to complete tests or other assignments. I feel this is preferential treatment and this would not be fair to other students. If students want additional time to complete an exam, they must require special permission from the University.

I felt these suggestions from this article were helpful, and I plan to implement these curriculum changes in the courses that I teach.

References

Amaro, D., Abriam-Yago, K., Yoder, M. (2006). Perceived barriers for ethnically diverse students in nursing programs. Journal of Nursing Education, 45 (7), 247- 254.

November 5th to 11th, 2007

In the past two years, our NCLEX pass rate has decreased, and we have made several changes in the undergraduate nursing curriculum. Recently, one curriculum change that our department has made was to make the standardized nursing exams count towards the student’s course grade. Each semester, students are required to take standardized exams in each nursing course, for example, OB, PEDS, medical-surgical nursing, psychiatric nursing, and pharmacology. The standardized exams are written by ERI world.

In previous years, students would not study for these standardized exams because they did not count toward their grade, and the scores were below average.Now, each standardizes exam counts 5% toward the student’s grade. If the student passes it on the first attempt, he/she will earn 5 points, on the second attempts 3 points, and third attempt 1 point. If the student does not pass on the third attempt, he/she will receive zero points. Now, the students take these exams very seriously, and they study hard for them. I teach OB, and I have an in class review for this exam. In addition, students can log onto ERI world and download review sessions to their pod cast and take practice quizzes.

There are a few faculty member who thought this policy seems too harsh, but I have seen a huge improvement in the amount of studying that the students are doing to prepare for this exam. I feel the more students study for a course the better, and hopefully this change in our curriculum will help our NCLEX results return to where they were two years ago.

October 29th to November 4th, 2007

Hooks (1994) recommends that faculty build community in the classroom by recognizing the value of each individual voice through journaling. Our nursing students are required to keep a journal in their Fundamentals clinical. I have found that the students tend to list the activities that they completed in clinical. After taking this class, I realized the purpose of journaling is to promote critical thinking. Now, I have higher expectations with my students when they submit their journals. Instead of simply telling me the activities that they completed in clinical, I ask them to write about how they are applying what they are learning in the classroom to the clinical setting. I also have them identify their strengths and weakness and how they plan to improve on their weaknesses. After I have told the students my expectations, I have found that the quality of their journals has improved, and they have been much more enjoyable for me to read.

I like the idea how Dr. Anderson allows us to create a blog to complete our journal, and I used a similar idea with my Fundamental students. I created a discussion board on WEB CT for each student, and the only person who can see their journal is myself and the student. I did not have them create a blog because I was worried that some of them may have technical difficulties, and I was concerned that private information would be posted on the web. With online journals, I don’t have to worry about loosing them, and I am able to provide more timely feedback. Finally, if there is a topic that was not discussed in class, journaling is an excellent method to learn more about the topic individually.

Since I found journaling a valuable learning experience in this class, I decided to make it an assignment for the Multicultural class that I am creating. I plan to have the students create a blog, and they will be required to write a weekly journal entry about any topic related to Multicultural nursing. Through this class, I have now view journaling in a totally different light, and it is an excellent learning experience.

References

Hooks, B. (1994). Teaching to transgress: Education as the practice of freedom. New York, NY: Rutledge.

October 22nd to 28th, 2007

The nursing department made another curriculum change within the undergraduate nursing program. We are now administering comprehensive case studies to each level of students every semester as an evaluation method. At the beginning of the semester, students will complete case studies on content that we have covered in previous semesters. At this point, the student will not receive a grade on the assignment, but they will receive feedback. The reason we decided to use it as an evaluation tool is because we found that students are not transferring knowledge from one course to the next. Through the case studies, we are hoping to stimulate our students to critical think, remember content from previous semesters, and associate clinical with the theory that we are teaching them in class (Rowles & Brigham, 2005).

When I teach, I love to use case studies. Case studies help the student have an in-depth analysis of real-life situation to help them understand class content. In addition, it applies didactic content and theory to real life (Rowles & Brigham, 2005). I have found that my students enjoy them also, and I always receive positive comments on my faculty evaluations regarding them. Rowels and Brigham (2005) said that developing case studies is a difficult and time-consuming skill for many and the option of published case studies should be considered. I have to agree that writing case studies is time consuming. When I write them, I study NCLEX books, and I make sure that I include the most common concepts that will be on the state boards in the scenario.

A senior tenure faculty member came up with the comprehensive case study idea, but a lot of the other faculty feels like it is "busy work". Personally, I feel we need to do whatever we can to assist students to be successful on the state boards, and I am willing to give it a try.

References

Rowles, C., & Brigham, C.(2005). Strategies to promote critical thinking and active
learning. In D. M. Billings & J.A. Halstead (Eds.), Teaching in nursing: A guide
for faculty (pp. 283-315). St. Louis, MO: Elsevier Sanders.

October 15th to 21st, 2007

For this week’s journal entry, I want to discuss some curriculum changes that I plan to make in the OB course that I teach. This spring, I taught OB to sophomore nursing students in the undergraduate program over 7 weeks (2 hour class twice per week). I had a total of 75 students who were divided into two sections, and my faculty evaluations from these students were excellent.

This summer, I taught OB to the second degree students in an accelerated program over 4 days (8 hour classes). I had 22 students, and my faculty evaluations for this group were poor. The content and teaching methods for both groups of students were exactly the same, and I am frustrated that my evaluations are so drastically different.

The students that I teach in the spring and summer are totally different. The average age for the sophomore students is 19 years old. However, the students in the accelerated program already have a baccalaureate degree in another discipline and vary in age. For both group of students, I use a variety of teaching methods, for example, lecture, questions/answers, and case studies. There is information that I do not have time to teach in class (common discomforts of pregnancy and maternal-child nutrition), and I have created case studies on the discussion board and online quizzes in WEB CT.

This year, I am up for my 3 year review for tenure, and I need to explain my student evaluations to the department for my faculty evaluation. I believe one reason that I received poor evaluations from the accelerated students is because the material was taught in 8 hour classes over a 4 day period. Some of the students told me that they stopped paying attention because they could no longer absorb the information. I am unable to change how the course is delivered over 4 days so I decided to focus on my teaching methods.

This summer, I took Feminist Pedagogy with Dr. Grassley, and she told me that when she taught OB, she used a lot of videos to teach the content. This is one change that I plan to use in the course. For example, instead of lecturing about the stages of labor, I plan to show a short video about this content, and follow it with a case study. One of my personal goals for this course is to review the literature to find some teaching strategies for adult learners in an accelerated second degree program.

October 8th to 14th, 2007

In today’s curriculum meeting, one faculty member made a motion to change our undergraduate curriculum. Currently, we teach the nursing curriculum using the “womb to tomb” theory. For example, OB/PEDS is taught in the sophomore year and geriatrics is taught in the senior year.

Prior to this course, I had no problem with this curriculum theory. However, I posted this theory on Blackboard, and a classmate made a suggestion to teach med-surg first to serve as a foundation and then follow it with the specialty courses (e.g., OB/PEDS and Psych). I feel this rationale is logical because most employers prefer a nurse to have at least two years of experience in med-surg before working in a specialty area.

The proposed curriculum change is to teach med-surg and pharmacology in the spring semester of the sophomore year, and OB/PEDS in the fall semester of the junior year. I have two concerns regarding this proposal. First, the content that is taught in the sophomore year is difficult (med-surg and pharmacology), and I am not sure if students will be able to grasp it after only having Fundamentals. Second, we currently use Erikson and Maslow as theories in our curriculum. Obviously, with this curriculum change, Erikson will no longer be applicable in our program. One of my personal goals for this course is to learn about curriculum models that we could use in our undergraduate nursing program.

October 1st to 7th

Today, I attended a nursing curriculum meeting, and we discussed how the DNP program proposal is progressing. There will be 30 credits in the core of the program, and students will choose a concentration in Mental Health, Management, Education, or Gerontology.

We have been funded for two full-time doctoral faculty, but we are concerned if we will be able to find doctoral prepared faculty who are willing to relocate to northeastern PA. Since the program will be online, it was questioned if the faculty member would be required to move to PA and that answer is undecided.

The syllabuses have been sent for approval to the University curriculum department and the Department of Education. We are planning to start this program online in the fall of 2008, and we need a cohort of 20 to 30 students. Since it is mid October, I was wondering if it will be difficult to recruit these many students. I do not know how long it will take for the University and Department of Education to approve the program. In addition, we will need time for advertising, submitting of applications, and interviewing prospective students.

It was discussed that the DNP programs are “taking off” on the East coast, and the West Coast are not as interested in the program. I was wondering why? Also, some universities are allowing faculty with a DNP program to obtain tenure and others are not. I personally feel that a faculty member with a DNP should not receive tenure because the amount of credits in a DNP program is considerably less than a Ph.D. degree. The Ph.D. degree is a research degree and the DNP is a practice degree, and research skills are needed by nursing faculty.

Another point that was mentioned is that the University cannot guarantee the job market for our DNP graduates. One faculty member commented that she does not believe that hospitals will pay nurses for the DNP degree. I question why there is such a “push” for the DNP degree. I realize that nurses need the terminal degree to be competititive with other professions, e.g., pharmacy, physical therapy, etc., but will the employers be willing to pay for this degree? The University that I teach at is a private school. Students will be paying a great deal of money for their tuition, and they will not be guaranteed a job that will pay for this level of degree. I realize that the DNP degree will be required in 2015. At that point, will employers start paying nurses more money for the degree?

I have mixed feelings about the DNP program. In my Exploring Scholarship class, we had to debate the DNP program, and I was on the con side. I really haven’t change my opinion regarding this program, and it has been over a year since I have taken that class.

Week #5 (September 24th to 30th)

This week, I attended a curriculum meeting within the department. Our department chair announced to the faculty that she will be hiring a nursing consultant to evaluate the curriculum. The consultant will evaluate the University’s and department’s mission statement/philosophy, program objectives, and course objectives. After the evaluation, the consultant will present his findings and recommendations to the faculty. I was very excited to hear this because evaluating the University’s and department’s mission statement was one of this week’s class assignments.

At this meeting, the faculty decided to make another change within the curriculum. In the sophomore year, we have the students complete a comprehensive demo prior to entering clinical. In this demo, the students are required to demonstrate fundamental skills such as physical assessment, vital signs, sterile dressing changes, etc. The students had a positive learning experience while completing these comprehensive demos, and the faculty decided to have them complete one every semester while they are in the nursing program. The reason for this curriculum change is to encourage students to transfer knowledge from previous semesters and promote their critical thinking, prioritization, and delegating skills.

The final curriculum change made at this meeting was to change the senior level clinical course. Currently, the senior students complete this clinical at the nursing home, but the course provides the students with minimal leadership experience. The faculty plans to change the focus of this course so the students will receive more leadership experience, for example, delegating and supervising nursing care.

Week #4 (September 17th to 23rd)

This week, I attended a conference on curriculum development, which was sponsored by ERI world. The presenter, Larry Simmons, presented a lecture on “Mapping Curriculum to the NCLEX Test Plan”. Dr. Simmons explained that the content of the NCLEX-RN Test Plan is organized into four major client needs categories. Two of the four categories are further divided as follows:

1. Safe and Effective Care Environment

• Management of Care
• Safety and Infection Control

2. Health Promotion and Maintenance

3. Psychosocial Integrity.

4. Physiological Integrity

• Basic Care and Comfort
• Pharmacological and Parental Therapies
• Physiological Adaptation

The NCLEX Test Plan can be found at the web site www.ncsbn.org

Dr. Simmons suggested that Universities match courses within the curriculum, course description and objectives, and test items to the NCLEX Test Plan. For example, one course objective in English 101 is to use appropriate sentence structure and grammar. This course objective would fall under the category, Safe, Effective Care Environment and under the subcategory, A1: Management of Care: Documentation in the NCLEX Test Plan.

After the lecture, the class was divided into four groups, and we had to analyze a senior level nursing course, Family Health across the Life Span. Our group had to make sure that the course objectives were stated in the course description. Also, we had to decide which category each course objective and test question would fall under according to the NCLEX Test Plan. After analyzing this course, we discovered that the course did not address content in the Basic Care and Comfort category. Dr. Simmons recommended that every nursing course contain some content from each category and subcategory on the NCELX Test Plan.

In conclusion, Dr. Simmons said that mapping the entire nursing curriculum provides a framework for program evaluation and curriculum revisions. In addition, the NCELX test plan provides criterion-related validity to the program. I benefited a great deal by attending this conference because the concept of Mapping Curriculum to the NCLEX Test Plan was totally new to me.

Week #3 (September 10th to 16th)

I have been teaching nursing students for the past six years. When I first began teaching, I never thought about having a student with a disability. Through my teaching experience, I have encountered a couple of students with learning disabilities, and the students were provided with accommodations (e.g., allowing them additional test taking time). However, despite these students receiving accommodations, I have found that they either failed or struggle through the course and nursing program.

Chapter four mentions students with physical disabilities (e.g., impaired vision or hearing), and I was surprised to read that these students progressed through the program without much difficult by simply alternating their learning environment.

Although I have never had a student report to the classroom or clinical setting under the influence of alcohol or drugs, I had students arrested for public drunkenness and driving while under intoxication. It was helpful to read in the book behavioral, personality, and physical characteristics that a student with an alcohol and chemical dependency would present with.

I had a student who had schizophrenia and was displaying bizarre behavior in the clinical setting. The student was removed from clinical and course for patient safety and was required to seek medical assistance. I have had many students diagnosed with anxiety, depression, and display potential violent behaviors. Through this course, I would like to explore a variety of teaching methods to assist students with disabilities to be successful in the nursing program.

Week #2 (September 3rd to 9th, 2007)

I had an “ah ha” moment after I read Dr. Anderson’s explanation between the vertical and horizontal portions of the curriculum or “threads” on how content is implemented. He explained that a vertical thread is like a silo of instructional content, a single course, for example, psychiatric nursing. Horizontal curricular content is content which is common to all nursing courses and is "threaded" throughout the curriculum, for example, communication, ethics, delegation.

As an undergraduate student, I was taught pharmacology as a vertical thread. At the past two universities that I have taught at, the content has been delivered horizontal or “threaded” through the curriculum. The students told me that they do not like the content presented this way, and they prefer the content taught as a single course. I was wondering if there is any research on a higher retention rate if content it is taught as a vertical or horizontal thread.

I previously taught at Georgia College State University, and I taught maternal child nursing over an entire semester. I currently teach at Wilkes University, and the course is taught over 7 weeks. I complained to the senior faculty in my department that I feel that it is too much content to teach in a half of a semester. I was very surprised to hear that some universities are deleting (OB/PEDS) from their curriculum. I don’t understand how this is being done because there are OB/PEDS questions on the NCLEX, and I am wondering how the students are passing this portion of the exam. Is this content taught horizontally or “threaded” through the curriculum? If so, it seems like it would be difficult to “thread” this type of content through the curriculum. These are two curriculum questions that I have reflected upon this week.

Week #1 (August 27th to September 3, 2007)

One of the suggested topics for the first week journal is to describe perceptions and possible revisions about curriculum development. I currently teach in an undergraduate nursing program at Wilkes University in Wilkes-Barre, Pennsylvania. The nursing department is considering revising their undergraduate nursing program, and I would like to take an active role to assist the faculty to accomplish this task. Currently, our curriculum is based on developmental theory and nursing courses are taught from “womb to tomb”. For example, OB/PEDS are taught in the spring semester of the sophomore year and geriatrics is taught in the senior year.

This seems like a logical method for teaching nursing curriculum; however, there is much debate among the faculty whether this is the best curriculum for our undergraduate program. Personally, I feel this is a rational method, but I may change my opinion after taking this class. Some of the faculty members feel that med-surg should be taught in the spring semester of the sophomore year and OB/PEDS in the fall semester of the junior year. The rationale for this curriculum change is because the students need the med-surg content to serve as a foundation for the specialties courses (e.g., OB/PEDS, psychiatric nursing, etc.). I have posted online surveys on WEB CT for the sophomore students regarding the possibility of making this curriculum change, and the student response is split (e.g., 50% desire OB/PEDS and 50% desire med-surg in the spring semester of the sophomore year).

I have two personal learning objectives for this course. First, I would like to analyze our undergraduate nursing curriculum and see if it needs to be changed. Second, if the curriculum needs to be changed, I would like to explore a variety of nursing theories and philosophy that could serve as a theoretical framework for redesigning our undergraduate curriculum.