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Curriculum Development Issue

Claudette D. Johnson

Grand Canyon University: NUR: 647E

February 27, 2013

Abstract

The impact of advances in technology and the challenges caused by nursing shortage has affected nursing education. The issue has placed a growing emphasis in the ability to reach more students with less staff has created a dilemma in nursing education. Curriculum development, as the problem solving process in education is tasks to consideration innovated strategies to counter issues in education planning. This paper will discuss how access and affordability affect nursing curriculum and explore strategies to ensure accessibility of nursing education to combat shortage of nurses and faculty.

Curriculum Development Issue

As nursing adapt to the changes in legislation, economics, and healthcare policy, nursing educational curriculum is challenged to do the same. As a result of the technological revolution and environmental changes, review of curriculum is necessary to be relevant. Barriers in nursing can be divided into issues that affect either higher education or the nursing profession (Billings & Halstead, 2010). Higher education faces concerns regarding accessibility of education to meet the demands of the working students interested in nursing as a career.

The need to proactively redesign nursing curriculum taking into account better access and affordability of its program is critical in maximizing the educational benefit to a diverse student population (Institute of Medicine, 2010). This paper will discuss the impact of lack of access to education, relevance of information and technology, and explore strategies to counter access issues in nursing education.

Impact on Nursing/Staff/Education

Educational institutions are faced today with many challenges. Advances in technology, shrinking and taxed resources, and demands to reach an increasing student population are factors influencing nursing education curriculum (Jones & Wolf, 2010). Nursing educators are forced to be innovative in creating an educational plan that reflects the current needs of students. The creation of a program that reaches more students with fewer faculty resources is inevitable. Integration of technology in education to meet the increasing demand is a necessity because failure to do so can impact the future of the nursing profession.

Nursing Shortage

The lack of access and affordability of educational opportunities for student prospects can add to the nursing shortage. The Bureau of Labor Statistics (2012) projected that the nursing job force will top other occupations in job growth through 2020, expecting the Registered Nurse (RN) growing from 2.74 million to 3.45 million and more than 581,500 brand new RN positions will be created through 2018 (Bureau of Labor Statistics, 2012). Nursing faculty shortage can affect patient care.

Lack of Nursing Faculty

Nurse educators must take a lead in heightening public awareness about the shortage and potentiate efforts in recruiting quality nurses (Institute of Medicine (IOM), 2011). To meet the nursing demands, pressure to address gaps in nursing faculty becomes a priority. Each year, nursing schools are reported to turn away qualified applicants due to lack of faculty. The AACN in 2011-2012 reports that nursing schools has rejected 75,587 applicants to advanced education programs (IOM, 2011). The report identified the factors affecting nursing to insufficient faculty, clinical sites and preceptors and budget constraints. The Southern Regional Board of Education in 2002 survey finding reveals a 12% shortfall in unfilled faculty positions from resignations, retirements and students shortages for faculty role, threatening the ability to bring education to nursing students (Pathman, Chuang, Weiner, 2008).

Patient safety

Shortage of bachelors prepared nurses is linked to higher mortality. The study by Aiken, Chueng & Olds (2009) linked patient outcomes to Nurses’ education. The Effects of Hospital Care Environment on patient Mortality and Nurse Outcomes found that every 10% increase in proportion of BSN nurses in hospitals was associated with 4% decrease in death risk (Aiken et al., 2009). Educational preparation of nurses must be addressed to maintain quality care and patient safety in nursing.

Relevance to Nursing/Staff/Education

Curriculum development provides students not only with the skills, knowledge and competencies necessary to successfully function in healthcare, taking into consideration the accessibility of the program. As the health care climate changes, specific trends in nursing are surfacing affecting the curriculum and the way it is delivered. In 2006, the National League of Nursing, Nursing education recognized the emerging trend to expand upon technology training and focus on technology training for nurses, allowing access to technology for research and evidence based practices.

Shortage of nursing educators in nursing programs adds to the challenge resulting in nursing school programs turning away qualified students. State and federal funding were allocated to support educational scholarships and retention and recruitment programs. An example is the 2009 American Recovery and Reinvestment Act. The act addresses the issue of providing federal funding for education and training (Aiken et.al. 2009). Health care is challenged to meet the face paced demand in healthcare leaving educators to strategize to overcome the demand.

Strategies to Resolve Issue

Nursing education issues needs resolution. Finding strategies to address access & affordability of nursing education is necessary. The plan is to create Innovative strategies to make nursing curriculum fit the current needs of as many students with the limited available faculty and make it affordable and relevant to the current changes in health reform. The call for flexibility of nursing curriculum, financial support from governmental and private agencies, polishing nursing image and use of technology to change curriculum are some of the solutions suggested (Aiken et al., 2009).

Flexibility to enable increase attendance

In an issue of Health Affairs, Hospitals Responses to Nurse Staffing Shortages (2006) reports that 97% of hospitals surveyed use strategies to address the education shortage of nurses (AACN, 2006). Strategies such as partnering with nursing schools, subsidizing nurse faculty salaries, flexibility in schedules and increasing reimbursement for advance education in exchange for work commitment, The paper calls for support from public financing sources to find creative ways to expand student attendance.

Financial support

Governmental efforts to increase enrollments includes the passage of in 2010 of Senator Durbin’s Nurse Education, Expansion and Development Act (NEED Act) which amended the Title VII, authorizing more grants for students and faculty(AACN, 2006). In addition, the 2009 American Recovery and Reinvestment Act by President Obama helps in allocating money to the National Health Service Corps, the Nursing Workforce Development Programs and the Health Professional training Programs, providing federal funds toward health professionals training, including scholarships to nurse practitioners and certified midwives (AACN, 2006).

The U.S. Department of Health and Human Services (HHS) (2012) funded $ 8.1 million in Nurse Education Loan Repayment Program . The program helps RNs pay 60% of nursing school debts in exchange for two years of work in facilities with nursing shortage. The Health Human Service funded the Nurse Faculty Loan Program funds graduate and doctoral degrees nurses to pursue teaching faculty positions. Allowing cancellation of up to 85% of the loan principal in exchange for working full-time for four years as a faculty member at a nursing school (U. S. Department of Health and Human Services, 2012).

Partnerships for private support

Strategic partnerships between universities and businesses are formed to support expanding student capacity. An example is the partnership of Shenandoah University in Virginia and Inova Health System supporting accelerated Bachelors completion programs. In the 2 year agreement, Inova promises to award 55 $7,500 scholarships to students committed to Inova after graduation, funding $ 500,000 for new classrooms, skilled simulation labs and clinical rotation slots at Inova Hospitals (Beal, 2012).

There are additional state-wide efforts addressing shortage of nursing educators. Efforts in Pennsylvania by Governor Edward Rendell in 2008 resulted in the private sectors matching the states investment of $ 750,000 and the private sector responded generously by contributing $870,000 in funds (AACN, 2012). The public–private partnership provided new money to hire more nurse faculty and educate more students.

Polish the image of Nursing and education

Government alone cannot reform nursing. Nursing has to make efforts to polish the image of nursing to make the profession attractive to potential students. Johnson & Johnson launched a Campaign for Nursing Future in 2002 (AACN, 2006). This multimedia initiative was aimed to promote careers in nursing which included recruitment videos, television commercials, website and brochures. In addition, Johnson & Johnson extended this campaign for the next 5 years through 2012 (Stringer, 2012).

Nursing needs to improve its environment to address its retention issues. Nursing should be improving working conditions. This would include competitive salaries, better retirement benefits, flexibility in schedules and vacation benefits. Efforts to educate in prevention of horizontal violence, improvement in mentoring and preceptorship should be included. Awareness of issues in education and healthcare including advocacy should be encouraged. The Center for Nursing Advocacy suggests media coverage for public awareness and transparency of nursing issues, not to scare the public but to generate support for federal efforts supporting nursing, nursing education and its causes (AACN, 2006).

Use of Technology

The revolution in technology improves access to education for many of its working students. With the completion of higher education encouraged by employers, the need to find affordable and convenient ways to complete this requirement becomes a necessity for many. Enrollment in online learning has increased (Marcyjanik & Zorn, 2011). The frowned upon efforts of its originators such as University of Phoenix is replicated by every major university. The convenience of online learning for professionals seeking educational advancement makes online learning a viable choice to fit their needs.

The computer advancements of the 21st century influences development of curriculum in every level of learning. Computer use as interaction for studies among university students is standard. Multimedia, social media influences educational experiences of students. Though welcomed by younger generations, computer technology is stressful to its older nursing counterparts. Education’s responsibility is to respond to the rapidly evolving technology, challenged by increased complexity of care (advances in treatment emergence of new diseases) and an aging workforce (Aiken, Cheung & Olds, 2009). Educators should use technology as a means to create innovative ways to reach and teach nursing students. However, integrating nursing curriculum with the new ways of learning- online, simulation, wed based education & social media is challenging (Schmitt, Sims-Giddens & Booth, 2012). Educators are challenged to merge the clinical aspects, requiring critical thinking and clinical demonstration in online curriculum without losing its efficacy.

Conclusion

The nursing force of today faces many challenges in the development and implementation of nursing curriculum. Analysis of nursing’s past will aid the understanding of the nursing challenges in the future. The complexities of nursing issues hinder resolution of nursing issues. In addressing nursing curriculum challenges collaborative efforts from the private, public, legislative and academic sectors is necessary to address access issues in education. Nursing education’s efforts to continually find innovative ways to use technology contain cost and rally for legislative advocacy to improve student access and contain cost will allow nursing to position itself for a better future.

References

Aiken, L., R. Cheung & Olds, D. (2009, July-August). Education policy initiatives to address the nurse shortage in the United States. Health Affairs. 28(4).646-656. doi: 10.1377/hlthaff.28.4.w646

Allen, I. E., & Seaman, J. (2011). Going the distance: Online education in the United States (Sloan Consortium). Washington, DC: U.S. Government Printing Office. Retrieved from

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Beal, J. (2012). Academic-Service Partnerships in Nursing: An Integrative Review. Nursing Research and Practice. 2012: 501564. doi: 10.1155/2012/501564. Retrieved from

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Jones, D., & Wolf, D. (2010). Shaping the future of nursing education today using distant education technology. The ABNF Journal. 44-47.

Marcyjanik, D. & Zorn, C.R. (2011, November-December). Accessibility in online nursing education for persons with disability. Nurse Educator. 36(6). 241-245. doi: 10.1097/NNE.0b013e3182333f9d.

National League for Nursing (NLN). (2006). Startling data from the NLN’s comprehensive survey of all nursing programs evokes wake-up call. Retrieved release05.pdf

Pathman, D., Chuang, E., Weiner, B. (2008). Effectiveness of a grant program's efforts to promote synergy within its funded initiatives: perceptions of participants of the Southern Rural Access Program. BMC Health Services Research. 8(263).doi: 10.1186/1472-6963-8-263

Schmitt, T., Sims-Giddens, S., Booth, R., (2012, September). Social Media Use in Nursing Education. OJIN: The Online Journal of Issues in Nursing. 17(3). doi: 10.3912/OJIN.Vol17No03Man02

Stringer, H. (2012). Still going strong: Johnson & Johnson Campaign for Nursing Future turns 10. . Retrieved from

U.S. Department of Health and Human Services. (2012). Nurse Faculty loan program. Health Resource Services Administration Website. Retrieved from

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