Using quality and safety education for nurses principles to enhance foundational nursing courses: Outcomes from an innovative curriculum project

Abstract

Background: Shortcomings of traditional methods used to prepare undergraduate nursing students for the increasingly complex demands of the current healthcare environment have been cited by national organizations as rationale for the revision of nursing program curricula. In this curriculum project, two undergraduate nursing courses, in which students were simultaneously enrolled, were enhanced to meet emerging national standards for nursing education.

Objectives: The aims of this project were to: 1) integrate the didactic and psychomotor skill components of the two courses into congruent modules with a focus on application in complex health care settings, 2) increase the emphasis on self-directed and collaborative learning to prepare students for inter-professional practice, and 3) implement learning experiences that incorporate the knowledge, skills, and attitudes necessary for professional role development.

Methods: Guided by recommendations from the Quality and Safety Education for Nurses project and the American Association of Colleges of Nursing document Essentials for Baccalaureate Education, several enhancements were implemented. First, enhancements were piloted in the fall semester with a small group of students enrolled in the two courses. In the following semester, the full project was implemented for all students (n=126) and course faculty (n=12). Specific strategies included the development of a set of 24 proprietary skills videos, a group cultural competence project, an unfolding case study, and adding clinical situations to support learning in context in the classroom and during psychomotor skills training. Outcomes were evaluated with student and faculty surveys and a faculty focus group. Descriptive statistics were used to summarize survey data and a content analysis was performed on data from the focus group.

Results: Overall, the faculty and students evaluated the curriculum enhancements positively with 57% to 88% rating most of the items as “strongly agree” or “agree”. From the focus group, faculty perceived that the enhancements were “more organized…it just flowed”, and “it made clinical a little easier. Faculty thought students were “taking more ownership…of their own learning.”

Implications and Conclusions: Students and faculty thought that course changes encouraged self-directed learning and successfully merged clinical application with didactic and psychomotor skills classes. These findings may be useful for others planning course changes that enhance self-directed learning, and that want to merge clinical application within the didactic and psychomotor skills classes.  Future research to examine changes in student knowledge, skills, and attitudes as a result of educational initiatives, at all levels of the nursing curriculum is recommended.