Curriculum Development

1. Curriculum Development Expanding Geriatric Education in Undergraduate Nursing Education Group: Siobhan McMahon Gail Prothe Ebere Ume Ellie Lacabral

2. Mission and Goals Mission:  The College of Nursing within the XXXX University is a learning organization that prepares students to provide and lead evidence based nursing practice that optimizes health and well-being of diverse older adult populations. Goals: • Maintain a curriculum that is contextually relevant  • Prepare nurses to practice in a complex and continually changing health environment • Prepare professional nurses to care for individuals across the life span, including older adults.

3.  Philosophy The College of Nursing integrates the philosophy of XXX University that is dedicated to the exchange of knowledge and pursuit of wisdom within and atmosphere of intellectual honesty and freedom

4. Nursing Philosophy The faculty within the College of Nursing also believe the central concepts within nursing practice include:  • Client/ Person • Nursing • Environment • Health, • Teaching and Learning Environment • Nursing Education

5. Curriculum Scope Objectives:  • Enhance the knowledge and skill of nurses to care for older adults and their families across diverse settings and specialties.  • Enhance the sensitivity of nurses caring for older adults and their families across diverse settings and specialties.

6. Curriculum Scope Setting: University Time Frame: 18 Months. • All undergraduate faculty involved in some way  • Curriculum leader and steering committee • Working groups  • Data collection   • Philosophical approaches  • Goals  •  curriculum matrix course development •  Course Development

7. Curriculum Defined A curriculum is a framework  upon which specifics are added. Like a house, the foundation is the philosophy, values and mission for the house. Upon this foundation, the outer framework, curriculum, is built. Inside the framework then are specific rooms and these rooms are representing the specific courses. Each course has more detail added. Curriculum, therefore, is a structured framework.

8. Rational and Needs for Development —Aging Population and their diverse health care needs —Patient Protection and Affordable Care Act 2010 —Health Care Trends —Current Educational Deficits

9. Aging Population • Baby Boomers will be crossing the age of 65 in record numbers starting in 2011. • Average life expectancy at age 65 is an additional 17 to 19 years • Average life expectancy at age 75 is additional 12 years • Proportion of US Population over the age of 65 • 2010: 40.2 million (12%) • 2030: 72 million (20%) • 2050: 88.5 million

10. Aging Population and Health • 80 % of people over 65 have at least one chronic condition • 50% of people over 65 have at least two chronic conditions • Proportion of older adults (John A. Hartford): • 50% of persons in acute care settings. • 70% of persons receiving home care services • 90% of persons living in long term care settings •  34% of all prescriptions

11. Aging Population and Health • Health status of older adults is diverse and often complex. influenced by • income level,  • living arrangements,  • need for physical and psycho/social supports. • A major focus of health promotion is to minimize loss of independence associated with functional decline and illness. (CDC, 2010). • Fewer than  40 % of adults r are up-to-date on potentially life-saving clinical preventive services such as screening for breast, cervical, and colorectal cancers, and vaccinations against influenza and pneumococcal disease (CDC, 2010).

12. Health Care Reform • Patient Protection and Affordable Care Act 2010 • Increased Subsidies for 32 million of Americans • Created National Health Care Workforce Commission • Nursing • Increased funding for the National Health Service Corps • Creates grant programs for nursing retention • Increases loan amounts for Nursing Student Loan program • Expands Nurse Loan Repayment and Scholarship Program • Geriatric Nursing Career Incentives

13. Health Care Trends Institute of Medicine(2008, 2010) •Retooling for America (2008) • Older Americans account for a disproportionate share of professional health care services but the number of geriatric specialists remain low. • Many generalists treat geriatrics without specialty training • The Future of Nursing (2010) • Competencies needed to practice have expanded, especially in areas such as geriatrics

14. Health Care Trends • Chronic Disease • 82%of older adults  have at least one chronic     illness •  Specialty treat Over 65 population • Aging of Nursing Workforce • 73,000 RN’s leave profession annually • Average age of Nursing Faculty  55.2

15. Current Education Deficits • BSN program • In 2005 1/3 Nursing programs had required geriatrics course •  In 2003 34% had any  free standing geriatric program and 23% had an integrated geriatric education • Geriatric Education • Often presented during Fundamentals or during Medical Surgical • Clinical experience at Nursing Homes at beginning of education

16. Barriers to Curriculum Development • Full curricula • Lack of interest in geriatrics • Limited faculty • Limited funding and time • Limited evidence supporting the best methods by which to accomplish this (IOM, 2008) •  Reluctance to change (philosophical views, roles, relationships, teaching-learning approaches, evaluation approaches)

17. Full Curricula Examine current teaching-learning styles and provide workshop about newer methods that move away from the quantity of content to the

18. Faculty without interest or knowledge in geriatrics Faculty development resources     Updated baccalaureate competencies (2010)     Evidence Based Nursing Resources     Assessment Series     Teaching Workshops     Curriculum Mapping Tool     End of Life Training     Review Courses  "Faculty should partner with health care organizations to develop and prioritizecompetencies so curricula can be updated regularly to ensure that graduates at all levelsare prepared to meet the current and future health needs of the population." (IOM, 2010)

19. Limited Faculty Recommendation 5: Double the number of nurses with a doctorate by 2020. Schools of nursing, with support from private and public funders, academic  administrators and university trustees, and accrediting bodies, should double the number of nurses with a doctorate by 2020 to add to the cadre of nurse faculty and researchers, with attention to increasing diversity.

20. Limited Funding and Time

21. Limited evidence supporting the best methods by which to accomplish enhanced Geriatric Education Across the Curriculum

22. Curriculum Philosophical Approach • Synergy Model of Nursing Education?? • Originally developed to link patient outcomes with certified critical care nurses • Learner center stage • Continuum with opposing end points to describe both educators and learners. • Matching the needs of the learner and competency of the educator optimizes learning. • or • Constructivism plus collaborative inquiry (Iwasi, pp. 179) • Meaning and knowing are constructed; learning is connected; new understandings occur between among students teachers and clients.  • generation of new knowledge from reflection, shared power, active learning and decision making

23. Educator Competencies Clinical Judgement Advocacy Caring Practices Collaboration Systems thinking Response to diversity Clinical inquiry Facilitator of learning Learner Characteristics Resiliency Readiness Experiences Vulnerability Resource Availability Participation in learning     & decision making Predictability Curriculum Philosophical Approach

24. Curriculum Philosophical Approach

25. Curriculum Philosophical Approach Cognitive Apprenticeship: Mentoring

26. Curriculum Design See Matrix

27. Curriculum Evaluation Plan Definition: Thoughtful, organized appraisal  of  the central elements  of the course of study

28. Curriculum Evaluation Plan Purpose: • To ensure relevant, internal consistency  • Implementation fidelity • Outcomes congruency • Student/faculty satisfaction

29. Curriculum Evaluation Plan Reasons: • Ensure standards  • Justify fiscal/resources requests and allocation  • Obtain data for maintenance or modification or discontinuation

30. Curriculum Evaluation Plan Types  • Internal:  Program-based • External:  Accrediting/Regulatory bodies (CCNE, NLNAC)

31. Curriculum Evaluation Plan Frequency based • Formative:  Regular intervals for feasibility and effectiveness • Sumative:  At the end of a course or the program.

32. Curriculum Evaluation Plan Planning of curriculum evaluation (Iwasiw, Goldenberg, & Andrusyszyn, 2009 • Determine purpose and audience • Consider internal vs external consistency and fidelity • Individual or committee responsible for coordination of the CE • Evaluate the CE Model to be used • Evaluate the CE questions to be addressed (small bites) • Consider the standards or criteria to be used

33. Curriculum Evaluation Plan cont. • Decide the data essential to answer the CE questions • Methods and timing of data collection (Include person responsible for obtaining  • and providing data • Repository for the data collected • Individuals to interpret, judge the evidence and formulate recommendations for moving forward. • Process for reporting the CE results to the relevant audience • Deadline for the completion of CE

34. Curriculum Evaluation Plan  Components of curriculum Evaluation: 1.Philosophical approaches 2.Curriculum outcome statements 3.Curriculum design 4.Curriculum outcomes 5.Courses 6.Teaching-learning strategies 7.Strategies to evaluate student                 achievement 8.Human and physical resources 9.Learning climate 10.policies

35. Curriculum Implementation

36. Bibliography American Association of College of Nursing (2010). Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older adults. Retrieved from http://www.aacn.nche.edu/education/pdf/AACN_Gerocompetencies.pdf Center for Disease Control [CDC] (2010).  Healthy AgingRetrieved from www.cdc.gov/aging Institute of Medicine  (2008). Retooling for an aging America building the health care workforce. Washington DC: The National Academies Press.