The CNA Nursing Education Development Program

A discussion of activities associated with getting organized for curriculum development is followed by an introduction to faculty development as part of this initial organization. The synthesis activities that conclude the chapter include, first, a case study and critique to illustrate the foremost points of the chapter, followed by a second case for analysis. Included are questions to determine readiness to begin curriculum development.

Chapter Goals

•             Overview factors important in organizing for curriculum development

•             Consider methods to organize for curriculum development

•             Identify activities involved when organizing for curriculum development

•             Contemplate faculty development activities related to organizing for curriculum development

Organizing for Curriculum Development

Deciding on Leadership

Deciding on leadership is an important aspect of organizing for curriculum development. Questions to be answered are: what is leadership and what is involved in effective leadership? What style of leadership would be most effective? Who should be the leader and how should this person guide the process?

Few topics in the social sciences have attracted as much commentary, theory, and research as that of leaders and leadership. Schools of thought about leadership have been evolutionary, and there is an expanding body of knowledge on the subject. Progression has occurred from the great man theory, to trait or characteristics of leaders, to behavioral theory, and from a focus on the individual leader to leaders and followers, and to the situation and environment. The following summary of leadership may help potential curriculum leaders assess their aptitude for this role.

Leadership is the process of influencing people to accomplish goals or to move toward goal setting and achievement. It is generally conceived that any person can use the leadership process, that it can be learned, and that anyone can become a leader in primarily one of two ways. First, a leader can be informally chosen or formally elected by members of a group who recognize and accept the leader’s influence to lead, and who view the leader as someone who is competent and trustworthy. This is referred to as emergent leadership. Secondly, a leader may be appointed or elected to the position by people external to the group. This is called imp posed or organizational leadership. Imposed leaders may have difficulty being accepted by the group or receiving support because of lack of trust.

Effective Leadership to lead successfully, leaders must possess knowledge, skills, and a caring and compassionate attitude, since leading is essentially about people (Yoder-Wise, 1995). Obviously, leadership roles in curriculum development are multiple, due to the numerous environments in which the work is conducted and the levels at which leaders must operate. In fact, 19 roles applicable to a curriculum leader have been identified: expert, instructor, trainer, retriever, referrer, linker, demonstrator, modeler, advocate, confronter, counselor, advisor, observer, data collector, analyzer, diagnose, designer, manager, and evaluator (Havelock and Associates as cited in Wiles 8c Bondi, 1998).

Interrelated attributes for effective leaders include awareness of self and group members, advocacy for the group, and accountability for one’s actions to self, group, profession, and superiors (Bernhard 8c Walsh, 1990). Five practices associated with exceptional leadership are:

•             challenging the process by searching for opportunities, experimenting, and taking risks

•             inspiring a shared vision by envisioning the future and enlisting the support of others

•             enabling others to act by fostering collaboration and strengthening others

•             modeling the way by setting an example and planning small successes

•             encouraging the heart by recognizing contributions and celebrating accomplishments (Huber, 2000)

Three levels of leadership have also been identified: individual, in which leaders mentor, coach and motivate; group, where leaders build teams and resolve conflicts; and organizational, in which leaders build a culture (Huber, 2000). Three suggested skills needed for effective leadership are: diagnosing (understanding the situation); adapting (matching behaviors and resources to the situation); and communicating (advancing the [curriculum] process in ways that individuals can understand and accept).

Case Study Of Undergraduate Nursing Program

Two case studies are presented to illustrate the ideas of this chapter. The first is critiqued. Consider whether pertinent aspects of the case have been assessed and whether there are other points to be discussed. The second case is followed by questions to guide analysis. Finally, questions are offered for consideration of curriculum change in your situation.

Charlevoix University Undergraduate Nursing Program

Charlevoix University School of Nursing has introduced a new integrated baccalaureate nursing program. The final year includes a classroom course and an associated clinical course about nursing of clients with complex needs. Broad goals and general descriptions for the courses were developed by the curriculum designers. Tom McLean, a clinical nurse specialist in the intensive care unit of a quaternary-care teaching hospital, was hired to design and teach the classroom course and manage the associated clinical course.

These courses are intended to help students integrate concepts from other nursing and support courses in situations of high acuity related to physiological, psychological, and/or social needs. Tom developed the classroom and clinical courses mainly by himself, consulting with the Undergraduate Program Chair about matters related to course structure: hours of instruction, regulations about examinations, frequency of clinical evaluation, and so forth. In his first year of teaching, Tom’s content focus in the course was the patient in the emergency room and intensive care unit.



Synthesis Activities

Throughout the clinical course, Tom met regularly with the clinical teachers to discuss matters related to the course and student progress. As well, he met informally with clinical staff. Tom was struck by the remarks of both teachers and staff that it took the students a long time “to get up to speed” in the clinical sites. He also noted on the clinical evaluations that many students were hesitant about the technical equipment, had difficulty attaching meaning to signs of rapidly changing physiological status, and/or felt overwhelmed by the clinical situations.

Tom discussed the situation with Sandra Greenberg, a trusted friend and pediatric intensive care nursing specialist who was responsible for the course in children’s health, which is prerequisite to Tom’s course. She said that students reacted in a similar fashion when assigned to the pediatric units of the tertiary care teaching hospital where she does clinical teaching.

Sandra and Tom believed they must do everything possible to ensure that students com-plating the program are able to provide competent, hospital-based care in situations of high acuity. Together, they began to consider reshaping the undergraduate curriculum to emphasize enhanced knowledge and skill development related to tertiary-level care. For example, they talked about reconfiguring the family nursing courses to address care of ICU patients’ families. They would like to see curriculum changes implemented in the next academic year so that successive classes will be “up to speed.”

Knowing that they need the support of nursing faculty, Tom and Sandra tested their ideas with a few faculties whose class or clinical teaching is aligned with acute care nursing, as well as with other intensive care clinical nursing specialists. All were supportive of the idea of increasing the focus on acute and intensive care in the curriculum and most said they will do whatever possible to help. Filled with enthusiasm for their plan, Tom and Sandra arranged a meeting with the Undergraduate Program Chair, certain that their ideas would be welcomed.

Critique The reasons for the proposed curriculum revision were Tom’s once-only experience in teaching the class and clinical courses about nursing of clients with complex needs, students’ clinical performance evaluations, and comments from other acute-care teachers and clinical staff. As well, Tom and Sandra wanted to ensure that graduating students would be able to provide competent hospital-based care. They were enthusiastic about a curriculum revision, but lacked a sufficient database upon which to recommend a change from the current program.

Tom and Sandra needed to examine the curriculum philosophy and intent, review the original course goals, and determine the expected level of performance for graduating students. Was the course really meant to focus on intensive care and emergency situations? They also needed more concrete information about what it meant for students not to be

How Online CNA Classes Are Developed

And decision-making power (Conley, 1973). Indeed, curriculum development is the pivotal and ongoing point of the faculty’s activities in most cna classes online programs (Rush, Ouellet, & Wasson, 1991). However, curriculum development is not only the responsibility of those teaching in the curriculum undergoing change; faculty in all programs ought to participate, as should the school leader.

Student participation in curriculum development is also very important (Thornton 8c Chapman, 2000). Students bring previous experiences and perspectives, needs and aspirations, which when combined, influence the curriculum. Their role in curriculum development should be as credible as that of other participants (Astride, 1996).

The importance of collaborative interfacing with colleagues from practice settings should not be overlooked. Service agencies are affected by the curriculum and potential faculty role changes. Clinical experts can provide useful, practical input, and validate suggested practice changes. Curriculum dialogue among faculty, students, administrators, and clinicians has been described as mutually enriching, not only to them, but to the curriculum and profess- son (Carmon et al., 1992).

Who else should be involved in the curriculum development process? When writing about the curriculum revolution, Rentschler and Spemann (1996) include anyone from the larger community, and suggest that these individuals might also serve on curriculum advisory boards. Such stakeholders could include faculty from other disciplines, program graduates, professor’s emeriti, health care leaders, educators from the school system, community leaders, and clients, as well as members of professional bodies. Their knowledge, experience, and vested interests would assure that standards are maintained, and expectations of preparing cna training online “for the changing health care field, rapid proliferation of health knowledge and technology, and diverse client needs” (p. 390) are upheld. Table 2.5 represents those who should be involved in curriculum development.

What Wall the Timeframe Be?

An important consideration when undertaking curriculum revision or development of an entirely new curriculum is the timeframe for conclusion of the work. How urgent is the curriculum change and when does it need to be completed? There are several factors to examine when thinking about the start and completion dates for the potential curriculum development project. Each must be assessed within the context of all the other questions posed in this chapter.

First is the urgency of the curriculum change. This is influenced by the factors that prompted consideration of a change in the first place. If, for example, graduates for several years have had a high failure rate on licensing examinations, then improving the curriculum is urgent and faculty must complete curriculum changes quickly. Similarly, a change in clinical services in local health care agencies may necessitate an immediate refocusing of cline call courses. Conversely, the immediacy of altering an undergraduate curriculum to reflect a slowly changing trend in local demographics is not as great.

Another factor to review when contemplating a timeframe is the culture of the organization. Is this an organization that innovates, or one that is satisfied with the status quo? Does it operate at a measured pace, with each step clearly delineated, or is implementation expected to rapidly follow decisions (Tappan, 2001)? Will it be necessary to gain approval from administrators for each step of the curriculum development process, or will they want only to be informed of progress? The speed at which work normally proceeds within the organization will affect the interval allotted for curriculum change.

The normal work cycle of the organization influences the schedule for beginning and com-plating the curriculum development process. Is there a semester when faculty is normally less busy with implementing programs and able to devote concentrated time to curriculum development? If so, consider how much work could be achieved in those time periods. If not, analyze the amount of curriculum development time that can be integrated into the ongoing work of the school.

Finally, when thinking about a timeframe for curriculum development, a mindful review should be conducted of the people who will be involved to identify those likely to be supporters and resisters. How much time can the supporters are expected to give to curriculum development? How much time will be taken up with overcoming resistance and winning.


The Nursing Major Curriculum Development

When reasons for curriculum change are questioned, it is tempting to invite challengers to explain their position. This is a strategy to be used with caution. Involvement in a distracting and ongoing dispute about that is right is not productive. It could lead to criticism by those who feel that their current teaching is the real work of the school of nursing. It is more constructive to respond that the reasons are compelling but, naturally, all will draw their own conclusions.

It may be that people are feeling overstretched so that even the idea of curriculum development, and thus more work, is overwhelming. The time required for this endeavor can seem daunting and may be a real barrier. It is important to acknowledge that curriculum development is a large undertaking. The reality of workloads and time available should be explored thoroughly: competing demands may make curriculum development impossible at this time. Perhaps some responsibilities can be delayed or given up, at least for a short period, to allow the process to unfold.


Chapter 2: Preliminary Considerations for Curriculum Development

To win the support of particular individuals, it is wise to identify the criticisms they have voiced about the current curriculum, as well as aspects they value. Through individual or small group meetings, they can be reminded that curriculum development is an opportunity to eliminate the weaker aspects of the current curriculum. As well, it is essential to emphasize that their active involvement in the curriculum development process could lead to incorporating parts of the curriculum they cherish. Affirming that strengths of the present curriculum maybe retained, if this is deemed appropriate, might induce cooperation.

Financial constraints will be a concern for the school leader. Curriculum development takes time, and faculty and staff time is costly. It is necessary, therefore, to enumerate the costs and potential risks of avoiding curriculum development. These can include unfavorable external reviews by approval or accrediting bodies, decreased ability to attract students and faculty, difficulty retaining faculty, and unrealized funding opportunities. Ideas for managing curriculum development will go a long way in gaining support.

Another reason for objecting to the idea of curriculum development might be that those proposing curriculum change do not have the respect of colleagues. The same idea, introduced by others, could be well received. Identifying if personalities are the reason why the idea of curriculum development is not supported is a painful process. That advocating curriculum change might consider whether or not their ideas are usually sought and supported by colleagues and if others generally choose to work with them. If personality seems to be a reason for objecting to the idea of curriculum development, it may be wise to leave the initiation of curriculum development to others. If this is not possible, some interpersonal work must be done before support will be gained for curriculum change. Table 2.4 summarizes objections that may be raised to the idea of curriculum revision or development, and offers possible responses.

Not all objections will be overcome, nor will all resistance melt away. Nonetheless, once a majority of faculty agrees with the need for curriculum change and the dean or director is supportive, the curriculum development process is ready to proceed. Faculty support for curriculum development is the foundation upon which the quality of the curriculum will rest.

Appeal to Values

Need for curriculum change or develop-mint due to:

•             Deficiency in current curriculum

•             Trends requiring new approaches

•             Evidence from literature to support change

Requirement to provide a curriculum responsive to health care and societal needs

Need for curriculum to be congruent with mission, values of organization

Possibility of obtaining funding for curriculum development

Congruence with:

•             Organizational mission and values

•             Personal and professional values Desire for:

•             Professional and personal growth of learners

•             Competent graduates

•             Enhancement of School prestige

•             Status as innovators, leaders Opportunity for:

•             Personal prestige

•             Innovation and transformation

•             Organizational preeminence

•             enhanced reputation

Consequences of avoiding curriculum development:

•             Decreased appeal and marketability of School to students, faculty, and employers of graduates

•             lost opportunities for funding

•             Implications for accreditation

•             diminished prestige