While going through nursing school in the late 1970s, Martha J. Greenberg, RN, PhD, remembers one of her nurse instructors from the military, who taught a class on how to make a hospital bed. To test students skills, she would bounce a quarter on the freshly made bed to ensure the hospital corners were tight and wrinkle-free.
Modern-day nursing school curricula puts more emphasis on the concepts and rationale and less on specific tasks. Students who learn bed making, for example, would learn about the science behind the task, including how to turn patients correctly and prevent pressure ulcers, according to Greenberg, associate professor and chairperson at the Lienhard School of Nursing at Pace University in Pleasantville, N.Y.
Changes in the last decade to how RNs are taught are necessary to keep pace with the evolving population demographics, informatics technology explosion and the recommendations of healthcare trendsetters, such as the Institute of Medicine, according to Judy Honig, EdD, DNP, CPNP, professor of clinical nursing and associate dean of student affairs in the School of Nursing at Columbia University Medical Center in Manhattan.
Theres an effort to address safe and quality care, Honig says. We always wanted quality care, but it wasnt as systematically approached; it wasnt measured; it wasnt evaluated. It was an expectation, surely, but theres a science to assure quality, quality improvement and quality assessment.
Emphasizing EvidencePhyllis Shanley Hansell, RN
Todays RN curricula feature stronger scientific underpinnings, according to Phyllis Shanley Hansell, RN, EdD, FAAN, dean of Seton Hall Universitys College of Nursing in South Orange, N.J.
We still teach the [bed-making] procedure, but its really placed in a different context, Hansell says. I believe our students are more focused now on using the results of nursing research to provide practice that has scientific basis.
About 10 years ago, nursing school research courses taught students how to conduct research; whereas instructors now tend to hone in on research utilization, according to Rona F. Levin, RN, PhD, professor and chairperson of the graduate department at Pace Universitys Lienhard School of Nursing in New York City. The emphasis, she says, is on learning how to ask clinical questions and find the best evidence to answer those questions.
The shift at Pace started about a decade ago on the graduate level, Levin says, and soon filtered into RN education. The integration of evidence-based practice in the RN curriculum continues to evolve.
[Evidence-based practice] is not just limited, now, to the research courses, Levin says. It started there but has also been integrated into clinical courses.
Making Room for EssentialsRona F. Levin, RN
Greenberg says todays courses are increasingly focused on the need for proficiency in computers, computer languages, outcomes data anything thats an indicator for quality. Students are charged with using that technology to self-learn basic skills that already packed curricula cannot accommodate, such as how to give a bed bath.
Packing the essentials and other pertinent courses into the curriculum takes some maneuvering, says Minerva Guttman, RN, EdD, NP, director of Fairleigh Dickinson Universitys Henry P. Becton School of Nursing and Allied Health in Teaneck, N.J.
Guttman, who took on the role of director at Fairleigh Dickinson about 11 years ago, says she reduced the baccalaureate nursing programs liberal arts courses from 72 to 57 credits to make room for nursing major courses. Students were really telling us they were interested in epidemiology, nutrition and other aspects of nursing that could not be accommodated in our already very crowded curriculum, Guttman says.
Among the courses removed: one of three English classes. A math course to help with dosing calculations and more was among those added, according to Guttman.
Baccalaureate programs always have prepared students for community health nursing, but todays curricula emphasize the greater complexity of care that nurses often face in the field, Hansell says. The education attempts to prepare nurses for complex care, with patients who might have multiple chronic illnesses with an acute episode of illness, for example.
One of the changes that I would say has occurred within the past 20 years in baccalaureate nursing education is a greater emphasis on critical thinking and analytical skills of the students, Hansell says.
Constant ChangeMinerva Guttman, RN
Pace did a complete revamp of its nursing school curriculum and launched the new curriculum nearly a year ago in August for the accelerated program in New York City. Those nursing students, Greenberg explains, are about to graduate, and the faculty already has changed that new curriculum.
Healthcare reform will usher additional changes to nursing school curricula, including what nurses need to know so they can inform patients about pending changes, Guttman says.
We evaluate our curriculum once a year to see if we are up-to-date with current issues or current developments, Guttman says. We have very savvy students nowadays. When they choose our college; they look at whether the curriculum is responsive.