Concept Based Curriculum Development

Concept-Based Curriculum

By: Laura Beasley MSN, RN

Objectives

• Discuss the definition of a concept-based curriculum.

• Explore how a concept-based curriculum supports student success.

• Identify best practices for curriculum revision for a concept-based curriculum.

• Examine essential factors for success when developing and implementing a concept-based curriculum.

• Discuss the process for selecting curricular concepts and exemplars when building the nursing curriculum.

The purpose of this presentation is to engage the audience in discussing the following:

At The End of This Presentation Participants Will Be Able To:

• Comprehend what a concept-based curriculum is and how it can support student success.
• Identify best practices for a curriculum revision to a concept-based curriculum.
• Identify factors to develop and implement a concept-based curriculum.
• Develop strategies to select concepts and exemplars for the new concept-based curriculum.

1. What is the definition of a concept-based curriculum? 2. What is the definition of concept-based teaching? 3. What is the definition of concept-based learning? 4. How to prepare students for this type of learning?

If someone asked you why you are changing to a concept-based curriculum what would you say?

Clinical Judgment

Clinical Reasoning

Clinical reasoning is the active mental process and subtle perception, analysis, synthesis, and evaluation of information collected or derived from observation, experience, reflection, reasoning, or communication leading to conviction for action.

• Is the DOING that happens after critical reasoning
• Foundation of NEX Gen NCLEX
• The most commonly needed and important activity of nurses
• Conceptual learning is the DOING

Why Are Concepts Important For Categorizing Information?

How would you categorize these pictures?

Why Make the Change to a Concept-Based Curriculum?

Concept-based curriculums have been around for quite a while but over the last decade, more nursing programs are implementing a change because of two landmark studies released in 2010. These two studies indicated that there needs to be a change in how we teach nursing students.

• Nursing students are not prepared for practice when entering the profession
• Need to eliminate “additive” curriculum and superficial learning
• Learning rather than teaching should be the primary goal of education

Benner (2010)

Weak classroom instruction and limited integration between classroom and clinical experiencesInstitute of Medicine (2010)

35 % of new graduate RNs reported as safe or in an acceptable range for safe (Del Bueno, 2005)

How Do Concept-Based Curriculums Support Student Learning?

• Increased NCLEX scores

• Retention of students

• Engages students

• Eliminates the banking theory of learning

• Eliminates memorization of facts

• Helps new faculty know where things are covered in the program blueprint.

• NCLEX is conceptually based (analysis and application questions)

• Decreases content saturation

• Graduates unprepared for practice

• Curriculum in the United States “An inch deep and a mile wide”

• Increases critical thinking/clinical judgment

• Helps students organize and retain information

• Concepts can be applied to a variety of clinical settings

Best Practices for Curriculum RevisionBig Picture- 30,000 Feet View

• Obtain faculty buy-in.
• Administration- provide education, resources, and support where needed.
• Assess faculty knowledge- do they know how to revise a curriculum?
• Create a timeline of events.
• Create a meeting schedule with goals for each.
• Start backward- when do you want to implement this change? Usually takes 1.5-2.5 years.
• DO NOT START WITH CHOOSING CONCEPTS. Start with revising or creating the program’s mission, vision, philosophy, and student learning outcomes.
• Engage community partners- students, advisory boards, and the general public.
• Research other concept-based programs to understand how they structured their program.
• What do you like, what don’t you like- reach out to other programs- they might help you!
• What do you want your students to look like when they leave your doors and enter practice?

Factors to Develop and Implement a Concept-Based Curriculum- 20,000 Feet View

• Consider a teach-out plan for the old curriculum- what will students do if they fail the old curriculum- this will have to be included in the teach-out plan.
• Consider working with the science department to implement some nursing science in their prerequisite courses – Chemistry and A&P.
• Now is your time to revamp the entire program.
• Research how to get all new courses through your academic affairs- this usually takes time.
• How many semesters need to be approved before you can roll out the new program?
• Consider the timeline for recruiting new students- new students thinking of enrolling are usually in prerequisite courses for two years.
• When to start marketing the new program?

Factors to Develop and Implement a Concept-Based Curriculum- 10,000 Feet View

• Make sure faculty understand the concept of “concepts.”
• Some programs adopting a concept-based curriculum do not take the time to work through definitions, and most start in this process confused and frustrated.
• Start playing around with concepts- start with a game to demonstrate how they work with a certain course or topic.
• The Giddens book would be a good place to start so faculty can start looking at how their concepts are placed.
• This would be a great book to purchase for faculty

Factors to Develop and Implement a Concept-Based Curriculum- 5,000 Feet View

• Assemble a learning team or a task force to tackle concepts and revise the mission, vision, philosophy, and student learning outcomes.
• Sometimes, working with a large group of faculty can be too difficult.
• Task force groups can work independently and report back to the larger group.
• Consider other learning platforms such as Elsevier or ATI.
• What do they use for concepts?

Time To Land! How To Select Themes, Concepts, and Exemplars

• No two programs have the same concept layout, and there is no standard number of concepts in a program. There are 60+ concepts in Giddens.
• Two types of concept-based curriculums:
• Pure- All concepts chosen
• Modified- Use what you think works- add your own
• MUST define concepts and be on the same page with definitions
• May want to include concepts that are unique to your program
• Never lose sight of your program mission, vision, philosophy, or student learning outcomes
• Look at other program layouts- what concepts did they choose
• You could adopt what has already been created- Giddens book
• Selecting concepts can take a considerable amount of time, so make room for adjustments in the timeline plan.

Themes, Concepts, and Exemplar Examples

PROFESSIONAL NURSING AND HEALTH CARE CONCEPTS THEME: Nursing Attributes and Roles CONCEPT: Professional Identity

• Exemplar: Domain of Nursing Practice
• Exemplar: Scope of Nursing Practice

CONCEPT: Clinical Judgment

• Exemplar: Delegation and Assignment
• Exemplar: Role of Patient and Caregiver Teaching

HEALTH AND ILLNESS CONCEPTS THEME: Homeostasis and Regulation CONCEPT: Fluid and Electrolyte Balance

• Exemplar: Calcium Imbalances
• Exemplar: Potassium Imbalances

• Exemplar: Sodium Imbalances
• Exemplar: Heart Failure
• Exemplar: Acute Kidney Failure
• Exemplar: Disorders of Posterior Pituitary Gland

Selection Of Concepts With Input

• Include students when selecting concepts.
• Advisory board might want to weigh in on the selection of concepts.
• What concepts are most prevalent in your region?
• Talk to your healthcare partners to have them weigh in on what to focus on.
• You can add your own concepts based on your region or culture.
• Are you rural-focused, or urban-focused? Is diversity a priority for you to focus on?
• Achieving consensus on concepts might be impossible with a large group of faculty.
• Consider creating a task force once you get to a certain point.

You Have Selected Concepts, Now What?

• How do you distribute concepts across four semesters?
• Each concept will probably be covered in each semester
• The key is to pick which exemplars to include in each semester
• Consider how to prepare students for this type of learning
• Each concept will have to be taught with a lifespan approach.
• If you decide to keep your specialty courses, you could at least provide a foundation for those lifespan considerations.
• For example
• Concept: Gas Exchange
• Exemplar: Pneumonia
• Need to teach about pneumonia in infants, adolescents, adults, and older adults

04

03

01

02

Exemplars Across the Curriculum Concept: Gas Exchange

Semester

Semester

Semester

Semester

• ARDS
• Infant RDS
• Trauma
• Flail Chest

• Pulmonary Emboli
• Hemothorax
• Asthma/Acute

• Pneumonia
• Asthma/Stable
• RSV
• Atelectasis

• COPD
• Cystic Fibrosis
• Sickle Cell

04

03

01

02

Exemplars Across the Curriculum Concept: Professionalism

Semester

Semester

Semester

Semester

• Managing Care
• Client Rights
• Nursing Roles
• Responsibilities
• Professional Values
• Actions
• Ethics

• Management
• Professional Development

• Ethical Dilemma

• Prioritizing
• Care
• Caring
• Interventions

• Delegation
• Leadership
• Mentoring
• Accountability

04

03

01

02

Exemplars Across the Curriculum Concept: Professionalism

Semester

Semester

Semester

Semester

• Managing Care
• Client Rights
• Nursing Roles
• Responsibilities
• Professional Values
• Actions
• Ethics

• Management
• Professional Development

• Ethical Dilemma

• Prioritizing
• Care
• Caring
• Interventions

• Delegation
• Leadership
• Mentoring
• Accountability

How to Develop the Program Plan

1. Create a course that includes foundational concepts (less complex) such as gas exchange, fluid and electrolytes, elimination, etc.

• Students need to know the "normals" of concepts before they can dive deeper.
• For example: gas exchange: what two gases are being exchanged? What is a normal O2 sat? etc.
• Introduce the complex concepts later in the program such as intracranial regulation, cellular regulation, acid-base balance, etc.

2. Consider putting the mental health concepts in a MH course.3. Consider putting the professional concepts in a leadership course such as communication, professionalism, ethical and legal practice, etc. 4. Create an overall map of where concepts are located.

• Include where the concept was first covered and where it is reinforced.

5. Include concepts throughout the entire program, or keep them in main courses such as the Med Surg course that is included each semester. This frees up the specialty faculty to focus on their specialty courses such as Peds, OB, Mental Health, etc.

Teaching Conceptually

• Do you remember what conceptual teaching is?
• Conceptual teaching and learning need to carry across from the classroom to the lab and clinical.
• How will you prepare and support faculty for conceptual teaching?
• How will you prepare clinical faculty to teach conceptually?
• The biggest challenge of implementing a concept-based curriculum is faculty learning how to teach conceptually.

• Offer support for professional development if needed.
• Letting go of old curriculum habits are hard- give time for faculty to grieve.
• Be ok with tough meetings. Give time for that in the timeline.
• Always stay focused on the goal.

• Curriculum revisions are emotionally based.
• If faculty love what is happening, they will be more likely to embrace change.
• Not all faculty know how curriculum revisions work.
• Make sure to listen to all faculty concerns.

Faculty Are The Key To Success

Barriers to Success

• Lack of knowledge of curriculum revision
• Comfortable replicating behavior
• Faculty unwilling to change teaching practices
• Concept-based is student centered not teacher centered
• Faculty uncomfortable with letting students find answers on their own
• Fear of loss of structure of course
• Faculty fear loss of identity- having to teach across the lifespan
• Cannot transfer old ways of teaching or old curriculum plans
• Most faculty are not prepared to teach conceptually

Time for Reflection

01

“Moving faculty away from a content-focused, teacher-centered learning environment to conceptual teaching approaches may be the greatest challenge faced by nursing programs that adopt a CBC.”

“Even the most carefully planned conceptually designed curriculum will not succeed unless faculty embrace conceptual learning.”

“Teaching approaches must allow students to develop deep understanding.” (Giddens and Brady, 2007)

12-Step Program

1- Mission and philosophy2- Develop the curriculum framework3- Establish program outcomes4- Determine the plan of study (degree plan)5- Select and define concepts6- Select exemplars for each concept 7- Write course descriptions and student learning outcomes8- Determine concept layout over the entire curriculum9- Develop a concept presentation for each concept10- Determine where each exemplar will be placed over the entire curriculum11- Develop syllabi12- Work on conceptually based clinical and lab activities

References

• Del Bueno, D. (2005). A Crisis in Critical Thinking, Nursing Education Perspectives. 26(5), 278-282.

• Benner. (2010). Educating nurses : a call for radical transformation (1st ed.). Jossey-Bass.

• Cantrell, M. A., & Farer, D. (2019, January). Millennial Nursing Students’ Experiences in a Traditional Classroom Setting. Journal of Nursing Education, 58(1), 27–32. https://doi.org/10.3928/01484834-20190103-05

• Cue, Erin N. and Casey, Zachary A.. (2017). “I Didn’t Know Anything About It”: Critical Pedagogy, Cultural Literacy, and (Missed?) Opportunities for Praxis. i.e.: inquiry in education: Vol. 9: Iss. 2, Article 3. Retrieved from: https://digitalcommons.nl.edu/ie/vol9/iss2/3

• Fernandez-Balboa, J. (2014, June 22). Critical Pedagogy: Making Critical Thinking Really Critical. Analytic Teaching, 13(2).

• Giddens, & Brady, D. P. (2007). Rescuing nursing education from content saturation: the case for a concept-based curriculum. The Journal of Nursing Education, 46(2), 65–69. https://doi.org/10.3928/01484834-20070201-05

• Giddens, J. F., Caputi, L., & Rodgers, B. L. (2020). Mastering Concept-Based Teaching: A Guide for Nurse Educators (2nd Ed.). Elsevier.

• Higgins, B., & Reid, H. (2017, April). Enhancing “Conceptual Teaching/Learning” in a Concept-Based Curriculum. Teaching and Learning in Nursing, 12(2), 95–102. https://doi.org/10.1016/j.teln.2016.10.005

• Ignatavicius, D. (2017). Teaching and Learning in a Concept-Based Nursing Curriculum. Jones & Bartlett Learning.

• Laurent, K., & Gontarz, J. (2015, October). Evaluation of a concept-based curriculum: A tool and process. Teaching and Learning in Nursing, 10(4), 169–175. https://doi.org/10.1016/j.teln.2015.08.002

• Wangerin, V., Hall, A. (nd). CBC from the ground up – How did we get here? Part 1 [Webinar]. NurseTim. https://nursetim.com

• Wangerin, V., Rosati, J. (nd). CBC from the ground up – The essentials! Part 2 [Webinar]. https://nursetim.com

Thank You!

Any Questions?