curriculum and teaching in nursing handout 2

Curriculum and Teaching in Nursing

UNIT IV – The Curriculum

A. Curriculum Objectives/ School Purpose

1. Sources of Objectives

2. Screening of Goals

3. Levels of School Objectives

4. Instructional Objectives

a. Taxonomy of Objectives

b. Formulation of Objectives

B. Components to Consider in Developing a Curriculum Context Sources, Selection, and Organization of Learning Content

C. Related Learning Experiences, Curriculum and Instruction, the 8 M’s of Teaching and Learning Course Planning

1. Course Outline, Syllabus

2. Resource Unit/Instructional Plan

3. Module

D. Evaluation of Learning

1. Concept and Rationale of Evaluation

2. Characteristics of Evaluation of Instructional Outcomes

a. Preparation Phase

b. Administration Phase

c. Utilization Phase

3. Planning for Evaluation of Student Performance

a. Classroom

b. RLE

c. Curriculum Evaluation

Prepared by: Mariven W. Pavino


C. Related Learning Experiences, Curriculum and Instruction, the 8 M’s of Teaching and Learning Course Planning

Related Learning Activities

The Related Learning Experiences (RLEs) is composed of Clinicals and Skills Laboratory. The RLE activities are carefully selected to develop competencies utilizing the nursing process in varying health situations. The following conditions must be observed:a. Related Learning Experiences (Clinicals) shall be offered simultaneously or immediately

after the lecture. Classroom and RLE activities must be congruent with the objectives of the course.

b. Faculty teaching the lecture shall supervise students in their RLE. In the case of team teaching, there should be close coordination and collaboration between the lecturer and the clinical faculty.

c. A documented RLE rotation plan showing distribution of students and faculty supervision in each clinical area of base hospital and affiliation agencies shall be made available.

d. Effectiveness and efficiency of the related learning experience, shall consider the following factors:

1. Quality of supervision of clinical instructors and teaching-learning process2. Readiness and capability of the learner3. Quality of the learning resources both in institutions and communities4. Adequate number and variety of clientele5. Utilization of appropriate feedback mechanism6. Adequate number of qualified nursing staff and other personnel7. Quality of nursing care services8. Compliance with the required equivalence of fifty one (51) hours to one (1)

unit RLE9. Ratio of student to clientele depends upon the objectives and the capacity of

the student.



Source: CHED MEMORANDUM ORDER (CMO) No. 14 Series of 2009



1. Unconscious Incompetence The individual does not know at all. What is more, is that he does not know that he does not know, and most likely he does not care.

2. Conscious IncompetenceThe learner providentially gets to discover that he does not know and realizes that he needs to know.

3. Conscious CompetenceThe learner gets instruction from a teacher who explains what is to be learned (content) and shows him how (coaching). He tries to do it with the help and encouragement of the teacher (guided practice), gets immediate correction (feedback), and does it again and again on his own (independent application) over a period of time.

4. Unconscious CompetenceThe stage where the learner is so proficient that it has become second nature to him and he is able to exhibit the new behavior without conscious effort. He has reached the level of complete mastery.

Strategies

PreconferencesDuring the preconference, planning of patient care continues. Learners usually share some of the results of their research from the previous day. Tentative nursing diagnoses are discussed, and the assigned learner can discuss possible


Goals of clinical

teaching (Cox, 1993)

Unconscious

incompetence

Conscious

incompetenc

e

Conscious competenc

e

Conscious

incompeten

ce


nursing interventions with the other learners and the instructor. This is a good time to answer student’s questions about their assignments and try to alleviate their anxieties. Preconference time may also be used to help learners organize their day and prioritize the care they must give.

Practice Session- Scavenger hunt – help orient learners to the clinical unit- Demonstration with explanations - - Questioning – assist learners in developing problem-solving and decision-

making skills- Coaching – help learners through psychomotor skills and help refine their

thinking skills

Observation AssignmentsLearners may be assigned to observe nurses or other professionals performing various aspects of health care that learners usually cannot perform. Given some guidelines to channel their observations, they usually find this a valuable experience. If they can be paired off with nurses whom they can both observe and question, the learning experience may be even better.

Nursing RoundsThis involves a group of learners and their instructor visiting patients to whom the learners are assigned. Before entering a patient’s room, the assigned learner briefly informs the group about the patient and the diagnosis. Once in the room, the same learner interacts with the patient while others observe as much as they can about the patient and the environment. The instructor may point out the use of certain equipment or procedures. All other discussions take place in the corridor after the visit or in a post conference (Sedlack & Doheny, 1998; 1985)

The purpose of the nursing rounds is to expose learners to additional nursing situations and to encourage them to consult each other in planning and evaluating care. Nursing rounds provide opportunities to apply classroom theory to patients’ situations and to compare and contrast patient care.

Shift ReportEnabling the learners to listen to or give a shift report is a useful teaching strategy. Yurkovich and Smyer (1998) identify shift report as a unique time for learning. It is a way for students to learn the uniqueness of nursing communication and is a means of professional socialization.

Learning Contracts This is a useful way to structure and guide learning in the clinical setting.



A written agreement between instructor and learner spelling out the learner’s outcome objectives (Chan & Wai-tong, 2000)

Also includes learning experiences planned, a timeline, and an evaluation plan (Renner, Stritter & Wong, 1993)

Sample Learning Contract

Learning Objectives

Resources Needed Activities and Accomplishments

Means of Validation

Improve communication skills with families of dying patients.

1. Literature research2. Assignment of

terminally ill patients

1. Analyze the essential elements of communication in this scenario.

2. After talking with families, recount the conversation with the preceptor.

Instructor will evaluate the therapeutic adequacy of the conversation.

Correctly perform colostomy care.

1. Procedure manual2. Practice in skill lab3. Assignment to patient

with a colostomy

1. Perform the skill in the lab.

2. Perform the skill on a patient with the supervision of the preceptor.

1. Instructor will evaluate performance in the skill lab.

2. Preceptor will evaluate performance with the patient.

Written Assignments- Individualized nursing care plan

Help learners think like a nurse, in that they use problem-solving techniques to address patient problems, and use their knowledge of the interdisciplinary health care team as a resource.

- Clinical logs or journalsIt is one way in which students can create a dialogue with their teacher and reflect upon and explore their clinical experiences in the context in which these experience occur (Holmes, 1997, p. 489).

Learners use the reflection process to relate their clinical learning to prior learning, to make sense of what they have seen and felt in the clinical setting, and to think clinically about their experiences.

- Critical-Thought PaperThis exercise asks the student to identify key problems and issues for the patient, to identify underlying assumptions that the patient and the student bring to the situation, the meaning of these issues for the patient and student, and therapeutic approaches the students used.

- Student-generated drug card (Morgan, 1991)



Students are required to look up each drug their patient is receiving and to write all the pertinent information on an index card.

Post ConferencesAn ideal opportunity for pointing out applications of theory to practice, for analyzing the outcome of hypothesis testing, for group problem solving, and for evaluating nursing care (Letizia, 1998).

It is an opportunity to let learners take the lead in determining much of the direction of the conference (Letizi, 1998; Rossignol, 2000)

Educators should encourage learners to analyze ethical issues related to patient care. Time should also be allowed for learners to air their feelings about nursing in general or their clinical experience.

Post conferences are a means to help socialize learners into the world of nursing and are another opportunity to get the learners to think like a nurse.

Curriculum and Instruction

Curriculum

The sum of all learning content, experiences and resources that are purposely selected, organized, and implemented by the school in pursuit of its peculiar mandate as a distinct institution of learning and human development. (Palma, 1992)

Instruction

The actual implementation of the plan through contrived experiences.

Two Sides of the Coin of Curriculum

Curriculum “Plan”

Instruction “Implemen

tation of the Plan”



C.1. Course Outline, Syllabus

Parts of a course outline

1. Course code, title and description

2. Credit unit

3. Course objectives

4. Topic outline consistent with semester’s schedule

5. General activities

6. Course requirements

7. Grading system

8. References

9. Consultation hours

Given to students preferably at the beginning of the semester

C.2. Resource Unit/Instructional Plan

Parts of a lesson plan or an instructional design

1. Course code, title and description

2. Credit unit

3. Unit objectives

4. Topic outline consistent with objectives

5. Teaching-learning activities

6. Assessment plan

Made by teachers; usually submitted to heads of units

For accreditation

Learning Objective

Statement of what learners should be able to do when they have completed a segment of instruction (Smith & Ragan, 2001)

Learner-oriented, learning-based, explicit, assessable statement of intended learning outcomes (Anderson, Krathwohl, et al., 2001)



Continuum of Educational Statements (Anderson, et al, 2001)

Outcomes and Domains of Learning

Knowledge Cognitive Domain

Skills Psychomotor

Attitudes Affective Domain

Taxonomy of the Cognitive Domain of Learning (Anderson, 2001)


Dimensions Global objectives

Educational objectives

Instructional objectives

Terminal Objectives

Intermediate Objectives

Specific Objectives

Scope Broad Moderate Narrow

Time needed One or more yrs

Weeks or months

Hours or days

Purpose Provide vision Design a curriculum

Prepare lesson plans

Example Plan a multi year curriculum

Plan units of instruction

Plan daily activities, experiences


Sample Objectives in the Cognitive Domain

• Define digestive system

• Identify the major digestive organs

• Explain the functions of each of the digestive organs

• Discuss the digestive processes involved from ingestion of a bolus of food up to excretion.

• Enumerate common diseases in the gastrointestinal system

• Given the following cases with signs and symptoms, identify the correct gastrointestinal disorder

• Formulate the best therapeutic plan for the following patients with GI disorders

The Psychomotor Domain of Learning (Simpson, 1972)

Sample Objectives in the Psychomotor Domain

• Properly set up the microscope


RememberUnderstand

ApplyAnalyze

SynthesizeEvaluate

PerceptionSet

Guided ResponseMechanismComplex Overt Response

AdaptationOrigination


• Correctly manipulate the microscope in examining the blood specimen

• Follow the step-by-step procedures in examining blood specimen using the microscope

• Properly examine various specimens under the microscope

The Affective Domain of Learning (Krathwohl, et al., 1960)

Sample Objectives in the Affective Domain

• Demonstrate concern for the client’s well-being

• Voluntarily conduct home visits to follow up condition of clients

• Conduct extension classes/counseling activities when necessary

Guidelines in Formulating Learning Objectives

• Begin with a verb.

• State objective in terms of learner performance (rather than teacher’s).

• State objective as a learning product.

• State objective indicating a terminal behavior.

• State only one learning outcome at a time.

The value of learning objectives


ReceivingResponding

ValuingOrganizationCharacterization


Topic Outline - outline the relevant topics for the given objective

• Observe principles in:

– Concepts integration

– Practicing relevance

– Individualizing instruction

Sample Topic Outline

• Enumerate common diseases in the gastrointestinal system

• Given the following cases with signs and symptoms, identify the correct gastrointestinal disorder

• Formulate the best therapeutic plan for the following patients with GI disorders

General Activities

Learners

A. Generation X learners (Dziuban, Hartman, Moskal, 2004)

• Born from 1965 to 1980

• Heavily impacted by ICT gadgets like radio, newspapers, movies, TV, computers and pagers

• Major features as persons:

– Work to live rather than live to work

– View jobs within the context of a contract

B. Millenial learners (Dziuban, Hartman, Moskal, 2004)

• Born from 1981-1994


Content

Assessment

Teaching & learning activities

Learning Objectives


• Heavily impacted by ICT gadgets and cell phones, instant messaging, the WWW wireless communication, and advertising without boundaries

• Major features as persons and learners:

Tend to live for a moment

• Major features as persons and learners:

– Are attuned to the immediacy of technology

– Respond to clear and consistent expectations

– View money as an immediate consumable

– Will give respect only after experiencing it

– Tend to question everything

Methods

1. To generate ideas & opinions

a. Buzz groups

b. Brainstorming

c. Snowballing

2. To clarify and/or build consensus

a. Tutorials

b. Seminars

c. Small group discussion

d. Nominal group technique

3. To practice and/or play certain roles

a. Role play

b. Games and simulation

Brainstorming

1. Facilitator presents the topic, issue to solve.

2. Group members present their ideas. Facilitator writes all answers on the board.

3. All answers are taken and not judged. Members review the answers and group them according to areas.

4. The group evaluates ideas and summarize.

Buzz groups

1. Smaller groups of 4-5 members (buzz groups) are formed to discuss a problem/issue.

2. Facilitator presents the problem/issue.



3. The buzz groups generate ideas to the problem just like in brainstorming within 5 minutes.

4. After the time, buzz leaders present their answers to the facilitator who then presents them during the plenary.

Snowballing

1. Teacher divides the class into pairs.

2. Teacher assigns all pairs to discuss the same stimulus material.

3. Each pair joins another pair and compares notes, then on to the next pair. Outputs should reveal the complexity of how the group understands the stimulus material as they accumulate like the snowball.

Tutorials

Phases of PBL Tutorials

• Read and understand the problem

• Brainstorm and analyze the problem

• Identify and prioritize learning objectives

• Search and gather information and other resources

• Share and synthesize the new information

Seminars

1. Teacher negotiates with learners which topic the latter will present in class.

2. Assigned presenter delivers the seminar on a pre-set date before the whole group.

3. The whole group actively interacts with the presenter and teacher regarding the seminar topic.

Small Group Discussion

1. Facilitator introduces topic/task.

2. Members present their opinions and questions/issues on the topic

3. Facilitator summarizes or assigns a member to summarize answers and solutions

Nominal group technique

1. Facilitator presents the issue to be resolved.

2. Round robin 1: Group members take turns in sharing an answer to the issue.

3. Round robin 2, 3,. . . For as long as there are new contributions.



4. Facilitator asks the group to vote on the generated contributions and come up with the final consensus of answers or solutions to the issue/problem.

Role play

1. Facilitator presents the scenario/s to all groups.

2. Groups are given 5 minutes to collect their acts. No script and rehearsals are needed.

3. Let one group role play while the others are process observers.

3. Debrief.

4. De-role.

Games & Simulations

• General guidelines

– Relate with learning objectives

– Set clear rules including time limit

– Give prizes or recognitions for winners

Instructional media



C.3. Module

Are also called self-learning modules, self-directed learning modules, self-paced learning modules, elf-learning packets, and individualized learning activity packages.

Defined as a self-conatined unit or package of study materials for use by an individual.

Based on principles of adult learning:

- Adults are self-motivated to learn material for which they see relevance.

- Adult’s prior experience is a resource for further learning.

- Adults are problem focused and readily learn material they use to solve problems (Herrick, Jenkins, & Carlson, 1998; Mast & VanAtta, 1986)

Components

Introduction and instructions- tells the learner how to work through the module- how to use the pretest and self-evaluation guides - where to locate resources


The more senses involved, the

better

WordsDiagramsMapsFlat picturesSlidesStereographsFilmsModelsObjectsTotal Situation

Concreteness


- what procedures to use for handling in assignments or scheduling skill tests- what the roles of the educator and learner are

Behavioral Objectives- express in clear language what the learner will be able to do on completion of

the module- includes overall objectives at the beginning of the module, and repeat those

objectives that are pertinent to each unit of the module at the beginning of the unit

Pretest- usually but not always included in a module- learners evaluate which sections of the module they might skip over and

which ones they need to study in depth Learning Activities

- most creative portion of the self-learning module- designed to achieve the objectives- should appeal people with differing learning styles- might include:

Reading textbook chapters, articles, or pamphlets Reviewing handouts, charts, pictures or diagrams Attending short lectures, speeches, or demonstrations Answering study questions and getting feedback Watching a video or slide presentation Using a computer program Practicing a psychomotor skill in a laboratory Participating in a discussion group

- learners should have access to an instructor during the time they are involved in learning activities

- while participants are working through the learning activities, they should be checking occasionally to see whether they are achieving the objectives that were listed at the beginning of the unit

Self Evaluations- use to assess how well the learners are achieving the objectives- self-test is included at the end of every lesson or subconcept- multiple-choice questions or short-answer questions

Posttest- used to determine mastery of module objectives- objective-item test, case study, care plan or demonstration of skill



References:DeYoung, Sandra (2003) Teaching Strategies for Nurse EducatorsPalma, Jesus C. Curricuculum Development Systems. 1992. National BookstoreCHED MEMORANDUM ORDER (CMO) No. 14 Series of 2009


curriculum and teaching in nursing handout 2

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