- Conceptual Framework
At the beginning of the 21st century, many trends influence and will continue to influence health care in general and nursing specifically. These include technological advances, advances in genetic knowledge, an increasingly aged population, as well as, increasingly diverse populations, and nursing workforce. Additionally, as the healthcare environment becomes more complex in an ever-changing healthcare delivery system, there is an increased focus on population-based care and an increasingly interconnected global environment. Nursing education must keep pace with these changes and the "Essentials of Baccalaureate Education for Professional Nursing Practice" (1998), as published by the American Association of Colleges of Nursing (AACN), provides direction for the educational preparation of a baccalaureate-prepared nurse, or professional nurse. These guidelines, along with faculty beliefs developed from their education, experience, and grounded in nursing science, form the foundation for the conceptual framework of this program. Additionally, it is the belief of faculty that the delivery of professional nursing care is patient-centered and that this focus, as opposed to practice that is driven by any specific nursing theory, guides the nursing curriculum. Other supporting theories and concepts are incorporated into the conceptual framework providing an eclectic model for nursing education.
A liberal education in arts, sciences, and humanities, integrated with nursing education, is provided to nursing students in the baccalaureate program. This approach enables students to develop and use critical thinking skills, apply knowledge regarding social, political, economic, and historical issues in the analysis of societal and professional problems, and appreciate and understand the character of professions. Baccalaureate education for professional nursing also facilitates the development of professional values and value-based behaviors, which form the foundation for practice. Caring is a concept central to the practice of professional nursing. While a variety of definitions of caring have been postulated, this curriculum subscribes to the Essentials definition that caring "encompasses the nurse's empathy for connection with the patient, as well as the ability to translate these affective characteristics into compassionate, sensitive, appropriate care" (p. 8).
The curriculum identifies four vertical threads: recipient of care, professional role, clinical decision-making, and communication.
The recipient of care is the first vertical thread and is identified as individuals, families, groups, and communities across the life span in a variety of clinical settings. Incorporated into this definition are cultural concepts that the student nurse recognizes and addresses. Recipients of care partner with healthcare professionals in making healthcare decisions. The student understands the global environment in which health care is provided and recognizes that care delivered at the local level may impact the global community.
Professional role, the second vertical thread, evolves in scope and depth in response to the acquisition of knowledge and experience. Included in professional role are skill mastery, complexity of practice, patient care management, and integration of theory and research with practice. This role incorporates the development of practice attitudes and skills congruent with legal and ethical standards. Furthermore, the professional role encompasses a worldview that is culturally sensitive, advances the profession of nursing, and embraces life-long learning. The student's role as a professional progresses from provider of care, to coordinator of care, and then to designer/manager of care.
Clinical-decision making, the third vertical thread, reflects the process and outcome of critical thinking. Critical thinking is inherent in making sound clinical judgments and includes both cognitive and affective dimensions. It increases in depth and sophistication throughout the curriculum and provides a foundation for safe and effective skill performance. Students learn to gather assessment data and recognize normal versus abnormal data. As they increase their clinical judgment and decision-making skills, they begin to interpret findings, prioritize patient care needs, and develop plans of care utilizing research-based knowledge. Eventually, they synthesize information and collaborate within various agency and community settings, addressing environmental issues and external resources. As critical thinking skills advance, more sophisticated technical skills are learned and implemented.
Communication, the fourth vertical thread, addresses the exchange of ideas, thoughts, and feelings, and is viewed as an essential element of professional nursing practice. Effective communication is vital to the role of provider of care, coordinator of care, and designer/manager of care. Students initially learn the fundamental skills and techniques of communication, as well as, facilitators and blocks to communication. Students implement these skills initially with individuals. As they learn effective interviewing and patient teaching, they interact with patients, families, and members of the interdisciplinary team. As designer/manager of care, students learn problem solving and behavior modification techniques with groups, and communities, and begin interacting as a facilitator within the interdisciplinary team.
Horizontal threads in the curriculum include supporting theories and concepts. Theories include psychosocial, cognitive, interpersonal development, and moral reasoning. Additionally, concepts that are present throughout the curriculum include nursing process, ethical and legal decision-making, cultural diversity, spirituality, and research.
Revised: 5/6/02; 8/15/03
Approved, Faculty Organization: 5/9/02