Foundations of Nursing Education

Table of Contents

Changing from an Associate Degree Nursing Program to a BSN Program 3

Two Factors That Influence the Need for a BSN Program 3

How the IOM Has Informed the Decision for a BSN Program 4

IOM’s Recommendations for Guiding the Integration of Quality and Safety Initiatives in the New BSN Program 5

Rationale for the Recommendation 5

One Possible Barrier 5

Learning Theory to Support the Development of Critical Thinking Skills in the New BSN Program 6

Two Advantages of the Theory 7

Two Disadvantages of the Theory 7

Key Components of Authentic Learning That Can Inform the Development of the New BSN Curriculum 7

One Advantage of Authentic Learning in the New BSN Program 8

One Disadvantage of Authentic Learning in the New BSN Program 8

Two Current Modalities for Delivery: Traditional Classroom Learning and Online Education 8

Justification for Traditional Classroom Learning 9

Justification for Online Learning 9

Potential Barriers 10

Why Formative and Summative Assessments Will be Used in the New BSN Program 10

Two Benefits of Using Formative Assessments 11

Two Benefits of Using Summative Assessments 11

Two Limitations of Using Formative Assessments 11

Two Limitations of Using Summative Assessments 12

How Classroom Assessment Techniques (CAT) Can Increase Student Success 12

How the ANA Code of Ethics Will be Incorporated and Applied in the New BSN Program 13

Family Educational Rights and Privacy Act (FERPA) 13

Americans with Disabilities Act (ADA) 14

Health Insurance Portability and Accountability Act (HIPAA) 14

Copyright Laws 15

How Accreditation Methods Will be Incorporated and Applied 15

Conclusion 16

Summary of Key Recommendations Essential for Consideration 17

References 18

Changing from an Associate Degree Nursing Program to a BSN Program

While both the Associate degree nursing program and the Bachelor of Science in Nursing (BSN) program will lead one to become a registered nurse (RN), the BSN program does provide nursing students with more exposure to the kind of training, knowledge, skills and experience that can be very useful to RNs in a real world nursing environment. The Associate degree nursing program, on the other hand, is a very limited program that does not utilize all the possibilities for deepening the nursing student’s knowledge of and appreciation for the various nursing concepts that are need in today’s nursing industry. For example, an Associate degree nursing program will not spend as much time focusing on the importance of evidence-based practice in nursing as will a BSN program. Or, an Associate degree nursing program will not spend as much time as a BSN program will providing students with simulation opportunities so that they can strengthen their nursing skills in a controlled environment before stepping into a live format where decisions can be a matter of life and death. For that reason, changing from an Associate degree nursing program to a BSN program is the recommended route for nurses today.

Two Factors That Influence the Need for a BSN Program

Two factors that influence the need for a BSN program are 1) social and 2) economical, as Khawaja (2015) has noted. The social factor that influences the need is the reality that BSN programs provide students with more choice in terms of how to apply their human capital. An Associate degree nursing program only gives nursing students a limited option and range in terms of what they can do over the course of their nursing career. However, the BSN program sets nursing students up with a firm foundation upon which a policy of lifelong learning can be built.

Moreover, nurses who enter into a BSN program come out with greater range and depth of training that prepares them to provide higher quality of life (both economically and socially) for themselves as they pursue their career in nursing and a higher level of quality care to a diverse set of patients. A BSN program might offer student nurses courses in community nursing, pediatrics, psychosocial nursing, and so on—all of which give nurses a better preparation for addressing the needs of patients and for building a solid base of nursing knowledge that can be used to pursue higher caliber careers in nursing. Additionally, the more education an RN has, the more critical that RN is to a country’s health: that nurse will be able to offer care in a range of settings (Kirschling, 2017), which thereby provides social and economical support to the nation’s infrastructure (Well, 2007). Thus, there are both social and economical factors that tell the need for a BSN program.

How the IOM Has Informed the Decision for a BSN Program

The Institute of Medicine (IOM) has informed the decision for a BSN program by promoting the “Future of Nursing,” which advocates for increased education for nurses. The IOM (2010) recommends that the percentage of nurses with a BSN reach 80% by 2020. Another of its goals is for the number of nurses with a PHD double by 2020. These goals cannot be reached without more BSN programs giving student nurses more opportunities to advance their education.

IOM’s Recommendations for Guiding the Integration of Quality and Safety Initiatives in the New BSN Program

The IOM (2010) recommends that in order for quality and safety initiatives to be integrated in the BSN program, there should be more focus on evidence-based practice, collaborative practice, teamwork, and how technological tools can help create an environment of top-notch quality care. In following these recommendations, it is expected that nurses will be able to practice to the full extent of their education in serving their communities and provide safe, quality care to patients.

Rationale for the Recommendation

The IOM (2010) cites high turnover rates among nurses resulting from a lack of transition-to-practice residency programs and a lack of education and training for student nurses. Associate degree nursing programs do not offer enough opportunities for nurses to prepare for the real-world challenges that await them in today’s health care facilities where patients present with a complex array of health problems. Nurses who obtain a higher level of education are in a position to help patients with a higher complexity of issues. The more education and training a nurse has with evidence-based practice, collaborative care, teamwork, and technology, the more likely the nurse will be able to supply quality, safe care to patients no matter what their condition, and the less likely the nurse will be to commit errors on the job.

One Possible Barrier

One possible barrier to the implementation of the IOM’s recommendation is that establishing an environment in which multiple opportunities for education exists has been made difficult at the federal level. For example, the Federal Trade Commission (FTC) “has long targeted anti-competitive conduct in the health care market, including restrictions on the business practices of health care providers” (IOM, 2010, p. 2). The FTC must eliminate policies that restrict healthy competition in the health care field, which limits student nurses’ options in terms of obtaining higher levels of education and disinclines professionals from pursuing pathways to being educators. In order for a BSN program to be fully efficient, it requires having access to a sufficient pool of nursing educators. Therefore, it is important for stakeholders at local, regional, state and federal levels to communicate with nursing educators and nurse professionals to ensure that the student nurses’ potential is not limited by federal trade rules. The more that nurse professionals, nurse educators, and nursing students work together to create the best possible learning environment, the more likely the recommendations of the IOM are to be implemented.

Learning Theory to Support the Development of Critical Thinking Skills in the New BSN Program

The humanistic theory of learning puts the student at the center of the learning process. It is based on the work of Carl Rogers and Abraham Maslow. Rogers (1951) stated that the person-centered approach was the most efficient because it offered “the best vantage point for understanding behavior is from the internal frame of reference of the individual” (p. 495). Likewise, Maslow’s (1943) hierarchy of needs identified key components within a needs paradigm that must be met before an individual can become self-actualizing.

Two Advantages of the Theory

Two advantages of the humanistic theory are: 1) it provides a student-centered approach to learning that focuses on the needs of the individual student, and 2) it provides the basis for adequate motivation, relationship-building, communication, and self-efficacy (Halstead, 2007).

Two Disadvantages of the Theory

Two disadvantages of the humanistic theory of learning are 1) that it places too much emphasis of the subjective experience, and 2) that it assumes too positive a perspective of human behavior. At some point students must be required to engage in simulations, pass assessments, and show critical thinking skills regardless of the challenges they face personally (Halstead, 2007). Just as the teacher may adopt a student-centered approach, the student must adopt a subject-centered approach. Self-centeredness is not conducive to learning.

Key Components of Authentic Learning That Can Inform the Development of the New BSN Curriculum

The key components of authentic learning are: 1) the opportunity to engage with real-world problems that allow students to participate in the work that actual professionals encounter; 2) the opportunity to engage in critical thinking activities that promote cognitive development via simulation exercises; 3) the opportunity to engage with other learners in a real community; 4) the opportunity to empower students by supporting the development of their will through student choice (Rule, 2006). These key components of authentic learning can inform the development of the new BSN curriculum by providing it with a framework for approaching nursing students over the course of a 4-year program.

One Advantage of Authentic Learning in the New BSN Program

One advantage of this theory is that is enables teachers to provide students with the kind of real-world experience they require in order to be ready to enter into the nursing profession. As a result of authentic learning experiences in the BSN program, nursing turnover rates could be reduced and the nursing field could experience more stability and greater growth.

One Disadvantage of Authentic Learning in the New BSN Program

One disadvantage of authentic learning in the new BSN program is that every student has a unique learning method—and so authentic learning might not appeal to all students (Halstead, 2007). Some students might find the approach to be poorly organized, planned and executed and may benefit from a more traditional method of learning.

Two Current Modalities for Delivery: Traditional Classroom Learning and Online Education

Traditional classroom learning settings are irreplaceable when it comes to providing an optimal learning environment for nursing students. However, in the current Digital Era, there is great demand for alternatives to this modality—and one that fits the needs of the new generation of students is online learning.

Justification for Traditional Classroom Learning

Traditional classroom learning provides student nurses with an environment in which they can engage in face-to-face interactions with other students and professors. More possible training scenarios are available, and communication skills can be developed through continual practice in and outside the classroom, by meeting with students and teachers before and after class. There is more opportunity to give and receive feedback in traditional classroom learning as well (Halstead, 2007). Traditional classroom learning can also help students to feel more confident about the learning process as they physically in attendance at classes and investing time, energy and resources into being there—meaning they may be less inclined to put their studies off or adopt a lax attitude towards the material.

Justification for Online Learning

Online learning presents numerous opportunities for nursing students who cannot overcome the distance required for attending traditional classroom sessions or who have an atypical schedule that can only be facilitated via online learning. As Milstead and Nelson (1998) show, online courses provide students a more convenient way to obtain higher level education, as the classes may be streamed by the student according to his or her schedule instead of according to the school’s schedule. Deadlines and timeframes are still the norm, but there is a lot more flexibility with how lectures are received and how school work is turned in for assessment. Additionally, Appana (2008) notes that online learning allows students to have greater access to nursing education options along with “improved quality of learning, better preparation of students for a knowledge-based society, ‘lifelong’ learning opportunity,” and a chance to boost one’s career (p. 5).

Potential Barriers

These two modalities should not present any barriers to nursing students as they offer both the campus-based platform for learning and the distance-learning-based platform. For students who have access to and prefer the campus-based platform, the traditional classroom approach is available. For those who prefer online education for any of the numerous reasons that make this platform appealing, it is provided. The only potential barrier that might occur is that which exists for any student, no matter the learning platform: cost. The cost of education has risen over the years and decades and does present a challenge for some students. However, while classroom learning may be higher in cost than it was a quarter century ago, online learning can still be obtained at a reasonably lower rate.

Why Formative and Summative Assessments Will be Used in the New BSN Program

Formative and summative assessments are both important tools in monitoring and evaluating student performance. Formative assessment allows teachers to monitor student progress using both formal and informal assessment methods—i.e., direct observation, exams, essay writing, simulations, etc. Formative assessments are given in a variety of methods throughout the course in order to provide the student with feedback that can facilitate development. Summative assessments help the teacher to evaluate the student at the end of a unit, section or course to determine whether the student has sufficiently mastered the concepts and obtained the competencies required in order to pass the course or move on to the next level.

Two Benefits of Using Formative Assessments

Two benefits of using formative assessments are that 1) they are an opportunity to provide students with continual feedback throughout an entire course, and 2) they help the student to identify strengths and weaknesses while also giving the teacher a sense of where students are struggling and where they are doing well, so that they too can see which areas to spend more time on in developing.

Two Benefits of Using Summative Assessments

Two benefits of using summative assessment are that 1) they help to indicate whether a student has obtained enough knowledge of a subject to be able to respond to a specific prompt or question in which critical thinking is required of the student on that point, and 2) they help the teacher to evaluate whether the student demonstrates sufficient knowledge of concepts to progress onward.

Two Limitations of Using Formative Assessments

Formative assessments require continual monitoring and evaluation: the teacher must constantly be gauging the student’s advancement and providing feedback, which can be considerably time consuming. Moreover, in order for feedback to be effective, it must be direct, immediate and sustained—which is not easy for teachers to do, especially if there are many students in a class (McCord, 2012).

Formative assessments are opportunities to provide feedback to students and help them identify their strengths and weaknesses, but they do not necessarily translate into the student actually engaging with that feedback in a positive or constructive manner. In order to motivate a student to engage with feedback, sometimes extra impetus is needed—i.e., making it a requirement that students respond to whatever feedback they receive after a formative assessment.

Two Limitations of Using Summative Assessments

Summative assessments are very high stakes assessments. This means there is a lot of pressure on the student to pass them. This pressure could impact the student’s ability to test well, as not all students test strongly even if they show via formative assessment that they understand the material.

Summative assessments are typically narrow and limited in terms of what they can evaluate. A single summative exam is only able to determine how a student responds to questions or a prompt within a specific scope. Alone it cannot represent accurately or sufficiently the entire depth or range of a student’s acquisition of nursing competencies.

How Classroom Assessment Techniques (CAT) Can Increase Student Success

Classroom assessment techniques (CAT) are helpful for teachers because they enable them the opportunity to obtain useful information about where the students are in general in terms of learning objectives. For instance, common CAT include, the background knowledge probe, the minute essay, and the defining features matrix. Each CAT provides the teacher with a sense of what methods are working, which are being received well by students, and what information is being retained by students and what information is being lost by them.

CAT can increase student success by providing just-in-time feedback for both teachers and students on how the learning process is going. That information can obtained from CAT much more quickly than it can be obtained via formal assessments or even summative assessments. CAT can also help students feel more engaged in the learning process and can give the student a sense that the teacher genuinely cares about how the students is progressing—which can help give students the confidence they need to get ahead.

How the ANA Code of Ethics Will be Incorporated and Applied in the New BSN Program

The American Nurses Association (ANA) Code of Ethics will be incorporated and applied in the new BSN program by ensuring that each of the provisions of the code are taught to nursing students and that their knowledge of them is assessed throughout the program. The ANA (2015) Code of Ethics for Nurses provides 9 provision statements that describe the nurse’s primary commitment, the nurse’s primary responsibility, the nurse’s duties, and so on. All 9 of these provisions will be integrated into the courses of the BSN program so that they are used as the overall framework for delivering the nursing competencies.

Family Educational Rights and Privacy Act (FERPA)

The Family Educational Rights and Privacy Act (FERPA) is a federal law governing the protection of privacy rights of students with respect to their education records. The law applies to that schools that accept funding from the federal government. As a school that will accept funding from the U.S. Department of Education, the BSN program must adhered to FERPA and protect student records from being publicly disseminated or from being provided to third parties without the consent of the student in question. It is very critical for the success of the BSN program that students feel confident and secure that their rights will be protected and safeguarded by the institution where they attend the program.

Americans with Disabilities Act (ADA)

The Americans with Disabilities Act (ADA) is a civil rights law that obliges organizations to withstand from discriminating in any way, shape or form against individuals who suffer from disabilities. This means that the BSN program must accept all students with disabilities—from those who have physical disabilities to those who have learning disabilities. It is very important to the success of the BSN program that it not deny service to any student willing to pursue the degree, just because that student has a disability of some form or another. Federal law protects disabled persons from discrimination, and the BSN program will honor that law by being inclusive, welcoming, and offering assistance to students who suffer from both physical and learning disabilities. That assistance will take a variety of forms—from handicap access to buildings and classrooms to learning assistance programs offered for free by the school to help students with learning disabilities.

Health Insurance Portability and Accountability Act (HIPAA)

The Health Insurance Portability and Accountability Act (HIPAA) focuses on protecting the privacy of patients’ health care information and ensuring that people can keep their health insurance while allowing the health care industry to keep its administrative costs in check. The BSN program will incorporate the basis of this law into the curriculum as an important reason for nurses to respect patients’ right to privacy. Nursing students will also be made aware of how important it is for patients to have coverage and why administrative costs must be kept low in order to guarantee that a health care provider can operate in the black year over year.

Copyright Laws

As LaVelle, LaVelle, Port and Sherlock (2015) note, it is important that nurse professionals be aware of copyright laws when they share protected resources among themselves. In order for nurse professionals to be aware of this information, it is important that they be taught it as student nurses. The BSN program will integrate copyright law basics into the course curriculum so that students are aware of how copyright laws impact them in the nursing industry.

How Accreditation Methods Will be Incorporated and Applied

There are five standards of accreditation that serve as requisites for BSN programs under the Accreditation Commission for Education in Nursing (ACEN). Those five standards regard the following areas:

· Standard 1—Mission and Administrative Capacity

· Standard 2—Faculty and Staff

· Standard 3—Students

· Standard 4—Curriculum

· Standard 5—Resources

The criteria for each of these standards must be met by the BSN program in order for it to comply with the standards for accreditation under the ACEN. Therefore, it is critical that the BSN program incorporate each of the criteria for the five standards into its program.

To that end, the BSN program will ensure that the mission and program are consistent with the values of school at which the program is offered. It will ensure that instructors are qualified, that adequate resources are available to the program; that stakeholders have provided input into the program; and that distance/online learning meets the standards of the program.

It will ensure that all faculty have a minimum graduate degree in nursing and that at least a quarter of the faculty have or are in the process of earning a doctorate; that teachers’ credentials meet state and school standards; that faculty engage in continuous learning; that the size of the faculty is appropriate to the size of the program; and that distance/online learning is supported with the proper infrastructure.

It will ensure that student policy for nursing students is consistent with civil rights laws and that all public information regarding the program is accurate and clear. It will ensure that the program meets the needs of a diverse student body, and that educational records comply with federal and state law. It will ensure that technological support is given to students in both traditional classroom and online settings.

It will ensure that the curriculum utilizes professional standards and competencies and that learning outcomes are consistent with national standards. It will ensure also that the necessary fiscal, physical and learning resources are available. And finally it will ensure that the program is supported by these resources.

Conclusion

The BSN program is necessary for nursing students in today’s health care industry because patients are presenting with more complex problems that require nurses to have a higher level of education that the Associate degree nursing program simply does not offer. Additionally, the IOM (2012) has shown that nurses need more education in today’s climate to ensure that safe and quality care is provided to patients. The BSN program can better prepare nursing students to be ready for the real-world of nursing.

Summary of Key Recommendations Essential for Consideration

Key recommendations essential for consideration are that the BSN program incorporate authentic learning as a primary approach and the humanistic theory as the basis for this method. Two modalities should be implemented: traditional classroom learning and online learning, as each supplies a unique learning platform that can meet the needs of all students. Formative and Summative Assessments should be used and CAT conducted so as to obtain a sense of where students are succeeding and where they are failing throughout the program. The program should respect the civil rights laws and code of ethics that are national standards in the industry as well.

References

ANA. (2015). Code of ethics for nurses. Retrieved from

http://nursing.rutgers.edu/civility/ANA-Code-of-Ethics-for-Nurses.pdf

Appana, S. (2008). A review of benefits and limitations of online learning in the context

of the student, the instructor, and the tenured faculty. International Journal on E-Learning, 7(1), 5-22.

Halstead, J. (2007). Nurse Educator Competencies: Creating an Evidence-Based

Practice for Nurse Educators. New York, NY: National League for Nursing.

IOM. (2010). The future of nursing. Retrieved from

http://nacns.org/wp-content/uploads/2016/11/5-IOM-Report.pdf

Khawaja, M. (2015). Economic and social factors behind the choice of medical

profession by Saudi female students: An applied study at Qassim University. Journal of Administrative and Economics Science, 9(1), 1-20.

Kirschling, J. (2017). Well educated RNs are critical to country’s future. Retrieved

from http://www.baltimoresun.com/news/opinion/oped/bs-ed-nursing-force-20170108-story.html

LaVelle, M., LaVelle, B., Port, K., Sherlock, J. (2015). Copyright law basics for the

nursing professional. Journal for Nurses in Professional Development, 31(5), 252-257.

Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370.

McCord, M.B. (2012). Exploring effective feedback techniques in the ESL classroom.

Grammar Matters 27, 2, 41-45.

Milstead, J., Nelson, R. (1998). Preparation for an online asynchronous university

doctoral course: Lessons learned. Computers in Nursing, 16(5), 247-258.

Rogers, C. (1951). Client-Centered Therapy. New York, NY: Houghton Mifflin.

Rule, A. (2006). The components of authentic learning. Journal of Authentic Learning,

3(1), 1-10.

Well, D. N. (2007). Accounting for the effect of health on economic growth. The

Quarterly Journal of Economics, 122(3), 1265-1306.

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