Experiences of First-Year Nursing Students during an Education Redesign: Findings from the Oregon Consortium for Nursing Education

Article excerpt

Abstract

AIM The aim of this article is to summarize first-year students' (n = 908) experience during a nursing education redesign.

BACKGROUND Oregon Consortium for Nursing Education (OCNE) began its redesign of nursing education in 2000, long before the current national calls for nursing education reform. As OCNE moved from planning to implementation, a comprehensive evaluation of the students, the program, and curriculum ensued.

METHOD Data were collected from first-year nursing students each spring from 2007-2010 using a standardized survey instrument that included demographic, attitudinal, and opinion-based survey items.

RESULTS Results indicated fellow students, course lectures and interaction, and faculty and courses were rated areas of satisfaction.

CONCLUSION Areas needing improvement included advising and facilities, administration, quality of instruction and curriculum, and overall program effectiveness. Mean scaled and open-ended responses from each area are reported.

KEY WORDS

First-Year Student Experience--Curriculum Redesign--Oregon Consortium for Nursing Education

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Given the dynamic state of the health care system in the United States and the renewed focus on transforming nursing education as detailed by Benner, Sutphen, Leonard, and Day (2010) and the Institute of Medicine (IOM, 2010), strengths and weaknesses of the nursing educational system have been highlighted and discussed on a national level. These discussions provide a framework for the profession to redesign nursing education for students and faculty, potentially advancing both the nursing profession and educational models. The IOM report includes specific recommendations and highlights educational models designed to meet the demands of the changing health care system. One of the highlighted models, the Oregon Consortium for Nursing Education (OCNE), was advancing nursing education reform long before the IOM recommendations were published.

In 2000, nurse leaders from Oregon began developing a vision for both nursing and nursing education within the state, as well as the mechanisms for achieving that vision (Gaines & Spencer, 2013; Gubrud-Howe et al., 2003; Munkvold, Tanner, & Herinckx, 2012; Tanner, Gubrud-Howe, & Shores, 2008). They identified 10 competencies for registered nurses and created a nursing education system that would prepare students for these competencies. To conserve scarce resources, they created a partnership among the four campuses of the state-supported university and eight community colleges.

The leaders agreed upon a common curriculum to be taught on all campuses for the first two years of the three-year baccalaureate degree, co-admitted community college students to the community college and university, and provided mechanisms for a seamless transfer of students to the university for the final year of the baccalaureate curriculum. Faculty from each of the partner campuses created a curriculum radically different from the traditional, specialty-focused curriculum in which students became generalists by rotating through specialties. (Refer to Table 1 for a list of the course requirements for a BSN degree.) Instead, OCNE developed an integrated, spiral (Harden, 1999), and competency-based curriculum organized around foci of care. The faculty also committed to shift their teaching practices from dense, content-packed, Microsoft PowerPoint lectures to case-based discussions, believing students would develop a deeper understanding of important concepts if they learned them in a context similar to clinical practice.

In this article, we explore the student experience as reported by first-year students using survey data collected from four cohorts during the initial years of the transition to the OCNE curriculum and philosophies. It is important to note that the reference to first-year students is not intended to imply a freshman-level experience. …