The Development of a Community-Based Baccalaureate Curriculum Model in a Culturally Diverse Health Care Delivery Area

Article excerpt

ABSTRACT In 1997, faculty at the University of Texas Health Science Center at San Antonio School of Nursing embarked on the development of a community-based care model within the existing curriculum to serve the culturally diverse populations in rural and urban areas of South Texas. A grant awarded by the Helene Fuld Health Trust in 2000 enabled faculty to develop the requisite knowledge and skills relating to community-based care and develop strategies for the delivery of community-based care in a variety of settings. This article provides an overview of the process of curriculum development and its impact on faculty, students, and a diverse community service area.

Concerned about the need to prepare students for employment in community-based health care systems, faculty at the University ofTexas Health Science Center at San Antonio School of Nursing embarked on an evaluation of the curriculum in the fall of 1997. The development of a new curriculum, unique to the School of Nursing and based on a community care model, ensued. * The process of curriculum revision has yielded opportunities for growth, both intentionally and by chance. One such oppoutunity entails a change in focus for faculty, a departure from the traditional medical model. In the new vision of professional nursing education, knowledge and practice are directed toward meeting the health promotion and health maintenance needs of individuals, families, aggregates, and communities. An expanded network of clinical settings provides educationally challenging learning opportunities for students. This vision is in keeping with current expectations for the professional nursing role. A focus on health promotion and risk reduction goes hand in hand with practice across a variety of settings and with divese populaitons (1). * The client as community was also mandated by the state Board of Nurse Examiners and Board of Vocational Nurse Examiners (2). In March 1993, the two groups issues the Nursing Education Advisory Committee (NEAC) Report, which differentiates essential competencies expected of graduates at all levels of nursing education and identifies clinical behaviors and judgments appropriate to each group of practitioners - vocational, diploma, associate degree, and baccalaureate graduates. Of particular note is the use of the term client. For AD and diploma graduates, the client is the individual and the family. For BSN graduates, the term refers to individuals, their families, aggregates, communities, and society (2).

The Educational Setting Chartered by the Texas Legislature, the Health Science Center at San Antonio has been a growing force in the culturally diverse, rural and urban South Texas/Rio Grande Valley border region. It consists of five schools - the School of Nursing as well as a medical school, a dental school, the School of Allied Health Sciences, and the Graduate School of Biomedical Sciences. Its mission is to provide excellent educational opportunities in the health professions while supporting health-related research, patient care, and community service, particularly to underserved populations. The provision of culturally acceptable health care to vulnerable and underserved communities is considered paramount.

Thirty-five percent of the baccalaureate students in the School of Nursing are from ethnic minorities, and many are first-generation college students. The undergraduate program includes a generic nursing program as well as a flexible baccalaureate-completion track for RNs and LVNs. The school is a leader in bringing academic programs to distant sites, including Del Rio, Texas, on the Texas-Mexico border, and the Texas A&M University-- Kingsville System Center at Palo Alto. Palo Alto College is one of four campuses of the Alamo Community College District, which serves metropolitan San Antonio and surrounding rural counties. Other extended campus sites for undergraduate nursing education are being planned.

Opportunities for Community-Based Care The San Antonio area has a large, culturally diverse, predominately Hispanic population. …