Reexamining the Associate Degree Curriculum: Assessing the Need for Community Concepts

By Cahill, Marion; Devlin, Martha et al. | Nursing and Health Care Perspectives, July-August 1998 | Go to article overview

Reexamining the Associate Degree Curriculum: Assessing the Need for Community Concepts


Cahill, Marion, Devlin, Martha, LeBlanc, Phyllis, Lowe, Barbara, Norton, Betty, Tassin, Karen, Vallette, Elaine, Nursing and Health Care Perspectives


Today burgeoning widerly population and growing need for home care in the community have led faculty in Baton Rouge, Louisiana, to reexamine the associate degree curriculum. Comments from a nurse executive whose agency enables senior citizens to remain in their homes, and community college faculty in Queens, New York, who have already revamped their curriculum, are also presented.

SIGNIFICANT CHANGES taking place in health care delivery in our community in Louisiana have led faculty to reexamine the associate degree nursing curriculum. We recognized the trend toward the decreased need for inpatient care and the greater need for out-patient care and home care in the community. In addition, we noted the need for nursing care to assist the elderly in the management of chronic illness and provide education on health promotion and disease prevention. [paragraph] Following a curriculum review in 1995, the nursing faculty at our institution proposed objectives for community health nursing. Each nursing course implemented the objectives independently, which resulted in lack of organization, visibility, and progression of community health concepts. In response, an ad hoc committee undertook a broad-based assessment of the need for community concepts in the curriculum for our ADN program. We collected data from a literature review (see box, Review of Literature), interviews with full-time nursing faculty at our institution, questionnaires to selected ADN programs, and interviews with local community agency directors. We also reviewed and analyzed the community-based clinical experiences that were part of our curriculum during the past six years.

Faculty Interviews One committee member interviewed 21 full-time nursing faculty members using Lewin's field model for phases of change (1). The purpose of the interviews was to identify strong beliefs that would be forces for or against a curriculum change. Faculty were asked to share their "philosophy of community health nursing in an ADN program." Responses were grouped according to beliefs concerning the need for curriculum change in theory and clinical components and according to the level in which the faculty members were teaching.

The results, presented in Table 1, indicate sharp differences in faculty readiness for curriculum change. To guard against bias and weak reliability of results, the report to the full committee showed actual faculty responses as well as categories assigned by the interviewer.

[TABULAR DATA 1 NOT REPRODUCIBLE IN ASCII]

ADN Program Questionnaires Questionnaires were mailed to 58 accredited ADN programs; the response rate was 47 percent. All ADN programs in Pennsylvania, Florida, Missouri, and Colorado were included, with Louisiana schools added for regional comparison. The questionnaire asked for the following information:

* What are the program objectives that relate to community nursing?

* At what level do you begin to incorporate community nursing into your program?

* Is community nursing taught in selected courses or throughout the curriculum? Provide an example of how community experiences progress throughout the curriculum.

* What theoretical concepts are taught regarding community nursing?

* What clinical experiences are provided? Are they observational or "hands on"?

* What types of agencies are used to provide experience?

* Is your program in a rural or an urban area?

The responses indicate that most programs are currently involved in curriculum revision pertaining to community health nursing. The various program objectives, theoretical concepts, sequencing, and clinical experiences illustrate the lack of clear guidelines for ADN programs. The majority of schools teach aspects of community health nursing throughout the program rather than in selected nursing courses.

Table 2 shows that 34.6 percent of the programs have community nursing content, with most such content introduced during the first year. …

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