Nursing Education and Curriculum Design Model for Undergraduate, Licensed Practical and Vocational, Diploma Programs

Undergraduate Program Curriculum Models In Nursing Education, Licensed Practical and Vocational Programs Curriculum Model In Nursing Education, Diploma Programs Curriculum Model In Nursing Education, Associate Degree Programs Curriculum Model In Nursing Education.

Undergraduate Program Curriculum Models In Nursing Education

    Various undergraduate nursing program models have been developed to facilitate multiple entry points into the profession and to encourage undergraduate students to pursue graduate study early in their nursing careers. Generally there are many similarities among the program models, with variations occurring within the internal configuration of courses and course content. Prelicensure nursing programs include those for the LPN, LVN, and RN. 

    For the preparation of RNs, the three most common traditional program models include the 2-year associate degree, the 4-year baccalaureate degree, and the 3-year diploma program. In addition to these three educational models, there are accelerated baccalaureate programs as well as accelerated graduate degree nursing programs for those students who already hold a non nursing degree. 

    For example, students with previous non nursing academic degrees may choose to pursue an accelerated bachelor’s degree or generic master’s degree program, or a clinical nurse leader program. Streamlined academic pathways for undergraduate students that lead to doctoral studies are also available. 

    Diploma, associate, and baccalaureate degree program designs are discussed in further detail in this section, as are LPN and LVN programs. Academic progression models are also addressed.

Licensed Practical and Vocational Programs Curriculum Model In Nursing Education

    LPN programs, also known as LVN programs in some regions of the country, provide an opportunity for many individuals to first enter the nursing workforce. LPN programs are typically 1 year in length and are taught in community colleges and vocational schools. LPNs are employed in structured environments, with approximately 20% employed in hospitals, 29% in long term care, and 12% in physician’s offices, as of 2012 (Bureau of Labor Statistics, U.S. Department of Labor, 2014). 

    It is estimated that the demand for LPNs is expected to grow 25% between 2012 and 2022, mainly because of the expected need for residential care facilities and home health services for the aging baby boomer population. 

    The importance of the growing role for the LPN in the nation’s health care system and the importance of developing curricula that adequately prepare LPNs for this role was recently addressed in the NLN’s (2014) Vision for Recognition of the Role of Licensed Practical/Vocational Nurses in Advancing the Nation’s Health. 

    Additionally, a curriculum framework based on the NLN Outcomes and Competencies model (2010) has been developed for LPN/LVN curricula and can be found at under Faculty Development and Resources LPN Curriculum Resources.

    Individuals who are first licensed as LPNs frequently return to school to pursue licensure as RNs, thus increasing their levels of responsibility and accountability within the health care environment. Providing avenues of academic progression for LPNs that recognize their previous learning and experience will continue to be an important component of nursing education academic progression programs.

Diploma Programs Curriculum Model In Nursing Education

    Diploma programs represent the first curriculum model developed for training nurses in the late nineteenth and early to mid twentieth centuries. Initially affiliated with hospitals, many of today’s diploma schools of nursing are also affiliated with institutions of higher education. Diploma programs prepare technical nurses who provide direct patient care in a variety of health care settings. 

    Typically the curriculum is designed to be completed in 3 years and provides an emphasis on clinical practice. General education courses in the biological and social sciences are provided through affiliation with a local college or university. These college course credits can commonly be applied toward a baccalaureate degree in nursing if the student chooses to continue his or her education. 

    With the shift of nursing education into colleges and universities, diploma schools have been gradually closing during the last 30 years, reconfiguring themselves as single-purpose institutions, or merging with existing colleges or universities. Diploma programs compose fewer than 10% of nursing programs educating students in the United States (American Association of Colleges of Nursing [AACN], 2011).

Associate Degree Programs Curriculum Model In Nursing Education

    ASN or associate degree in nursing (ADN) programs were first envisioned in 1952 by Mildred Montag in response to a critical nursing shortage. The intent of the associate degree programs, as originally conceived by Montag, was to prepare in 2 academic years a technical nurse who would provide direct patient care in acute care settings under the supervision of a professional nurse (Dillon, 1997). 

    Despite the persistent call for increasing the level of preparation of the RN, associate degree programs continue to be very popular. According to the Health Resources and Services Administration (HRSA), (2010), in 2008 the percentage was approximately 45.4%. 

    As acute care agencies push for increased numbers of BSN-prepared nurses, the trend is clear that many ASN/ADN nurses are returning to school to pursue baccalaureate or graduate nursing degrees. Associate degree programs are often situated in community colleges, and have served local community needs for a registered nursing workforce for years. 

    As the demand for registered nurses has increased, associate degree nurses have been an important way workforce needs have been met. As the complexity of the professional nursing role has increased, and the expectations for practice in rapidly changing environments, associate degree nursing programs have responded (Robert Wood Johnson Foundation [RWJF], 2013). 

    One challenge inherent in this response, however, is the difficulty of incorporating a large body of complex information and skills into an associate degree. Some programs have responded by increasing the credits in the program beyond the typical number (60) in a two-year degree, a solution that may extend the program length. 

    As increased attention is placed on the costs of higher education and the amount of student loan debt incurred by students, the number of credits required in associate degree programs is coming under more intense scrutiny. 

    It will be important for faculty who design and revise curriculum plans for ASN/ADN programs to consider the number of credits they are requiring in their programs, and consider ways to ensure that the curricula remain free of excess credit hours. 

    The curriculum of associate degree programs commonly consists of nursing courses that include concepts and content related to the practice of medical–surgical, pediatric, maternity, and psychiatric mental health nursing care, focused most intently on what is needed to succeed in the first RN role, consistent with the National Council Licensure Examination test blueprint. 

    Some programs may also include additional topics including management, community health, gerontology, and research. Because the National Council of State Boards of Nursing has responded to changes in the practice environment, most nursing programs leading to licensure as an RN have widened their focus to teach principles and practices related to the management of care, such as prioritization, delegation, and multi patient management.

    Students completing the ASN are prepared to practice in structured health care settings. In response to future workforce needs and employment patterns, faculty teaching in associate degree programs will want to instill in their students a sense of lifelong learning and the expectation of advancing their initial education to at least the bachelor level. 

    The recent Institute of Medicine (IOM) (2010) report on the future of nursing recommended that the profession move to increasing the proportion of practicing nurses with a baccalaureate degree to 80% by 2020. Facilitating the academic progression of associate degree– prepared nurses through innovative curriculum models will become a strategic goal of the profession over the next decade.


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