Nursing education and Developing Academic Institutions, Curricula and Course

Developing Academic Institutions, Programs, Curricula and Courses, Institutional Values, Academic Programs, Recruitment, Retention of Students, Preparation for Graduation and Transition to Practice, Curriculum, Course Design, Syllabus, Course Materials and Instructional Resources.

Developing Academic Institutions, Programs, Curricula and Courses

    To meet the needs for diversity in nursing education and to prepare a workforce that is representative of the diversity of patients to be served, administrators, staff, and faculty must build a culture of inclusivity at the institutional level as well as within the school of nursing, and develop academic programs that embrace the strengths of all members of the academic community. 

    Additionally, the school must be able to recruit, retain and graduate a diverse student body and support a culture of inclusivity in its programs, curricula, and courses.

What are Institutional Values

    Developing a culture of inclusivity begins at the institutional level and is made visible through explicit values for diversity and inclusivity; practices and procedures that support recruitment and retention of faculty, staff, and students from underrepresented populations; and policies that hold no tolerance for acts of discrimination. 

   Whereas a diverse culture is open to a variety of perspectives, beliefs, cultures, religions, and sexual orientations, an inclusive culture brings this variety into the decision making structures, academic programs, and classrooms; embraces it; and removes barriers to full engagement in the mission of the institution (Bleich et al., 2014). 

   Bleich and colleagues (2014) have identified six strategies that accelerate the development of an inclusive organization: 

(1) improve admission process

(2) reduce invisibility of underrepresented faculty, staff, and students

(3) create communities of support and ensure that promotion and tenure structures are balanced

(4) eliminate exclusion

(5) stand against tokenism

    Additionally, colleges and universities and their schools of nursing must have statements about their commitment to diversity and inclusivity as well as specific campus conduct policies and procedures for discrimination related to age, gender, race, color, national origin, disability, and veteran status, among other factors.

What  are Academic Programs

    To establish inclusive learning environments at the school level, administrators and faculty can first assess their current environmental support for inclusion. Inclusive academic programs also have programs to support recruitment, retention, and graduation of underrepresented students. These programs also have a dedicated office of diversity and a dean or director of diversity. 

What is Recruitment

    To obtain a diverse student population, the school of nursing must be involved in active recruitment efforts. Recruitment of underrepresented minority students or a “diversity pipeline” program can begin as early as grade school at a time when students are making career choices. 

   These programs involve sharing information about nursing as a career such as “shadow a nurse” activities or clubs that focus on nursing careers. Another strategy is to prepare high school students for certified nursing assistant positions with the intent of transitioning these graduates to nursing programs (Colville, Cotton, Robinette, Wald, & Waters, 2015). 

    Other programs include establishing partnerships or academic transition programs between high schools, BSN, and graduate programs that streamline the curricula to facilitate admission and progression in the next level of academic preparation. Financial support and scholarships dedicated to underrepresented minority students also aid in recruitment. 

    In a study of the success of diversity pipeline programs, Brooks Carthon, Nguyen, Chittams, Park, and Guevara (2014) found that mentorship and academic and psychosocial support were associated with increased enrollment and graduation for students participating in these programs. They also noted that only 20% of nursing programs in their study reported having diversity pipeline programs.

       Program admission criteria can also affect recruitment efforts. Admission requirements that depend solely on achievement test scores and grade point averages may restrict minority student application and acceptance rates, and limit the school’s opportunities for experiencing the benefits of having a more diverse student body. 

    Some schools are taking a more holistic view of admission criteria and have added interviews, essays, academic readiness, and potential for success as a student and professional as other admission criteria to a holistic admission process (Urban Universities for Health, 2014).

Retention of Students

    Once underrepresented minorities are admitted, nursing schools must also have programs in place to ensure student success. Barriers to success include lack of financial support, decreased family support, lack of cultural competence, poor preparation for college, insufficient basic technology skills, and lack of role models. 

    Success programs seek to help students overcome these barriers. Success programs can include early identification of students at high risk for failure, mentoring, advising, study skills and test taking skills programs, peer tutoring, use of social workers, writing centers, and empowerment sessions. 

    Persistence and perseverance has been noted as one powerful aspect of students’ completion of a nursing program (Nadeau, 2014).

Preparation for Graduation and Transition to Practice  

    As students approach graduation, other strategies can be employed to prepare students for transition to practice. Here licensing exam or certification exam preparation courses are helpful in preparing students to pass these exams. Capstone courses, internships, and elective courses can prepare students for the realities of employment. 

    Residency programs have proved successful in facilitating transition to practice and retention to the employment setting. Other courses within the curriculum focus on leadership, career, and professional development, and prepare students to be lifelong learners and active members of professional nursing organizations.

What is Curriculum

    Diverse cultural content should be integrated throughout the curriculum. The multicultural model designed by Banks and Banks (2004, 2006) can be adapted to all levels of the curriculum. Bagnardi, Bryant, and Colin (2009) describe the experience of integrating Banks and Banks’ model throughout an undergraduate curriculum. Students should learn to apply various nondominant perspectives (Morey & Kitano, 1997). 

    As Banks and Banks suggest, instructors must move beyond the initial level of integrating cultural artifacts such as names and holidays to an integrative level where students obtain more substantive information about cultural groups (Banks & Banks, 1993, 2004). Educators should make concerted efforts to exhibit attitudes of positive portrayal of diversity and indicate that diversity is valued. 

    Exposing students to various cultural norms, health beliefs, practices, and a balanced assignment of reviewing articles and research written or conducted by faculty of color and members of the lesbian, gay, bisexual, transgender (LGBT) community, or covering topics of concern to the marginalized is a feasible first step in diversifying the curriculum. 

    Underwood (2006) used an inquiry approach to facilitate enhanced knowledge and sensitivity related to culture and health. A student assignment was to write three questions about an ethnic group of the student’s choice. The themes that emerged from these questions were used to structure the course. 

    The expected curricular outcomes should be clearly identified and should guide didactic content, student assignments, and evaluation. In this way, students’ progress toward cultural competence can be monitored and assessed as students move through the curriculum. 

    The curriculum provides a framework for mapping and a set of criteria for evaluation. The results of the evaluation should exemplify the attainment of specific knowledge, skills, and attitudes.

What Is Course Design

    A thorough course analysis is a significant component of multicultural course transformation. The modification itself can present in various ways. A first step is to identify the expected outcomes. 

    For example, after articulating that one goal for a course is to increase knowledge of bias and ethnocentrism as it relates to the study of various cultural groups, a faculty member may determine that the course’s content includes various examples of cultural groups. 

    However, the course may not facilitate opportunities for open and equitable exchanges of ideas and values. Therefore, the transformative work may begin in the area of instruction for classroom as well as clinical practice.

What Is Syllabus

    The syllabus should be welcoming and convey inclusiveness. Because the syllabus is a contract with accompanying legal ramifications, faculty should ensure that the language used shows respect for differences and equity of opportunity . Most syllabi have references to disability services and sexual harassment and bullying policies, but often religious observance policies are missing. 

    Having a religious observance policy in place and including it prominently in the syllabus sends a tangible cue of respect for all religious holidays given that most college campuses follow the Christian calendar. 

    The policy should indicate that it is the student’s responsibility to inform the faculty member of religious holidays that conflict with any exams, project due dates, or assignments so that other reasonable arrangements can be negotiated. By doing so, students get practice for the work world where such responsibilities will be theirs as well.

Course Materials and Instructional Resources

    As educators choose instructional resources to support teaching and learning, they should pay careful, close attention to implicit and explicit cues, wording, stereotypes, or generalizations. This also may mean that a variety of materials, articles, and media should be used to make up for deficits of limited information and examples in textbooks. 

    Faculty should also examine teacher made course materials for inclusion, exclusion, and bias. For example, course syllabi, handouts, worksheets, and evaluation instruments may inadvertently be written with culture or gender bias. Additionally, special documentation such as books and web resources that include photos or illustrations may not include adequate racial, ethnic, or gender representation. 

    To facilitate the availability of more unbiased instructional materials, evaluation and feedback should be provided to authors, with suggestions to include content that supports a transformed curriculum. The use of a guide similar to the one developed by Byrne, Weddle, Davis, and McGinnis (2003) can be useful in the assessment of instructional materials as well as in helping faculty evaluate and create new products.


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