Professional Nursing Curriculum - Program Learning Outcomes and Conceptual Threads
Subject: Academic Affairs
Policy: PROFESSIONAL NURSING CURRICULA - PROGRAM LEARNING OUTCOMES AND CONCEPTUAL THREADS
Revised: December 2020; September 13, 2022
Effective date: 2021
Review date: 2025
Responsible Party: Level I: UAAC; Level II: Associate Dean for Academic Affairs
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Introduction and Purpose
The Montana State University College of Nursing is committed to meeting its land grant mission to enhance the health of the people of Montana, our nation, and the global community by providing leadership for professional nursing through excellence in education, scholarship, practice, and service.
Policy
To provide excellence in education, the undergraduate and graduate degree and certificate curricula are founded on the transformative learning theory which emphasizes critical reflection, self-reflection and dialogue, and the AACN Essentials (2021) and/or other relevant accreditation or national certification standards including the Core Competencies for Basic Midwifery Practice (ACNM, 2019) and Criteria for Pre-accreditation of Midwifery Education Programs (ACME, 2020) and Standards for Quality Nurse Practitioner Education (NONPF, 2022). A competency-based educational approach is incorporated in the MSU curricula to ensure students graduate with the knowledge, skills, values, and attitudes necessary to provide evidence based, competent, compassionate, and culturally sensitive nursing care for individuals, families, and communities. Students will achieve these through diverse clinical experiences within the spheres of health promotion/disease prevention, chronic, acute, and palliative care.
The following formative, entry Level, and advanced-Level program learning outcomes are adapted from the AACN Essentials: Core Competencies for Professional Nursing Education (2021) and/or other relevant accreditation or national certification standards which provide a strong foundation of the nursing discipline, liberal education, and principles of competency-based education. The outcomes are established to assess student learning and are designed to be applicable across four spheres of care (prevention/promotion of health and wellbeing, chronic illness care, critical/trauma care, and hospice/palliative care), throughout the lifespan, and with diverse patient populations.
Domain 1: Knowledge for Nursing Practice
Integration, translation, and application of established and evolving disciplinary nursing knowledge and ways of knowing, as well as knowledge from other disciplines, including a foundation in liberal arts and sciences. This distinguishes the practice of professional nursing and forms the basis for clinical judgment and innovation in nursing practice.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will apply knowledge, skills and technology from the established and evolving art and science of nursing as well as the biological, social and behavioral sciences using the nursing process in the delivery of care.
Entry Level Learning Outcome
Students completing our program will synthesize knowledge, skills, and technology from the established and evolving art and science of nursing, as well as the biological, social and behavioral sciences, to apply critical thinking and the nursing process in the delivery of care.
Advanced Level Learning Outcome
Students completing the graduate nursing program will evaluate, integrate, translate, and apply evidence from nursing science and other disciplines in the delivery of care.
Domain 2: Person-Centered Care
Person-centered care focuses on the individual within multiple complicated contexts, including family and/or important others. Person- centered care is holistic, individualized, just, respectful, compassionate, coordinated, evidence- based and developmentally appropriate. Person-centered care builds on a scientific body of knowledge that guides nursing practice regardless of specialty or functional area.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will establish therapeutic relationships with clients to identify individual preferences, values, needs, resources, and health determinants of health to provide evidence-based, holistic, compassionate, and respectful person-centered care.
Entry-Level Learning Outcome
Students completing our program will provide evidence-based, holistic, compassionate, and person-centered care respectful of the preferences, values, needs, resources, and determinants of health unique to and in partnership with the client, identified support persons and the health-care team.
Advanced Level Learning Outcome
Students completing the graduate nursing program will create, communicate, and evaluate person-centered care that includes holistic, individualized, just, culturally aware, respectful, compassionate, coordinated, evidence-based and developmentally appropriate.
Domain 3: Population Health
Population health spans the healthcare delivery continuum from public health prevention to disease management of populations and describes collaborative activities with both traditional and non-traditional partnerships from affected communities, public health, industry health care, local government entities, and other stakeholders for the improvement of an equitable population health outcomes.
Formative Learning Outcome
After completing the first two semesters the BSN program, students will identify the impact of social determinants of health on individuals, families, and populations.
Entry-Level Learning Outcome
Students completing our program will promote health equity through advocacy, health promotion, community resource partnerships, and disease prevention strategies at the individual, family, community, and population levels with consideration of social determinants of health.
Advanced Level Learning Outcome
Students completing the graduate nursing program will analyze current population health gaps and create and evaluate cost-effective, evidence-based interventions to meet the needs of the target population.
Domain 4: Scholarship for the Nursing Discipline
The generation, synthesis, translation, application, and dissemination of nursing knowledge to improve health and transform health care.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will ask a clinical question, acquire and critically appraise relevant evidence, and integrate best evidence with clinical expertise and client preferences.
Entry-Level Learning Outcome
Students completing our program will demonstrate the ability to synthesize, translate, apply, and disseminate nursing knowledge to improve health outcomes.
Advanced Level Learning Outcome
Students completing the graduate nursing program will advance the scholarship of nursing through the integration of best evidence and ethical conduct of scholarly activities.
Domain 5: Saftey and Quality
Employment of established and emerging principles of safety and improvement science. Quality and safety, as core values of nursing practice, enhance quality and minimize risk of harm to patients and providers through both system effectiveness and individual performance.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will apply principles of safety and quality improvement in the delivery of care.
Entry-Level Learning Outcome
Students completing our program will integrate principles of safety and quality improvement into the delivery of high-quality care to individuals, families, communities, and populations.
Advanced Level Learning Outcome
Students completing the graduate nursing program will employ improvement science to ensure system effectiveness for safe, person-centered care within a physically, psychologically, secure, and just environment.
Domain 6: Interprofessional Partnership
Intentional collaboration across professions and with care team members, patients, families, and communities to optimize care, enhance the healthcare experience, and strengthen outcomes.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will participate as a member of an interprofessional team to explore the effects of collaboration and communication on the patient experience, safety, outcomes, and costs of care.
Entry-Level Learning Outcome
Students completing our program will demonstrate collaborative interprofessional communication and practice to optimize the patient experience, safety, improve outcomes and reduce costs.
Advanced Level Learning Outcome
Students completing the graduate nursing program will collaborate across professions and with other stakeholders to optimized care, enhance the healthcare experience, and strengthen outcomes.
Domain 7: System Based Practice
Responding to and leading within complex systems of health care. Nurse effectively and proactively coordinates resources to provide safe, quality, and equitable care to diverse populations.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will demonstrate system awareness, fiscal prudence, and equity in the care of diverse populations.
Entry-Level Learning Outcome
After completing the program, students will apply knowledge of systems, cost-effectiveness, and regulation to plan, provide, and evaluate care.
Advanced Level Learning Outcome
Students completing the graduate nursing program will coordinate the resources of the complex healthcare system to provide safe, quality, and equitable care to diverse populations.
Domain 8: Information and Healthcare Technologies
Information and communication technologies and informatics processes are used to provide care, gather data, form information to drive decision making, and support professionals as they expand knowledge and wisdom for practice. Informatics processes and technologies are used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practice and professional and regulatory standards.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will employ communication and technology to plan, provide, and evaluation care.
Entry-Level Learning Outcome
Students completing our program will function as effective users of information and communication technologies to deliver evidence-based care in accordance with regulatory and institutional policies.
Advanced Level Learning Outcome
Students completing the program will use information and communication technology to anticipate, manage and improve healthcare in accordance with best practice and professional and regulatory standards.
Domain 9: Professionalism and Professional Identify Formation
Formation and cultivation of a sustainable professional identity, including accountability, perspective, collaborative disposition, and comportment, that reflects nursing’s characteristics and values.
Formative Learning Outcome
After completing the first two semesters of the BSN program students will examine ethical decision making in nursing practice in a variety of
Entry-Level Learning Outcome
After completing the program, students will apply principles of professional nursing ethics, accountability, and respect in the care of diverse populations
Advanced Level Learning Outcome
Students completing the program will model a sustainable professional identity of accountability, ethical comportment, and collaborative disposition.
Domain 10: Personal, Professional, and Leadership Development
Participation in activities and self-reflection that fosters personal health, resilience, and well-being; contribute to life-long learning; and support the acquisition of nursing expertise and the assertion of leadership.
Formative Learning Outcome
After completing the first two semesters of the BSN program, students will identify areas of personal strengths and weaknesses related to resilience, well-being, leadership, and career-long learning.
Entry-Level Learning Outcome
Students completing our program will create a personal and professional plan for long-term resilience, self-care, lifelong learning, and ethical leadership and decision making in the provision and oversight of nursing practice in a variety of settings.
Advanced Level Learning Outcome
Student completing the graduate nursing program will participate in activities and self-reflection that foster personal health, resilience, and well-being; students will contribute to life-long learning; and students will support the acquisition of nursing expertise and the assertion of leadership.
Threads throughout the Curriculum
The curricular threads are adapted from the AACN Essentials: Core Competencies for Professional Nursing Education (2021).
Clinical Judgment
A key attribute of professional nursing, clinical judgment is the process by which nurses make decisions based on knowledge, evidence, intuition, critical thinking, and clinical reasoning (Manetti, 2019). These skills are used to process and interpret information in the delivery of care. Clinical decision making based on the use of clinical judgment is directly related to patient care outcomes (AACN, 2021).
Communication
Communication, informed by nursing and other theories is fundamental to nursing practice. Communication is as an exchange of information, thoughts, and feelings through a variety of mechanisms and includes all the various ways people interact with each other including verbal, written, behavior, body language, touch, and emotion. In addition, communication also includes intentionality, mutuality, partnerships, trust, presence. Effective communication with individuals and other health professionals is necessary for effective person-centered nursing care. Communication is essential for team-based, interprofessional care integral with the concept Determinants of Health (AACN, 2021).
Compassionate Care
As an essential principle of person-centered care, compassionate care refers to the way nurses relate to others as human beings and involves “noticing another person’s vulnerability, experiencing an emotional reaction to this, and acting in some way with them in a way that is meaningful for people” (Murray & Tuqiri, 2020). Compassionate care is interrelated with other concepts such as caring, empathy, and respect and is also closely associated with patient satisfaction.
Cultural Sensitivity
Culturally sensitive health care has been described as care that reflects “the ability to be appropriately responsive to the attitudes, feelings, or circumstances of groups of people that share a common and distinctive racial, national, religious, linguistic, or cultural heritage” (DHHS, OMH, 2001, p. 131)
Diversity, Equity, and Inclusion
Collectively, diversity, equity, and inclusion (DEI) refers to a broad range of individual, population, and social constructs and is adapted in the Essentials as one of the most visible concepts. Although these are collectively considered a concept, differentiation of each conceptual element leads to enhanced understanding. Diversity references a broad range of individual, population, and social characteristics, including but not limited to age; sex; race; ethnicity; sexual orientation; gender identity; family structures; geographic locations; national origin; immigrants and refugees; language; any impairment that substantially limits a major life activity; religious beliefs; and socioeconomic status. Inclusion represents environmental and organizational cultures in which faculty, students, staff, and administrators with diverse characteristics thrive. Inclusive environments require intentionality and embrace differences, not merely tolerate them (AACN, 2017; Bloomberg, 2019). Everyone works to ensure the perspectives and experiences of others are invited, welcomed, acknowledged, and respected in inclusive environments. Equity is the ability to recognize the differences in the resources or knowledge needed to allow individuals to fully participate in society, including access to higher education, with the goal of overcoming obstacles to ensure fairness (Kranich, 2001). To have equitable systems, all people should be treated fairly, unhampered by artificial barriers, stereotypes, or prejudices (Cooper, 2016). Two related concepts that fit within DEI include structural racism and social justice (See the glossary for definitions structural racism and social justice).(AACN, 2021)
Ethics
Core to professional nursing practice, ethics refers to principles that guide a person’s behavior. Ethics is closely tied to moral philosophy involving the study of or examination of morality through a variety of different approaches (Tubbs, 2009). There are commonly accepted principles in bioethics include respect for autonomy, beneficence, non-maleficence, and justice. (ANA 2015; ACNM, 2015, AANA, 2018; ICN, 2012). The study of ethics as it relates to nursing practice has led to the exploration of other relevant concepts, including moral distress, moral hazard, moral community, and moral or critical resilience. (AACN, 2021).
Mental Health
Mental health nursing includes diagnosing and treating human’s reaction to potential and actual mental health problems with an emphasis to improve and preserve mental health performance, prevention of mental diseases, and to assist in the recovering of health. These goals are realized through a wide range of nursing activities across populations and settings. Mental health nursing is faced with increasing challenges. Aging population, cultural differences, and developing technology are among the factors that influence future of mental health nursing (Mohtashami et al, 2013)
Social Determinants of Health
Determinants of health, a broader term, include personal, social, economic, and environmental factors that impact health. Social determinants of health, a primary component of determinants of health “are the conditions in the environment where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks.” The social determinants of health contribute to wide health disparities and inequities in areas such as economic stability, education quality and access, healthcare quality and access, neighborhood and built environment, and social and community context (Healthy People, 2030). Nursing practices such as assessment, health promotion, access to care, and patient teaching support improvements in health outcomes. The social determinants of health are closely interrelated with the concepts of diversity, equity, and inclusion, health policy, and communication. (AACN, 2021).
Certificate and Specialty Option Program Learning Outcomes
Program learning outcomes for certificate programs and DNP specialty options are adapted from the AACN Essentials: Core Competencies for Professional Nursing Education (2021) and/or other relevant accreditation or national certification standards including the Core Competencies for Basic Midwifery Practice (ACNM, 2019) and Criteria for Pre-accreditation of Midwifery Education Programs (ACME, 2020) and Standards for Quality Nurse Practitioner Education (NONPF, 2022). The outcomes are established to assess student learning and are designed to be applicable with diverse patient populations and settings. Students who graduate from the following programs are prepared to:
Nursing Education Certificate
1. Develop a variety of evidence-based teaching strategies based on educational theory.
2. Articulate the elements for an effective academic or clinical curriculum.
3. Employ evidence-based strategies to evaluate learner knowledge, skills, and attitudes.
Post Graduate Psychiatric Mental Health Nurse Practitioner Certificate (2022)
- Conduct comprehensive and systematic psychiatric assessments in complex situations. AACN Domains: 1, 8.
- Apply selected therapeutic modalities for individuals, group psychotherapy, and the integration of multicultural skills for health promotion and management of mental health problems and psychiatric disorders. AACN Domains: 1, 2, 3, 6, 7, 10.
- Demonstrate appropriate evidence-based use of psychopharmacology concepts in the psychiatric care and management of individuals and families. AACN Domains: 2, 4, 5, 7, 8, 10.
- Demonstrate expertise, specialized knowledge, and expanded responsibility and accountability in the advanced psychiatric care and management of individuals and families. AACN Domains: 2, 5, 6, 7, 8, 10.
DNP Nurse Midwifery Specialty Option
Vision: The Montana State University Mark and Robyn Jones College of Nursing nurse midwifery specialty transforms the lives of people through leading in midwifery practice, education, and research.
Mission: The Montana State University Mark and Robyn Jones College of Nursing midwifery specialty enhances the health of individuals and families through educating nurse midwives in the provision of person-centered, evidence-based, inclusive, and equitable midwifery care. The midwifery specialty has a special commitment to serving childbearing families and households in rural and underserved populations.
Philosophy: We believe:
- Midwifery is a specialty within the discipline of nursing which is both a science and art requiring synthesis of evidence-based knowledge, professional skills, ethical values, and human caring.
- The childbearing cycle is essentially a healthy event and honors non-intervention but also supports intervention and interprofessional collaboration when appropriate and needed.
- Nurse midwives provide comprehensive evidenced-based care to people and families/households throughout the childbearing cycle, the pre and post childbearing periods, and to neonates.
- All people regardless of ethnicity, socioeconomic status, gender identity, sexual orientation, religion, culture, or ability have the right to respectful, compassionate, holistic midwifery care.
- Nurse midwives advocate for people’s empowerment, right to self-determination, and informed decision-making regarding their health.
- The formal education of nurse midwives within the College of Nursing prepares skillful, knowledgeable, and ethical providers who will be leaders who work towards improving the health of women and their families/households.
Program Learning Outcomes: Students completing the program will
1. Integrate foundational knowledge from the basic and applied sciences into clinical, evidenced-based midwifery practice. (AACN Domain: 1, 4, 5, 8).
2. Demonstrate midwifery knowledge, skills, and abilities when providing safe, ethical care during the pre-conception, antepartum, intrapartum, post-partum, and neonatal periods and when providing common primary and gynecologic care. (AACN Domains: 1, 2, 4, 5, 8, 9, 10).
3. Diagnose and manage complications within the midwifery scope of practice when caring for women, individuals in the childbearing cycle, neonates and those receiving primary and gynecologic care by professionally consulting, collaborating, and communicating with or referring to healthcare team members as appropriate. (AACN Domains: 2, 5, 6, 7, 8, 9, 10).
4. Assume the role of the nurse midwife when collaborating as a member of the intra- and inter-professional health team to impact the outcome of midwifery care. (AACN Domains: 2, 5, 6, 7, 8, 9, 10).
5. Use information literacy skills to prevent and reduce errors to improve midwifery care outcomes. (AACN Domains: 2, 3, 5, 8).
6. Provide leadership in the complex health care delivery system to eliminate health disparities advocating for equitable, inclusive, and accessible midwifery care for families, households, and populations. (AACN Domains: 2, 3, 4, 5, 6, 7, 9, 10).
7. Apply principles of ethics, human rights, diversity, equity, and inclusion when providing compassionate, holistic, person-centered care to individuals in the childbearing cycle, women, families, and neonates. (AACN Domains: 2, 9, 10).
8. Integrate knowledge of social determinants of health when providing care and advocating for socially just and economically viable health policies for childbearing families and households. (AACN Domains: 1, 3, 5, 6, 7, 9, 10).
9. Complete and successfully defend a scholarly project designed to improve health or transform health care appropriate to the role and scope of the doctorally prepared nurse midwife through critical analysis, interpretation, and application of research findings that contribute to evidence-based practice. (AACN Domains: 4, 6, 7, 8, 9, 10).
References
American Association of Colleges of Nursing, (2020). The Essentials: Core Competencies for Professional Nursing Education.
Bloomberg. (2019). When addressing the Abilities community, words matter and people come first. https://www.bloomberg.com/company/stories/when-addressing-the-abilities-community-words-matter-and-people-come-first.
Cooper, C. L., (2016) The Blackwell Encyclopedia of Management. Blackwell Publishing, Blackwell Reference Online. Accessed at http://www.blackwellreference.com/public/book.html?id=g9780631233176_9780631233176.
Kranich, N. (2001). Equality and equity of access: What’s the difference? Libraries and Democracy, Chicago, IL: American Library Association, 2001: 15-27. For the ALA Intellectual Freedom Committee. http://www.ala.org/advocacy/intfreedom/equalityequity
Mohtashami, Salsali, Razargadi, Manoochehri & Majd, (2013) Competency-based curriculum education in mental health nursing. Open Journal of Nursing, 3, 545-551. Doi:10.4236/ojin.2013.38074.
Internal control considerations, if applicable: N/A