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Foundations Of Nursing Education

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By Author: Sherry Roberts
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An associate degree in nursing has been a benchmark for a long time for getting a nursing job, but change is becoming afoot. Individual and population health requirements are ever changing, so the health system needs to evolve so as to have nurses that know more and are better trained top offer care in a transformed system. There is an increasing number of hospitals in the US that are now recruiting nurses that with a bachelor degree in nursing or above. According to American Associate College of Nursing, by 2013 the nurses BSN-credentialed were only 55%. Many schools in the U.S are now incorporating BSN to RN programs for those nurses that are AND-credentialed and want to have extra training. Many reasons justify the reason for changing from the AND program to BSN program including the push from the national health policy makers that want more nurses to be BSN-credentialed. Also, America’s surging population consists of elderly people that need more and complex care compared to other age brackets (Nursing Licensure, 2013).
Factors that influence the need for a BSN program
The population of patients is aging in the United States, and many patients are presenting more complicated health conditions. That is why there is increasing the requirement for BSN-credentialed nurses that can provide care in the increasing complex health system. That can only be possible through the increase of the BSN and higher degrees in institutions. The nurses with the AND can do many essential day-to-day tasks that the public requires of them when it thinks of nurses. Those nurses can listen to patients and write down their symptoms, understand crucial signs, coach patients on what they need to do after the treatment, and teach patients how to manage tier illnesses or injuries better. However, many hospitals require more. The nurses with AND will face more and bigger caseloads that are challenging than their education prepared them. That is another reason there is a need for the transition from the AND program to a BSN program.
External forces informing the need for a BSN program
1. The National Academy of Science
The ways in which nurses received training in the 20th century are not adequate any longer in dealing with present health care realities of the 21st century. Patient needs and care environments are becoming more complex, and nurse need to acquire requisite competencies that they can deliver high-quality care. The competencies include system improvement, leadership, teamwork and collaboration, health policy, public health and geriatrics, research, and evidence-based practice. The nurses also are in the requirement to fill expanding responsibilities and to master the technological pools as well as information management systems as they collaborate and coordinate care across the health professional teams. That provides the reason for the nurses to achieve the high levels of education so as to have the required skills to meet the health care needs of the population.
2. The Institute of Medicine (2010 report)
The Institute committee came up with a report on 2010 entitled, “The Future of Nursing Leading Change, Advancing Health.” The report’s elements present substantial reasons as to why there is a need for a BSN or higher. The report puts the need for higher levels of education at the top as it is the factor that aid in achieving the other subsequent recommendations. The report had four major elements that as listed below.
• Nurses need to practice to the full extent of their training and education.
• Nurses have a requirement to attain higher levels of education and training via an advanced education system that fosters seamless academic progression.
• Nurses ought to be full partners with other health care professionals to aid in redesigning health care in the U.S.
• Improved information infrastructure and better data collection are a requirement for effective policy making and workforce planning.
The incorporation of quality and safety initiatives in the new program: QSEN
The Quality Education for Nurses had its inception in the year 2005 through the funding of Robert Wood Johnson Foundation. Its initiative is for the development of safety and quality competencies that act as a resource for the faculty of nursing education. QSEN has the mission of making sure that nurses have the attitudes, skills and knowledge that is necessary to improve consistently the safety and quality of the healthcare systems in which they are working. The Institute suggests that the nursing education needs prepare nurses that can help redesign the ‘what’ and ‘how’ they are offering nursing care so that the nurses can ensure safe and quality health care. It states that nurses should identify and bridge the gaps that exist between what is and what should be and to help them have focused via the lens of safety and quality (QSEN Institute, 2013). For the nurses to have that focus, the QSEN requires a contemporary approach to be in usage and the contemporary approach need to incorporate system thinking. They have it that system thinking helps nurses to achieve the challenge of improving treatment through moving beyond competencies so as to improve the entire health care system’s quality and safety.
The institute’s major contribution to the teaching of nursing education offers six competencies whose modeling followed the IOM reports. The competencies offer a tool for faculty and staff educators to find gaps in the curriculum so as to have changes made to provide quality and safety education. The six repositories include patient-centered care, evidenced-based practice, quality improvement, teamwork and collaboration, and Informatics. There is the incorporation of the QSEN competencies even in textbooks, such as the second generation QSEN and also the Quality and Safety for Transformational Leadership. The BSN program needs to equip nurses with the QSEN competencies so as to help the nursing students to apply the competencies at both the individual and the system levels. There should be a vigilant individual care as well as vigilant systems care requirement for nurses to offer to their patients. There should be the teaching of nurses the knowledge and skills that have an association with system thinking (QSEN Institute, 2013). In the delivery of health care, system thinking provides that nurses should understand and value how the components of a health care system can influence the care of an individual patient.
1. Rationale for the QSEN recommendation
Much of the education in nursing should have a focus on the individual level of care and the nurses need to possess the necessary skills and knowledge for the delivery of the same. Much of the competencies in the QSEN recommendation entail the giving of the education can equip the nurses with such skills and knowledge. The nurses learn those skills and can apply them to improve system-wide quality and safety of the patients. The nurses can understand how to associate the environments with the health of their patients and so emphasize a strong system perspective. System thinking, as suggested by QSEN, can help the nurse development educators to offer an education program that helps the nursing students to evaluate critical situations and make more informed decisions. Thus, the incorporation of the six QSEN competencies is very necessary to the nursing education programs.

2. Barrier to the implementation of the recommendation
For the six QSEN competencies to have an implementation of the BSN program, there is a need for a lot of funds, and that can be a challenge. The need for the funds is for acquiring the educators that have the necessary competence in the subject areas so that they can handle those areas as expected. There may also be a lack of funds for the establishment of the labs that help the learners in the various fields acquire practical training on the areas as provided in the QSEN competence list.
Constructivist learning theory and development of critical thinking skills in the BSN curriculum
The constructivist learning approach provides a resourceful foundation for designing of methods of BSN nursing and also supporting the student’s self-directed learning. Constructivists have a tenet that knowledge can have construction when an individual can attach meaning to the experience. It helps the nursing students how to learn by consciously and actively bringing their experience and insight into a collaborative exercise with other students. That helps them make interpretation, processing and negotiation of the meaning of the new information. That helps the students top think critically by generating their rules and mental models that they can use to derive a sense of their experiences. The learner can construct an internal representation of knowledge as well as a personal interpretation of the experience. That is due to the known fact that learning is an active process whereby one develops meaning on the basis of experience. As the learner attaches the experience with the present situation, an internal cognitive schemata change takes place.
The students can construct reality through the engagement of the mental activities as thinking has a basis in physical and social experiences. The theory places the ownership of the problem and its solution on the students, and this helps the students become effective thinkers. It eventually provides skills for life-long learning through the incorporation of projects in every module. Constructivist learning theory emphasizes on the student having active involvement in the learning process. The theory supports the education of nurses by improving their critical thinking skills and encouraging quick adaptation of changes that occur in the evidence-based practice (Ervin et al., 2006). It helps produce nurse graduates with critical thinking skills. That is because it gives the students the ability to gather information, to analyze it critically and then come up with a new framework for that information. The prior knowledge based on problem-solving skills helps the student to adjust and increase his/her prior knowledge with something new.
The approach enables the learners to analyze, interpret and also predict information. It fosters the ability of the holistic approach to issues where the students can understand parts in the context of wholes. The students have the ability to construct meaning through the analyzing and interpreting situations rather than just memorizing the right answers or someone else’s answers. The student can, in a diligent manner with consideration to the patient’s cultural background, assess the patient’s needs and then plan and implement nursing care in a surgical setting. The student can for health promotion and aid the patient with health care decision-making. Te student gains knowledge in through the treatment chains and gets an insight of the etiology as well as the surgical treatment process of the common surgical diseases. The nursing student can carry out pain assessment and then make use of the principles of rehabilitation health care to the patients. Those are significant critical thinking skills.
1. Critiquing the constructivist learning theory
In constructivist learning, the answer of different individuals is not always the same. The constructivist relaxes at their decisions, and they cannot defend those decisions (Liu & Mathews, 2005). The theory, however, helps in the development of problem-solving skills in a learner, and it also helps the student to have higher retention of the learned material because of active involvement. The disadvantages of the theory are that it encourages diversity of thought where conformity can be in the requirement, and it entails unpredictable outcomes.
Authentic learning components that can inform the development of the new BSN
The authentic context component of this philosophy helps the students to explore ideas in the context of real life situations. That will also help the students to have motivation for learning. The component of authentic tasks in this philosophy will also help students, through the real-world tasks; have the ability to produce knowledge rather than reproducing it. The multiple components of the philosophy also will help the students to develop a range of views in a situation that requires critical thinking (Avery, 1999). The other component of this philosophy that can have adoption in BSN curriculum is collaboration. The component helps the educators to group students and assigns tasks to them so that they can develop the idea and skills of teamwork. There is also the component of articulation that is essential to the provision of opportunities for the learners to write about their growing understanding. There is also the scaffolding component that says the teacher’s role is supporting and not didactic.
1. Critique of the authentic learning philosophy
The philosophy has real-world relevance because of the authentic activities tasks that match the activities of practitioners. Learning becomes authentic when lets the students work actively incorporating abstract concepts, formulae and facts in a realistic and highly social context. The authentic activities also provide the opportunity for the learners to assess the task from a variety of perspectives using a variety of resources. Students can distinguish the relevant from the irrelevant information in that process. However, creating an authentic learning experience is not easy, and it needs considerable amounts of learning as well as practice. Many people also believe that the philosophy focuses mostly on applications rather than concepts.

Current modalities for the delivery of the BSN program
a. Traditional classrooms
The traditional classrooms are effective in delivering the BSN program as students have been using the same method from the time they were young. Therefore, changing the method of learning can result in fear and frustration. Many learners desire an active face to conversational face setting as it enhances their understanding. The traditional classroom settings offer that opportunity for those learners to gain maximally from the teachers. It also offers the opportunity for the students to get instant feedbacks. Nurses are usually busy people and the management of time is often the biggest challenge. Traditional classes offer a set calendar for attending classes, allowing the nursing student to set his/her schedule around the calendar early in the course. The traditional classes are also effective when it comes to handling of practical as nursing education is a practical-oriented subject. The barrier that may exist while implementing this approach is, for instance, the lack of enough classrooms in case students will be too many. There will also be outstretching of some resources like labs because of the high turn up of students for the program.
b. Competency-based learning
The model awards credit to learners based on their proof of competencies’ masterly in their area of study. The application of this modality will put the students in total charge of their studies. Its application n the new BSN program will help the students to learn at their base especially for the students that may have busy schedules, for instance, those that are working while studying. It makes many people have access to affordable higher education as it offers the flexibility that many learners would require fitting their education into their work or lives. It will provide an opportunity for some people that want to have knowledge of specific areas to pay only for the modules the modules that entail those areas rather than wasting time studying the whole course. The barrier that may exist for this approach is the lack of enough teachers that can take care of specific students separately depending on their subscriptions.
Why formative and summative assessments will be in usage in the new BSN program
Formative assessment
The method of assessing BSN students will have usage because it can help to modify the students’ thinking or their behavior, and this will consequently improve learning. The learner can evaluate his/her feedback and using the information received and then the student can make adjustment accordingly. It will also have usage because it helps to identify gaps in knowledge of the students, aid novice students to identify crucial information, and also it helps in connecting procedural misconceptions. The feedback received from the assessment can be useful in improving the teaching process. It helps clarify the desired outcomes as the teacher can know how much the learners were able to understand (Peterson, 2008). The limitation of formative assessment includes the lack of the students to take the assessment seriously and thus the teacher may misread the feedback from them. Another limitation is that the teachers may lack the training on how to use formative assessment effectively because basements normally come at the end.

Summative assessment
Summative assessment will have usage in the new BSN program to help teachers in discovering what the learners achieved during the entire program of study. Historically, assessment comes at the end of the study or course so as to evaluate students to see if they acquired the skills, knowledge or understanding that the course provided for them. The assessment will provide an overall picture of the entire course. The summative assessment is what will lead to the awarding of grades and certificates to the students. The employer looks for the records and qualifications of achievements to ascertain their new employees’ skills and abilities. It also a requirement of awarding bodies to make sure that their assessments and qualifications are having applications uniformly across the country. The assessment will be essential to measuring the effectiveness of the BSN the educational program. It will also help in measuring progress toward improving goals of the course delivery. The limitations include; summative assessment is not always an accurate reflection of learning, and making one big test makes everybody be anxious and it disrupts the school life.
How High-stakes exams could improve BSN students’ performance
The usage of high-stakes testing as the type of assessment for the BSN students can help clarify the challenging performance expectations for learners, teachers, and the university. The school needs to have clearly articulated standards as these will provide a clear picture of the students’ performance expectations. The students will work hard as they know there will be an assessment at the end and failure to pass they will have faced some consequences, for instance of repeating or failure to graduate. The assessment also helps to highlight achievement gaps of the schools and through that it will put in place appropriate mechanisms to assist in breaching those gaps. All groups collaborate to ensure the improvement of the student’s performances as driven by government sanctions and rewards. The teachers will be using this kind of assessment results to find out whether the students are mastering the major content knowledge and attaining the necessary skills. Through the assessment, the administrators will pinpoint possible issues and redirect the curriculum and the instructional activities accordingly. That will help improve the students’ performance.
How to incorporate and apply the ANA Code of Ethics for the new BSN program
There will the incorporation of all the nine provisions in the teaching policy of the new BSN course so as to ensure that the institution provides nurses that have all those characters. The institution will ensure that the teaching of the course entails all those provisions and that the students begin to practice right in the institution as they are learning. The institution will incorporate all the provisions of the code of ethics into some booklets and provide the same to the BSN students so that they can memorize those provisions. The institution can also include some penalties due to the failure of the nursing students to adhere the ANA regulations as stipulated in their program.
1. Incorporating legal accountabilities of nursing education in the new BSN program
a. Family Educational Rights and Privacy Act
There will be a need for the institution to keep the students information as confidential as possible and not to disclose it to other unauthorized people. The institution will also keep all student records strictly confidential and share the records only among the school administration, faculty and advisors where applicable. The institution will have no right to release the confidential information of any student to third parties, unless under the authorization of a written documentation by the student.
b. Americans with Disabilities Act
The college will include in their rules and regulations, the ADA so as to ensure that the entire school abides by all the provisions of the act outlined in the school regulations document. They will also ensure that they allow admission of a student with disabilities and provide them with the necessary assistance to access education just like other students without disabilities. They will need to put strict measures in place to any intimidation, abuse or mistreatment of those students with disabilities by any person.
c. Health Insurance Portability and Accountability Act
The college will have to educate the staff as well as other students on the requirements of the act and assure any students that their health information will be safe as provided by the HIPAA act. It will have the staff members aware of the consequences of disclosing any health information to a student to third parties. That will ensure that the students with some health issues have protection and respect for their rights as provided in the act. There will have to be the implementation of basics as well as advanced security measures as outlined by the act. Any violation of the same will have the perpetrators face the full force of the law. The institution will provide information that may be in the requirement by only the government of the insurance company.
d. Copyright laws
The institution will have in its regulations, the inclusion of the provisions for the copyrighted materials and that will apply to students, leaders, and workers. The teachers and students will not use any material against the provision of the U.S copyright act. The institution will let the violators of the act to bear the liability for their actions as may have determination by the court of law. The college will have materials for learning of the new BSN course in place, and those materials will be accessible to all students as well as their teachers. The teachers and students will also be free to use the materials either from the Internet or elsewhere according to the ‘fair use’ policy. The college will need to put I place strict laws to protect any individual or groups work of art or intellectual copyrighted material so that the materials will not have usage minus the individuals consent.
Commission of Collegiate Nursing Education incorporation into the BSN program
The institution will, first of all, get chartered by the US Department of Education so as to have the allowance of offering the BSDN course. It will then ensure there are qualified professionals to handle all the areas of the new BSN program. The institution will then develop the curriculum, ensuring that it incorporates all the necessary areas of BSNA. It will then need to sermon the CCNE to come and assess the developed curriculum and other areas such as the facilities or resources to ascertain that the school qualifies to offer the program.
The program is a good idea for the college as it is the requirement of the time. However, the school will have to have the essentials such as the fully qualified teachers and enough facilities such as labs and classrooms in case they will use the traditional method of teaching. The institution will have to ensure that they get accreditation from the CCNE so that they will have the right to transit from AND to BSN. They will need to have a flexible program for all students so as to incorporate part-time as well as full-time teaching. They will also consider students that want to have training offered to them in specific areas only. That will lead to the college attracting many students and helping many people to acquire this vital education.

Avery, P. G. (1999). Authentic assessment and instruction, Social Education, 65(6). 366-373.
Brandon, A. & All, A. (2010). Constructivism theory analysis and application to curricula. Nursing Education Perspectives, 31(2), 89-92
Dolansky, M. & Moore, S. (2013) Quality and Safety Education for Nurses (QSEN): The Key is Systems Thinking. The Online Journal of Issues in Nursing, 18( 3).
Ervin, N. et al. (2006). Environments of care: A curriculum model for preparing a new generation of nurses. Journal of nursing education, 45(2), 75-80.

Carolyn Morgan is the author of this paper. A senior editor at Melda Research in nursing term papers if you need a similar paper you can place your order for a custom research paper from pre written essays.

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