Sixteen Months, Second Careers and a New Set of Essentials: The External and Internal Forces Reshaping an Accelerated BSN Curriculum
Student Name
American College of Education
NUR5233: Curriculum Development, Assessment, and Evaluation in Nursing
Module 1 Assignment
Instructor Name
July 11, 2028
The Program
The program analyzed in this course is a composite accelerated Bachelor of Science in Nursing offered by a private university's school of nursing in a mid-sized Midwestern city. It admits 64 students each January into a 16-month, five-semester sequence. All students hold a bachelor's degree in another field; recent cohorts have included former teachers, biologists, military veterans, accountants and a musician. The program holds CCNE accreditation, and its first-time licensure pass rate over the past three years has averaged 88%, slightly below the university's traditional BSN program. The curriculum was last revised seven years ago, before the current professional standards and licensure examination took effect, and the school's faculty have agreed that it must be rebuilt rather than patched. The author chairs the curriculum task force.
What the Current Curriculum Does
Before analyzing the forces, the task force reviewed the curriculum as it now operates, so that the analysis would be tied to real gaps. The current curriculum has 17 courses organized by specialty: fundamentals, medical-surgical nursing in two parts, maternal-newborn, pediatrics, mental health, community health, leadership and a capstone practicum, with pathophysiology, pharmacology, health assessment and research taught as separate courses in the first two semesters. Course outcomes were written to the previous edition of the Essentials. Most courses assess students mainly with multiple-choice examinations, which account for between 70% and 85% of the course grade, and clinical performance is graded pass or fail using a checklist that varies from course to course. Clinical judgment is named in the capstone course but not taught with a common model elsewhere. The review also found repetition that accelerated students resent: the same content on therapeutic communication appeared in four courses, while delegation and prioritization for multiple patients appeared in only one. Graduates' comments on the exit survey echoed these findings; the most frequent suggestion was more practice managing several patients at once, and the second was less repetition of basics. These findings frame the forces that follow. Several of them do not require new content so much as a different organization of existing content and a different approach to assessment.
External Forces
Professional standards. New Essentials published in 2021 define baccalaureate education as competency-based, arranged in ten domains that run from knowledge for nursing practice to personal and professional development, each broken into competencies and sub-competencies for the entry-level professional nurse (American Association of Colleges of Nursing [AACN], 2021). Accredited programs are expected to align their curricula with these Essentials. The shift is not only a new list of content. Competency-based education requires that students demonstrate what they can do, assessed repeatedly and in context, which challenges a curriculum built around course grades and credit hours.
Licensure testing. Since 2023 the licensure examination has measured clinical judgment explicitly, using item types built on the clinical judgment measurement model developed by the national council that writes the examination. Dickison et al. (2019) describe how the model's layers, which move from noticing and making sense of cues through choosing and acting to judging the result, can be integrated with educational frameworks such as Tanner's clinical judgment model. A curriculum that teaches content and tests recall will leave students unprepared for questions that require them to reason through an unfolding case.
Practice partners. The hospitals that hire the program's graduates report that new nurses are not ready for practice. Their concern has support: in performance-based assessments of more than 5,000 newly graduated nurses at one large academic medical center, only 23% demonstrated entry-level competency and practice readiness (Kavanagh & Szweda, 2017). The program's advisory board, which includes chief nursing officers from its three main clinical partners, has asked for graduates who can prioritize care for several patients and recognize deterioration early.
Clinical access. Clinical placements in the city are scarce. Four nursing programs compete for the same acute care units, and one major partner has reduced student capacity by a third since it began using travel nurses, who do not precept. Every clinical hour in the curriculum must therefore be used well, and simulation must carry more of the learning.
Internal Forces
Learners. Accelerated students bring prior degrees, work experience and high motivation, and they are often older, with family and financial obligations and no income during a 16-month program that allows little room to work. Faculty describe them as strong in analysis and writing and impatient with content that repeats what they already know, but some struggle with the pace and with the transition from being expert in their first career to being novices again. A curriculum for these learners should build on their prior learning, move quickly through foundational content that can be learned independently and invest classroom and clinical time in application and judgment.
Faculty. The program has 14 full-time faculty, five of whom will be eligible to retire within four years, and relies on part-time clinical instructors for most clinical supervision. Several faculty have not worked with competency-based assessment. A curriculum that depends on intensive assessment of performance will need faculty development and realistic workloads.
Resources. The school has a well-equipped simulation center that is used at about half its capacity, a learning management system that can track competency assessments if configured to do so, and a university budget that will not fund additional faculty positions in the next two years. The resources favor a design that shifts learning toward simulation and makes better use of existing faculty time rather than one that requires more of it.
Mission. The university's mission emphasizes service to the region, and the school's strategic plan commits to increasing the number of graduates who work in the area's rural hospitals. Keating and DeBoor (2018) emphasize that the parent institution's mission and the program's own philosophy are internal frame factors a curriculum must reflect, not decorations added afterward.
Priorities for the Revision
Taken together, the forces set four priorities, ranked by how many forces point toward each. First, the curriculum must be organized around demonstrated competence, aligned with the Essentials' domains, because the accreditation standard, the practice partners and the licensure examination all require it. Second, clinical judgment must be taught and assessed in every course, not left to a capstone, using a shared model so that students hear the same language from the first semester to the last. Third, the curriculum must use clinical time strategically and shift more learning to simulation, because placements are scarce and the simulation center has capacity. Fourth, the design must fit accelerated learners, with independent learning of foundational content and class time for application. Every force in the analysis points the same direction: away from covering content and toward proving what a graduate can do.
The next module translates these priorities into program outcomes and a curriculum map, and the later modules design a course, write assessments, build an evaluation plan and propose the revision to the faculty.
References
American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education.
Dickison, P., Haerling, K. A., & Lasater, K. (2019). Integrating the National Council of State Boards of Nursing Clinical Judgment Model into nursing educational frameworks. Journal of Nursing Education, 58(2), 72-78. https://doi.org/10.3928/01484834-20190122-03
Kavanagh, J. M., & Szweda, C. (2017). A crisis in competency: The strategic and ethical imperative to assessing new graduate nurses' clinical reasoning. Nursing Education Perspectives, 38(2), 57-62. https://doi.org/10.1097/01.NEP.0000000000000112
Keating, S. B., & DeBoor, S. S. (Eds.). (2018). Curriculum development and evaluation in nursing education (4th ed.). Springer Publishing.
How this NUR 5233 Module 1 example is structured
NUR 5233 Module 1 typically analyzes the internal and external forces that shape a nursing curriculum; your classroom's instructions decide whether a named frame factors model is required. This example describes the program, analyzes external and internal forces separately with sources and local data, states what each force requires of the curriculum and ranks the resulting priorities.
NUR5233 Module 1 questions, answered
What does NUR5233 Module 1 usually ask for?
NUR5233 Module 1 typically asks you to analyze the internal and external forces that shape a nursing curriculum, such as accreditation standards, licensure requirements, community and employer needs, learners, faculty and resources. Your classroom's instructions decide whether a specific model is required.
Which standards should I cite for a BSN curriculum?
The current AACN Essentials and the standards of the program's accreditor, usually CCNE or ACEN, along with the licensure examination's framework. Cite the current versions.
How do I move from forces to curriculum decisions?
For each force, state what it requires of the curriculum, then look for requirements that several forces share. Those shared requirements become your priorities.
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