Evaluation of how a curriculum change in nurse education was managed through the application of a business change management model: A qualitative case study

Effect of national curriculum reform on medical students' preparedness for practice: a prospective cohort study from undergraduate to postgraduate periods

BACKGROUND

In recent years, a national curriculum reform was implemented in undergraduate medical education in Taiwan to reduce clinical rotation training from 3 years to 2 years. The last generation of the old curriculum and the first generation of the new curriculum both graduated in 2019. This study aimed to compare the learning outcomes of the medical students in these two curriculum groups in terms of preparedness for practice during the transition from undergraduate to postgraduate study.

METHODS

This was a 3-year prospective, longitudinal, comparative cohort study between 2017 and 2020. Medical students from both the 7-year and 6-year curriculum groups received biannual questionnaire surveys starting 18 months before graduation and running until 11 months after graduation. The measurement tools were the Preparedness for Hospital Practice Questionnaire (PHPQ) and Copenhagen Burnout Inventory (CBI). Personal demographic information was also collected. Linear mixed models were used to determine the effect of curriculum change on learners' preparedness and burnout levels.

RESULTS

A total of 130 medical students from the two cohorts provided 563 measurements during the study period. Compared to their counterparts following the old curriculum, the participants following the new curriculum showed a lower level of preparedness when first entering clinical rotation (p = 0.027) and just after graduating (p = 0.049), especially in the domains of clinical confidence (p = 0.021) and patient management p = 0.015). The multivariate linear mixed model revealed gradual increases in preparedness and burnout in serial measurements in both curriculum groups. Students following the new curriculum, which involved a shortened clinical rotation, showed a slightly lower overall preparedness (p = 0.035) and the same level of burnout (p = 0.692) after adjustment. The factor of year of change did not show a significant effect on either preparedness (p = 0.258) or burnout (p = 0.457).

CONCLUSION

Shortened clinical rotation training for medical undergraduates is associated with a decrease in preparedness for practice during the transition from undergraduate to postgraduate study. Clinical confidence and patient management are the main domains affected.

Comprehensive initial evaluation of an innovative yearlong population health internship for undergraduates

BACKGROUND

The innovative Population Health Internship (PHI) addresses the evolving need for baccalaureate-prepared nurses to achieve population health competency. A comprehensive evaluation of the inaugural year of the PHI was conducted using the Centers for Disease Control and Prevention (CDC) Framework for Program Evaluation in Public Health and the Context, Input, Process, Product (CIPP) curricular evaluation model. Students and community agency partners-both key stakeholders-contributed to the evaluation.

METHODS AND RESULTS

Quantitative data were used to address functional and outcome areas of the PHI for purposes of PHI logistics, student learning gains, and program impact and sustainability. Qualitative data were used to provide insights into challenges in instituting curricular change, complexity in student-agency communications, importance of student preparedness/attitude, issues of role confusion, misperceptions about the population health nursing role, student learning, and impacts on partner agencies and their populations.

IMPLICATIONS

Educational implications include the importance of assessing both learning gains and student buy-in, the need for a long-term evaluation approach to accommodate for challenges related to radical curriculum change, and the importance of strong stakeholder support to facilitate mutually beneficial relationships and a positive learning experience.

Evaluation of how a real time pre-registration health care curricula was managed through the application of a newly designed Change Management Model: A qualitative case study

BACKGROUND

Curricula change in nurse education is of international importance. The pace of such change has been continuous and has triggered criticisms of inadequate preparation of practitioners. There are no change formulae for managing curricula change and despite a raft of change methods, globally change success remains low. A lack of a unified voice, undue focus on cognition, and arguably no existing models for academia and a literature gap contribute to change challenge. A new Change Management Model designed from research with emotion as its underpinning philosophy is evaluated.

OBJECTIVE

Evaluation of a newly designed Change Management Model through a real time pre-registration health care curricula change.

DESIGN

A qualitative case study was adopted. The single case study was the new pre-registration health care curricula.

SETTING

This study took place in a Faculty of Health and Social care in one HEI in the UK.

PARTICIPANTS

Four senior academics and fifteen academics across professions and specialisms involved in the curricula change took part in the study.

RESULTS

The findings suggested that leadership operated differently throughout the organisation. Distributive and collective leadership created a critical mass of people to help deliver the new curricula but academics felt excluded at the strategic level. Emotion at the strategic level inhibited innovation but boosted engagement, emotional relationships and creativity at the operational level. Face to face communication was favoured for its emotional connection. A top down approach created an emotional disconnect and impacted inclusiveness, engagement, empowerment, vision and readiness for change.

CONCLUSION

Testing the new model widely not only in organisations, practice and team changes but personal change in improving health and wellbeing could be beneficial. The continuing gap in knowledge on the link between emotion and curricula change, practice and organisational change and therapeutic value of the model also warrants further research.

Designing programmes of assessment: A participatory approach

Programmatic approaches to assessment provide purposeful and meaningful assessment yet few examples of their development exist. The aim of this study was to describe the development of a programme of assessment using a participatory action research (PAR) approach. Nine work-based assessors together with three academics met on six occasions to explore the current approach to competency-based assessment in the placement component of a dietetics university course, the findings of which were used to design a programme of assessment. Findings revealed disconnect between current assessment approaches and best practice. The PAR methodology fostered a shared vision for the design of a programmatic approach to assessment and strong leadership was essential. Participants experienced a philosophical shift in their views towards assessment, supporting the implementation of a new assessment programme. This paper is the first to describe a PAR approach as a feasible and effective way forward in the design of programmatic assessment. The approach engaged stakeholders to strengthen their abilities as work-based assessors and produced champions for best practice assessment.