Journal of Gerontological Nursing

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Is Gerontological Nursing Included in Baccalaureate Nursing Programs?

Deborah R Malliarakis, MS, RN; Christine Heine, MS, RN, C, CNAA

Abstract

Do baccalaureate nursing programs include gerontological nursing content and clinical experiences in the curriculum, and to what extent? Do qualified faculty teach gerontological nursing to undergraduate nursing students? The findings from this and other recent studies suggest that there is a significant effort on the part of baccalaureate nursing programs to include gerontological nursing content and clinical experiences in undergraduate programs, and that there are more faculty with formal academic background in gerontological nursing.1,3

Can we then assume that this trend will continue? Should we be satisfied with the current status of gerontological nursing in baccalaureate nursing programs? This study indicates that there needs to be continued monitoring and evaluation as to the nature and* extent of gerontological nursing in undergraduate nursing programs.

CURRENT STUDY

Using the Curriculum Process Model developed by Torres and Stanton4 as a framework, baccalaureate nursing programs accredited by the National League for Nursing (NLN) in 1 1 Southeastern states were surveyed to determine the status of gerontological nursing content, clinical experience, and formal faculty academic background in gerontological nursing programs. The Curriculum Process Model includes four stages: directive, formative, functional, and evaluative. These stages are interdependent and provide a logical and systematic approach for developing or revising a curriculum.

In the directive stage, the total direction of the curriculum is set and the foundation for the development of all subsequent stages occurs. Components of this stage include the nursing curriculum philosophy and characteristics of the graduate. During the formative stage, curriculum design and requirements, level and course objectives, and content map are developed. The functional stage is the action stage, consisting of approaches to course content, teaching methods, and learning experiences related to each course. The evaluative stage, the last in the curriculum process, reviews the nursing curriculum. The evaluation is done by measuring the success with which graduates meet the end-of-program behaviors and through ongoing formative and summative evaluation of the students and faculty.

This study focused on the directive, formative, and functional stages of the curriculum of NLN-accredited baccalaureate schools of nursing. The diverse backgrounds in education and experience of the faculty members, especially those committed to a nursing specialty, strongly influence the outcome of the directive stage.4 Faculty with gerontological backgrounds influence the curriculum by encouraging gerontological nursing content. The formative stage was examined by identifying the specific gerontological content offered in the curriculum. Clinical settings used for gerontological experiences also reflect the functional stage. The Figure presents the Curriculum Process Model through which gerontological nursing curricula in baccalaureate schools of nursing was examined.

PROCEDURES

A self-administered questionnaire was mailed to the directors or deans of all NLN-accredited baccalaureate schools of nursing in 1 1 states located in the Southeastern United States. Of the 104 questionnaires mailed, 42 were returned and sufficiently completed, thus producing a response rate of 40%. The number of faculty members in all schools totaled 661 full-time and 125 part-time. The majority of schools had 200 or fewer enrolled baccalaureate students.

The questionnaire consisted of four components: information about the school of nursing; faculty background preparation; gerontological content and curriculum format; and clinical settings used specifically for learning experiences with older persons. The questionnaire's content and format was developed from a survey questionnaire used by the American Nurses' Association Council on Gerontological Nursing Practice; National League for Nursing Standards for Gerontological Nursing Curriculum; and Gunter's and Estes's gerontological nursing content outline for baccalaureate schools of nurs1.5.6 ing.

TABLE

MA(OR GERONTOLOGICAL NURSING CONTENTTOPICS INCLUDED IN BACCALAUREATE SCHOOLS OF NURSING CURRICULA*…

Do baccalaureate nursing programs include gerontological nursing content and clinical experiences in the curriculum, and to what extent? Do qualified faculty teach gerontological nursing to undergraduate nursing students? The findings from this and other recent studies suggest that there is a significant effort on the part of baccalaureate nursing programs to include gerontological nursing content and clinical experiences in undergraduate programs, and that there are more faculty with formal academic background in gerontological nursing.1,3

Can we then assume that this trend will continue? Should we be satisfied with the current status of gerontological nursing in baccalaureate nursing programs? This study indicates that there needs to be continued monitoring and evaluation as to the nature and* extent of gerontological nursing in undergraduate nursing programs.

CURRENT STUDY

Using the Curriculum Process Model developed by Torres and Stanton4 as a framework, baccalaureate nursing programs accredited by the National League for Nursing (NLN) in 1 1 Southeastern states were surveyed to determine the status of gerontological nursing content, clinical experience, and formal faculty academic background in gerontological nursing programs. The Curriculum Process Model includes four stages: directive, formative, functional, and evaluative. These stages are interdependent and provide a logical and systematic approach for developing or revising a curriculum.

In the directive stage, the total direction of the curriculum is set and the foundation for the development of all subsequent stages occurs. Components of this stage include the nursing curriculum philosophy and characteristics of the graduate. During the formative stage, curriculum design and requirements, level and course objectives, and content map are developed. The functional stage is the action stage, consisting of approaches to course content, teaching methods, and learning experiences related to each course. The evaluative stage, the last in the curriculum process, reviews the nursing curriculum. The evaluation is done by measuring the success with which graduates meet the end-of-program behaviors and through ongoing formative and summative evaluation of the students and faculty.

This study focused on the directive, formative, and functional stages of the curriculum of NLN-accredited baccalaureate schools of nursing. The diverse backgrounds in education and experience of the faculty members, especially those committed to a nursing specialty, strongly influence the outcome of the directive stage.4 Faculty with gerontological backgrounds influence the curriculum by encouraging gerontological nursing content. The formative stage was examined by identifying the specific gerontological content offered in the curriculum. Clinical settings used for gerontological experiences also reflect the functional stage. The Figure presents the Curriculum Process Model through which gerontological nursing curricula in baccalaureate schools of nursing was examined.

PROCEDURES

A self-administered questionnaire was mailed to the directors or deans of all NLN-accredited baccalaureate schools of nursing in 1 1 states located in the Southeastern United States. Of the 104 questionnaires mailed, 42 were returned and sufficiently completed, thus producing a response rate of 40%. The number of faculty members in all schools totaled 661 full-time and 125 part-time. The majority of schools had 200 or fewer enrolled baccalaureate students.

The questionnaire consisted of four components: information about the school of nursing; faculty background preparation; gerontological content and curriculum format; and clinical settings used specifically for learning experiences with older persons. The questionnaire's content and format was developed from a survey questionnaire used by the American Nurses' Association Council on Gerontological Nursing Practice; National League for Nursing Standards for Gerontological Nursing Curriculum; and Gunter's and Estes's gerontological nursing content outline for baccalaureate schools of nurs1.5.6 ing.

FINDINGS

Ten major content areas of gerontological nursing, with corresponding subtopics, were identified in the questionnaire. The majority (90%) of the schools of nursing responding to this survey indicated that all 10 major content areas were included in the curriculum. The Table presents the 10 topics in order of frequency. Cultural variations affecting health care of older adults and legal and ethical issues of aging were the two topics least identified as being incorporated in the nursing curriculum.

FIGUREA CONCEPTUAL FRAMEWORK FOR THE ANALYSIS OF GERONTOLOGICAL NURSING IN BACCALAUREATE SCHOOLS OF NURSING USING TORRES'S & STANTON'S CURRICULUM PROCESS MODEL

FIGURE

A CONCEPTUAL FRAMEWORK FOR THE ANALYSIS OF GERONTOLOGICAL NURSING IN BACCALAUREATE SCHOOLS OF NURSING USING TORRES'S & STANTON'S CURRICULUM PROCESS MODEL

Each of the 10 major gerontological nursing topics included corresponding subtopics. More than half of the gerontological nursing subtopics were included by a majority of the schools in this study. The subtopics relating to assessment and legal issues of older adults, were included least in the curricula for diese schools. Integration of gerontological nursing through required courses was the most prevalent format used in the baccalaureate nursing curricula.

Clinical settings used by baccalaureate schools of nursing for specific experiences with older clients were primarily hospitals, nursing homes, and home health agencies. Clinical settings that focus on the well elderly, such as adult day care centers and senior centers, were used by approximately 74% (31) of the respondents; however, the * majority of clinical hours was reported for hospitals, nursing homes, and home health agencies.

Twenty of the 42 schools reported that none of the faculty teaching gerontological content or clinical courses ^j had a formal academic background in gerontological nursing; only 25% (48) of the 197 faculty teaching gerontological nursing had formal academic backgrounds in it. Eight percent (16) had ANA certification in gerontological nursing or as a gerontological nurse "* practitioner.

CONCLUSION

Nurses are responsible for providing quality health care for older clients. To do this, they must have an educational base in gerontological nursing. Baccalaureate schools of nursing prepare graduates to practice as generalists in gerontological nursing. Review of the literature reveals that the status of gerontological nursing content, faculty preparation in gerontological nursing, and clinical settings used for gerontological experiences in baccalaureate schools of nursing have improved over the last 10 years. However, they are not at a level that would provide the needed educational background for students in caring for the older client.

The results of this study support the findings in the literature. It is imperative to encourage the inclusion of gerontological nursing content in all baccalaureate programs and to strengthen it through direct changes in the nursing curriculum. Nurse educators in bacca- 4 laureate schools of nursing are responsible for ensuring the presence of gerontological nursing content throughout the curriculum.

The Curriculum Process Model4 provides a systematic and organized approach to developing or revising a nursing curriculum. The four stages of the curriculum process (directive, formative, functional, and evaluative) can ensure that gerontological nursing is incorporated in the curricula beginning with the philosophy of the program and ending with an evaluation of how graduates improve their care of elderly clients.

This study did not address the following components of the Curriculum Process Model: philosophy of the school, level and course objectives, teaching methodology, and validation of learning in relation to gerontological nursing content. Rüther research is needed to provide insight into the specific gerontological content that is being taught, the amount of time spent on the content areas, who is teaching the content, how and where the content is presented within the curriculum, the nature and extent of clinical experiences in gerontological nursing, and the outcome of teaching gerontological nursing to undergraduate nursing students.

Ongoing studies are necessary to monitor the progress toward incorporating gerontological nursing in baccalaureate schools of nursing. Improving the quality and quantity of gerontological nursing content through ongoing research will directly affect the quality of nursing care for the older population.

Table

TABLEMA(OR GERONTOLOGICAL NURSING CONTENTTOPICS INCLUDED IN BACCALAUREATE SCHOOLS OF NURSING CURRICULA*

TABLE

MA(OR GERONTOLOGICAL NURSING CONTENTTOPICS INCLUDED IN BACCALAUREATE SCHOOLS OF NURSING CURRICULA*

REFERENCES

  • 1. American Nurses* Association. Gerontological Nursing Curriculum: Survey Analysis and Recommendations. Kansas City, Mo: Author; 1986.
  • 2. Edel MK. Recognize gerontological content. Journal of Gerontological Nursing. 1986; 12(10):28-32.
  • 3. Hogstel M. Gerontological nursing in the baccalaureate curriculum. Nurs Ed. 1988; 13(3): 14- 18.
  • 4. Torres G. Stanton M. Curriculum Process in Nursing. Englewood Cliffs, NJ: PrenticeHall; 1982.
  • 5. Gioiella EC. Gerontology in the Professional Nursing Curriculum. New York: National League for Nursing; 1986.
  • 6. Gunter LM, Estes CA. Education for Gerentic Nursing. New York: Springer Publishing Co; 1979.

TABLE

MA(OR GERONTOLOGICAL NURSING CONTENTTOPICS INCLUDED IN BACCALAUREATE SCHOOLS OF NURSING CURRICULA*

10.3928/0098-9134-19900601-04

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