Foundations of Nursing Education

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Foundations of Nursing Education

 1.1 Introduction

Nursing profession is essential for any nation that has the prospects of providing quality healthcare to its citizens. Meeting the prospects will require the change of nurse training from ADN program to a BSN. Although the nursing degree is not the only requirement for nurses, it helps the students to pursue other relevant disciplines such as financial management, leadership, quality standard improvement, and systems thinking, which form the prerequisites for quality healthcare. Also, the BSN program will prepare students in practical skills of research, team building, and partnership in nursing, aspects that are not integrated into the Associate degree program (Washington-Brown & Ritchie, 2014). Furthermore, the increasing demand for healthcare provision has seen nurses called upon to take lead in coordination efforts during an emergency thus calling for nurses to have the required competencies for the tasks, many of which are incorporated in the BSN program.

1.2 Justification for the BSN Program

1.2.1 Need for Program

Provision of care in health facilities is experiencing a paradigm shift from simple to complex cases which require nurses to have critical thinking capacities in terms of care for complicated cases. Such cases rely on the use of sophisticated technology coupled with comprehensive complex knowledge in systems operations; skills that are not taught in associate degree program hence the need for trainee nurses to enroll in BSN programs.

Healthcare provision outside the health facilities has continued to be complex and nurses called upon to lead teams of healthcare professionals in assisting the society in addressing ailments and prevention of chronic diseases (Benner, Sutphen, Leonard & Day, 2010). Therefore, it is essential for the nursing program to be shifted from an associate degree to a bachelorette degree so that nurses may be more equipped to meet the increasing demands.

Moreover, most health organizations prefer absorbing students with a BSN at entry levels due to the perceived skills they seem to possess as compared to their counterparts with an associate degree in nursing. This, therefore, means that the former will secure jobs as the latter remain unemployed for a better period. Avoiding such scenario calls all trainee nurses to pursue the BSN program to increase their probability of securing employment upon completing their training.

1.2.2 External Factors

The general society is going through various tremendous changes that impact on nursing students, nurse educators and those already practicing the nursing profession. Nursing care is changing to complex state as the role of nurses become highly demanded thus calling upon nurses to take part in decision making as well as in policy formulation on matters of the nursing profession. There is a need for nurses to be efficient and effective in learning how economic, social and political factors influence nursing practice (Payne, Glaspie & Rosser, 2014). The training ought to equip learners with the knowledge and skills that will help them to competently address the changes experienced in patients. Furthermore, nurse trainers need to be vigilant in understanding the changes and incorporating them into the curriculum. On the other hand, nurse trainees also need to be aware of the emerging issues in nursing practice and how they influence healthcare outcomes. They should not just know the changes but also integrate them into the practice.

Social factors

The American population just like any other population is undergoing significant changes in social aspects. The dynamics have negatively impacted on the healthcare fraternity hence the need to have a holistic nurse training program that will help nurses address the changes. The citizens’ lifespan is on the rise due to health promotions on adoption of positive lifestyles (Masaki, Nagae, Teshima & Izumi, 2012). People are living longer with a resulting rapid increase in the number of the elderly. Most of the elderly live with various diseases, disability, and substandard conditions. Such individuals need comprehensive care that has a specific geriatric approach which the current associate degree holders may not have hence the need to have a BSN program.

Furthermore, America has received a number of immigrants from the war-torn continents such as Africa, Asia, and Europe, a factor that has contributed immensely to various social consequences. The ethnic diversity of the immigrants with the locals leads to vices such as disrespect, conflict over resources, abuse and violence (Ana, 2016). These challenges call for a nursing program that will enable learners to have an understanding of cultural diversity as well as the health values of each community with the aim of addressing the challenges. The nurse trainers need to incorporate tolerance and cultural aspects in their training curriculum.

Also, the number of people living in poor conditions as a result of increasing population coupled with unemployment is high. Such populations experience hunger and chronic illnesses. There is, therefore, the need for nursing students to enroll in a BSN program which is comprehensive enough to train them on skills on providing healthcare to special groups in the community. Cases of domestic abuse on women and children are on the rise in homes, learning institutions and places of work. The rise is attributed to substance abuse, mental problems and unending societal problems that trigger violence. The problems cause a health risk to nurses, patients and the community as a whole. The challenges require well-trained nurses who have the capability to care for patients with mental problems and also with the capability to carry out a successful health promotion to affected individuals.

The United States is experiencing numerous incidences of obesity with significant effects on healthcare practice and national growth. It results in health problems such as high blood pressure and cardiovascular challenges with a long term effect on the strain of resources (Hemphill, 2018). It is therefore vital for healthcare providers to train on consequences of obesity and its prevention. A BSN is an appropriate program to help in minimizing the occurrence of lifestyle diseases as it trains learners on dietary aspects using a comprehensive approach.

Lastly, population expansions more so in urban areas as well as disasters such as floods and earthquakes have precipitated the need for more nurses with the ability to address effects of such hazards as well bringing victims to normalcy through a well-prepared recovery process. This calls for a need to have a BSN program that trains nurses on essential of responding to a disaster such as prevention, preparation, management, and recovery.

Institutional factors

The nursing profession is a discipline that is not controlled by the educational centers providing the training but by legal institutional entities. The institutions evaluate the relevance of the curriculum offered in addressing the current challenges and recommending adjustments where necessary. Bodies such as Institute of Medicine, Commission on Collegiate Nursing Education and Accreditation Commission for Education in Nursing have the sole mandate of advising and regulating the nursing education and ensuring that it is in line with the societal demands. The bodies will recommend the conditions to be met by the centers that opt to offer BSN such as the number of nursing educators required, physical facilities in schools and the guidelines to be used in offering the BSN program.

1.3 Recommendations to Guide Quality and Safety Initiatives

The Institute of medicine

The Institute of medicine is a section of the national academics of medicine that operates under the broad umbrella of the nonprofit organization. It has aided in improvement in the standards of nursing and medical training curriculum through the provision of independent and objective advice to the medical fraternity. It is involved in policy formulation as well as decision making on matters concerning health. It assists the government and those in private sectors to come up with a sustainable and appropriate medical training that is aligned with the changing economic, political and social aspects of the society (IOM, 2010). The Institute of medicine has significantly influenced the decision of putting the BSN in place through its analysis of pertinent issues that affect the nursing profession.

In its assessment, the institute realized that a number of people had no access to quality care due to inadequacies experienced in the associate degree nursing program whose products were the practicing nurses. The institute, therefore, suggested a system that will allow all the public to access quality healthcare. The institute believes that appropriate healthcare is that which promotes wellness, improves health outcomes and provides care that is compassionate to all population regardless of the life stage (Dzau, 2015). The institute will influence the decision to conceptualize the responsibilities of nurses within the entire labor force by ensuring that shortage, community challenges, current, and future technology are incorporated in the curriculum to be used in the BSN program. This will not only allow the nurses to be trained on medical knowledge but also on technical skills and cultural aspects that will make them competent in the delivery of services in the dynamic society. Secondly, IOM was dissatisfied with the number of nurse training institutions. It, therefore, influenced the proposal of developing a BSN program that will expand the faculty of nursing, increase the capacity of nurse educators and redesigning nursing education to ensure that it fills the gap in nurse shortage. IOM has done several surveys as well as assessing patient satisfaction in health facilities and developed innovative solutions related to care delivery that it proposes they be incorporated in the nursing profession.

IOM’s Recommendations

In its efforts of ensuring that the nursing profession is relevant to the changing societal needs, IOM made a number of recommendations in terms of how the BSN program should be designed. IOM suggested that nurses should fully put their educational training in practice and help address the health challenges that the public is facing.  Nurses are capable of leading innovative mechanisms to make the healthcare system better. However, a number of barriers such as fragmented healthcare system, high rates of nurse turnover, difficulties encountered in the transition from nursing schools to nursing practice, aging labor force and demographic challenges have limited the nurses’ ability to exploit their potential (Masaki, Nagae, Teshima & Izumi, 2012). These limitations have developed due to flaws in the associate nursing degree program, unfavorable work environment, lack of political goodwill and the changing societal makeup.

Furthermore, different variations are seen in the scope of practice in the nursing profession. Some states have a detailed practice while others contain vague provisions of the health system that allow nurses to examine the patient’s health status as well as prescribing medications without consulting a physician. As a result, nurses’ roles in healthcare facilities varies greatly depending on their ability, training they received and the regulatory mechanisms in states they work. Nurses ability to make full use of their training will be possible if the barriers are removed as well as training them on successful transitions strategies from training to practice.

The second recommendation of the IOM is that nurses should be given an opportunity to achieve a high level of training through a restructured and well-programmed education system that does not hinder seamless academic progression (Grabois & Institute of Medicine, 2012). Major dynamics experienced in the health system demands adjustments to be made in the training of nurses to enable them to address the changes. The education system should be modified to offer quality skills that will allow future nurses to deliver quality care that has a holistic approach. Nurses have to go through the competency and evidenced-based training offered at higher levels of nursing to enable them to practice in the changing world. Nurses are called upon to use sophisticated technologies, address challenges affecting special groups in society as well as taking part in policy and decision making in health matters. These aspects require them to receive a higher level of training rather than possessing an associate nursing degree. One strategy of realizing this recommendation is for a significant number of nurses to enter the workforce in possession of a baccalaureate degree or advance to this level in the later stages of their career.

IOM also recommended that nurses should work in partnership with physicians and other healthcare professionals in ensuring that the healthcare system gets a new look (Grabois & Institute of Medicine, 2012). Competent leadership is essential for the realization of a transformed care system. For the nurses to play an active role towards the achievement of this vision, the nursing institutions should strive at training the nursing students on leadership management courses to enable them to take leadership roles in the healthcare system. The partnership calls the nurses to be responsible and contribute ideas which will bring the desired transformation in the health system. Being a full partner will require nurses to have leadership and competency skills that must be applied in the practice. In care environments, full partnership entails taking responsibility in establishing problems, designing and implementing a plan to make the situation better, tracking the improvement and putting in place necessary adjustments to realize the expected goals. Higher educational training enables nurses to take part in policy formulation, an aspect that allows them to look at policies as something they can shape rather than something that is enforced on them. Ensuring that nurses take up leadership roles will mean the change in nursing curriculum to integrate leadership-related competencies. They must practice the competencies in both private and public settings, within and outside the nursing discipline.

Achievement of higher education by nurses requires the education system to make a number of adjustments in its current system. More nurse training institutions should be developed to allow for more enrollment of students. Also, more nurse educators should be recruited to cater for the increasing number of nursing students and reducing fees paid through the implementation of subsidy incentives.

Lastly, IOM recommended appropriate strategies to be put in place for better data collection mechanisms and a good communication structure to allow for effective workforce planning and policy making (Grabois & Institute of Medicine, 2012). Achieving required healthcare standards requires a balance of skills and perspectives among health professions. However, strategic workforce planning is limited by a lack of reliable data on the number of nurse training institutions available, a number of BSN trainees enrolled in each center and also the number of nurse professions employed and practicing the profession, where they are employed, their working capacities capacity as well as the roles they play. The data will be relevant in designing policies as well as planning for the workforce.

1.3.1 Rationale for Selection

My rationale for the recommendations is based on a number of reasons: there are changes in terms of demography, economy, societal and political aspects hence the need to revolutionize education system to train learners on addressing the challenges that come with the changes. IOM recommends improved education level which is a good strategy that will help address the challenges. Also, the IOM recommends the involvement of nurses in decision making and policy formulation. The recommendation when implemented will boost nurses’ morale of working as they would feel to be part of the whole system of healthcare. Lastly, the IOM recommendations value the role of workers in the health system. It encourages nurses to take up leadership roles which would enable them to be active participants of health care transformations as well as enabling them to have a say in restructuring the system based on needs that arise.

1.3.2 Barriers to implementation of IOM Recommendation

IOM recommendations are appropriate in ensuring a healthy society with an adequate number of nurse professions who possess relevant competencies to address the patient care needs. However, implementation of the recommendations will be hindered by the nursing faculty shortage experienced in various institutions of higher learning in the nursing profession. Most of the institutions lack adequate nurse educators to provide practical training to those enrolling in the field. According to the American Association of Colleges of Nursing (AACN), Universities reported having turned away 78,089 qualified candidates for nursing in 2013 due to a limited number of instructors.

Faculty shortage is a problem that develops due to various reasons: Nursing instructors tend to retire at an average age of 64.4 years. The aging aspects leave vacant positions which take time to be filled. It also means that nurses do not serve as faculty members long enough to build meaningful and competent nurses in the departments before their departure, a factor that leaves the faculty with young members who lack experience in addressing some of the complex issues in the nursing profession. Also, the institutions of learning have limited resources which do not meet the enormous demand for nurses. Lack of professors, equipment and inadequate funding to hire new faculty members will limit the implementation of IOM recommendations that highly depend on resources for their successful execution (Geys & Sorensen, 2016). Lastly, the faculty shortages result in poor remuneration of practicing nurse educators. They lack morale to work for the little pay that does not match the changing economic demands. The educators, therefore, opt to engage in other incoming generating activities such as carrying out business or diverting to other professions that are more satisfactory.

1.4 Argument

Learning theory

The new BSN program requires learning that enforces on critical thinking skills to enable learners to use their training experience and integrating them in societal aspects. Various learning theories have been developed by different theorists. The theories describe ways in which learners absorb, process and retain the knowledge acquired. The learning process is in most cases influenced by cognitive, emotional and environmental influences as well as having a prior experience (Taylor & Hamdy, 2013). One notable theory is the Constructivist Learning Theory that is likely to have a significant influence on the BSN program. It operates on a student-centered approach principle rather than instructor-centered approach. The theory encourages learners to relate information gained in class to their life experiences and designing solutions to emerging problems rather than having a fixed response that may not be appropriate in solving the challenge (Thomas, Menon, Boruff, Rodriguez & Ahmed, 2014). The theory, therefore, expects learners to create an answer based on their critical analysis of the problem. Constructivism avoids direct instruction and allows instructors to guide students in discovering new knowledge on their own. This theory encourages a number of aspects; students should be active participants in the learning process rather than writing notes and that the learning environment should be democratic in nature allowing learners the freedom to air out their viewslearning(Taylor & Hamdy, 2013). The BSN program requires a learning approach in which goals are well stipulated and learners given room to establish the strategies they would put in place to meet the goals. The nursing professions ought to model, coach and scaffold to make activities interesting and engaging rather than being overly structured. The new BSN program has a holistic approach to patient care. Due to the changing societal needs that arise from terror attacks, gender-based violence, poverty, and criminal activities, a number of cases that require highly specialized health care are on the rise. Addressing the problems calls for nurses who will critically think over the problems reported, integrate them in their training and critically think of methods of addressing the problems. Also, there is an increase in cultural diversity as a result of immigration and displacements. This comes with health-related challenges which require health care professionals that will design the health strategies to adopt in dealing with the issues. The constructivism theory is appropriate to the new BSN program in a number of ways. It will give room for learners to establish the individual patient needs rather than relying on one offered in class which is not comprehensive as well as not touching on the specific health concern that faces patients. Also, the BSN program will not impart knowledge to learners in all cultures. This will call upon the nurse trainees to use constructivism theory to research on cultural diversity in terms of values and beliefs thus providing a patient-centered approach to care.

1.4.1 Theory Critique

The Constructivist theory has various benefits for the new BSN program. If applied, it will place more emphasis on sensory input, an aspect that has been overlooked by other theories that have been used in educating nursing students. It will be appropriate for students with special learning needs such as disorders in sensory processing or Autistic spectrum. Though some of these special students have brilliant minds, the other approaches to learning have not been successful in reaching to them. Using the Constructivism approach in the BSN program, the nurse educator will guide and encourage them to participate in the learning process rather than involving them in dolling out information to them.

The significant disadvantage with constructivism is lack of lesson structure. Some learners will require a well-designed structure with a fixed curriculum for them to excel. Constructivism in the BSN program will call for the teacher to disregard the predetermined and standardized curriculum and adopt strategies that are in line with the learners’ needs (Thomas Etal, 2014). This will make some students fall behind others. Also, constructivism requires students to form relationships with the external environment outside classroom learning in search of information. The approach may not work with BSN learners who will prefer instructor-centered approach rather than the learner-centered approach that expects them to do more of research on their own within the external environment

1.5 Key components

Educational philosophies

The learning process involves the integration of aspects to be learned in the proposed philosophy to aid in better delivery and attainment of the targeted goal. Selection of the philosophy to adopt depends on the age of learners, their preference as well as the content to be delivered by the instructor (Freeman, 2014). The new BSN program entails the selection of a philosophy that will be appropriate for the implementation of the recommendation of the various stakeholders such as AANC, NLN, QSEN, and IOM. Most of the learners enrolled in the BSN program are young adults and middle-aged people whose opinions, experience and knowledge ought to be incorporated in the learning process. This calls for a critical andragogy philosophy that is appropriate in the integration of adult needs in the learning process. In the dynamic world coupled with career options and technical advancements, more adults are realizing the need for educational training hence, their choices of enrolling in nursing programs.

The development of the new BSN program will require an educational philosophy that is appropriate for adult learners who require to be fully engaged in learning. One such philosophy is the andragogy that emphasizes self-directed learning. The philosophy will be appropriate in the new BSN program due to different reasons. Most of the learners enrolling in BSN programs are those with deeper knowledge in nursing obtained from the former associate degree program. They have therefore adopted learning and life experiences that will form a basis on what they want to learn in the new BSN program, especially aspects that were not captured in the associate degree. It could be positive or negative experiences. The positive experiences will help them in borrowing from it and making the program successful. Negative experiences will mean that the learners use the new BSN program to bring adjustments so that mistakes done earlier on are not repeated.

Also, the BSN program will enroll adults who are self-directed and ready to learn. Andragogy philosophy will enable them to seek answers to specific challenges they want to know rather than fixing their learning on already prepared curriculum that may not match their learning needs (Freeman, 2014). It will, therefore, be appropriate for life changes that will stimulate the learners to find out how to address the dynamics. Also, the philosophy recommends the involvement of learners in the planning and development of the instructional materials. Giving them a voice in preparing what they will learn will keep them engaged and have feelings of being participants in the program. Engaging them in the evaluation of the program will also enable them to give feedback on areas that need improvement in the program, making the BSN a successful program.

Unlike other philosophies of education, andragogy focuses on the relevance of the program in meeting learner needs and solving emerging challenges (Lubin, 2013). Due to the changing societal needs, andragogy will be an appropriate philosophy in the new BSN program as it will give the learners an opportunity to incorporate the changes in their learning. This will aid them in the acquisition of knowledge and skills relevant in addressing the current challenges rather than using an already prepared rigid program that cannot be used in dealing with the current changes.

Furthermore, there are already identified problems in the society that the previous associate degree in nursing failed to address. The rising societal challenges such as gender-based violence and disaster will require a philosophy that is problem centered and not that which has a general approach in churning out knowledge. Therefore, appropriate implementation of the proposed BSN program will require andragogy approach which is open to opinions from both learners and tutors.

1.5.1 Philosophical Approach Critique

The critical andragogy philosophy of learning is of significant advantage in the new BSN program. Its ability to incorporate learners in the learning will give nursing trainees an opportunity to be involved in the formulation of the curriculum that best fits their learning experiences. This will entail establishing the challenges that society is facing and designing the curriculum in a way that addresses the challenges. Also, the learners’ past experience will be put on the foundation of learning making learning enjoyable through the exchange of knowledge based on the experiences received.

However, philosophy has a limitation that may limit the timely and appropriate implementation of the program. The philosophy requires all learners to give views on how they feel the program should run and what should be incorporated in the program (Loeng, 2018). Consulting each individual learner may be time-consuming thus delaying the execution of the program. Also, learners have diverse experience which according to the philosophy should form the basis of learning. It is therefore difficult to develop a curriculum that is inclusive of the experiences of learners since it may have a lot of content that could not be completed within the stipulated four-year period. Also, incorporation of the experience of learners in the teaching curriculum could make the course lose meaning and disinteresting since one’s experience may not be relevant in addressing the challenges faced by the other learner. The benefits and shortcomings that come with andragogy approach should be critically evaluated by the stakeholders to establish which learning outcomes are expected from the BSN program so that relevant learning objectives may be incorporated in the training.

1.6 Modalities of Delivery of the new BSN Program

Different delivery modes are employed by instructors in teaching. The choice of which mode to use depends on the complexity of the subject matter as well as the willingness of the learner to accept the mode. BSN program is a complex course in terms of its comprehensive theoretical coverage as well as the technicalities involved regarding the use of medical devices. It, therefore, calls for the use of more than one delivery mode to enhance a competent delivery of the knowledge and skills as well as in meeting the different delivery mode preferences of the learners. The two notable delivery modes appropriate for the current BSN are traditional classroom and online education modes.

1.6.1 Justification for Selected Modalities

Traditional classroom method entails the imparting of knowledge and skills through face-to-face interaction in a classroom setting. The students are taught the same subject matter controlled with the same grading criteria that gauge students’ IQ. This technic is appropriate because students’ performance is gauged against the set standards and only allowed to move to the next level upon satisfaction that they have excelled in the previous levels (Compton, 2014). The traditional classroom delivery mode has various benefits that make it the best fit for the BSN program.

The face to face aspect will allow full interaction between the nursing trainees with their tutor as well as their peers. This will create learning that promotes productivity since learners will ask questions or seek more clarification on concepts they did not understand thus facilitating participative learning. Also, it will allow students to hold discussions and solve complex tasks. Furthermore, the traditional system requires students to attend classes on specified days or times. Gathering together under the guidance of an instructor will enhance the sharing of experience and challenges they face. Possible solutions to the challenges will be sought and nurse trainees will gain the required competency in solving the challenges they encounter. The traditional classroom model has a fixed timetable that must be followed by students. This will train the BSN students to be responsible for managing time, a factor that is observed in their future nursing practice. In the nursing practice, for instance, there is a shift in daily duties and nurses are expected either to leave or assume duties at specific times. The mode also emphasizes on punctuality and discipline, very essential traits in the nursing practice (Compton, 2014). Arriving at school in time, having time slots for each topic and availability of recess time and off timings are preplanned and are done based on routine. This will give the BSN learners and instructors a feeling of uniformity and early preparation of what they should expect in their future practice. Training nurses on time schedules in nursing schools will be vital as they will pass the experience they attain in their nursing practice. The traditional model also equips learners with a wide scope of knowledge as compared to other delivery modes. The nursing students in the BSN program will get a chance of learning technical, social and sporting skills relevant to their future field of practice. The teachers will be the main source of information but coupled with the andragogy technics, learning will be broad-based and very inclusive of learner needs. The teachers will equip knowledge to the BSN students as well as help them in solving challenges they might have encountered in their daily interaction with society.

Online learning will also be relevant to the training of BSN students. It is electronically supported learning that depends on the internet for the interaction of the students and instructors as well as the distribution of learning materials. Students have the advantage of turning anywhere with internet access and electricity to pursue their learning without physically meeting the instructors. Online mode of delivery is appropriate for the BSN programme in different ways. It lowers the learning costs on the part of the learners since there are no commuting costs and expenses incurred in the purchase of textbooks and other learning materials since all can be accessed online. BSN students will, therefore, be in a position to save money for future use such as enrollment in masters of nursing programs.

Furthermore, online learning is convenient and flexible for BSN students. The online course gives the learners the opportunity to plan for their study time rather than the students being subjected to follow the laid down routine (Tannenbaum & Van, 2018). Students study at the time convenient for them hence provides them with chances of pursuing other complementary courses. Also, students get time to work and raise tuition fees, an aspect that reduces the discontinuation of studies that arise to the inability of students to raise fees. Lastly, the online studies will allow for learners to fully play their family roles while pursuing their studies. This leads to continued family bonds and unity at the same time when learners are being equipped with professional knowledge and skills.

1.6.2 Delivery Mode Barriers

Though the two barriers carry various advantages that make them suitable for training the BSN students, they have a number of limitations. For instance, the traditional classroom model does not incorporate the aspect of segregating learners with learning disabilities from the rest of the students, something that is not practiced in most classroom settings. This is because the method encourages inclusivity and open dialogue about differences in abilities, cultural affiliations, and needs. Though the inclusivity aspect is essential, it might not be appropriate for the learners who need special attention thus being left out in knowledge acquisition (Compton, 2014).

The traditional classroom method is appropriate only in institutions with enough physical resources as well as adequate instructors. Most of the nursing schools face challenges in adopting this method since they lack enough classrooms, learning materials, and adequate staffing. Public institutions have a problem in terms of funding hence cannot smoothly run this mode of delivery. Also, the faculty shortage is a hindrance to this delivery mode. Inadequate staffs, as well as instructors shifting to other careers, limit the ability of institutions to competently use this mode in teaching.

Online learning too, faces hindrances that limit its adequate use. This mode of delivery requires competent technological skills on the part of learners. This makes some of the BSN students hesitant in leaping into eLearning because they feel they lack the skills and experience the technologies used in the delivery mode. Past experiences with online learning have posed a great challenge in embracing this mode of study by the students. Some of the technologies delay communication between instructor and learners. For instance, poor network connectivity during exam time is reported to have led some students to fail to take exams. Also, technology breakdown is claimed to have caused some of the students to delay sending assignments to tutors leading to their expulsion from the program (Tannenbaum & Van, 2018). Such experience may influence potential users from adopting this mode of learning. Lastly, this mode of delivery is limited in course coverage. Learners are not fed on enough knowledge like it is done in the traditional classroom. Leaners lack physical interaction with instructors hence lacking the close guidelines that the BSN program demands.

1.7 Assessment in BSN

Assessment is essential for any earning process as it allows the students and instructors to monitor the progress of the learning process to establish where they are on track towards achieving the objectives. Achievement of the BSN objectives will call for the instructors to carry out close monitoring of the students to establish the degree to which they are understanding the concepts. The assessment of the BSN students can be approached in two different ways: Use of formative and summative techniques.

1.7.1 Benefits of Formative Assessments

The approach will be used in the course of learning to establish the struggles, learning difficulties and gaps that the BSN students will be facing as the learning progresses. It will be used throughout class activities or course to check students’ progress and will seek to improve student achievement of the objectives in learning through the use of techniques that are specific to children needs (Theal and Franklin, 2010). It targets to reshape learners into filling loopholes that exist through helping them understand concepts that they find hard to understand (Trumbull and Lash, 2013). It will involve short quizzes and application assignments that do not add up to their final marks.

Formative assessment will have a number of benefits in the evaluation of students’ progress. It will not be graded and this will help take away anxiety from the students. It will instead serve as practice for students aimed at granting them the assistance they need. They will help establish the degree to which students have understood by the assessment of the feedback from the tests, assignments, and projects. Any gap will be approached by the instructor using a simple approach to ensure that the learning objective is achieved. Furthermore, it is beneficial since it will avoid time wastage on activities that are not useful to learners. In the course of learning, the instructor will evaluate the effectiveness of the learning tools used in meeting the learning needs of the learners. Techniques that are not relevant will be eliminated immediately and appropriate techniques employed thus preventing incompetent techniques from being used.

1.7.2 Benefits of Summative Assessments

The BSN instructors will adopt summative assessment in evaluating the extent to which learners have understood the concepts. It will be carried out at the end of the course through issuance of final exams that include final project and a recital which will be marked against standard criteria. The exams will be graded to form the final mark of the students in that particular course.

The summative assessment will be beneficial to BSN students in various ways. It will determine learners’ achievement by evaluating the marks scored at each section of the final tests. This will determine whether they will move to the next level of the course or repeat the course until they attain the learning objectives. This will aid the institution in churning out students who have achieved the learning goals and ready to enter into the nursing practice. Moreover, summative assessment helps in identifying weak areas among the learners. The midterm examinations and research proposals will act as a mirror on learners’ strength and weakness. This will aid in strengthening their abilities while at the same time developing strategies that will be adopted to address the weakness thus ensuring their attainment of the goals

1.7.3 Limitations of Formative Assessments

The formative assessments technique has a number of limitations despite its numerous benefits. It is time consuming especially when carried weekly or monthly. Teachers and students will have to sacrifice in creating extra time for the assessment. Also, there may be fear that the syllabus will not be completed. Teachers will be forced to rush through the syllabus, an aspect that will cause students to lack the mastery of the content. Also, formative assessment is a tiring process hence some of the recommendations will not be implemented at all times.

1.7.4 Limitations of Summative Assessments

However, the summative approach of assessment will have a number of limitations in evaluating the BSN students. It focuses on measuring students’ progress at the end of the course. This aspect delays the rectification of students’ difficulties and challenges making the learners face challenges in coming back on track (Smagorinsky, 2014). Also, the instructional tools that are not effective will continue being used since there is no room for assessing them in the course of the learning. This means that learners could be subjected to instructional techniques that are not meeting their learning needs for a full semester, a situation that leads to wastage of time and other resources.

1.7.5 Assessment Method Analysis

Assessment methods are aimed at measuring the relevance of particular teaching techniques towards student’s achievement of learning objective. They help to determine whether the students understood a particular concept and putting appropriate mechanisms in place in filling some of the gaps identified (Srivastava, Mishra & Waghmare, 2018). Various assessment methods are employed by different instructors depending on the learning needs, institutional policies or directives of the national educational boards. A notable example of the assessment methods is the Classroom Assessment Techniques that is a form of formative assessment. They provide insights on how the BSN students are progressing with their studies. The primary purpose of the classroom assessment tests will be to empower the BSN students and instructors in improving the quality of learning in classrooms. Also, the instructors will be able to identify the teaching techniques that do work well for the students so that appropriate methodologies could be adopted.

1.8 Incorporation of ANA Code of Ethics BSN program

Code of ethics are essential since they guide professionals in any field in doing what is socially acceptable .The American Association of Nurses has a code of ethics that regulates the actions of all practicing nurses in ensuring adherence to nursing policies. The codes provide that nurses should act with dignity, have strong commitment towards patients’ needs, protect the rights of patients, provide an ethical environment in which patients will be able to acquire health services as well as engaging in research to bring more information on board (Lachman, Swanson & Winland-Brown, 2015).The codes will be incorporated and applied in the BSN program in a number of ways. The code of ethics will be part of the content to be covered in the BSN curriculum. This will enable learners understand the ethics before they start practicing in the profession. Also, the learners will have the opportunities to interact with diverse people from different cultures during their field practicum sessions. This will allow them to now the values of different cultures so that they may provide health services that respect the dignity of the people and their cultures. Also, the BSN students will be guided in research methods concepts which will enable them know the research skills that they will use in collecting and analyzing data concerning new phenomena in the nursing field. This will help in generation of new knowledge that will aid in appropriate policy formulation and decision making.

1.8.1 Legal Accountabilities in Nursing Education

Nursing is a professional course that commands recognition across the globe. Unlike other courses that are regulated by the learning institutions in which they are offered, nursing programs are accountable to legal institutions that are mandated to regulate it. Various legal accountabilities in nursing education are:

1.8.2 Analysis of FERPA

This is a federal body that protects the confidentiality of the student’s education information. The schools are requested by the body to ensure that all their student records are well kept. The body will therefore ensure that the education records of BSN such as examination marks and personal data are stored in a manner that they cannot be accessed by unauthorized persons. The policies will be adopted in BSN programs using technological techniques. The department in charge will have students’ records with appropriate entries stored in their computer, have a stable back up in place .According to Fuller (2017), students’ parents and next of kin should have their records taken and entered against the students’ records. This will be adopted by BSN department so as to give room for the appropriate third parties to access the records when need arises.

1.8.3Analysis of ADA

The act protects the disabled people from all forms of discrimination in both public and private places in terms of employment, public accommodations and access to government services (Thompson, 2015). The BSN disability act will be adopted and applied in the BSN program in different ways. The institutions offering BSN program will provide auxiliary services to BSN students with vision, hearing impairments and other physical disabilities so that they can access equal opportunity to pursue their education as well as participating in classroom activities. The institutions also will remove the physical barriers such as inappropriate stairs and elevators to high buildings.

1.8.4 Analysis of HIPAA

The HIPAA regulation is a state body under the ministry of health. It was created to ensure that all workers are covered by health insurance, to reduce financial burdens in provision of health services and ensuring that clients’ records in health centers are protected from unauthorized access (Cohen & Mello, 2018). The BSN program will incorporate HIPAA security rule in its programs. The learners will be taught on record keeping as per the standards set as well as being educated on ways of controlling data from wrongful access. The BSN students will also be taken through the HIPAA policies on insurance cover for workers, what is involved and the penalties provided in the act. This will enable them get the necessary basics of the act they should be in a position to execute in their nursing practice after completion of their studies.

1.8.5 Analysis of Copyright law

The United States copyright law encourages the citizens to create artistic works through an assurance that piracy will not be extended to their works. The law permits authors and artists to publish produce and sell their creations publicly. The law also prohibits the copying and production of materials of other authors and artists without their permission (Mysoor, 2018). The laws are essential to BSN students who will have the passion to explore and make discoveries that they would like to have them published. The increasing societal changes have resulted in a number of social issues and new diseases whose causes are yet to be established. The BSN students can do research and publish their findings on the causes of the ailments. They will therefore benefit from the provision of the copyright law as their works will be protected from unauthorized piracy.

1.8.6 Accreditation Methods

The demand for nurses is on the rise due to the emerging changes in the societal medical needs. The demand for nurses therefore requires quality nursing education that will produce competent nurses to address the challenges. Accreditation is an evaluation process that reviews the nursing programs based on set quality standards. Accreditation Commission for Education in Nursing establishes the quality of nursing education offered in all the institutions to ensure that students are provided with the right education for their professional field (Richardson, 2015). ACEN will be incorporated in the BSN program in several ways. It will assess the BSN program in terms of the content it aims to cover, instructional techniques as well as assessment modes that respective institutions propose to adopt and give appropriate recommendations that will aid in the achievement of the BSN objectives. Also, ACEN will evaluate the ability of the institution to offer conducive and quality learning through assessment of physical infrastructure such as learning materials, availability of adequate and competent instructors, availability of enough classrooms and other recreational facilities. This will help in ensuring that all institutions meet the minimum qualifications before being awarded a charter to offer the BSN program.

1.9 Conclusion

The BSN program is essential in meeting the increasing demand for nursing services and addressing gaps that exist in AND programme .The successful implementation of the BSN program will require a multi-disciplinary approach by the accrediting institutions, education centers and the health organizations in designing programs that has a holistic approach to the nursing needs. The training institutions should put in place mechanisms that will help address faculty shortage in their respective centers to cater for the needs of students. Also, the accrediting institutions should work closely with training centers to offer timely recommendations on resources needed to implement the program. Furthermore, the schools should adopt appropriate delivery modes such as classroom and online learning which will be favorably for this program. To attain understanding of the learners in the program, andragogy philosophy of learning should be adopted to give the learners room for choosing their needs an aspect that will motivate them to pursue their studies. Learning should not be instructor centered, rather, the BSN students should be involved in the design of the curriculum as well as in selection of the teaching methodologies and instructional approaches to be employed. Assessment of learners is vital in evaluating the degree to which the learning objectives are being met. Both formative and summative assessments should be employed as they will give a guideline of what should be done based on the performance of the students in the assessment exams and assignments. Lastly, the societal challenges should be incorporated in the learning curriculum with a great emphasis on extensive research on the part of the learners.










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