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Concept-based Curriculum in the Clinical Setting
When a program moves to a concept-based curriculum, how should the clinical experiences be structured? While there is much similarity between clinical experiences in a CBC and a systems-based curricular approach, there are nuances that must be considered. Specifically, the emphasis should be on the concepts that are highlighted in the didactic course. For example, when students are assigned to a labor and delivery or post-partum unit and one of the important concepts to be integrated into the plan of care is perfusion in the context of post-partum hemorrhage (the exemplar), the students should be encouraged to review the concept of perfusion and the exemplar of post- operative hemorrhage and be able to differentiate between their nursing care, including medications, of these two exemplars. Recognizing the similarities and differences in the care of patients with these different diagnoses will strengthen the students’ use of clinical judgment in each situation. In addition, close communication among didactic and clinical faculty guided by the course and clinical objectives/outcomes is essential to ensure that learning from the class and clinical are congruent. After students have participated in a clinical assignment, Brandon, and All (2010) suggested that case studies from the students’ experience can provide significant reinforcement of the concept(s) being addressed during the clinical assignments. The authors noted that as students talk through the case being presented, they are given the opportunity to increase their clinical knowledge and skills, clinical judgment, and confidence in their ability to provide patient care. In subsequent post-clinical conferences, different students can take the lead by sharing a different case situation. This variation in presentation, followed by robust discussion, allows students to see the relevance between the concepts and exemplars discussed in class and actual clinical practice. During these discussions, the clinical instructor models expert clinical judgment; however, students provide the direction for the discussion. This approach to clinical experiences encourages students to continuously assess their progress. During these discussions, students are given an opportunity to talk about their own strengths and weaknesses as well as respectfully discuss the performance of others. Such an opportunity helps students to develop communication skills and learn to use constructive criticism and positive feedback. (Brandon, All, 2010). Conclusion The learning processes in both didactic and lab/clinical experiences chosen for a concept-based curriculum are central to effective student outcomes. The learning processes must be dynamic, meaningful, and engaging, while encouraging collaboration, reflection, and ongoing constructive and nonjudgmental feedback. Consistent use of activities that meet these criteria will increase students’ clinical judgment competency and their ability to consistently provide safe and effective nursing care.
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