HealthMarch 12, 2017

How using a spiral curriculum in nursing can help students grasp even the most difficult nursing concepts

Nursing in the 21st century is characterized by continuous change; Instruction needs to keep up with changes in a complex health care environment.

Despite the increased research on the merits of student-centered pedagogy, nursing education has essentially remained tied to a conventional, teacher-centered approach. Subsequently, nursing education been accused of "teaching heavy and learning light."

In order to prepare nurses to function in most successfully in clinical settings, nursing education needs to adopt pedagogical approaches that engage learners as it develops within the student essential cognitive and meta- cognitive skills.

What is the Spiral Model?

A spiral model in nursing can be one such pedagogical approach. Spiral learning is experiential learning that will encourage students to think like a nurse and become reflective practitioners.

By utilizing a spiral curriculum in nursing curriculum, concept learning if fully embedded; scaffolding concepts used in spiral curricula will better prepare nurses to be on the job as registered nurses.

Spiral learning as it progresses should revisit basic ideas repeatedly, building upon them until the student has the full understanding as well as the application of those essential nursing concepts. By revisiting these concepts progressively throughout the educational experience, students are offered a variety of ways to learn that concept and numerous repetitions of that concept for the greatest retention.

Nursing instructors shouldn't avoid certain topics because they believe they are too complex for the students. In fact, Jerome Bruner's landmark text, The Process of Education (1960), argued that schools waste a great deal of students" time by postponing topics because they seem "too difficult." He concluded, "A curriculum as it develops should revisit basic ideas repeatedly, building upon them until the student has grasped the full formal apparatus that goes with them." Spiral learning offers students the opportunity to understand and, later, apply, even some of the most difficult nursing concepts.

The features of a spiral curriculum are:

  • Topics are revisited: Students revisit topics, themes or subjects on a number of occasions during a course.
  • There are increasing levels of difficulty. Each return visit has added objectives and presents fresh learning opportunities leading to the overall objectives.
  • New learning is related to previous learning. New information or skills introduced are related back and linked directly to learning in previous phases of the spiral. Previous learning is a prerequisite for the later learning.
  • The competence of students increases: The learner's competence increases with each visit, until the overall objectives are achieved. This progressive gain in competence can be tested through the assessment procedures.

The value of a spiral curriculum lies in reinforcement, a move from simple to complex and also logical sequence. Advantages of a spiral curriculum include:

  • Reinforcement: Once learned, a topic or subject is reinforced if there is continuing exposure to it.
  • A move from simple to complex: Students achieve a better understanding by exploring the same topics at deepening levels.
  • Logical sequence: Attention is paid in a spiral curriculum to both the scope and sequence of topics. The spiral curriculum can help to bring some order to the increasingly complex nature of medicine and medical education.

Spiral Curriculum Examples

So now we understand what spiral learning in nursing education is. But how exactly does a spiral curriculum work in nursing education?

The Clinical Learning Spiral incorporates reflective processes into undergraduate nursing education. It entails successive cycles of four phases: preparative (briefing, planning), constructive (practice development,) reflective (debriefing,) and reconstructive (planning for change and commitment to action.)

As students become more experienced problem solvers, they master a better understanding of the concepts, retain material because they revisit basic ideas repeatedly, and apply their knowledge to more complex problems and scenarios.

Here are some spiral curriculum examples:

  • In the first semester of a concept-based nursing curriculum, the concept of oxygenation is introduced. What is the purpose of oxygen in a person's health? How do we assess that the person's oxygenation in their blood and body is optimal? Various methods to improve oxygenation are discussed. There is focus on oxygen administration devices and how a nurse cares for the patient with these devices. The nurse also needs to assess that the devices are working.
  • The next course builds upon the concept of oxygenation by bringing in some of the disease processes related to oxygenation (the exemplars). These might include upper respiratory diseases, COPD, lung cancer, and pneumonia.
  • Later, in a higher level course covering medical-surgical scenarios, the student is exposed to a complex patient with multiple problems, which addresses multiple concepts. The nursing student is expected to independently apply the nursing process and critical thinking. At this level, the student "puts it all together."

How a Concept-Based Curriculum Bolsters Spiral Learning

A concept-based nursing curriculum encourage students to grasp the concept being taught within the classroom and how it relates to real-life patient care or patient illness. Further, offering students a variety of ways to learn that concept promotes the spiral teaching method.

At the core of a spiral curriculum are the essential concepts involved in nursing practice. Concept-based learning effectively bridges the gap from nursing education to practice.

Michael Youngwood, a nurse educator at Haywood Community College in Clyde, N.C., says: "With the advent of conceptual-based nursing education, we"re able to pull all the minutia, put it back in and take the critical thinking and put it at the bedside where it's needed the most."

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Lippincott CoursePoint for nursing concepts

Haywood's nursing program needed concept-based solution that instructors could use to fill the gap, one that offered a seamless integration from the classroom to hands-on digital media where ever they [nursing students] are.

"If you can get that seamless integration with what you"re trying to deliver and what they"re [students] getting, at the end of the day, you"ve got student success," Youngwood says. "Lippincott allows us to bridge those gaps, gives us the tools to facilitate the bridging of those gaps."

Lippincott's CoursePoint for Nursing Concepts naturally supports a concept-based, spiraled curriculum. Our solution presents trusted, authoritative content organized in a way that allows students to become familiar with a concept and navigate their way through simple to complex clinical scenarios. The student and instructor assets promote spiral teaching by reaching students with different learning styles.

Lippincott CoursePoint for Nursing Concepts organizes our superior content by concept and exemplar so your students have everything they need to be successful. What's more, we've included different types of content to meet the needs of diverse teachers and learners. We go far beyond textbook readings -providing you and your colleagues with access to journal articles, animations, videos, curated web links, and case studies, including:

  • More than 500 journal articles from respected journals
  • 98 videos
  • 38 animations
  • 47 interactive case studies
  • 6 interactive tutorials
  • Dosage calculation quizzes
  • Curated web links covering more than 60 different topics
  • Spanish-English glossary
  • Sample heart and breath sounds
  • Movie viewing guides
  • Nursing interview guides
  • Physical assessment guides
  • Procedure checklists
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