NURS 619 Week 1 Reflection Paper 1 on Forces Shaping Nursing Curricula Example

Reflection Paper 1: From Content Lists to Competencies, Reflecting on the Forces Reshaping the Curriculum I Will Teach

Introduction

When I began my practicum at a hospital-affiliated school of nursing this term, I arrived in the middle of a curriculum redesign. Faculty meetings that I expected to be about scheduling were about competencies, domains and checkpoints. My first reaction, I will admit, was impatience: the old curriculum produced nurses who passed the licensure exam, so why rebuild it now? This reflection examines that reaction honestly, the forces behind the redesign, and what the change asks of nurse educators, including me.

The Forces Behind the Change

Billings and Halstead (2016) describe curriculum development as shaped by forces both outside and inside the institution: changes in health care and population needs, professional standards and accreditation, licensure requirements, technology, the characteristics of students and the resources of the program. In my practicum site, several of these forces were at work at once. Hospitals in the region were reporting that new graduates needed long orientations before practicing independently. The program's accreditor expected alignment with the 2021 AACN Essentials. And faculty had noticed that students could recite content but struggled to apply it in clinical settings.

The force that drove the redesign most directly was the shift to competency-based education. Instead of organizing the curriculum around topics to be covered, faculty were asked to state the performances a new graduate must show and then check whether students could show them. That sounds simple, but it changes almost everything: course outcomes, assignments, clinical evaluations and the way faculty talk about progress.

What Other Programs Have Learned

Recent reports helped me see the redesign as part of a broader movement rather than a local enthusiasm. Weltin and Crawford (2026) described how a college of nursing redesigned its graduate practice programs using backward design, beginning with program outcomes, identifying required knowledge and organizing concepts into a scaffolded curriculum; the process produced new plans of study, progression indicators and 82 new or revised courses, and faculty surveys showed strong support for the design process. Sak et al. (2026) described a faculty team that used a logic model to introduce competency-based teaching in an accelerated BSN population health practicum, piloting clinical checkpoints with validated tools for formative and summative assessment and mapping activities to the Essentials, which gave faculty consistency and clarity.

Those accounts made me less impatient. The faculty at my site were not inventing a fashion; they were doing what the profession now expects. I had mistaken a change in what we measure for a change in what we value, when in fact it was an attempt to measure what we had always claimed to value.

The Part That Worried Me: Evaluating Competence in Clinical Settings

My second reaction was worry about clinical evaluation. If progression depends on demonstrated competence, someone has to judge it, and much of that judgment happens in clinical settings by preceptors and adjunct faculty who may not share the program's understanding of what a competency means. Tschannen et al. (2026) reviewed 21 articles on preparing clinical preceptors for competency-based education and found that most preceptor training improved knowledge, confidence and teaching effectiveness, but that much of it lacked a clear definition of competency, did not report evaluations of the competency-based approach, and did not report the psychometric properties of the tools used. Their conclusion that preceptors need training and consistent tools matched my worry exactly. A competency framework is only as good as the people applying it at the bedside.

Faculty Experience of Curriculum Change

I also realized that faculty resistance, including my own, is a predictable part of curriculum change. Yasin et al. (2025) interviewed 18 nurse educators implementing a new concept-based curriculum and heard about thin preparation, a bumpy changeover and colleagues who pushed back, along with the observation that firm leadership and teamwork made the move easier. Over time, resistance faded as educators saw students' critical thinking and clinical judgment improve. Although that study concerned a concept-based rather than a competency-based model, its pattern matched what I saw. Faculty who had attended the redesign workshops were enthusiastic; those who had not felt that something was being done to them.

A Conversation With a Senior Faculty Member

Midway through my first week, I asked one of the program's most experienced faculty members, who has taught medical-surgical nursing for twenty-two years, what they thought of the redesign. The answer surprised me. The old curriculum, this colleague said, had always asked students to demonstrate competence in clinical settings, but that the evaluations were inconsistent from one instructor to the next, and that students who were weak in reasoning could pass by being pleasant and hardworking. In this colleague's view, the new competencies did not change what good teaching looked like; they made faculty say out loud what they had always looked for and gave students a fairer way to know what was expected. The colleague also admitted that the redesign had doubled their own workload for a year, because every assignment and clinical evaluation had to be rewritten.

That conversation changed my reflection in two ways. It showed me that experienced faculty can hold mixed feelings about a change they support, and it reminded me that the cost of curriculum change is carried largely by faculty time. Any educator who leads such work needs to plan for that cost honestly rather than assume colleagues will absorb it.

What the Shift Means for Students

I also tried to imagine the redesign from a student's point of view. Under the old curriculum, a student who earned an 80% average in a course passed, even if the 20% they missed included the most dangerous errors. Under a competency-based approach, a student must demonstrate specific competencies, such as safe medication administration or recognizing deterioration, regardless of how well they performed elsewhere. That is more demanding, but it is also more honest, because it ties progression to the abilities patients depend on. For students who learn more slowly, competency-based education may offer more chances to practice and demonstrate competence before a final judgment, which could make the program fairer as well as more rigorous. Whether it actually does so will depend on how faculty design the checkpoints and how much time students are given to meet them.

What This Means for Me as an Educator

These reflections lead me to three conclusions about my own role. First, I need to learn the Essentials well enough to explain them to students and preceptors, not just to follow them. Second, I should treat clinical evaluation as the place where competency-based education succeeds or fails, which means investing in preceptor preparation and in clear, observable descriptions of what competence looks like. Third, I need to remember my own first reaction when I lead change myself, and to involve colleagues early so that a redesign feels like shared work rather than an imposition. In practical terms, during the rest of this practicum I plan to sit in on the subcommittee writing clinical evaluation tools for the new competencies, volunteer to draft one observable behavior statement for the safety competency, and ask two preceptors what would help them use the new tool consistently. Those small steps will let me test what I have written here against the actual work of curriculum change, and they will give me material for the curriculum plan I build later in this course.

A Faith Perspective

Jesus described the wise scribe as one who brings out of the storeroom "what is new and what is old" (English Standard Version Bible, 2001/2016, Matthew 13:52). That picture fits curriculum work well. Not every new framework deserves adoption, and not every old practice deserves to be kept. A faithful educator tests both against what serves students and patients, keeping what is good from the old curriculum while embracing changes that help students become safe, capable nurses.

Conclusion

My impatience with the redesign at my practicum site came from not understanding the forces behind it. Billings and Halstead's account of those forces, and recent reports of competency-based redesign, preceptor preparation and faculty experiences of change, helped me see the redesign as a reasonable response to real needs and showed me what it will require of educators. I begin this course ready to learn how curricula are built, not only how they are taught, and I expect my own impatience to be replaced by a more useful question: whether each change we make helps students become the nurses their future patients need.

References

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed.). Elsevier.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Sak, H., Davis, R., Harty, A., Luksan, M., Jessen, J., & Genua, J. A. (2026). Advancing competency-based education in nursing: Faculty-driven innovation for transforming population health. Journal of Professional Nursing, 66, 28-35. https://doi.org/10.1016/j.profnurs.2026.05.018

Tschannen, D., Cooper, M., & Ashford, K. (2026). An integrative review exploring support for clinical preceptors in competency-based education in health professional programs. Journal of Professional Nursing, 66, 247-258. https://doi.org/10.1016/j.profnurs.2026.08.003

Weltin, A., & Crawford, D. J. (2026). Using backward design to create a new graduate nursing curriculum. Journal of Professional Nursing, 66, 104-107. https://doi.org/10.1016/j.profnurs.2026.06.003

Yasin, Y. M., Al-Hamad, A., Safi, I., & Salman, A. (2025). Nurse educators' experience in implementing concept-based curriculum: A phenomenology study. International Journal of Nursing Education Scholarship, 22(1). https://doi.org/10.1515/ijnes-2024-0074