Nursing Program Student Learning Outcomes (SLOs)

1. Provide safe, quality, evidence-based, client-centered nursing care in a variety of healthcare settings to diverse client populations across the lifespan.
2. Engage in clinical reasoning to make client-centered care decisions and to function within the complex healthcare environment.
3. Integrate quality improvement processes that improve client care.
4. Collaborate as part of the inter-professional team, the client, and the client’s support persons.
5. Participate in information management principles, techniques, systems, and client care technology that communicate, manage knowledge, and mitigate error and support decision-making.
6. Adhere to management, legal, and ethical guidelines in practice as a professional practical nurse.

Nursing Program Mission and Philosophy

Mission

The mission of the Yakima Valley College Practical Nursing Program is to provide quality nursing education that reflects the College’s commitment to enrich and enhance individuals and the community by delivering accessible, student-centered education. The Practical Nursing Program is designed to prepare successful critical thinkers and lifelong learners who are equipped to meet the current and future health care needs of the local and global community.

Values​​

Diversity – affirming the uniqueness of and differences among persons, ideas, values, and ethnicities

Caring – showing compassion for others

Integrity – respecting the dignity, moral wholeness, and ethical principles of every person without conditions or limitation; honesty

Excellence – co-creating and implementing transformative strategies with daring ingenuity

Collaboration – working jointly with individuals and multidisciplinary teams.

Philosophy

Nursing education at the certificate level at Yakima Valley College is a process that facilitates changes in behavior and the acquisition of knowledge, skills, and attitudes necessary to function in the role of an entry-level nurse. The curriculum incorporates the principles of Malcolm Knowles Adult Learning Theory, Bloom’s Revised Taxonomy, Tanner’s Clinical Judgment Model, and Patricia Benner’s concepts of the transition from novice to expert in nursing practice.

Knowles Adult Learning Theory

Knowles Adult Learning Theory has six assumptions about adult learners. These assumptions are:

1. Adults need to know why they need to learn something.
2. As people mature, their self-concept moves from one of being dependent toward one of being self-directed.
3. As people mature, they accumulate a large amount of experience that can serve as a rich resource for learning.
4. Real-life problems or situations create a readiness to learn in the adult.
5. As a person matures his or her time perspective changes from one of postponed application of knowledge to immediacy of application.
6. Adults are primarily motivated by a desire to solve immediate and practical problems. As a person, matures, motivation to learn is stimulated by internal stimuli rather than external stimuli (McEwen and Wills, Theoretical Basis for Nursing, 2006, p. 399).

Bloom’s Revised Taxonomy

Bloom’s Revised Taxonomy defines three domains of educational activities or learning: cognitive (knowledge), affective (attitudes), and psychomotor (skills).

The cognitive domain involves the ability to obtain and demonstrate knowledge. Acquisition of knowledge, attitude, and skills proceeds from simple actions such as memorization to more complex intellectual actions such as synthesizing information from multiple sources.  Bloom’s revised taxonomy discusses six categories of knowledge that describe the progression of knowledge from simple to complex:

Remembering: Recalling facts or basic concepts
Understanding: Explaining ideas or concepts
Applying: Using information in new situations
Analyzing: Drawing connections among ideas
Evaluating: Justifying a stand or decision
Creating: Producing new or original work

The affective domain involves internally valuing the unique multidimensional individual, respecting the individual’s right to self- determination, as well as valuing the core beliefs of the nursing profession.

The psychomotor domain involves performing coordinated fine motor, manual, and gross motor skills that are guided by intellectual reasoning.

Critical thinking in today’s complex health care system is necessary for safe, effective, and efficient patient care. Learning to critically think is successful when knowledge is presented in a systematic fashion wherein concepts are presented in a progressive manner of simple to complex incorporating all three learning domains.

Tanner’s Clinical Judgment Model

Tanners Clinical Judgement Model identifies the processes of clinical judgment that reflect the way nurses think in practice. As students learn to think like a nurse, the processes develop from noticing to interpreting, to responding, and then reflecting.

Noticing: a perceptual grasp of the situation at hand. It is the process of perceiving important or salient aspects of the situation.

Interpreting: the development of sufficient understanding of a situation to respond. It is the ability to take the data in a situation and then determine the etiology, patterns, additional factors to consider or additional information needed and resolution; the ability to draw a conclusion.

Responding: the ability to decide on a course of action, including no action. It requires the student to consider the situation and determine patient goals, nursing response and intervention; to develop a plan of care. It includes identifying stressors experienced when responding to the situation.

Reflecting: the attention to the patient /family response to the nurse’s action while acting. It is the ability to identify what occurred, what the nurse did, and how one might adjust the action differently in the future. The nurse identifies what additional knowledge or skills needed. It includes reflection on values and feelings with the situation.

Patricia Benner’s Stages of Learning and Skills Acquisition

Patricia Benner’s research describes how nurses develop skills and an understanding of patient care over time through both education and experience in caring for patients.  Benner describes how beginning nurses progress through five distinct levels; novice, advanced beginner, competent, proficient, and expert.  According to Benner (2001), nurses move from the novice level of no experience to the next stage of advanced beginner, which demonstrates acceptable performance after having considerable experience with caring for patients. At the advanced beginner level, experience in actual patient care enables the nurse to recognize meaningful elements in the individual patient care situation and use those elements to guide care. Students are expected to be at the advanced beginner stage at the time of program completion.

Student-centered nursing education is best achieved when educators meet adult students at their level while creating an environment of mutual respect and collaboration in the educational process. Learning is an interactive process by which the educator and the learner share responsibility in obtaining successful student outcomes.  Through the Practical Nursing Program’s use of the theories and research identified above, students transition from novice to advanced beginner and demonstrate clinical judgment necessary for safe entry-level practice in today’s complex healthcare environment.

References
Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing practice. Prentice-Hall.
Benner, P., Tanner, C., & Chesla, C. (2009). Expertise in nursing Practice: Caring, clinical judgement, and ethics (2^nd Ed.), Springer Publishing.
McEwen, M. & Wills, E. (2006). Theoretical Basis for Nursing (2^nd Ed.). Lippincott Williams & Wilkins.
Moore, K (2012).  Effective instructional strategies: From theory to practice (3^rd ed.), Sage Publications.
Tanner, C. (2006). Thinking like a nurse: A researched-based model of clinical judgement in nursing. Journal of Nursing Education, 45, (6), 204-211.