A curriculum model for an integrated senior year clinical experience

Transformations in the delivery of health care from hospital to community have brought about many changes in nursing practice. These, in turn, have necessitated alterations in the education of nursing students, the curricula, and clinical experiences. Confident that nursing is an independent practice, exclusive of the health care setting, our faculty decided to direct our teaching efforts to reflect changes in health care delivery. We restructured our baccalaureate nursing program's senior level clinical education experience to prepare students to meet the needs of the clients we serve--the community--and the demands of professional nursing education. In doing so, we have supported Ryan's definition of community, which includes "all settings where consumers seek health care" (1, p. 140). In response to the recommendation by the pew health professions commission for new models of content integration "between education and the highly managed and integrated systems of care" (2, p. 51), a decision was made to merge three senior level clinical courses--pediatrics, public health, and nursing leadership and management--into one integrated experience. This process required an examination of collective values and beliefs with respect to course content and learning experiences. The challenge was to examine "sacred cows" and eliminate redundancies and replication of learning activities.