The need for significant reform: a practice-driven approach to curriculum

The central theme of the curriculum revolution is the preparation of graduates with new and different perspectives and abilities who can function well in a rapidly changing health care environment. Discussions of approaches needed to prepare such graduates center on making substantive changes within the education system. Experience from a collaborative undergraduate nursing program reveal that revised structural and power relationships between nursing education and nursing practice are needed to support such fundamental changes in nursing curricula. This article explores structural and power relationship issues arising from implementing a practice-driven, phenomenological approach to a 4-year undergraduate nursing curriculum. The meaning of a practice-driven approach, the inherent benefits and risks, the outcomes and evaluation issues are included in the discussion. It is suggested that if learning to nurse is grounded in nursing practice as well as in nursing academia, then systems of nursing practice and of educating nurses must change.