145CHAPTER 7

Internal Frame Factors

Sarah B. Keating

OBJECTIVES

Upon completion of Chapter 7, the reader will be able to:

OVERVIEW

Section III introduced the reader to the Frame Factors model and Chapter 6 discussed the external frame factors that nurse educators should review when conducting a needs assessment for program planning and curriculum development purposes. The data collected from a review of the external frame factors provide information related to the external environment of the educational program and feed into the decision-making process for developing new programs or revising existing ones. These factors can have a major impact on the program’s existence and decisions regarding changes. Chapter 6 initiated a case study as an example of a needs assessment, using the Frame Factors model that is continued in Chapter 7 with the internal frame factors to consider. See Figure 7.1 for a conceptual model of the internal frame factors that impact the curriculum (Johnson, 1977). This chapter discusses the components of the curriculum and continues the case study with recommended revisions of the current program and a proposal for a new doctor of nursing practice (DNP) program based on the needs assessment.

Faculty continues to be responsible for curriculum development and evaluation and is part of the process for collecting information about the internal frame factors that impact the educational program. The internal frame factors include a description and organizational structure of the parent academic institution; mission and purpose, philosophy, and goals; internal economic situation and its influence on the curriculum; resources within the institution (laboratories, classrooms, library, academic services, instructional technology support, student services, etc.); 146and potential faculty and student characteristics. The information related to these factors is analyzed for its relevance to the program and the findings are weighed as to their importance to the quality of the program, its existence, and possible changes.

FIGURE 7.1 Internal frame factors for a needs assessment for curriculum development. Adapted from Johnson (1977).

Chapter 7 provides detailed information about each of these internal frame factors and there is a table with guidelines for collecting information about the factors and assessing the need according to the desired outcomes. The chapter ends by continuing the case study of a fictional nursing school that is conducting a needs assessment for revising and expanding the program.

DISCUSSION

DESCRIPTION AND ORGANIZATIONAL STRUCTURE OF THE PARENT ACADEMIC INSTITUTION

When looking at the environment that surrounds a nursing education program, the parent institution in which it resides is examined in light of the scenario it sets for the program. The physical campus and its buildings create the milieu in which 147the program exists with the nursing program a reflection of its place within the institution. The nature of the institution influences the structure of the campus and for nursing education programs, can be located in health care agencies, academic medical centers, liberal arts colleges, large research universities, land grant universities, multipurpose state-supported or private universities, or community colleges. The history of the institution is important to know such as its growth or change over the years and the role the nursing program had in its political fortunes or misfortunes. In small private institutions, the school of nursing can be one of the largest and most influential constituents, while in statewide university systems, nursing can be a small department within a health-related college that is within the greater university.

All educational institutions and health care agencies have organizational structures, usually of a hierarchal nature. Faculty should analyze the structure of the parent institution as well as that of the nursing program to describe the hierarchal and formal lines of communication that guide the faculty in developing and revising programs. For example, as described in Chapters 2 and 3, curriculum proposals and changes must be approved first on the local level (the nursing curriculum committee and faculty), moved to the next level of organization such as a college curriculum committee and dean, and finally, to an all-college or university-wide curriculum committee with its recommendations going to the faculty senate (or its like) for final approval. There can be administrative approval along the way from department heads, deans, and perhaps academic vice presidents or provosts; especially in regard to economic and administrative feasibility. Nevertheless, the major approval bodies are those that are composed of faculty and within faculty governance prerogatives.

At the same time, it is useful to include the major players within the faculty and administrative structures in order to discuss with them the plans and rationale for proposed new programs or curriculum revisions. Prior consultation with these key people can help to smooth the way when the proposals are ready to enter the formal arena and they can give advice related to changes that might enhance approval or advice on the best presentation formats that facilitate an understanding of the proposal. These contacts can be of a formal or informal nature; however, a word of caution: to avoid disastrous results, never blindside an administrator or decision maker. It is wise to keep them informed of new proposals or possible changes to place them in the advocate role as the approval process wends its way through the system.

MISSION AND PURPOSE, PHILOSOPHY, AND GOALS OF THE PARENT INSTITUTION

The mission/vision and purpose, philosophy, and goals of the parent institution determine the character of the nursing program. Most institutions of higher education focus their missions and philosophies on three endeavors: education, service, and scholarship/research. Nursing must examine the mission and philosophy of its parent institution to determine its place within these three basic activities. For example, a state-supported university may have as part of its mission and philosophy the education of the people of the state for professional, leadership, and service 148roles. Thus, the nursing program could focus its mission and philosophy on the preparation of nurses for leadership roles and provision of health care services to the people of the state. If the statewide system is the predominant preparer of nurses within the state as compared to independent colleges, then the additional mission or purpose might be to provide an adequate nursing workforce for the state.

In contrast, independent or private colleges and universities may have missions and philosophies that have a sectarian flavor such as preparing individuals with strong liberal arts foundations for public service or roles in the helping professions. Again, a nursing program’s mission is usually compatible with this mission. Academic medical centers are yet another example of nursing’s match to health disciplines that are housed in one institution and whose mission is to prepare individuals for the health professions. Community college or junior college missions usually focus on technical education or on prerequisite preparation for entering into upper division level colleges and universities. Although the debate still rages about the role of nursing programs in these institutions, there is no question that they fit the mission of the 2-year college as most expect that their graduates will function as registered nurses (RNs) and continue with their education at the baccalaureate and higher degree levels. Rosa (2009) surveyed associate degree in nursing (ADN) faculty members to identify the factors that contributed to their advising students to continue their education and earn a baccalaureate. She found that faculty members felt a moral commitment to advise students as professional colleagues to continue their education. Another factor influencing their advisement was the extent to which the ADN school was affiliated with baccalaureate completion programs.

INTERNAL ECONOMIC SITUATION AND INFLUENCE ON THE CURRICULUM

As stated in Chapter 6, the economic health of the institution has a significant impact on the nursing program and curriculum. How much of the share of resources, income, and expenditures that the nursing program has can affect program stability and room for expansion. For example, nurse-managed clinics must be self-supporting or economic recessions can cause their demise. For state-sponsored programs, the parent institution is subject to the state economy during periods of recession and prosperity. Independent colleges, unless heavily endowed, depend on tuition, student fees, or other income-generating operations.

All institutions depend upon endowments, financial aid programs for students including scholarships, loans, and grants. Nursing programs are eligible for many federal grants and have a history of securing other types of grants from private foundations, state-supported programs, and private contributions including those from alumni associations. These income-generating programs illustrate to the parent institution that the nursing program is viable and at the same time, the institution’s reputation and ability to garner external financial resources help the nursing program to secure funding.

Institutions usually have support systems for assisting faculty to write grants and to seek outside financial support. Nursing programs should have close relationships with these support systems and have a plan in place for securing 149additional funds. Faculty plays a major role in writing grants with the perks related to them, if funded, of released time for program development and scholarship and research activities. Two sources for funding to support program development on the national level are the Health Resources and Services Administration (http://bhpr.hrsa.gov/nursing) and the National Institutes of Health (http://www.ninr.nih.gov). The latter focuses on clinical research; however, it is possible that faculty may wish to conduct curriculum and educational program research. A list of private foundations with funding opportunities for program development is located at www.research.ucla.edu/ocga/sr2/Private.htm (University of California-Los Angeles, 2014).

Assessment of the economic status of the parent institution and the nursing program provides a realistic picture of the potential for program expansion and curriculum revision. When developing curriculum, the first demand for financial support comes with the need for resources to conduct a needs assessment such as the costs of released time for those who are conducting the assessment, review of the literature, and surveys of key stakeholders. A cost analysis for revising a curriculum or mounting a new one requires a business case to justify the costs and to forecast its financial viability. Unless there is a nursing program financial officer, the nursing program administrator and faculty should work closely with the parent institution’s business office or chief financial officer in developing the business case.

RESOURCES WITHIN THE INSTITUTION AND NURSING PROGRAM

An analysis of the existing resources within the institution and the nursing program supplies information related to possible program expansion and curriculum revisions. First, there should be adequate classrooms, learning laboratories, library staff and resources, computer facilities, clinical practice simulations, instructional technology support, and distance education resources for the current program. When planning for revisions of the curriculum or for new programs, the need for expansion of these facilities and additional staffing should be identified. If expansion is not possible, then creative approaches to scheduling for the maximum use of these facilities can be examined, for example, evening classes, weekend learning experiences, and online delivery of courses.

Academic support services such as the library, academic advisement, teaching-learning resources, and instructional technology contribute to the maintenance of a quality education program and are internal frame factors that should be assessed when developing new programs or revising existing ones. If there are to be new programs or expansion of current curricula, the library resources must be adequate. Library resources include not only those resources on campus but also services for off-campus programs and students. There should be Internet and web-based library access for students and faculty and this is especially true when the campus has a large commuter student population, distance education programs, or proposes new programs. Library and instructional technology support staffing must be large enough and knowledgeable about nursing education needs. Thus, faculty should have strong relationships with librarians and the instructional technology staff in order to build the resources needed to revise the curriculum or develop new programs.

150Academic advisement services play an important role in program planning as new programs can require additional staffing. If the curriculum is revised, updates for academic advising are necessary so that the faculty and its support staff who provide the services have current information to impart to the students. Teaching–learning resources need to be available to keep faculty current in instructional strategies, particularly if the revisions to the curriculum have an effect on instructional design. For example, a baccalaureate program may decide to convert its RN program to a web-based delivery system. In this case, faculty needs training in preparing and implementing web-based courses.

Instructional support systems are part of planning as well since the nature of the proposed program or the revised curriculum may call for additional resources. These resources include programmed instruction units, audio–visual aids, hardware and software, computer technologies, high-fidelity and low-fidelity mannequins for simulated clinical situations, and so forth. They can generate large costs to the program and should be calculated into the business case and the costs associated with their maintenance and replacement expenses over time. Some instructional support systems include monthly or annual students fees as well. For new programs or revisions, these costs are often included in requests for additional student lab fees or external funding. If the updating or creation of new laboratory/simulation practice labs are one-time costs, external funding through donations, grants, or endowments are possibilities.

Student support services are equally important to nursing education programs and are an integral part of the curriculum development process. Major student services include enrollment (recruitment, admissions, registrar activities, and graduation records), maintenance of student records, advising and counseling, disciplinary matters, remediation and study skills, work study programs, career counseling, job placement, and financial aid. Depending upon the size of the university or college, these services can be congregated into one department or subdivided into several. Their role in curriculum development is important, as expanding or changing educational programs requires student services support. For example, if a new program is proposed, then the recruitment and admissions staff will need to be apprised of the program to best serve the needs of the new program in recruitment and admission activities.

Financial aid programs are crucial to the recruitment, admission, and retention of students and if the proposal brings in new revenues through grants or other financial support structures, the financial aid staff must be cognizant of the proposal. They can provide useful information to program planners and thus a partnership between the student services staff and the nursing program staff is beneficial.

Work–study programs and job placement information can supplement the curriculum, if these programs are in concert with the educational plan and not in conflict with the program of study. An example of a conflict is a revised curriculum that calls for accelerated study and clinical experiences that disallow student employment and therefore prohibits enrollment in the work–study program. Another aspect is the potential influence of students’ part-time employment on the curriculum and its role in intended and unintended outcomes on the educational experience. With 151the preponderance of adult learners in nursing programs, the reality of their outside employment while enrolled in studies must be taken in to account.

The informal curriculum often takes place through the planned activities of the student services department. Again, partnerships between them and nursing faculty increase the effectiveness of the formal curriculum. Students who could benefit from remediation or learning skills workshops should be referred to student services. Faculty work with student services staff to identify the learning needs of nursing students and this is especially relevant when curriculum changes are taking place. Additionally, student services staff work with faculty concerning the special needs of students with learning disabilities and the accommodations they require without imperiling the student’s individual needs or the safety of the clients for whom the students provide care. Brock (2010) describes essential student support services for at-risk groups and their success in improving graduation rates. Nursing students who are at risk for failure should be identified early in the program and referred to student support staff to facilitate their success in the program.

POTENTIAL FACULTY AND STUDENT CHARACTERISTICS

When proposing new educational programs or revising existing curricula, thought needs to go into the characteristics of the existing faculty and the student body who will participate in the educational program. If a new program is proposed, the faculty composition is reviewed. There should be adequate numbers of faculty members who represent diversity in gender and ethnic backgrounds and to reach the desired faculty to student ratio. Depending upon the nature of the program, clinical supervision of students requires a low student to faculty ratio but can differ according to program. For example, master’s and doctoral students are usually RNs and therefore may not need the close supervision required for entry-level students. However, for some advanced practice roles, there is a need for close faculty supervision. However, in these latter cases, preceptorships or internships are the usual format and a faculty member can supervise more students in collaboration with the clinical preceptors. In entry-level programs, the student to faculty ratio is usually 8 to 10; however, in the senior year, it is possible to have preceptorships with approximately 12 to 15 students, depending on the nature of the clinical experiences. While lectures can accommodate many students, seminars and learning laboratories demand fewer numbers of students and therefore additional faculty. Enrollment in online courses can vary with as few as 10 to 12 at the graduate level and seminar-type courses to didactic online courses that accommodate as many as 30 or more students. In the case of the latter, the format for the course is modified to adjust to the larger number of students and the resultant teaching load for the instructor. These are practical issues that must be addressed owing to the quality perspectives and cost factors that they present when developing curricula.

Yet another consideration related to faculty is the match of knowledge to the subject matter, clinical expertise, and pedagogical skills. Information on 152the numbers and types of faculty needed, their required educational levels, and scholarship and research history feed into decisions about curriculum development since faculty knowledge and expertise are critical to the delivery of the curriculum. As with faculty considerations, the characteristics of the student body and the types of students the faculty hopes to attract to the new program or the revised curriculum are important. If it is a new program, the potential applicant pool should be identified according to interest, numbers, availability, and competition with other nursing programs. If a new program is contemplated, its type dictates the kind of applicant pool that the program and the admission department need to target. If it is a curriculum revision to update the program and plan for future demands, the applicant pool might be the same as the current one.

The characteristics of the students in the program help to tailor the curriculum according to their learning needs. For example, if it is an entry-level associate degree or baccalaureate program, the applicants may be a mix of new high school graduates, transfer students with some college preparation, and adult learners with some work experience. The curriculum is then planned to meet a diversity of learning needs from traditional pedagogical learning theories to adult learning theories. Diversity of racial, ethnic, and cultural characteristics are other factors to consider and the educational program must plan to be culturally responsive as well as preparing professionals with cultural competence.

SUMMARY

Chapter 7 reviewed the internal frame factors to consider when conducting a needs assessment for developing new educational programs or revising curricula. These factors follow the assessment of external frame factors that influence the educational program and are equally important to the decision for changing a curriculum or developing a new program. While the external frame factors examined the macro-environment surrounding the program, the internal frame factors looked at those factors that are closer to the program and include the parent institution as well as the nursing program itself.

Factors that were examined include the characteristics of the parent institution and its organizational structure. How the nursing program fits into this structure can determine the economic, political, and resource support for program changes. It sets the stage for the processes that the nursing faculty must undergo to gain approval for the proposed changes. The mission and purpose, philosophy and goals of the parent institution influence the nature of the nursing program and to ensure success, the nursing program must be congruent with those of the parent institution. The internal economic status and the available resources of both the parent institution and the nursing program are assessed for the financial viability as well as the necessary additional resources and support services for proposed revisions to the curriculum or proposed new programs. Finally, the characteristics of the faculty and the potential student body are reviewed to determine their match to the proposed change. See Table 7.1 for guidelines to assess the internal frame factors when conducting a needs assessment for curriculum revision or new program proposals.

153TABLE 7.1 GUIDELINES FOR ASSESSING INTERNAL FRAME FACTORS

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