Cardiac arrhythmias are a significant health problem attributed to numerous fatalities annually. Srinivasan and Schilling (2018) note that cardiac arrhythmias account for 15-20 percent of all global deaths. Often, nurses are the first point of contact with patients, implying that the former must have the necessary skills and knowledge required to assess and manage cases of cardiac arrhythmias to prevent deterioration of the condition. Among the essential tools that nurses need in diagnosing cardiac arrhythmias is an electrocardiogram (EKG), which helps detect and monitor the heart’s health. While a majority of nurses are aware of EKG, a considerable number of these caregivers lack adequate information on the interpretation of the diagnostic tool, thus leading to poor patient outcomes. This proposal attributes this incompetency to the minimum implementation of modules on EKG implications in nursing programs and addresses this curriculum gap as identified at Western University.
This paper proposes curriculum change from the current Medical-Surgical Nursing II syllabus to a comprehensive module that incorporates EKG interpretation content. This curriculum change is expected to prepare future nurses by enhancing nursing students’ clinical skills and confidence required to facilitate positive patient outcomes. The proposal utilizes the analysis, design, development, implementation, and evaluation (ADDIE) model to address the university’s curricular change.
In the analysis phase, an investigation is conducted to establish the current curriculum gap, which is the foundation for subsequent changes. After reviewing the university’s course syllabus, field experience, and students’ skills, and developing an affinity diagram, the author identifies a limitation in the utilization of content on EKG interpretation in the current nursing program. This gap accounts for the high rate of inadequacy in ECG and lack of proficiency in the tool’s analysis among nurses, as Bojsen et al. (2015) noted. The investigation is followed by a rigorous literature review supporting implementing the EKG interpretation module in the program because it would enhance nursing students’ skills and patient outcomes, notably in emergency responses. A force field analysis is also completed. Its results reveal outdated ECG processes in the current curriculum, which, if amended, could enhance students’ preparedness for NCLEX, improve clinical skills, and increase their confidence when dealing with patients.
The design stage involves reviewing and enhancing the current syllabus to facilitate achieving the desired curriculum goals. The course syllabus created in this stage includes the course objectives, course description, content outline, learning materials, grading policy, and teaching and instructional strategies. Some of the significant changes made in the current syllabus are the introduction of two course textbooks and an optional EKG book that will enhance the student’s knowledge and skills in the heart’s anatomy and physiology. EKG interpretation implications of the patient care module is also added to the medical-surgical II nursing course to provide nursing students with the most recent evidence-based practice required to provide nursing care to individuals with cardiac electrical abnormalities. The designed syllabus is expected to fulfill two major curriculum goals: enhance the nursing students’ ability to replicate the acquired knowledge in real-life scenarios and increase their confidence during the management of cardiac electrical abnormalities that may require the use of EKG diagnostic tools.
The recommended curriculum is constructed at the development phase, and the proposal’s content is expanded and reviewed to reflect the desired goals. Among the areas addressed in this phase include creating the course content, materials, learning resources, and assessments required for the proposed curriculum change. Notably, the resource learning materials, including PowerPoint lecture material and simulations with the suggested module, are developed through the collaborative input of stakeholders such as the doctorate prepared educator, a nursing student, and the school’s administrator. The PowerPoint presentation is mainly selected because of its ability to enhance students’ overall test scores, as observed in prior research (Shigli, Nair, Sajjan, Kakodkar & Hebbal, 2016). Formative and summative objective assessment and summative performance tasks are also developed to help educators identify potential gaps in curriculum based on the student’s performance and assess the student’s critical thinking skills as reflected in the latter’s performance in the simulation and case studies.
In the implementation phase, the proposed module is piloted among nursing students in the second year of the second semester at Western University. Financial, human, and technological resources will be required to facilitate the university’s proposed curriculum change piloting. Moreover, constant feedback will be provided by the selected stakeholders during the implementation phase to help enhance the curriculum and meet the desired goals.
During the evaluation phase, the educators will do an assessment to determine the met and unmet goals. Some of the tools used in this phase will include student surveys to assess whether students acquired the desired clinical skills after implementing the module. Educators will also use key performance indicators and performance benchmarks in the evaluation phase to determine whether the set goals are achieved after implementing the proposed curriculum change. The evaluation phase’s fundamental goal is to help the nursing educator determine whether the module’s implementation bridges the curriculum gap and bolster students’ academic needs.
In summary, this proposal is developed to provide a blueprint for implementing EKG interpretation implications for the patient care module in the syllabus to bridge the current gap in the medical-surgical nursing II course. This curriculum change proposal’s primary reason is to overcome the existing barriers in the current curriculum and improve nursing students’ knowledge and skills required to enhance patient outcomes. The proposal will bridge the identified curriculum gap by introducing the EKG interpretation module in the syllabus to improve the nursing students’ ability to interpret the diagnostic tool during emergency responses. As noted from the literature review, implementing this proposal is vital because it will help nursing students achieve the desired level of ECG training and enhance their confidence during practice, which will, in turn, translate into enhanced patient outcomes. Moreover, implementing the proposal will better prepare the nursing students for the NCLEX and enable Western University to remain accredited.
Furthermore, this proposal utilizes an ADDIE model to meet the identified gap in the existing curriculum. This creative approach involves analyzing the curriculum gap and forces that may support or constrain the implementation of the proposed change. Other steps involved in this approach include designing, developing, implementing, and evaluating the proposed curriculum. This approach is ideal because it facilitates the proper organization and implementation of the recommended course content. The proposed course will also benefit the students’ diversity in learning styles in the academic setting by providing various learning resources and teaching strategies that suit their choice and preferences. Notably, the use of powerpoints, lecture material, and simulations with case studies will benefit the diverse student population in the clinical practice experience and academic setting who are oriented to learning styles that involve visuals, auditory, and writings. Overall, the proposed course aligns with and contributes to nursing education and practice by providing evidence-based practices essential in preparing students nurses for future professional tasks.
Bojsen, S.R., Rader, S.B.E.W., Holst, A.G., Kayser, L., Ringsted, C., Svendsen, J.H., & Konge, L. (2015). The acquisition and retention of ECG interpretation skills after a standardized web-based ECG tutorial- a randomized study. BMC Medical Education, 15(36), 1-9. doi:10.1186/s12909-015-0319-0
Shigli, K., Agrawal, N., Nair, C., Sajjan, S., Kakodkar, P., & Hebbal, M. (2016). Use of PowerPoint presentation as a teaching tool for undergraduate students in the subject of gerodontology. The Journal of the Indian Prosthodontic Society, 16(2), 187-192. doi: 10.4103/0972-4052.167940
Srinivasan, N.T., & Schilling, R.J. (2018). Sudden cardiac death and arrhythmias. Arrhythmia and Electrophysiology Review, 7(2), 111-117. doi: 10.15420/aer.2018:15:2