Formal nursing education and curriculum can be traced to the 17th century and the French Sisters of Charity, according to Em Olivia Bevis and Jean Watson in "Toward a Caring Curriculum: A New Pedagogy for Nursing." Until this time, untrained helpers, mostly servants, were nurses. When the order was formed in 1633, the prescribed course of study was a two-month probationary period followed by seven to eight months of instruction and supervision. The instruction consisted lectures, quizzes and religious exercises.
A significant advance in the nursing curriculum, according to Bevis and Watson, occurred in 1860 due to the influence of Florence Nightingale. There was a year of training and a probationary period, followed by three years of hospital service. Curriculum was based upon the development of 12 personal characteristics and 13 functions and skills. Most experts consider it a well-organized and highly-structured curriculum, and it was accepted worldwide. The "Nightingale Model," while still a treasured piece of nursing history, has faded into relative obscurity in modern education.
Bevis and Watson point to the establishment of formal "Curriculum Guides" as being a turning point in the history of the development of the nursing curriculum. In 1917, the Education Committee of the League of Nursing Education produced its "Standard Curriculum." It was designed to help nursing schools improve their programs and standards, as nursing requirements were minimal and not uniform. The work defined objectives, content and methods for each course. It provided lists of needed materials and equipment and bibliographies. The work was revised in 1927 and 1937.
Perhaps the most significant advance in the nursing curriculum came when institutes of higher learning adopted nursing education programs, according to Bevis and Watson. Based on the studies of Mildred Montag, who designed a two-year course of study for "technical nurses" in the late 1940s and 1950s,many two-year colleges developed associate of arts degree programs. Shortly thereafter, colleges introduced baccalaureate programs that based a professional nursing education on two years of prerequisite courses and liberal arts. College-based programs and expanding curricula saw a "geometric explosion," or a rapid rise in the number of nursing programs in higher education, from the 1950s through 1970s.
In 1949, Ralph Tyler, a consultant with the University of Washington School of Nursing, introduced "Syllabus for Education 360," which was then revised in 1950 to "Basic Principles of Curriculum and Instruction." Tyler's model was based on objectives or "goal-attainment," according to Keating. Tyler identified four principles for teaching:
1. Defining appropriate learning objectives.
2. Establishing useful learning experiences.
3. Organizing learning experiences to have a maximum cumulative effect.
4. Evaluating the curriculum and revising those aspects that did not prove to be effective.
This is considered the Classic Curriculum Model, one the earliest ideas in education that leads to the measurement of outcomes. Other models have followed, such as the CIPP and Baldridge Evaluation System, but the Tyler Model remains the foundation for a performance-based nursing curriculum.