What Specific Reform Efforts Have Affected the Curriculum of Nursing Schools?

The nursing profession has undergone revolutionary changes since the inception of the American nation. Prior to the Civil War, nursing was largely viewed as an innate skill that could not be taught. However, following the establishment of schools in the style of European schools founded by Florence Nightingale, hospital-based nurse training programs appeared in the U.S. The curriculum in the schools was developed in the early 20th century. Later, in the mid-20th century a new curriculum encouraged the growth of independent academic nursing programs in two- and four-year colleges.
  1. Nightingale Principles

    • The Nightingale principles were the precursors to modern nursing.

      Florence Nightingale, the legendary advocate for nursing, founded the St. Thomas hospital in England where she established a nurses' training program. There were strict admissions standards to enter the program and students were required to pass a certification examination upon completion of the program. In 1873, the first three nursing schools were founded in the U.S., basing their curriculum on the Nightingale principles. These schools (Bellevue Training School for Nurses, Connecticut Training School for Nurses and Boston Training School for Nurses) were established to teach a body of scientific knowledge, instead of relying on the widely held view that women were born nurses, rather than taught to be nurses.

    Formal Curricula Reform

    • In 1917, the hospital-based nursing programs in the U.S. adopted a curriculum entitled, "Standard Curriculum for Schools of Nursing." The standards were crucial in the move away from hospital-based programs toward nursing programs in the colleges and universities that had appeared by the end of the two world wars. The standards were revised on two occasions (1927 and 1937), but in 1949, they were replaced by the Tyler curriculum model. The Tyler curriculum revolutionized the teaching of nursing. Tyler was content rich and emphasized philosophy and measurable, behavioral objectives. Most two- and four-year nursing programs adopted the Tyler approach, which continues to dominate nursing curricula.

    Professional Associations

    • Nursing associations such as the National League for Nursing have had a lasting impact on nursing curricula. The NLN's predecessor organ, the American Society of Superintendents for Training Schools for Nurses, led efforts to professionalize nursing by establishing standards for the curriculum (the association developed the Standard Curriculum for Schools of Nursing). The Committee on Grading of Nursing Schools led the movement for licensing of nurses and, with the NLN, pushed for accreditation procedures. In 1934, the NLN began accreditation of nursing programs, a role that it continues to perform in 2010. The NLN takes positions on important aspects of the nursing training programs and issues a formal position statement urging specific reforms. During the accreditation process, the NLN verifies that nursing programs meet content and training requirements and that faculty have the requisite educational background to lecture and mentor student nurses.

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