2:29 p.m., Oct. 20, 2009----The University of Delaware's undergraduate nursing curriculum, which concentrates students' clinical experiences into an intensive senior year, has been recognized by the National League for Nursing as one of the most innovative in the nation.

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The league, a professional association that represents 1,200 institutions and 28,000 individuals, selected UD's School of Nursing among 15 undergraduate programs across the country to highlight at its annual meeting in September. The programs were chosen because they offer innovative, creative and effective methods of educating future nurses, according to the organization.

The University's undergraduate nursing curriculum was revamped in 2005 to delay much of the students' direct care of patients until their final year of school. Previously, nursing students gained clinical experience off-campus throughout their four years as undergraduates. Now, they still go into hospitals and other healthcare settings throughout those years, but the first three are more focused on observing nursing care and interacting with patients in other capacities, said Judy Herrman, associate professor of nursing and coordinator of undergraduate clinical experiences.

“Since the 1850s, we've been educating nurses through on-the-job training, a sort of baptism by fire,” Herrman said. “But now, the patients are too sick, the cases too complex, and they're too surrounded by technology to have students learning on the job. Our curriculum ensures that our students first have the knowledge, that they have all the skills under their belts, and then they're allowed the privilege of actually caring for patients.”

Another advantage of the intensive senior year clinical work is that students aren't distracted by academic courses, homework and tests while they're at work in a hospital, Herrman said. The immersion in hands-on work allows them to focus on honing their skills and prepares them for the transition they are about to make from student to working professional, she said.

Other benefits of the new curriculum are in patient safety and the efficient use of faculty time, Herrman said. For example, she said, a faculty member can teach a larger group of sophomores than was possible when that class also required clinical supervision of the students. That, in turn, has allowed the School of Nursing to shift some of its faculty time to senior students, who need that close supervision during their clinical experiences.

The curriculum change has been made possible by the school's high-tech simulation lab, in which lifelike, programmable mannequins are used to give students practice in everything from checking a medical chart and helping a patient get out of bed to caring for a premature baby and responding to a heart attack or other emergency.

“Students are in the simulation lab from freshman year on, and it gives them great experience -- the kind of experience they really remember because it's so realistic,” Herrman said. “When we decided to change the curriculum, we were very careful to create lots of experiences for students during their first three years that would prepare them well for the clinical immersion. When they begin their senior year, they really are knowledgeable and more confident than in the past.”

In addition to the simulation lab, students' first three years include field experiences in every course; they observe surgery and labor and delivery, for example, and they might engage in such activities as taking a hospital patient's health history. They also are required to work at least 160 hours, often during Winter Session or summer, in a healthcare setting, usually in a job such as patient care assistant.

Herrman said students have been successful in the curriculum, which is continuing to be evaluated, and reports from working nurses indicate that they are finding the UD seniors very well prepared. She has been asked to speak around the country about the curriculum as other schools consider changing their approaches to educating nurses.

The School of Nursing at UD graduates about 125 students each year in its traditional bachelor of science in nursing program. In addition, it offers programs for registered nurses without a bachelor's degree to earn that degree and for individuals with bachelor's degrees in other fields to earn an accelerated, second degree in nursing.

Article by Ann Manser