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Curriculum Change Plan: Part 4 - Approaches to Implementation
Wendy Ayers
School of Education, Liberty University
Author Note
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to Wendy Ayers.
Email:
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Objectives
Curriculum objectives are developed after establishing goals. Curriculum goals are broad,
and objectives are specific and measurable (Gordon et al., 2019). Objectives are aligned with
goals and identify what students are expected to learn or do by the end of a semester. Before
writing curriculum objectives, identifying student performance requirements may assist in the
process (Gordon et al., 2019). The following learning objectives are aligned with the created
curriculum goals.
1. Students will apply continuous positive airway pressure (CPAP) theory to set up bubble
CPAP on an infant in response to a patient scenario.
2. Students will design a table listing the mechanism of action, adverse effects, and clinical
considerations for the five most common benzodiazepines used for mechanically
ventilated patients (Alprazolam, Diazepam, Lorazepam, Midazolam, and Triazolam).
3. Students will design a table listing the mechanism of action and clinical considerations
for the five most common calcium channel blockers for cardiac arrhythmias in
hospitalized patients (amlodipine, diltiazem, nicardipine, nifedipine, and verapamil).
The three objectives listed above interconnect the three learning domains. Objective one
requires learners to apply the knowledge they gained from videos, lectures, and readings to set
up bubble CPAP on an infant in the laboratory and clinical to complete the competency. The
cognitive component is applying knowledge learned, the affective component is receiving the
information through multiple formats, and the psychomotor is the skill of setting up bubble
CPAP. Objective two requires learners to create a table after learning the mechanism of action,
adverse effects, and clinical considerations for the five most common benzodiazepines used for
mechanically ventilated patients. Students will learn benzodiazepine knowledge through lectures,
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the textbook, and worksheets. Objective three requires learners to create a table after learning the
mechanism of action and clinical considerations for the five most common calcium channel
blockers for cardiac arrhythmias in hospitalized patients. Students will learn calcium channel
blockers knowledge through lectures, the textbook, and worksheets. The cognitive aspect of
objectives two and three is the application of knowledge learning regarding benzodiazepines and
calcium channel blockers. The affective aspect of objectives two and three is using multiple
mediums to gain knowledge, and the psychomotor is creating a table.
Classification System
Bloom’s Taxonomy originated in 1956 utilizing nouns and was revised in 2001 to utilize
verbs. The shift from nouns to verbs removed the focus from acquisition to active performance
of the “types of learning involved in each stage of the hierarchy” (Bloom’s Taxonomy, n.d.). The
revised Bloom’s Taxonomy learning verbs are higher-order learning, apply, analyze, evaluate,
and create, and lower-order learning, remember, and understand (Agarwal, 2019). There are two
thoughts on how students should learn. According to Agarwal (2019), some educators believe
that cultivating higher-order learning requires focusing on learning essential knowledge and
reinforcing it before learning skills. Others believe there should be less instructional time and
more time spent on activities to support critical thinking, analysis, and inquiry.
The three learning domains, cognitive, affective, and psychomotor, are aligned with this
researcher's objectives. Bloom’s Taxonomy encompasses the three interconnected learning
domains corresponding to different learning levels (Nikolic et al., 2023). The cognitive domain is
related to intellectual abilities focusing on critical thinking, problem-solving, and developing a
knowledge foundation, and the hierarchy of remembering, understanding, applying, analyzing,
evaluating, and creating (Bloom’s Taxonomy, n.d.). The affective domain relates to
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communication skills connected to feelings, attitudes, and emotions and the hierarchy of
receiving, responding, valuing, organization, and characterization (Enoch et al., 2022). The
psychomotor domain involves performing tasks, skills, or procedures and the hierarchy of
reflexes, fundamental movements, perceptual abilities, physical abilities, skilled movements, and
non-discursive communication (Bloom’s Taxonomy, n.d.).
Instructional Model
Medical education relies on learners moving from the unable-to-do phase to being able to
do a skill or procedure with assistance until learners reach the phase of performing a skill or
procedure independently. This is the process students in healthcare educational programs must
accomplish. This researcher will implement instructional scaffolding with the proposed
curriculum change. Scaffolding is the progressive growth of students to independence and
understanding (Richardson et al., 2022). Instructional scaffolding involves teachers providing
students with educational support and gradually removing the support as students increase their
knowledge, leading to solving a problem or completing a task independently (Richardson et al.,
2022). The respiratory therapy (RT) program students have approximately 40 competencies to
complete to graduate. The curriculum progresses from simple to complex competencies. “Do not
be conformed to this world, but be transformed by the renewal of your mind, that by testing you
may discern what is the will of God, what is good and acceptable and perfect (English Standard
Bible, 2001/2016, Romans 12:2). This verse speaks on change and transition, and how we must
not conform to the ways of the world, instead, we need to change how we think to comprehend
God’s will for our lives.
Scaffolding is beneficial to both students and instructors. Streamlining student guidance
benefits instructors, leaving professors free to address other concerns (Shaw, 2019). This is
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beneficial for students to work more independently through a course. Improving student success
and challenging them “through deep learning and discovery” are student benefits provided by
scaffolding (Shaw, 2019). Scaffolding also provides more opportunities to work independently
and have better preparation. Creating content in segments enhances students' comprehension and
splits assessments into smaller manageable pieces (Shaw, 2019).
Instructional scaffolding aligns with how to educate healthcare students to master skills
and graduate as functional healthcare team members. More specifically, strategic scaffolding
incorporates providing simple educational concepts first and building on that knowledge with
increasingly more complex educational concepts (Richardson et al., 2022). This prevents
information overload, and students can better process each educational concept. The RT program
students begin by learning cardiopulmonary resuscitation (CPR), cardiopulmonary anatomy,
primary vital signs, cardiac rhythms, breath sounds, and basic cardiopulmonary skills and
procedures. As students progress through the program, they build on this knowledge by learning
more complex concepts, such as cardiopulmonary disease processes, treatment methodologies,
pharmacology, mechanical ventilation, and hemodynamics. Structuring the curriculum in
sections and building on acquired knowledge helps the student understand the content.
According to Lange et al. (2022), strategic scaffolding helps students better understand content
and be more engaged. This researcher has utilized strategic scaffolding for fourteen years, and
this approach has successfully delivered content from simple concepts to complex ones.
Scaffolding instruction by explaining the content, using multiple techniques for supported
practice, and providing an individual practice activity for independent work is standard practice
for teachers (Lange et al., 2022). The key to scaffolding instruction, specifically strategic
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scaffolding, is delivering content that leads to independent work. This is essential for healthcare
students since employers expect a new graduate RT who can function independently.
The first competency students must complete is handwashing. The process starts with
students understanding the purpose of handwashing and how it prevents cross-contamination and
hospital-acquired infections. Students must comprehend the value of handwashing; the final step
is performing handwashing. Competencies are completed in the laboratory and hospital with an
instructor. After completion, students can independently perform the competency. Handwashing
aligns with strategic scaffolding as a simple competency implemented first.
The curriculum change plan extends the neonatal/pediatric course from eight to 16
weeks. The purpose is to have additional time to deliver curriculum content in progressive
segments instead of compressed content. The additional time will also provide the opportunity to
introduce bubble CPAP in the curriculum. Previously, bubble CPAP was not taught because of
time constraints. Scaffolding will begin with an understanding of bubble CPAP theory, followed
by application assistance from an instructor, and lastly, students will independently set up bubble
CPAP in laboratory and clinical. This competency will better prepare RT students for
neonatal/pediatric clinical rotations.
The curriculum change plan also includes an additional eight-week pharmacology
curriculum. The purpose is to have additional time to deliver advanced pharmacology curriculum
content in progressive segments. Currently, advanced pharmacology is taught in two critical care
courses, and moving this content into one course will provide a better opportunity to scaffold
content into segments. Scaffolding advanced pharmacology drugs, benzodiazepines and calcium
channel blockers, will begin with comprehending the mechanism of action, adverse effects
(benzodiazepines only), and clinical application. An instructor-led group case study activity
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follows this. Lastly, students will work independently to develop a table to identify
benzodiazepine and calcium channel blockers' mechanism of action, adverse effects
(benzodiazepines only), and clinical application.
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References
Agarwal, P. K. (2019). Retrieval practice & Bloom’s Taxonomy: Do students need fact
knowledge before higher order learning? Journal of Educational Psychology, 111(2),
189-209. https://doi.org/10.1037/edu0000282
Bloom’s taxonomy. (n.d.). Uwaterloo.Ca. Retrieved November 23, 2023, from
https://uwaterloo.ca/centre-for-teaching-excellence/catalogs/tip-sheets/blooms-taxonomy
English Standard Bible. (2016). Literal Word. https://esv.literalword.com/ (Original work
published 2001).
Enoch, L. C., Abraham, R. M., & Singaram, V. S. (2022). A comparative analysis of the impact
of online, blended, and face-to-face learning on medical students’ clinical competency in
the affective, cognitive, and psychomotor. BMC Medical Education, 22(1), 753-765.
https://doi.org/10.1186/s12909-022-03777-x
Gordon, W. R., II., Taylor, R., & Oliva, P. F. (2019). Developing the curriculum: Improved
outcomes through systems approaches (9th ed.). Pearson.
Lange, C., Gorbunova, A., Shmeleva, E., & Costley, J. (2022). The relationship between
instructional scaffolding strategies and maintained situational interest. Interactive
Learning Environments. https://doi.org/10.1080/10494820.2022.2042314
Nikolic, S., Suesse, T. F., Grundy, S., Haque, R., Lyden, S., Hassan, G. M., Daniel, S., Belkina,
M., & Lal, S. (2023). Laboratory learning objectives: Ranking objectives across the
cognitive, psychomotor and affective domains within engineering. European Journal
of Engineering Education, 1-20. https://doi.org/10.1080/03043797.2023.2248042
Richardson, J. C., Secil, C., Castellanos-Reyes, D., Suzhen, D., Duha Mohammad, S., Holly, F.,
& Yishi, L. (2022). Instructors’ conceptualization and implementation of scaffolding in
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online higher education courses. Journal of Computing in Higher Education, 34(1), 242-
279. https://doi.org/10.1007/s12528-021-09300-3
Shaw, A. (2019, September 5). Scaffolding learning in the online classroom - Center for
teaching and learning. Center for Teaching and Learning | Wiley Education Services.
https://ctl.wiley.com/scaffolding-learning-in-the-online-classroom/
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