NUR 7000 Module 4 Course Design Paper: Backward Design of a Community Health Course Example

Starting From the End: Backward Design of a Community Health Course in Camden County

Student Name

M.S. in Nursing, Nurse Educator, Thomas Edison State University

NUR-7000: Curriculum Theory and Development in Nursing Education

Mentor Name

Month Day, Year

Starting From the End: Backward Design of a Community Health Course in Camden County

The Course as It Was

The program and its course are invented. The community health course in a BSN program in Camden County has been taught for years as a series of topics: epidemiology, communicable disease, environmental health, vulnerable populations, disaster preparedness and so on. Each week has a reading and a lecture; students complete a clinical rotation at a health department and write a paper on a community issue of their choice. Course objectives use verbs such as understand, appreciate and be familiar with. Faculty describe papers that summarize articles but do not use data, and health department preceptors say students arrive unsure what public health nurses do.

The course coordinator, an MSN student in nursing education, proposed rebuilding the course from its outcomes.

Tyler's Questions

Tyler (1949) proposed that curriculum planning answer four questions: which purposes a school should pursue, which experiences are likely to achieve them, how those experiences can be organized effectively and how anyone can tell whether those purposes have been reached. His rationale made objectives the starting point and evaluation a check on whether they had been met, and it shaped curriculum work for decades, including in nursing.

Backward Design

Wiggins and McTighe (2005) proposed backward design, which follows a similar logic but reverses the usual order of planning. In stage one, designers identify the desired results: what students should understand and be able to do. In stage two, they determine acceptable evidence: what performances and products would show that students have achieved those results. Only in stage three do they plan the learning experiences and instruction that will prepare students for those assessments. The authors warned against two common errors, activity-focused teaching that keeps students busy without a clear purpose and coverage-focused teaching that marches through content.

Writing Outcomes

Anderson and Krathwohl (2001) revised Bloom's taxonomy into two dimensions. Its cognitive process dimension has six steps, starting with remember and understand, moving to apply and analyze and ending with evaluate and create. The knowledge dimension distinguishes factual, conceptual, procedural and metacognitive knowledge. Objectives can be placed in a grid by both dimensions, which helps designers see whether a course asks students only to remember facts or also to analyze, evaluate and create.

Stage One: Outcomes

The coordinator rewrote the course outcomes using the revised taxonomy. Graduates of the course will be able to analyze population data from public sources to describe a community's health; evaluate the evidence for interventions addressing a priority problem; create an intervention plan with a community partner that includes measurable objectives; and apply principles of health equity to explain differences in health within the community. Each outcome sits at the analyze, evaluate, create or apply level, combined with conceptual and procedural knowledge.

Stage Two: Evidence

The main assessment is a community health assessment completed in teams of four with a partner agency, such as the health department or a community health center. Teams use public data sources, a windshield survey and interviews with residents and agency staff to describe a community's health, select a priority with the partner and propose an intervention with objectives and an evaluation plan. Teams present to the partner agency, which gives feedback. Individual reflective essays and short data exercises provide additional evidence for each outcome.

The Rubric

The team assessment uses a rubric with four criteria matched to the outcomes: use of data, evaluation of evidence, quality of the intervention plan and attention to health equity. Each criterion has four levels with descriptions of what the work looks like at each, and partner agency staff helped write the descriptions for the intervention plan so that the rubric reflects what agencies find useful. Faculty tested the rubric on two papers from the previous year, scoring them independently and discussing differences until their scores agreed. The rubric is given to students in the first week, so they know from the start what evidence they must produce.

Stage Three: Learning

Only after the outcomes and evidence were set did the coordinator plan weekly learning. Early weeks teach students to find and interpret data, with in-class workshops using real county data. Middle weeks cover evidence for interventions, with each team reviewing studies on its priority. Later weeks focus on planning and presenting. Clinical days at the agency are tied to the team project. Topics that once filled lectures, such as communicable disease and disaster preparedness, appear as they relate to the teams' communities and to agency work.

Aligning the Clinical Days

Under the old design, clinical days at the health department were observation, and students often shadowed nurses doing tasks unrelated to their papers. In the new design, each clinical day has a purpose tied to the assessment: meeting agency staff to choose a priority, conducting resident interviews, attending a community coalition meeting or presenting a draft for feedback. Preceptors know each day's purpose in advance, and students write a short note after each day about how it advanced their team's work.

Partners

The health department and two community health centers agreed to host teams and attend presentations. Preceptors helped choose the data sources and reviewed the rubric.

Evaluation

The coordinator will compare rubric scores across outcomes, gather partner feedback on the usefulness of team proposals and ask students to rate their confidence in community assessment before and after the course.

Limits

Team projects can hide uneven contributions; individual essays and peer evaluation address this partly. Partner agencies may not always have time. Some topics receive less direct teaching than before.

Conclusion

A course built from topics and vague objectives left students unsure of public health nursing. Tyler's questions, backward design and the revised taxonomy turned it into a course built from outcomes students must demonstrate, with a community assessment as evidence and learning planned to prepare for it.

References

Anderson, L. W., & Krathwohl, D. R. (Eds.). (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives. Longman.

Tyler, R. W. (1949). Basic principles of curriculum and instruction. University of Chicago Press.

Wiggins, G., & McTighe, J. (2005). Understanding by design (Expanded 2nd ed.). Association for Supervision and Curriculum Development.