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TITLE 22EXAMINING BOARDS
PART 11TEXAS BOARD OF NURSING
CHAPTER 214VOCATIONAL NURSING EDUCATION
RULE §214.9Program of Study

(a) The program of study shall include both didactic and clinical learning experiences and shall be:

  (1) a minimum of 1,398 clock hours: 558 hours for classroom instruction and 840 hours for clinical practice;

  (2) planned, implemented, and evaluated by the faculty;

  (3) based on the philosophy/mission and objectives/outcomes.

  (4) organized by subject and content to meet the needs of the program;

  (5) scheduled with the placement of courses or course content throughout the entire length of the program;

  (6) based on sound educational principles;

  (7) designed to prepare graduates to practice according to the Standards of Nursing Practice as set forth in the Board's rules;

  (8) designed and implemented to prepare students to demonstrate the Differentiated Essential Competencies of Graduates of Texas Nursing Programs Evidenced by Knowledge, Clinical Judgment, and Behaviors: Vocational (VN), Diploma/Associate Degree (Diploma/ADN), Baccalaureate Degree (BSN), October 2010 (DECs); and

  (9) designed to teach students to use a systematic approach to clinical decision making and safe patient care.

(b) The faculty shall be responsible for the development, implementation, and evaluation of the curriculum based upon the following guidelines:

  (1) There shall be a reasonable balance between non-nursing courses and nursing courses that are clearly appropriate for the study of vocational nursing and are offered in a supportive sequence based upon the rationale for the curriculum.

  (2) Instruction shall be provided in nursing roles; biological, physical, social, behavioral, and nursing sciences, including body structure and function, microbiology, pharmacology, nutrition, signs of emotional health, human growth and development; vocational adjustments; and nursing skills. Courses may be integrated or separate.

  (3) Delivery of the curriculum through distance education shall comply with the requirements of this section and §214.10 of this chapter (relating to Clinical Learning Experiences) to ensure that students receive comparable curriculum, supervised clinical learning experiences, and formative and summative evaluations. Faculty must have documented competencies specific to online education.

(c) Instruction shall include, but not be limited to: organized student/faculty interactive learning activities, formal lecture, audiovisual presentations, nursing skills laboratory instruction and demonstration, simulated laboratory instruction, and faculty-supervised, hands-on patient care clinical learning experiences.

  (1) Classroom instruction hours shall include actual hours of classroom instruction in nursing and non-nursing Board-required courses and content.

  (2) Laboratory activities/instruction in the nursing skills or simulation laboratory may be considered as either classroom instruction hours or clinical learning experience hours.

  (3) Hours in clinical learning experiences shall be sufficient to meet program of study requirements with a minimum of 840 hours.

  (4) Clinical practice learning experiences shall include actual hours of practice in nursing skills and computer laboratories; simulated clinical experiences; faculty supervised hands-on clinical care; clinical conferences; and observation experiences for the purpose of calculating the hours for clinical learning experiences in the curriculum. Observation experiences provide supplemental learning experiences that meet specific learning objectives.

  (5) The total weekly schedule throughout the length of the program shall not exceed forty (40) hours per week, including both classroom instruction and clinical practice hours.

  (6) Students shall be assigned two (2) consecutive non-class/clinical days off each week.

  (7) Students shall be allocated at least eighteen (18) days leave for vacation and/or holidays.

  (8) All scheduled holidays are to be observed on the holidays designated by the governing entity.

  (9) Vacation time shall be scheduled at the same time for all students.

(d) Educational mobility shall be a consideration in curriculum design.

(e) The program of study shall include, but not be limited to, the five (5) areas described as follows. Faculty-supervised, hands-on patient care clinical learning experiences in acute and non-acute settings may include long-term care, rehabilitation settings, clinics, respite or day care settings, or other settings where the clinical objectives can be met.

  (1) Nursing Care of Children. Content includes:

    (A) Common health problems of children and implications for nursing care.

    (B) Care and needs of infants and children.

    (C) Growth and development from infancy through adolescence.

    (D) Influences of the family.

    (E) Examples of clinical settings may include, but are not limited to: day care settings, clinics, settings providing care to infants, and facilities providing care to sick children.

  (2) Maternity Nursing. Content includes:

    (A) Psychological and physiological aspects of pregnancy, labor, and post-partum care.

    (B) Nursing care to assist mothers in the care of their newborn infants.

    (C) Examples of clinical experiences may include, but are not limited to: maternity clinics, units providing care for maternity patients, and newborn nurseries.

  (3) Nursing Care of the Aged. Content includes:

    (A) Physical, psychological, and cognitive changes associated with the aging process.

    (B) Implications of aging in planning nursing care.

    (C) Nursing care of individuals experiencing common health problems associated with aging.

    (D) Palliative and end-of-life care.

    (E) Examples of clinical experiences may include, but are not limited to: long-term care and rehabilitation settings, acute care units serving adult clients of all ages, clinics, elderly respite or day care settings, nursing homes, and assisted living settings.

  (4) Nursing Care of Adults. Content includes:

    (A) Common health problems of adults and implications for nursing care.

    (B) Physical, psychological, and spiritual components of health and disease.

    (C) External influences on adult health including the family and community resources.

    (D) Role of the nurse in preventive, therapeutic, and rehabilitation settings.

    (E) Clinical experiences may include, but are not limited to: acute care settings (long and short term), clinics, and rehabilitation settings.

  (5) Nursing Care of Individuals with Mental Health Problems. Content includes:

    (A) Personality development, human needs, common mental defense mechanisms, and factors influencing mental health and mental illness.

    (B) Common mental disorders and related therapy.

    (C) Role of the nurse in promoting mental health.

    (D) Clinical experiences: experiences are optional in psychiatric nursing.

(f) The selection and organization of the learning experiences in the curriculum shall provide continuity, sequence, and integration of learning.

  (1) The learning experiences shall provide for progressive development of values, knowledge, judgment, and skills.

  (2) Didactic learning experiences shall be provided either prior to or concurrent (at the same time) with the related clinical learning experiences.

  (3) Clinical learning experiences shall be sufficient in quantity and quality to provide opportunities for students to achieve the stated outcomes.

  (4) Students shall have sufficient opportunities in simulated or clinical settings to develop manual technical skills, using contemporary technologies, essential for safe, effective nursing practice.

  (5) Learning opportunities shall assist students to develop communication and interpersonal relationship skills.

(g) Course content shall be appropriate to the role expectations of the graduate.

  (1) Professional values, including ethics, safety, diversity, and confidentiality shall be addressed.

  (2) The Nursing Practice Act, Standards of Nursing Practice, Unprofessional Conduct Rules, and other laws and regulations which pertain to various practice settings shall be addressed.

  (3) The curriculum plan, including course outlines, shall be kept current and available to faculty and Board representatives.

(h) Faculty shall develop and implement evaluation methods and tools to measure progression of students' cognitive, affective, and psychomotor achievements in course/clinical objectives, according to Board Education Guideline 3.7.3.a. Student Evaluation Methods and Tools.

  (1) A system of grading shall be in place which does not allow grades of less than a "C" on any required subject areas in the program of study.

  (2) A program may develop admission policies to allow students to challenge course content the student may have previously completed that meets the program's course objectives/outcomes.

(i) Curriculum changes shall be developed by the faculty according to Board standards and shall include information outlined in the Board Education Guideline 3.7.1.a. Proposals for Curriculum Changes. The two (2) types of curriculum changes are:

  (1) Minor curriculum changes not requiring prior Board staff approval, which may include:

    (A) Editorial updates of philosophy/mission and objectives/outcomes; or

    (B) Redistribution of course content or course hours; and

  (2) Major curriculum changes requiring Board staff approval prior to implementation, which may include:

    (A) Changes in program philosophy/mission and objectives/outcomes which result in a reorganization or re-conceptualization of the entire curriculum, including but not limited to, changing from a block to an integrated curriculum or changing the approved delivery method of the curriculum to methods consistent with distance education/learning;

    (B) Revisions in program hours; and

    (C) Addition/reduction of course(s) in the program of study.

(j) Documentation of governing entity approval and appropriate approval from either the TWC or the THECB, if approved/licensed by the TWC or the THECB, must be provided to the Board prior to implementation of changes, as appropriate.

(k) Vocational nursing education programs that have full approval status and are undergoing major curriculum changes shall submit an abbreviated proposal, as outlined in Board Education Guideline 3.7.1.a., to the Board office for approval at least four (4) months prior to implementation. The abbreviated proposal shall contain at least the following:

  (1) new and old philosophy/mission, major concepts, program objectives/outcomes, course objectives/outcomes;

  (2) new and old curriculum plans;

  (3) rationale for the curriculum changes;

  (4) clinical evaluation tools for each clinical course; and

  (5) additional information, as requested, in order to provide clarity for Board Staff.

(l) Vocational nursing education programs not having full approval status, but proposing a major curriculum change, shall submit a full curriculum change proposal, as outlined in Board Education Guideline 3.7.1.a, to the Board office and meet the requirements as outlined in subsection (i) of this section. Vocational nursing education programs not having full approval status are not eligible to submit for Board approval a proposal for a new nursing education program until the program's status has been restored to full approval status by the Board.

(m) All vocational nursing education programs implementing any curriculum change shall submit to Board Staff an evaluation of the outcomes of the implemented curriculum change through the first graduating class under the new curriculum.


Source Note: The provisions of this §214.9 adopted to be effective February 13, 2005, 30 TexReg 545; amended to be effective July 10, 2005, 30 TexReg 3996; amended to be effective October 19, 2008, 33 TexReg 8501; amended to be effective December 27, 2010, 35 TexReg 11662; amended to be effective October 21, 2012, 37 TexReg 8294; amended to be effective August 10, 2014, 39 TexReg 6046

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