Concept-Based Curriculum, Course Design, Course Evaluation, Nursing Education, Pharmacology Education, Teaching Strategies



  1. Lanz, Amelia
  2. Davis, Rebecca G.


Abstract: Although concept-based curricula are frequently discussed in the nursing education literature, little information exists to guide the development of a concept-based pharmacology course. Traditionally, nursing pharmacology courses are taught with an emphasis on drug class where a prototype drug serves as an exemplar. When transitioning pharmacology to a concept-based course, special considerations are in order. How can educators successfully integrate essential pharmacological content into a curriculum structured around nursing concepts? This article presents one approach to the design and implementation of a concept-based undergraduate pharmacology course. Planning methods, supportive teaching strategies, and course evaluation procedures are discussed.


Article Content

A number of frameworks exist to support the design and implementation of concept-based curricula in nursing education. However, in both the planning and transition phases for an undergraduate nursing pharmacology course, our instructional team encountered some unique challenges. To begin with, the previous approach to teaching and learning in pharmacology was based on a conceptual method. General information pertaining to drug class was first considered, and then a prototype drug was used to provide a specific illustration. Many nursing pharmacology textbooks use this format to organize drug information. The need to memorize an endless drug list is avoided and replaced with conceptual learning that can be generalized across a drug class. We faced the question of how to infuse a new conceptual framework alongside the one that already existed for pharmacology. Thoughtful planning was required.


A common approach to concept-based course design, the concept-disease exemplar model, failed to translate seamlessly to pharmacology. Moreover, the nursing education literature offered little in the way of strategies targeted toward teaching pharmacology using a conceptual nursing framework. To optimize the course design and ensure that the goals of the new curricular model would be achieved, the course team engaged in a collaborative effort. This article describes our approach for the design and implementation of a concept-based undergraduate pharmacology course and discusses teaching strategies supportive of concept-based learning. We also discuss methods used for course evaluation.



Most educators, as they set out to plan a course, start by considering the question: What do students need to know? Thus, an initial step in course planning was to identify the essential drug classes to be included in course content. We reviewed several online resources to determine the most commonly prescribed medications and those routinely used in clinical settings. We also reviewed the pharmacological and parenteral therapies section of the National Council of State Boards of Nursing NCLEX-RN(R) Detailed Test Plan as well as the RN Practice Analysis. We sought faculty input from across the program to support curricular integration and obtained varying clinical perspectives. We also reviewed the course textbook along with supplementary resources to support conceptual learning.


The next step was to review nursing concepts specified for pharmacology in the program's curriculum map and arrange them in a sequence to create the course outline. That entailed using the concept outline as the categorizing framework to sort each of the previously identified drug classes in a logical manner. Example combinations include the concept of perfusion with antihypertensive drug classes and the concept of fluid and electrolytes with diuretic therapies and electrolyte replacements. In some instances, disease exemplars were needed to provide a context for medication use, such as medications for osteoporosis or medications used in the treatment of Parkinson's disease.


To further support conceptual learning and help students make connections, we often combined interrelated concepts in the same class session. As an example, the concept of inflammation was combined with the concept of pain, and both opioid analgesics and NSAIDS were considered in this category. When planning for subsequent semesters of pharmacology, we arranged concept-drug class combinations in a sequence to allow each week's new content to scaffold onto the concepts learned during previous weeks. Perfusion, oxygenation, and fluid and electrolytes serve as an example of this sequencing. In effect, rather than teaching concepts and drug classes as discrete categories, a "building on" approach was implemented to enhance conceptual learning.



Active, student-centered learning is one of the key components of successful concept-based teaching and learning (Giddens & Brady, 2007; Stanley & Dougherty, 2010). To meet this recommendation, we use a variety of active learning strategies to allow students to engage with and apply medication knowledge most essential for future practice. The majority of these activities are collaborative in nature, allowing students to learn from their peers as well as course instructors.


Conceptual teaching should require students to manipulate and organize content, to understand it within multiple contexts, and to connect new information to past learning (Giddens & Brady, 2007). To begin each course session, a visual map is presented to the class, illustrating the concepts for the week. Students are asked to provide examples of how the nursing concepts in the diagram interrelate with previously learned concepts and medications. For example, the session on medications for nutrition and gastrointestinal disorders follows the class session on medications for fluid and electrolyte imbalances. Guiding questions are asked to help students make connections and include points such as: What is the relationship between fluid balance and perfusion and what is the relationship between gastrointestinal dysfunction and electrolyte imbalance? These discussions serve to stimulate critical thinking and provide a foundation for subsequent learning activities.


A concept mapping strategy is also used to support active learning and student engagement. Organizing information graphically in a concept map promotes deep learning and provides a measure to assess student understanding (Schwartz & Heiser, 2010). The course team determines which drugs will be included in the concept map assignment prior to the onset of the semester. Commonly used medications and those associated with a narrow margin of safety generally comprise the list. A rubric is provided noting the key elements for inclusion (e.g., patient education, major adverse effects, and pertinent preassessments). Because learners are encouraged to structure map information in ways that align with their thinking, guidelines are kept to a minimum. However, to support learners in the process, mapping activities are often conducted in class when instructors are present to provide direction.


In the first semester of implementation, a survey was conducted to gauge student perspectives regarding the concept mapping assignment. Results indicated that 80 percent of the cohort (n = 93) believed the activity was beneficial to their learning. Standardized test results over two semesters suggested that drugs included in the strategy correlated with positive scores. With these favorable outcomes in mind, the concept mapping strategy was implemented in future semesters. To further support conceptual learning, one addition was made to the assignment, directing students to include key nursing concepts relevant to the featured drug or drug class.



The team developed a course evaluation plan to assess outcomes, guide future planning, and cultivate the development of the team's concept-based teaching skills. Evaluation is an essential element to promote course and program quality (Oermann, 2017). Drifting away from a new model and reverting back to "old ways" may happen in the early phases of curricular change. Thus, in instituting the concept-based pharmacology course, regular assessments were needed to ensure that a conceptual approach to teaching and learning was maintained.


The course test plan was expanded to include nursing concepts. Exam results, along with summary reports from a standardized testing product, helped support the evaluation of course strengths and weaknesses. One specific use for the data was to assess testing outcomes related to each concept. For example, in the first semester of concept-based pharmacology, the concept of cognition was found to be an area in need of improvement. Clearly, the course team could discern strategies for improvement in pharmacology, but this finding also supported a concepts appraisal across the curriculum. Because testing outcomes pertaining to cognition were found to be weak in other areas as well, collaboration among course teams was undertaken and a collective approach for improvement resulted.


Currently, focused discussion is conducted by the team at the end of each semester to evaluate both teaching and learning outcomes. This process has been beneficial in determining what works well and what needs to be improved. The results provide clear direction for future planning.



Nurses play a key role in the management of medication therapies. To provide safe, effective care, a sound foundation in pharmacological knowledge is essential for entry into practice and should receive focused attention in the nursing curriculum. This article describes one approach for the development of a concept-based nursing pharmacology course. Innovative planning was required during course transition, but the goals of concept-based learning were maintained. Positive outcomes for both students and faculty have been achieved using the course plan presented.




Giddens J. F., & Brady D. P. (2007). Rescuing nursing education from content saturation: The case for a concept-based curriculum. Journal of Nursing Education, 46(2), 65-69. [Context Link]


Oermann M. H. (2017). Program evaluation: An introduction. In Oermann M. H. (Ed.), A systematic approach to assessment and evaluation of nursing programs (pp. 1-6). Washington, DC: National League for Nursing. [Context Link]


Schwartz D. L., & Heiser J. (2010). Spatial representations and imagery. In Sawyer K. (Ed.), The Cambridge handbook of learning the learning sciences (pp. 283-299). New York, NY: Cambridge University Press. [Context Link]


Stanley M. J., & Dougherty J. P. (2010). A paradigm shift in nursing education: A new model. Nursing Education Perspectives, 31(6), 378-380. doi:10.1043/1536-5026-31.6.378 [Context Link]