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University System of Maryland: Maryland Course Redesign Initiative

University of Maryland School of Nursing, Baltimore

Course Title: Context of Health Care Delivery
Redesign Coordinator: Carol O'Neil

Status: This project originated as part of the Maryland Course Redesign Initiative, 2006 – 2009. The team has not submitted a final report. For more information, contact Don Spicer at or the project contact listed above. The project plan serves as a good example of how to think about redesigning a large-enrollment course.

Project Abstract

The University of Maryland School of Nursing, Baltimore plans to redesign Context of Health Care Delivery, a foundation course required of all generic BSN and RN to BSN students. Approximately 220 students enroll in this course each year, which is taught in a traditional classroom at two sites and also offered online.

Students enrolled in this course are heterogeneous in relation to age, educational background and work experience. The students enter the course with differing skill sets; some are already RN's, and some have little experience in nursing. Due to demand, several faculty members teach the course. Over time, the course content has changed from its original format. One exam is given to all students and content typically emphasizes readings, as opposed to lecture material. The traditional class is primarily taught using Power Point slides and lectures, with little student participation and interaction. Students are frustrated with the variation between the posted Power Point content and slides used in the classroom as well as the inconsistency between exam questions and class content. Student course evaluations consistently question how course content applies to nursing practice.

The focus of this redesign project is on the traditional classroom sections of the course, which will be redesigned using the Replacement Model. The course content will be redesigned into nine modules to be completed online. They will cover three content areas: Introduction to the Health Care System; Nurses in the Health Care System; and Nursing Practice in the Health Care System. The traditional face-to-face lecture class will be replaced by a hybrid or blended learning environment. Traditional classroom students, in groups of no more than six, will use scheduled classroom time to complete assignments. Faculty assigned to teach the class will meet with each group of students for 30 minutes, every two weeks during class time or more often, if requested. The purpose of this meeting is to facilitate the completion of group assignments. The online course will remain intact and the modules developed for the traditional hybrid course will also be used in the online course.

This course redesign will enhance the quality of Context of Health Care Delivery by creating an active learning environment. Students will complete modules online and also work in small groups on group assignments during classroom time. Non-graded quizzes will provide immediate feedback to the students and faculty will be available for individualized assistance throughout the semester. The redesign team considers measures of quality to include: consistency across delivery methods, course activities that are relevant to nursing practice; course exams that are based on module objectives; students actively involved in learning.

Learning outcomes related to course redesign will be evaluated by comparing performance on common final exams, average final course grades, and student responses using course evaluation tools, between the original and the redesigned courses. Data will also be collected and analyzed from faculty and student interviews to determine if pre-redesign course issues have been resolved.

Cost savings will result from decreasing the number of classroom sections from five to two, decreasing the total number of instructional faculty in these sections from six to four and increasing the number of students in these sections from 30 to 45 per section to 90. Technology will contribute to cost reduction through the use of online learning modules. Faculty will spend less time coordinating and organizing course activities and more time interacting with students. The cost-per-student will be reduced from $417 to $309, a 26% savings. The redesign team will recommend that a portion of these savings be used to support faculty development as well as faculty participation in national nursing conferences to present this redesign project.



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