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ABSTRACT
Nursing education has struggled for decades to develop a framework that would adequately reflect nursing and provide a stable yet dynamic curriculum for nursing education. Unfortunately, most of the frameworks the profession has used in the past either were adapted from other disciplines or based on processes, concepts, and theories that were too narrow to serve in the capacity of a unifying framework. Perhaps it is time that nursing begins to focus more on the profession's epistemological forest than on isolated trees when developing and selecting curricular frameworks. This article offers a framework that may help us do just that.
Since the movement of nursing curricula from hospitals into collegiate-based settings in the 1950s, nursing education has struggled to find a framework that not only would serve as a basis for teaching nursing but also would provide flexible structure that allowed for growth and change. Early nurse educators adopted the same framework used by schools of medicine, which was and continues to be based on the diagnosis and treatment of illness or disease. Almost immediately, the nursing profession realized that this illness-based medical model, while somewhat serviceable, did not accurately reflect the totality of nursing. The medical model, then and now, encompasses only those aspects of nursing that are shared with medicine and does not address other aspects that are unique and valuable to nursing and nursing education.
Early in the efforts to find a conceptual framework, nurse educators tried using concepts and theories from related disciplines, such as Maslow"s hierarchy of basic human needs (1970), Erickson's developmental staging (1963, 1968, 1978), and Selye's physiological stress adaptation (1956), as the foundation for nursing curricula. While these related discipline theories were and continue to be valuable, the nursing profession still needed a framework that reflected its uniqueness in a descriptive, yet organized, systematic, and logical manner.
This is when nursing process emerged. Originally penned by Hall (1955), nursing process was viewed as an approach to help ensure quality nursing care. By 1966, it had developed into a four-step process of assessing, planning, implementing, and evaluating, and by the 1970s, a fifth step, diagnosis, had been added (LeMone & Burke, 1996).
Nursing process provided, and still provides, a fundamentally simple and systematically linear method of...