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Introduction
Consistent with the Republic Act (RA) No. 7722, otherwise known as the “Higher Education Act of 1994” and in compliance with the outcomes-based quality assurance system advocated under the Commission on Higher Education Memorandum Order (CMO) No. 46 s.2012, CHED issued CMO No.15 s.2017 to implement the “shift from competency-based standards to outcomes-based education and to specify the “core competencies’ expected of Bachelor of Science (BS) in Nursing graduates. This CMO has provided Higher Education Institutions (HEIs) in the country with the freedom to design and innovate their nursing curriculum if they can demonstrate that it will lead to the attainment of the required outcomes set by the same CMO.
According to Uys & Gwele (2005), Outcomes-Based Education (OBE) is an approach to education in which the decisions about the curriculum are driven by the outcomes the learners should demonstrate upon completion of the program, with the product defining the process. The CMO No. 15 s.2017 though worded differently, has the same definition of OBE when it explained that OBE is an approach that focuses and organizes the educational system around what is essential for all learners to know the value, and able to do, to achieve a desired level of competence. The shift to OBE was pushed primarily by its potential to align education with the demands of the workplace and in developing transferable life skills, such as problem-solving and critical thinking skills. In their book titled “Curriculum Development in Nursing Process and Innovation,” Uys & Gwele (2005) explained that OBE uses a “design-down” approach in developing a curriculum and it begins with a clear specification of what the students should know, be able to do, and the attitudes desirable on completion of the program.
They also discussed the steps in creating an Outcomes-Based Curriculum as follows:
- Developing a Graduate Role Statement
- Determining Graduate Competencies in the form of Program Outcomes
- Deciding on the Program Structure, ensuring all outcomes are catered for in the program.
- Identification and designing modules/course outcomes.
- Planning the assessment and evaluation of learning
Developing a Graduate Role Statement is a step that requires the determination of what roles the nursing students can take upon completion of their nursing education and obtaining the license to practice. Program Outcomes (also referred to as Terminal Outcomes) describe the general destination of the nursing students in the BSN Program to which all teaching/learning is directed. It is also sometimes described as the “characteristics of graduates”. The Philippine BSN Program’s goal is to develop a professional nurse who is able to assume entry-level positions in health facilities or community settings. The statements are comprehensive, but also clear and attainable. While characteristics of nursing graduates are described as “capable of proving safe, humane, quality and holistic care.” In the third step which is the Deciding on the Program Structure, provisions for flexible entry and exit points for the learners of the program are carefully crafted allowing students leaving the program for some reasons to earn recognition in the form of a diploma or certificate or transfer of credits, thus avoiding unnecessary duplication of learning. It is also where different modules (fundamental, core & elective) are determined for a particular qualification as well as the organization of the curriculum on different levels in the BSN Program. This allows for the identification of level outcomes and which modules to be taken at each level. Planning the assessment and evaluation is the last step in the process of creating an outcomes-based curriculum. It is where the Curriculum Committee creates an assessment criterion to evaluate the learning. This is indicated in broad terms, observable processes and products of learning which serve as a culminating demonstration of the learner’s achievement of competence.
Methods
The method used for this paper is the discussion of Outcome-Based Education and the Commission on Higher Education’s Memorandum Order (CMO) No. 15 Series of 2017 Utilizing Uys & Gwele’s book titled “Curriculum Development in Nursing Process and Innovation” in the creation of a reflective analysis.
Results & Analysis
The below table shows the process of creating an Outcome-Based Curriculum discussed in the book “Curriculum Development in Nursing Process and Innovation” by Uys & Gwele (2005) and the guidelines on the creation of the Philippine Nursing Curriculum established by CMO No.15 s.2017. The comparison of the two pieces of literature provided a point for reflective analysis on the topic.
Curriculum Process in Outcomes-Based Education (OBE)
| Curriculum Process | Uys & Gwele | CMO No.15 s.2017 | Analysis |
|---|---|---|---|
| Developing a Graduate Role Statement | -Clinical Role -Management Role -Research Role -Clinical Teaching Role | I. Nurse Generalist -Client Care -Leadership & Management -Research II. Specialization -Advance Practice -Public Health -Nursing Education -Leadership & Governance | CMO No. 15s.2017 clearly defined the roles that a nurse can take at the beginning of his/her nursing career. It even provided advanced career paths for nurses. |
| Determining Graduate Competencies in the form of Program Outcomes | 3 Elements of Program Outcomes -Observable Behavior -Conditions under which the behavior must be performed -Evaluation Criteria for the performance of the behavior | Program outcomes are divided into 3 sets: -Outcomes common to all programs and all type of schools -Outcomes common to Health Professions -Outcomes specific to BSN* *BSN Level Outcomes | CMO No. 15s.2017 Program outcomes were determined with emphasis on the student’s ability to work not only with a medical professional but as well as professionals from other fields. The three elements of program outcomes are also well implemented on the performance key indicators set by the CMO |
| Deciding on the Program Structure | Program Structure Fundamentals *Social Sciences *Foundational Sciences Core *Nursing Courses Electives *Modules for additional credits | Philippine Nursing Curriculum Components General Courses -36 units Other Courses -14 units Major Courses -17 units Professional Courses – 125 units Total Units: 192 | CMO No. 15s.2017 used the OBE approach to establish the components of the Philippine Nursing Curriculum. It also ensured that the program is structured in a way that focuses on the expected outcomes to define succeeding Educational levels. |
| Planning the assessment and evaluation of learning | Two Main Purpose of Assessment 1. Identify area & Degree of competence. 2. Provide feedback for learning. Three Areas of Competence 1. Foundational 2. Applied 3. Flexible Competence | The CMO does not include specific Assessment methods. It does include a quality assurance clause where HEI’s are required to undergo accreditation by relevant accrediting agencies recognized by the Commission on Higher Education | CMO No. 15s.2017 implements the shift to OBE and gave HEIs 3 years to fully comply with the CMO. I strongly believe that another CMO must be issued to establish the assessment methods for the quality of learning. |
DISCUSSION
The information presented above clearly indicates that CMO No. 15s.2017 is an outcomes-based approach to creating the Philippine Nursing Curriculum. The stages that schools might undergo in the process of implementing an outcomes-based program according to Bonville (1996) (Originally suggested as approaches to OBE by Spady) (1994) can be observed in the sample curriculum provided in the CMO. The General Education Courses included in the curriculum cover a vast body of knowledge and focus on recalling information. It is also hard to find the connection between the courses to create knowledge integration. For example, Mathematics in Modern World to the Life & Works of Jose Rizal. Another observation is that the General Education Courses do not indicate a clear pathway of learning and the relationship between the courses to each other and to society appears to be vague. These are usually found in Traditional Outcomes-Based Education. The Other & Major Courses in the sample curriculum appear to show more of Transitional OBE where we can now start to see the connection of the courses to each other and to future courses that students will take as well as how the courses relate to the nursing profession, professionals from other fields and to the larger society. There is a clear reason why the learners must learn the courses included and the courses included are aimed at developing cross-disciplinary skills in learners, a characteristic of Transitional Outcomes-Based Education. The Professional Courses are aimed at developing future nurses equipped with knowledge, skills, and attitudes that will enable them to participate competently in the competitive global community and perform their roles with competence as demanded by their future and professional lives as nurses.
The only deviation of CMO No. 15s.2017 from the Curriculum Process in Outcomes-Based Education is the absence of a clear process for the evaluation of learning. Though there is a requirement for HEIs to undergo accreditation by relevant authorities recognized by the Commission on Higher Education, it does not provide a clear determination as to where exactly is the student in his/her performance towards the outcomes that he/she must demonstrate. The lack of a definite evaluation process makes it harder for both the student and the educator to make the necessary adjustments for the student to demonstrate the expected outcome under a specified condition and to the level of confidence expected from them. Since the CMO was issued to implement the shift to OBE and give the necessary time to HEIs to comply with the guidelines and policies set on the CMO, it may be understandable why there is a lack of planning for the evaluation of learning. The years that lapsed from the date the CMO was issued, I strongly believe, necessitate another CMO specifying the plans for evaluation of learning. Existing studies concluded that the healthcare needs of people change with time and nurses must be able to meet the demands of the nursing profession brought about by these changes.