NURS 6321:Week 2: Needs Assessment: External Factors That Impact Curriculum and Program Development, Part 1

Did you know that heart disease accounted for 25% of deaths in 2008, with the highest rates occurring in Mississippi and the lowest in Minnesota (Centers for Disease Control and Prevention, 2012)? Did you also know that in 2010 chlamydia rates increased in all regions of the United States and along with other sexually transmitted diseases accounted for $17 billion of health care expenses (Centers for Disease and control, 2010)?

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Nurse educators can use national websites such as the Centers for Disease Control and Prevention (CDC) to track external factors and trends that impact patient populations. Though population health has a large impact on the development of nursing curriculum and programs, there are more external factors nurse educators should take into account. This week you explore the many external factors that can impact curriculum and program development.

Learning Objectives

Students will:

  • Evaluate the impact of external factors on curriculum development, assessment, and evaluation
  • Evaluate the impact of external factors on nursing education
  • Conduct a needs assessment*

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 4.

Learning Resources

Required Readings

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed.). St. Louis, MO: Elsevier.

    • Chapter 5, “Forces and Issues Influencing Curriculum Development” (pp.73–88)Chapter 5 explores the diverse external, internal, and higher education issues that can influence the development of nursing curricula. Broad considerations are given, as well as strategies nurse educators can use to analyze current social contexts to align nursing curricula to future global trends.


  • Chapter 16, “Multicultural Education in Nursing” (pp. 263–281)Chapter 16 addresses the increased diversity of nursing students. Instructional strategies, approaches to creating an inclusive environment for all learners, and positive learning outcomes are discussed.

Keating, S. B., & DeBoor, S. S.  (Ed.). (2018). Curriculum development and evaluation in nursing (4th ed.). New York, NY: Springer.

    • Section II: Needs Assessment and Financial Support for Curriculum DevelopmentThis introduction to Section III provides an overview on nursing curriculum development. The author provides this information through external and internal frame factors and relates it to the total management of the curriculum.


    • Chapter 3, “Needs Assessment: The External and Internal Frame Factors” (pp. 46-54)In Chapter 3, Keating describes how to perform a needs assessment and the importance of identifying external frame factors.


  • Chapter 11, “Distance Education, Online Learning, Informatics, and Technology” (pp. 184-200)Chapter 11 highlights how technologies are being integrated into nursing education and the health care field.

Centers for Disease Control and Prevention (CDC). (2012a). Retrieved from

At this website, you can investigate various health statistics broken down by regions of the United States. For example, if you select “Data & Statistics” under the heading “Health & Safety Topics,” this will bring you to a web page that presents a wide range of health topics. Select any of these topics to view more information about its regional and demographic impact or to access studies related to the topic.

CDC. (2012c). Morbidity and mortality weekly report. Retrieved from


At the CDC’s Morbidity and Mortality website, you can select any region or state that you would like to investigate further. These links take you directly to your selected state’s Department of Health website, allowing you to explore health services of any community within that state.

McCawley, P. F. (2009). Methods for conducting an educational needs assessment: Guidelines for cooperative extension system professionals. Retrieved from


This document provides an in-depth example of how needs assessments can be conducted from start to finish. Use the Table of Contents on page 2 to explore specific needs assessment components that you or your team may need further clarification on.

National Historical Geographic Information System. (n.d.). Retrieved October 29, 2012, from

Document: Course Project Outline: Midwest Region (Word document)

Document: Course Project Outline: Northeast Region (Word document)

Document: Course Project Outline: Southeast Region (Word document)

Document: Course Project Outline: Southwest Region (Word document)

Document: Team Evaluation Form (Word document)

Consider the following scenario:

Linda has been a nurse educator at LiveWell Medical Center for about 3 years. Since taking over the position, she has received many accolades for the new evidence-based practices she has shared in nurse trainings. Linda is now looking to turn her attention to patient education. She hopes to initiate bimonthly sessions that will help current and recently discharged patients to better manage their health and/or cope with difficult health issues. At Linda’s next meeting with LiveWell’s board of trustees, she confidently shares her proposal for this new program. At once, she is taken aback at their dismissive responses. “That sounds great Linda, but we simply do not have time to implement something of that caliber here. And how do you know if patients would even be interested in such a service?”

Over the next hour, Linda contemplates these comments and realizes that, despite her best intentions, there was some truth to their remarks. Linda had initially been inspired to create this program after reading about a large rehabilitation center in San Antonio, Texas. The center had revolutionized their outpatient process, helping to demonstrate strong commitment to the community. Though it worked well in San Antonio, Linda had not conducted any preliminary research to learn if it could be effective in their small town of Pinedale, Wyoming.

What external factors should Linda have investigated before trying to develop such a program? In addition, how could these factors continue to impact her program if the LiveWell board of trustees approves her idea?

To prepare:

  • Review this week’s readings, specifically Chapter 3, “Needs Assessment: The External and Internal Frame Factors” (pp. 46-54), in the Keating text and Chapter 5, “Forces and Issues Influencing Curriculum Development,” in the Billings course text. Reflect on the various external factors that can impact the way curriculum is developed, assessed, and evaluated. Then, consider whether certain factors influence institutions (academic settings) more or less than they do agencies (clinical settings).
  • Select one external factor from the following list to further explore for your Discussion posting:
    • Community
    • Population demographics and trends
    • Political climate and body politic
    • Societal patterns
    • Health care system and health needs of the population
    • Characteristics of the setting
    • Need for the program
    • Nursing profession
    • Financial support
  • Consider how this factor might impact curriculum development, assessment, and evaluation in your own academic or clinical setting or in one with which you are familiar. In addition, conduct research to explore how this factor might impact nursing education as a whole.

Note: Although accreditation is considered an important external factor, it is not listed as a factor for this week’s Discussion, as it will be the focus for next week’s Discussion.

By Day 3

Post a description of the external factor you selected. Explain how this factor might impact curriculum development, assessment, and evaluation in an academic or clinical setting with which you are familiar. Share at least one authentic insight into how this factor might also impact nursing education as a whole.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Reflect on an external factor described by a colleague that is different from the one you selected. Offer strategies or professional insights that could be used to overcome barriers associated with this external factor.

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