By Sheri Hall
The role of nurses has evolved drastically over recent decades as our health care system expanded to provide more comprehensive, specialized care; with it, nursing education is also evolving to better train the next generation of health care providers.
UW–Madison’s School of Nursing is at the forefront of this movement with a sweeping project to redesign the school’s curriculum – a move that will shift the student experience toward more hands-on, practice-based learning.
“Our students need to not only know the information, but they also need to be able to “do” through demonstration,” explained Undergraduate Program Director and Clinical Professor Dana O’Brien, PhD, MHA, RN, CNE. “We want to ensure that they have the skills and attitudes to provide safe, evidence-based care. We also want to send them out into the nursing world with inner resources to withstand the long hours, frenzied pace, and moral distress that sometimes comes with nursing practice.”
The curriculum update began in 2021, when the American Association of Colleges of Nursing (AACN) released new guidelines for nursing schools across the country with the goal of better bridging the gap between education and practice. The guidelines, titled The Essentials: Core Competencies for Professional Nursing Education, focus on ten core domains that nursing students must master. The ten domains span four different caregiving spheres – disease prevention, chronic disease care, regenerative or restorative care, and hospice and palliative care.
“This transition to a competency-based education has required re-framing how we think about the development, implementation and assessment of our curriculum,” explained Lisa C. Bratzke, PhD, RN, ANP-BC, FAHA, the school’s associate dean for academic affairs and Sekelsky Professor in Education Innovation. “Our new program is cognizant of the changing health care landscape and continues our pursuit of innovation and education design – right back to where we started as a school 100 years ago.”
The overall goal is to build a nursing curriculum that prepares students for the work force, Dr. O’Brien said.
“As a teacher, I want my students to go out into the field with as much preparation as possible to help ensure their success,” she said. “It’s not enough to send them out with pure knowledge. We want to develop practice-ready nurses focused on improving patient safety, staying in the nursing workforce, and strengthening the profession.”
Curriculum updates: A focus on broad concepts
Leaders at the School of Nursing are updating the content and structure of the entire curriculum, which includes moving courses to different semesters, adding courses on emerging topics such as technology and informatics, and updating all the school’s textbooks.
“We knew we needed to update our entire curriculum, so this is a perfect time to make all of the changes at once,” Dr. O’Brien said. The new curriculum will build on itself each semester so that students are continually reviewing information they’ve already learned to enhance their knowledge and retention.
Other additions include population-based courses, where students learn the ins-and-outs of treating specific groups such as older adults, pregnant people, and children. The curriculum also shifts to focus on broader biological concepts – for example, learning about cardiac tissue perfusion and how it relates to cardiovascular disease instead of studying individual heart conditions separately. All of this leads to an increased emphasis on clinical judgment rather than simple knowledge, and a focus on health rather than a disease process.
The new curriculum includes input from practice partners, organizations in various care settings that collaborate with the nursing school to help ensure that graduates are prepared for the workforce.
“It’s a team effort,” Dr. O’Brien said. “We are working to make sure that all voices are heard, and everyone is on the same page. It takes a village, and when I say that I’m referring to both internal and external stakeholders.”
“Part of what the AACN’s goal is, is that no matter where you receive your nursing education throughout the country, all students will be held to the same standards when it comes to a competency-based education and preparation to work as a practice-ready nurse.”
Active learning: A key component
In addition to updating topics and courses, the School of Nursing is evolving its teaching methods to better prepare students for real-world jobs. Most classes will now involve active learning, which means not simply asking students to enhance their knowledge but to use that knowledge in a variety of classroom and real-world scenarios.
To accomplish this, the class structure will change. At the beginning of each class period, students will take a short quiz to help instructors determine what they know. “This will allow faculty to understand what topics the students need help with and conduct a review of important concepts,” O’Brien said.
Then, students will participate in activities that ask them to apply the information they have learned in various scenarios related to the four caregiving spheres outlined in ACCN’s Essentials.
For this type of learning, the setting is important. The School of Nursing uses interactive classrooms, known as active learning classrooms, where students sit in groups at high-tech tables with screens and microphones. The tables allow students to work together on activities – for example, jeopardy games, case studies, and interactive quizzes. And they can interact with other tables and faculty members through the classroom technology. This format helps them to better apply basic knowledge in a variety of situations.
“There are no traditional lectures where students just memorize a bunch of information, take an exam, and then they can forget it,” Dr. Bratzke explained. “The curriculum builds, so students have to tap into knowledge they have gained in previous classes.”
“Science tells us that the more senses students employ, the deeper the learning,” she continued. “We are helping the students to get used to pulling all of their knowledge together, which is what happens in nursing practice.”
The majority of classes will also include a reflection activity, where students are asked to assess their own progress – an effort to encourage continuous learning and competence.
To move toward active learning classes, the School is supporting faculty members with training sessions, more co-taught classes, and extra help from teaching assistants.
School of Nursing leaders have been steadily working toward these changes since AACN released their new guidelines in 2021. This year, faculty committees will continue to focus on redesigning courses with a plan to pilot the new curriculum during the summer of 2026.
“The overwhelming goal is to produce practice-ready nurses,” Dr. Bratzke said. “Together with our health care partners, we are saying, let’s get back to the basics and focus on developing practice-ready nurses who have a growth mindset, who are lifelong learners, and who have great generalist training.”