Vision, mission and program philosophy

Nursing Program Philosophy

The Nursing Program philosophy applies to both the Ontario Tech University – Durham College Collaborative BScN Program and the Ontario Tech University – Durham College – Georgian College Collaborative BScN Bridging Program. It is supported and enlightened by pluralistic philosophies/worldviews, including but not limited to, positivist, phenomenological, postmodernist, feminist, and critical social theories which focus on society’s changing health care needs. These perspectives give rise to the core concepts of the nursing program—that of caring and nurturing relationships through being, knowing and doing (praxis). This philosophy reflects its deep roots in the Caring Curriculum (Bevis & Watson; 1989; Hills, Watson, & Cara, 2020; Cara, Hills, & Watson, 2020), as well as our own unique context and perspective.

CARING IN NURSING

Caring is a central component of the human experience and foundational to nursing practice. While caring may be thought of as present in all aspects of everyday life, caring in nursing requires intentionality; self- and other- awareness; and active, thoughtful, and skilled engagement in concern for others and the world around us.

Caring in nursing requires that we actively attend (both in terms of paying attention and in responding) to other human beings, the world around us, and to ourselves. Caring in nursing requires that we try to bring the best of ourselves to all that we do, actively engaging in self-reflection and self-analysis so that we may continue to grow and develop in our nursing practice and in our lives. Caring in nursing requires that we recognize the position of privilege nurses hold in society, and from this position actively seek to make the world and the life experiences of others more just.  

Competence in intentional human caring in nursing can be acquired, honed, practiced, enhanced, modeled, and evaluated in theory and practicum settings. Caring can be seen as a human trait, a moral imperative, an affect, an interpersonal interaction, and a therapeutic intervention (Watson, 1985; Morse, Bottorff, Neander, & Solberg, 1991). All of these facets of human caring come together as intentional caring in nursing are actualized in practice (Roach, 2002).

While “nursing care” typically denotes skilled practices and implies a product focus, nursing caring more fully encompasses the interpersonal/intrapersonal/transpersonal process inherent in nursing. The concept of caring in nursing serves as the organizing framework of our curriculum and is threaded throughout the nursing program, drawing upon the transformative Caring Curriculum (Bevis & Watson, 1989). The beliefs, values and assumptions underlying the concept of caring are reflected in the program’s conceptualization of nursing, people (individuals, families (of origin or choice), groups, local and global communities), health and healing, and the environment. The teaching-learning process is rooted in caring in nursing, and is informed by various teaching methods encouraging critical thinking, reflection, empowerment, problem solving and inquiry.

NURSING

Nursing occurs within the context of intentional human caring from the nurse to the nursed, other human beings, and all life. It requires the skilled utilization, application, and evaluation of knowledge, mediated by multiple ways of knowing/being/doing, in partnership with the recipient of nursing care. This knowledge is drawn from nursing, natural sciences, social sciences, arts and humanities, and is uniquely employed within each specific nurse-person situation to promote and preserve caring, health-healing, dignity, and comfort.

Nursing occurs exclusively within the context of intentional human caring; they are inextricably linked. Nursing praxis occurs as the reciprocal relationship between nursing theory and nursing practice is explicated, in which each influences the other and supports the continual advancement of nursing. While often the most visible component of nursing, our profession is not characterized by a list of the skills or activities in which nurses participate. Rather, nurses must be conceived as knowledge workers. They possess high degrees of expertise, education, or experience, with the primary purpose of nursing (their work) involving the creation, distribution, or application of knowledge (Davenport, 2005). When the conception of nursing knowledge is expanded to include all ways of knowing, our understanding of nursing is enriched. It involves the constantly evolving application of all aspects of being, knowing, and doing, across a limitless range of situations, in the promotion of caring, health-healing, dignity, and comfort. Through the application of reflective practices (e.g., Johns’ Model of Structured Reflection, 2016; Debriefing for Meaningful Learning, Dreifuerst, 2015), the development, utilization, and refinement of clinical judgment (e.g., Tanner, 2006) is promoted.  

Nursing is both a profession and a discipline:

• As a self-regulated profession in Ontario, nurses are responsible and accountable to the public and the profession for their practice. Nurses practice autonomously and in partnership with other healthcare providers, contributing to a holistic perspective of caring. Nurses take on many roles, including clinician, professional, communicator, collaborator, coordinator, leader, advocate, scholar, and educator (CNO, 2020). Nurses have a professional responsibility to participate in lifelong learning through critical self-reflection (CNO, 2020), research, and innovation.
• As a discipline, the unique knowledge base of nursing and the methods for developing/expanding that knowledge are made explicit. Nursing knowledge arises out of theory, scientific inquiry, and critical reflection on practice. Nursing, as a discipline, values multiple ways of knowing, including but not limited to ethical, personal, aesthetic, empirical, and emancipatory (references). The theory base of nursing consists of grand, middle-range, and practice or situation-specific theories. The Nursing Program is committed to valuing theoretical pluralism, while recognizing nursing’s philosophical orientation toward humanity and nursing’s ethical global covenant with humanity to sustain human caring-healing-health for all (Watson, 2018).

PEOPLE

People include individuals, families (of origin or choice), groups, populations, and local and global communities, existing within the wholeness and complexities of our lives. The uniqueness of people is both limitless and a core characteristic of being human. This awareness requires that nursing champion equity, diversity, and inclusion as a moral imperative. For this to be achieved people need to have insight, and understanding when it comes to historicity, truth and reconciliation of individuals who are racialized and marginalized. People make choices about their lives and their health-healing based on many factors, including but not limited to their life experiences, values, hopes, and aspirations. We recognize and value the innate human capacity for caring (Watson, 2020), and the primal human desire to be seen and to be heard (Paterson & Zderad, 1976). 

People exist within the context of their lives as lived, including but not limited to their perceptions, choices, experiences, and environments. People’s lives and health-healing are affected by the relationships they have with self, others, and with all living beings. People make choices based on the unique meaning they attribute to their life experiences and are influenced by internal and external factors such as determinants of health, values and dignity. Through intentional caring practices, nurses nurture intra/inter/transpersonal healing relationships with individuals, families (of origin or choice), groups, and communities.

Within the Nursing Program, we champion equity, diversity, and inclusion. This involves respectful treatment of all people, leading to equality. In creating an environment of respect and opportunities for full participation by all, including equity-deserving groups, we support and strengthen the basic rights of all people. Cultural competence, cultural humility, and cultural safety are critical concepts that can be applied to help understand and interact with people effectively. 

ENVIRONMENT

Environment consists of all elements, internal or external to people (individuals, families (of origin or choice), groups, and communities) that influence people and/or the situation. Environmental elements may be experienced as positive, neutral, or negative. People both influence and are influenced by their environment. Examples of environmental factors include, but are not limited to, physical, social, psychological, and economic. Rights and freedoms, both entrenched in the law and as perceived by people, are part of their lived environment. We acknowledge the traditional territory of Indigenous peoples in Canada.

Watson (1999) shares that a caring and healing space or environment can expand the person’s “awareness and consciousness” and promote mindbodyspirit wholeness and healing (1999, p. 254). Through intentional caring relationships, the Nursing Program works to create a caring, healing space for all.

Within the Nursing Program, we strive to nurture bioactive and biogenic environments, in which people, including learners, and all life is able to thrive. Nurses have a responsibility to create the healing environment, offer the human to human connection, creating the space where healing, life sustaining and life-giving practices in a caring environment flourish.

Environmental factors impact all aspects of health. As such, nurses must be prepared to work with people to identify relevant factors explore the meaning that they hold. Nurses must be aware of environmental factors that exist both at the individual level and beyond it (e.g., determinants of health). Nurses must engage personally and across sectors to promote healthy environments and honour our responsibility to all life and mother earth.

Ontario Tech University (and the Nursing Program) acknowledge the lands and people of the Mississaugas of Scugog Island First Nation. We are thankful to be welcomed on these lands in friendship. The lands we are situated on are covered under the Williams Treaties and the traditional territory of the Mississaugas, a branch of the greater Anishinaabeg Nation, including Algonquin, Ojibway, Odawa and Pottawatomi. These lands remain home to a number of Indigenous nations and people.

We acknowledge this land out of respect for the Indigenous nations who have cared for Turtle Island, also called North America, from before the arrival of settler peoples until this day. Most importantly, we remember the history of these lands has been tainted by poor treatment and a lack of friendship with the First Nations who call them home.

This history is something we are all affected by as we are all treaty people in Canada. We all have a shared history to reflect on, and each of us is affected by this history in different ways. Our past defines our present, but if we move forward as friends and allies, then it does not have to define our future. (Ontario Tech University)

HEALTH-HEALING

Health-healing is a constantly changing, holistic human experience that transcends all phases of life and living. It encompasses all circumstances of living, as experienced, defined, and made meaningful by the individual, family, group, or community. In understanding that health-healing is defined and made meaningful by the client, we move away from a normative, often ableist, view of health versus illness. Rather, health-healing is viewed not as a singular state, but rather a process of moving towards wholeness, wellness, harmony, and balance. Our conception of health-healing is grounded in our appreciation of theoretical pluralism, while consistent with the caring curriculum. Health-healing has physical, socio-cultural, psycho-spiritual, political, and economic aspects. Health-healing is preserved and promoted through caring relationships that are affirming, enabling, empowering, and collaborative.

Health-healing is defined by the people experiencing it. Health-healing is a holistic, transformative process; it is multidimensional; and it involves continual repair and recovery. Promoting person-centred, health-healing involves partnering with, and enabling, people to increase control over and to improve their health. Health, as a continuum, encompasses the individual, family, group, or community and the environments in which they live, work, and play Empowerment, the process whereby people obtain and share power, resources and authority for healing, is considered central to health promotion. Access to the resources, authority, and ability to move to health and healing is unequal and uneven. We recognize this inequity and endeavor to strengthen all persons’ agency in reaching or moving to their optimum health and goals. This includes addressing individual, family, group, and community challenges and goals, as well addressing environmental issues and challenging systemic barriers. It involves working with people where they are at, and is influenced by factors that are intra/inter-personal, relational, and environmental. Nurses work to facilitate and support conditions that allow healing to occur in the lives of individuals, families (of origin or choice), groups, and communities.

TEACHING-LEARNING

Teaching-learning in nursing is a dynamic, transformative process which occurs both formally and informally, and within a context of intentional caring. Teachers, nurses, students, and people requiring nursing care are co-learners and partners in a collaborative learning process. Learning occurs over time and through a variety of approaches. It is a life-long process of personal and professional growth, which builds on experience, stimulates reflection, and transforms the meaning of life experiences. As teachers, we are committed to fostering a stance of inquiry with students.  Teacher-learner engagement, in all settings, always reflects our values of mutual respect, mutual intentional human caring, and mutual civility (Clark, 2022). Within the Nursing Program, teaching-learning is conceived of as an active process, whereby all participants take responsibility for fully engaging across a continuum of active learning approaches (Tanner, 2006).

We believe that teaching-learning is a dynamic, transformative process, based within reciprocal relationships between teachers and learners. Both teachers and learners bring valuable knowledge and experience to the learning situation. Conditions that promote effective teaching-learning in nursing education include mutual respect and safe learning environments. Student-teacher relationships that are created in a space of relational caring emphasize the uniqueness of each student as their lived experiences and their world views are accepted. “The student/teacher relationships grounded on respect, empathy and nonjudgmental stance creates the conditions for the development of an authentic caring transpersonal relationship, heightening and protecting their dignity as well as their learning” (Hills, Watson, Cara, 2021, p. 88-89).

Teaching-learning in nursing is student-centred, whereby educator and student-learner are equal partners. This rejection of “power over” relationships in nursing education does not diminish learning outcomes. Rather, it promotes active student-learner engagement in teaching-learning processes that connect the personal and the professional. This focus does not diminish or bypass the necessity for learners to demonstrate required course and program learning outcomes. Instead, it focuses on setting these pre-defined requirements as the beginning of the learning that is necessary and possible, not the end point. It recognized that learning has impacts for the learner well beyond the acquisition of knowledge. Learning contributes to self-esteem, self-knowledge, and self-empowerment.

Within the Nursing Program, teaching-learning is conceived of as an active process. Using Tanner’s Model (2006) as a foundational approach, teaching-learning is directed well beyond mastery of content, to focus on critical dimensions such as “thinking like a nurse”, developing and demonstrating high quality critical thinking, clinical reasoning, and sound clinical judgment. Teacher-learner engagement, whether face to face; through virtual means; in classroom, laboratory, simulation, or practicum settings, always reflects our values of mutual respect, mutual intentional human caring, and mutual civility. Active learning approaches are utilized in all teaching-learning contexts, whereby teachers and learners meet their obligations to be accountable and fully participatory in the teaching-learning process. 

Teaching-learning in nursing requires that diverse, evidence-based, and innovative teaching foci, teaching methods, and evaluation approaches be utilized. At the same time, we must remain cognizant of the diversity of learners we will encounter through formal nursing education, informal mentoring/coaching of nursing students, and the variety of teaching-learning opportunities within nursing practice with individuals, families (of origin or choice), groups and communities. The need to “meet learners where they are at” remains a time honoured value. Within the Nursing Program, we recognize that learning occurs over time, through a variety of approaches, which are reflected in the diversity of learning activities, informed by pedagogical pluralism, and situated within a stance of inquiry. All five dimensions of scholarship that have been described by Boyer (2000) are integral to teaching-learning in nursing education (discovery, integration, application, teaching, and engagement).

References

Bevis, E. & Watson, J. (1989). Toward a caring curriculum: A new pedagogy for nursing. New York, NY: National League for Nursing.

Boyer, E. L. (1990), Scholarship reconsidered: Priorities of the professoriate.  Carnegie Foundation for the Advancement of Teaching

Cara, C., Hills, C., & Watson, J. (2000). An Educator's Guide to Humanizing Nursing Education: Grounded in Caring Science. New York, NY: Springer Publishing Company

Clark, C. (2022). Core competencies of civility in nursing and healthcare. Indianapolis, IN: Sigma Theta Tau International Honor Society of Nursing.

College of Nurses of Ontario (2020). Entry to practice competencies for Registered Nurses. Toronto, ON: author.

Davenport, H T (2005). Thinking for a living: How to get better performance and results from knowledge workers. Boston, MA: Harvard Business School Press.

Hills, M., Watson, J., & Cara, C. (2021). Creating a caring science curriculum. A relational emancipatory pedagogy for nursing (2^nd ed.). Springer publishing.

Morse, J. M., Bottorff, J., Neander, W., & Solberg, S. (1991). Comparative analysis of conceptualizations and theories of caring. IMAGE: Journal of Nursing Scholarship, 23(2), 119-126. doi: 10.1111/j.1547-5069.1991.tb00655

Tanner, C. A. (2006). Thinking like a nurse: A research model of clinical judgment in nursing.  Journal of Nursing Education, 45(6), 204-211. Retrieved from http://www.slackjournals.com/jne

Watson, J. (1999). Postmodern nursing and beyond. Toronto, Canada: Churchill Livingstone.

 

Curricular Framework

Our curricular framework is structured around our analysis of what is necessary for BScN level Registered Nursing education, and beyond that, what more is required to ensure that this education is sufficient. We identify as necessary components of our curricular framework the following elements. We also depict them in our narrative curricular framework image, located following the text).

CONTEXT AS THE BACKDROP

An appreciation of ever-evolving complex contexts in which nursing and nursing education exist (including but not limited to professional, regulatory, educational, social, global, and health contexts). When you look at the narrative curricular framework image below, the tree is at the centre of the image, but it exists within context of the world around it.

CARING SCIENCE AND THE CARING CURRICULUM

Identification of the basic philosophical roots of our curriculum, those outlined in the Caring Curriculum (Bevis & Watson, 1989; Hills & Watson, 2011). Our narrative image shows the earth as a rich source of nutrition and protection as our structure continues to grow and develop.

NURSING PROGRAM PHILOSOPHY

Our unique Program Philosophy defines 6 core concepts (human caring, nursing, people, environment, health-healing, and teaching-learning). The roots of our tree show each of these core concepts, grounding us and creating the foundation from which we grow.

NURSING PROGRAM GOALS

Through this lens of evolving context, caring curriculum, and program philosophy, 7 terminal program goals create the roadmap toward successful program completion. As you look at the branches of our tree, you see each of them labelled to represent our Nursing Program goals, reaching upward and outward, stretching toward new possibilities. Our goals state that graduates of the Nursing Program will:

1. Demonstrate safe, competent, ethical, and compassionate nursing practice that is theory guided, evidence-informed, and in accordance with regulatory standards (CNO).
2. Actualize professional caring relationships with individuals, families (of origin or choice), groups, communities and populations; and, with nursing and interdisciplinary colleagues.
3. Synthesize critical inquiry, scientific inquiry, research and other ways of knowing to develop nursing knowledge and to demonstrate the professional contributions of nursing in healthcare.
4. Champion social justice, in partnership with vulnerable populations; respecting the autonomy of individuals, families (of origin or choice), groups, communities and populations.
5. Demonstrate leadership within the domains of practice, policy and quality of work-life for innovation and advancement of healthcare.
6. Commit to critically reflective practice and self-directed learning, within the regulatory context and accountability to the public, to support life-long learning.
7. Advocate with and for people (including self-advocacy), the nursing profession, the healthcare system, and the environment.

LEVELED NURSING PROGRAM GOALS

Each of the 7 Program Goals is leveled across all years of the program and mapped to course objectives, course content, and evaluation measures, ensuring that learners have met the Nursing Program Requirements.

CONCEPT THEMES

Carved into the trunk of our tree is an image of four interlinking circles, fluid and with no beginning and no ending. These represent our four theme areas of: Development of Self, Health & Healing, Foundational Nursing Knowledge, Foundational Interdisciplinary Knowledge. We use this symbol to represent the intersection of these themes:

 

CONCEPT AND CONTENT MAPPING: MEASURES TO MAINTAIN CURRICULAR RELEVANCE AND INTEGRITY

We further map the curriculum to currently accepted standards and regulatory requirements.

UNIQUENESS AND DIMENSION: TEACHING-LEARNING TOOLS, PROCESSES, AND PERPSECTIVES

While we view this structure as a necessary requisite of educational rigor, it is not sufficient to also capture the unique, holistic, and personal-professional learning and learning processes that inform and support our caring curriculum. To that end, we also describe incorporating the fundamental concepts of uniqueness and dimensionality, including our teaching-learning tools, processes, and perspectives. In our narrative image, you see that the trunk of our tree is textured and unique. This trunk is a vehicle for bringing nutrition from our roots (our core concepts) that reach down into the earth to ground us, up to the branches of our tree (our program goals) that reach upward and outward toward new possibilities.  

Narrative Curricular Framework Image