Deming’s Continuous Quality Improvement Model.

Posted: December 1st, 2022

Deming’s Continuous Quality Improvement Model.

Discussion

Farah Response

To expand on your post, there are other models that are used in program evaluation such as Scriven’s Goal-free Evaluation Model; Adoptions of innovations and change models;Deming’s Continuous Quality Improvement Mode; Deming’s Continuous Quality Improvement Model; and Stake’s Countenance Model. However, my response will focus on the three Cs Model (context, content, and conduct) and CDC’s framework as evaluation modelsbecause this was your focus. The three Cs Model can also be used to develop structures that underpin the evaluation plan and its incorporation of the NLNAC standards and criteria. In addition, the three Cs model is useful in developing role descriptions of the faculty members (Guerin et al, 2016)Deming’s Continuous Quality Improvement Model.

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In addition. I would also like to add that the CDC’s framework ensures that the evaluation meets all the needs of all stakeholders involved. This framework can inform if the program is meeting the needs of faculty members and students efficiently. Therefore, the three Cs Model and the CDC’s framework can be used to effectively evaluate the value and impact of a nursing educational program, and at the same time obtain feedback(Guerin et al, 2016). The evaluation findings can then be used to improve the program.

Catherine Response

Catherine states that curriculum evaluation is used to determine the value and efficacy of an educational program. As a result, there are various models that are used to evaluate the curriculum. Evaluation models can identify the weaknesses and strengths of a curriculum. Therefore, it would be feasible to select one specific model that can be used in evaluating a nursing education program.Deming’s Continuous Quality Improvement Model.

The Nursing Program Comprehensive Evaluation Plan that was selected to guide as the framework for the evaluation plan. This framework can identify and track the program activities and at the same time judge the merit of the educational program (Havaei& Maura, 2015). I will further add that an evaluation can help to establish how various components interact and if the program is meeting its objectives. In addition, a needs assessment can determine if the educational program was implemented as planned and if there are more resources required to improve the quality of the program.Deming’s Continuous Quality Improvement Model.

Generally, evaluation models and frameworks can help faculty to determine priorities when selecting teaching and learning activities and at the same time examine the congruency of teaching goals/strategies with the course objectives.

Farah:
Models of Evaluation
Through curriculum evaluation, faculty discover whether a curriculum is fulfilling its purpose and whether students are actually learning. The Three Cs Model (context, content, and conduct) integrated with the National League for Nursing Accrediting Commission’s accreditation standards and criteria provide the framework for curriculum evaluation, which helps determine if the program is effective in its delivery of intended objectives. The Centers for Disease Control and Prevention provide a guide for educators to use for program evaluation. Although program evaluation is broader than curriculum evaluation, they both serve as guides in the assessment of educational programs’ efficacy and quality improvement (Schug, 2012).Deming’s Continuous Quality Improvement Model.

Curriculum Evaluation Model Description
The Three Cs Model. The Three Cs Model – Context, Content, and Conduct – exemplifies the National League for Nursing Accrediting Commission’s accreditation standards into its model of evaluation to deliver quality and excellence in nursing education. The model was originally developed for nursing program evaluation, but was then applied to curriculum evaluation (Kalb, 2009). The Three Cs Model provides a framework for curriculum and program evaluation, integrating standards to endorse, improve, and develop nursing education in all types of nursing programs (Keating and Deboor, 2018). The concepts included in this model – Context (to weave together), Content (to hold together), and Conduct (to lead together) – correlate to the NLNAC Standards and Criteria. Standard 1: Mission and Administrative Capacity; Standard 2: Faculty and Staff; Standard 3: Students joins Context. Standard 4: Curriculum and Standard 5: Resources link Content. Last, Standard 6: Outcomes addresses conduct (Schug, 2012). In the Three Cs Model, the context of a nursing department is interlinked by faculty, staff, and students to build a respectful learning community with a common purpose and an operational structure. For example, in this model, context can be demonstrated by a nursing department’s views and values being consistent with the first NLNAC standard, Mission and Administrative Capacity. The content of a nursing department is bound by its curriculum framework, joining educators and learners in the process of learning to achieve outcomes as described in Standard 4 and Standard 5. Standard 6 addresses conduct in the Three Cs Model by faculty who lead and promote the education of students in the practice of nursing (Kalb, 2009).Deming’s Continuous Quality Improvement Model.

Program Evaluation Model Description
Centers for Disease Control and Prevention. In the late 1990s, the Centers for Disease Control and Prevention (2017) developed a framework as a guide for educators to use for program evaluation. The framework includes four standards for effective evaluation and six steps for evaluation practice. The standards were adopted from the Joint Committee on Standards for Education Evaluation (1994). These standards include: 1. utility (needs of stakeholders); 2. feasibility (realistic and prudent); 3. propriety (ethical and legal); and 4. accuracy (worth and merit). Step 1 includes engaging the stakeholders. For example, the institution’s faculty, staff, students, and clinical sites’ staff must agree on the goals and purpose of the program. Step 2 describes the program, including an explanation of the program along with its long-term goals and objectives and how those goals and objectives will be reached. Step 3 focuses on the evaluation plan, considering the stakeholders’ needs and clarification of roles and responsibilities. Step 4 determines which sources are available and useful to collect data. Step 5 explains and supports conclusions, summarizing findings reflecting the meaning of the program. Step 6 provides the lessons learned focusing on step 3, design. Also, feedback must be obtained from all parties and follow-up provided. The steps of the model integrate standards by which nursing programs are evaluated and accredited (Keating and Deboor, 2018).

External frame factors Needs Assessment
A needs assessment is used to evaluate the factors that impact a nursing education program and its effects on curriculum revision or evaluation. A nursing program needs to relate to the community that is going to serve and focus on the needs of the learners; therefore, the demographics of the general population are a vital part of the external frame factor in curriculum evaluation. Specific data collection questions to be included for a needs assessment in this region to determine what type of teaching/learning strategies to be selected for all beginning courses in a BSN program would comprise of 1) What are the characteristics of the general population? 2) Are nurses with LPN diplomas and AS degrees seeking to advance their nursing careers? 3) Are younger students pursuing nursing as a first-time profession? This region reflects a multiculturally diverse population with a wide range of student age groups, including young adults with no previous nursing experience and an older population of nurses who are returning to school seeking to advance their nursing education in BSN programs. Even though most adults are self-directed, motivated, ready to learn, and involve their experiences in learning, educators must guide learning and work together with students in planning and evaluating the curriculum (Candela, 2016).Deming’s Continuous Quality Improvement Model. Student-focused instructional strategies allow for the professor to be the facilitator to student learning. For instance, team-based strategies can be applied to all beginning courses in a BSN program, which encourage students’ engagement in the course, promoting understanding of course content. The National Survey of Student Engagement (2013) supports that engaged students are more likely to meet learning outcomes. Working in groups promotes critical thinking, teamwork, and increases performance while recognizing individual strengths and weaknesses. Team-based learning satisfies this region’s multiculturally diverse and broad age group population because students can learn from each other’s experience and give a chance to those who are struggling to perform better (Keating and Deboor, 2018).

Internal Frame Factors Needs Assessment
In addition, a students’ needs assessment determines what type of activities assignments are needed to foster program expansion and to meet the expectations of the stakeholders. Similarly to the external frame factors, the program’s internal frame factors also need to be considered for data collection in curriculum evaluation, such as resources within the Institution and Nursing Program. Specific data collection questions to be included for a needs assessment in this region to determine what type of activities assignments to be selected for beginning courses in a BSN program would consist of 1) Are student services readily available? 2) Is there an adequate library and technical support? 3) What are the available days/hours and staff support for students to access the library and other electronic resources? As this region reflects a wide range of student age groups, formative evaluation can be used as a foundation for improvement during the evaluation process of curriculum, connecting course objectives (Keating and Deboor, 2018). For example, student questionnaires can determine what library and technological competencies need improvement. Questions to include in the students’ questionnaires are as follows: 1) What is your competency level obtaining basic library resources? 2) What is your competency level searching databases? 3) What is your competency level using PubMed clinical queries? 4) What is your competency level using CINAHL searching techniques? 5) Do you know how to cite/reference research effectively? 6) Do you know how to write in APA style? Answers will be rated as follows: 1- need maximum assistance; 2- need assistance; 3- need little assistance; 4- no assistance needed. At the end of the questionnaire, further comments or suggestions will be encouraged. Information provided by respondents in general courses will help determine what library and technological resources are needed to assist new BSN students in making the transition from general education courses to nursing courses that require application and critical thinking. Educators can promote searching and information literacy by providing writing assignments that require students to visit the library and the writing lab, which are student service activities BSN students will benefit from when making the transition from general education courses to nursing courses. Giving students course participation credit is one way professors can promote library and writing lab visits, which are valuable skills needed throug
hout the nursing program.Deming’s Continuous Quality Improvement Model.

Curriculum Evaluation Model
Curriculum evaluation is a method for establishing worth and effectiveness of an educational entity’s curriculum. In nursing education, it is a series of actions that starts with identifying outcomes and criteria (outcomes of the program, course, learning, promotions, and tenure criteria), supports outcomes attainment opportunities (instructional and learning activities participation), gathers progress on data leading to outcomes attainment (practice skills prior to actual performance skills), and concludes in evaluation of the breadth to which the outcomes were attained. (Billings & Halstead, 2016. p.385).Deming’s Continuous Quality Improvement Model. Evaluation may be characterized by the time frame in which it is conducted. Formative evaluation highlights on the elements instead of the entirety. The goal of formative evaluation is to oversee progress (e.g. student learning, new teaching-learning strategy or curriculum or program development) and make ongoing corrections to ensure goal is achieved (such as the use of testing systems to monitor student’s progression through the curriculum concepts). Noted disadvantages of formative evaluation are interruption on the flow of outcomes, false sense of prediction and judgments prior to activity completion. Summative evaluation focuses on the data gathered at the end of the activity, instruction, course or program. The highlight is on the event’s entirety, the extent to which the objectives were met for the purposes of accountability, allocation of resources, certification, students’ grade assignment and teachers’ pay or promotion. Summative evaluation is most favorable at the end of learning module/course for program/course revision. A significant disadvantage of summative evaluation is that results are final and cannot be altered. (Billings & Halstead, 2016.p 385).
A curriculum evaluation model is a structure that guides the evaluation of a curriculum. A variety of models arise from contrasting philosophies, conceptions and interpretations of evaluation. Models of evaluation and approaches come in different array including checklists, suggestions to comprehensive appraisals. These models provide a direction for planning and conducting an evaluation and leads meaning to the processes, outcomes and value of the curriculum. Nursing education’s curriculum is commonly established on standards of quality, quantitative and qualitative undertakings. (Iwasiw& Goldenberg, 2015. p. 367).
Most program evaluation models and frameworks that were used in the past were no longer commonly used in nursing education as many of these models are complex and difficult to apply. A study by Sauter (2000) found that most baccalaureate nursing education programs do not use a theory-driven evaluation approach but instead are influenced by professional accrediting bodies. Currently, most schools continue to use nursing accreditation criteria as a framework to develop a systematic and comprehensive evaluation plan. (Billings & Halstead, 2016.p. 464)
Evaluation models that were noted by the author Iwasiw (2015) were, (a) quantitative approaches (typically use questionnaires to obtain data) such as Scriven’s Goal-Free Model, Provus’s Discrepancy Evaluation Model, and program logic models; (b) qualitative models such as constructivist evaluation model (addresses issues of stakeholders) and appreciative inquiry model (goal focus is to build on the positive psychology foundation through dialogue). Evaluation models were categorized into types, (a) Pseudo-evaluations (designed to achieve a hidden purpose such as training, as evaluation); (b) Questions and methods-oriented approach (quasi-evaluation studies); (c) Improvement and accountability-oriented (comprehensive questions and criteria to examine needs and outcomes); (d) Social agenda and advocacy-oriented (aims to increase social justice through evaluation)( (Iwasiw& Goldenberg, 2015. p. 367).
The purposes of evaluation according to the author Billings (2016) are, (a) to assist in learning (or change behavior of a student/employee); (b) to recognize problems (distinguish learning deficits, curriculum defect, or ineffective teaching practices among others); (c) to generate conclusions (assign grades, determine merit raises, promotion or tenure); (d) to enhance products (add content to independent study module, revise textbooks); (e) to assess efficacy (whether goals/standards are met); (f) to assess cost efficacy (determine if program is self-reliant). (Billings & Halstead, 2016. p. 387).
According to Billings (2016), the conditions in which frequent evaluation is useful are, (a)
complex learning; (b) emerging trends; (c) identified problems; (d) anticipated problems; (e) high risk for failure; (f) poor performance would yield to serious consequences; (g) recent major changes to the curriculum or program requirements. Instruments of evaluation include questionnaire, checklist, portfolio, interview, rating and attitude scale.
Evaluation Models Commonly used in nursing education are, (a) Program evaluation and accreditation models (often adopted from higher education); (b) Adoptions of innovations and change models (focus is on the extent of teaching-learning strategy practice integration, used to guide change and process/outcomes evaluation); (c) Quality assurance or total quality models (courses are reviewed by trained reviewers). Examples of Program evaluation and accreditation model are Chen’s theory-driven (2004) model (directs variables to be measured), Stufflebeams (1971) model (organizes variable to be evaluated as context), and naturalistic modes such as Lincoln and Guba (1985) (involves stakeholders participation in what needs to be changed); A noted Adoptions of innovations and change models are, (a) Kirkpatrick and Kirkpatrick’s (2014) four-levels of change evaluation model (reaction, learning, behavior, and results), Reaction and learning levels connotes time and resources for teaching and learning, while behavior and result levels show the education’s lasting outcome. Another example of adoptions of innovations model is the Rogers model (2003) notes that an innovation such as an adoption of a new curriculum or new teaching strategy, depends on the nature of the innovation, communication within the organization, time span and social system. One example of Quality assurance or total quality improvement model is the Quality Matters (2014), benchmarks were developed for online courses with rubrics used to assess standards for the design of online courses. (Billings & Halstead, 2016).
Evaluation models that are commonly found in nursing program evaluation as further noted by the author Billings (2016) were, (a) Scriven’s Goal-free Evaluation Model (introduced the ideas of “formative” and “summative” evaluation, encourages the use of an outside, objective evaluator to avoid bias); (b) Stake’s Countenance Model (describes three components: antecedents, transactions, and outcomes, takes into account the stakeholders such as students and teachings, educational experiences, and outcomes); (c) Tyler’s Behavioral Objective Model (based on what the faculty would like students to achieve at the end of a course or program, or the determination of the objectives); (d) Stuffelbeam’s CIPP Model (acronym representing context, input, process, and product evaluation, emphasizes improvement and corrections for problems within a program); (e) Deming’s Continuous Quality Improvement Model (consisting of four phases: plan, do, study, and act, a continuous process of plan, collect data, analyze, and make changes can occur); (f) Chen’s Theory-Driven Model (describes the causal linkages between the elements, interventions, and outcomes) (Billings & Halstead, 2016).
This writer would choose to consider commonly used evaluation approaches for the nursing program and higher education which are the following, (a) Program evaluation and accreditation models, (b) Adoptions of innovations and change models, and (c) Quality assurance or total quality models. The following models related to these approaches are Scriven’s Goal-free Evaluation Model, Chen’s theory-driven, Stufflebeams, Lincoln and Guba, Stake’s Countenance Model, Kirkpatrick and Kirkpatrick’s, Tyler’s Behavioral Objective Model and Deming’s Continuous Quality Improvement Model.
A program evaluation plan that will guide as a framework such as the Master Plan of Evaluation or more specifically, a Nursing Program Comprehensive Evaluation Plan will be constructed with considerations to the commonly used models in nursing education, to ensure appropriate implementation of program activities, and to support nursing education program’s continuous quality improvement and accreditation. Accrediting bodies such as state of nursing, regional accrediting bodies, professional nursing organizations will be continually be considered to ensure accreditation and that standards are satisfied, and the quality maintained. (Billings & Halstead, 2016). Since the evaluation of a curriculum is an extensive and intricate process, a systematic and comprehensive approach to program evaluation increases the likelihood that all program elements will receive appropriate attention and that evaluation activities will lead to program improvement.

Needs Assessment, External and Internal Frame Factors
• A needs assessment for curriculum development is the collection and analysis method that influences the decisions of a curriculum development or a program revision. In an educational entity, this describes the program creation or revision based on responses, critiqued feedback from stakeholders such as the students, staff, clients, faculty and administration among others. Program planners evaluate the external frame factors (influential factors outside of the nursing program and parent institution) and the internal frame factors (influential factors from within the parent institution and program itself)(Keating &DeBoor, 2018).Deming’s Continuous Quality Improvement Model.
Internal frame factors such as the existing and potential faculty and student characteristics need to be considered when proposing a new program or revising an existing curriculum. Such as, on educational tracks expansion, student enrollment needs to be considered, along with the faculty’s educational levels, clinical expertise, teaching experience qualifications, scholarship and research. Faculty to student ratio needs to be satisfied including an adequate number of faculty members representing diversity in gender and ethnic backgrounds. These factors must be considered to match the program needs, parent institutions’ expectations and bodies of accreditation standards (Keating &DeBoor, 2018.p 278). Specific to the needs of South Florida region as mentioned in the previous discussion, diversity metrics and demographics will be considered, such as ethnicity, age, gender and the geographic location of origin, including other factors such as income disparities, availability of scholarships and funding, undergraduate and graduate enrollment, average ages, distance and access, and technological or learning preferences. In conducting needs assessment of the students in South Florida region, specific questions that will suffice consideration of the student populace’s cultural diversity, demographic and geographic inclusion, technological and learning preferences are important aspects of the data gathering and collection during a need’s assessment for an inclusive and well-implemented new curriculum or revision.
Table 1.1 Sample Questions of Student’s Needs Assessment in South Florida Region
External Frame Factor Questions for Data Collection Desired Outcomes
Description of the Community What community services provide an infrastructure for the institution, i.e., transportation and communications services? Students have reasonable cost access to public transportation to and from home (for commuter students) and other services. There are multiple high-quality media communication networks for marketing, public relations, and educational purposes. Internet, postal service, and delivery systems are reliable.
Demographics of the Population What are the characteristics of the general population?Deming’s Continuous Quality Improvement Model.
What indications are there that the population supports higher education? The population reflects multicultural and ethnic characteristics with a wide range of age groups.
Most of the population and the power structures completed high school or higher levels of education and/or there is growing interest in and need for these levels of education.
Financial Support Analyze the present financial health of the parent institution and the nursing program. The institution and the nursing program are in solid financial condition and there are either guaranteed state or national support or substantial endowment funds from local and greater communities for the future.

Internal Frame Factor

Questions for Data Collection Desired Outcomes
Resources within the Institution and Nursing Program If the program is on-campus or a combination of on- and off-site, how many classrooms, clinical practice, simulation, and computer laboratories does the nursing program have and are they under its control? Can they accommodate additional students or newer technologies in the proposed program or curriculum revisions? Are there plans for these facilities in the proposal and are costs calculated in business plan? The current physical facilities such as classrooms, offices, clinical practice and simulation laboratories, computer facilities, are adequate and can accommodate curriculum revisions or new programs OR there are plans for expansion in place that are part of the business plan and have the support of the financial bodies of the institution.Deming’s Continuous Quality Improvement Model.
Potential Faculty and Student Characteristics Describe the characteristics of the current faculty.
Are the numbers of faculty enough? Do they meet program requirements, educational level, clinical expertise, scholarship/research, and teaching experience qualifications? Do they represent diversity? Are there plans to recruit additional faculty if indicated? There is enough qualified faculty members who represent diversity and meet faculty to student ratio standards as well as academic, accreditation, and professional requirements.
Note: Data gathering is specific to teaching/learning strategies and activities for beginning BSN courses. (Referenced from: Keating &DeBoor, 2018.p 63)

Student Transition
A successful student transition from general courses to nursing courses will need the faculty’s knowledge and understanding of the students. The faculty will need to understand the student’s differences in levels of knowledge, learning styles, technological skill levels and prior student experiences, to balance the students’ learning needs, interests, and abilities. Supportive learning opportunities and activities need to be provided to enhance the student’s learning ability. Such as in clinical teaching, the clinical educator needs to coach students as they learn clinical reasoning and judgment. Novice students struggle with the ability to engage in clinical reasoning required to make sound judgments and does not have the ability to identify the subtle or relevant cues in a patient’s changing health condition. Faculty can assist students in identifying these subtle and important cues and to collaborate with other health care professionals in teaching-learning experience (Billings & Halstead, 2016.p 289). Teaching behaviors that facilitate students’ development in higher-order or critical thinking skills include prompts to help students recognize the salient cues in a situation, prioritization, retrieval, and application of theoretical and factual knowledge from coursework (Billings & Halstead, 2016).Deming’s Continuous Quality Improvement Model.

Essential resources, Approaches to Student-learning support and Student services
Essential resources will be advocated to support the student, student learning and empowerment. These essential resources are to include library resources, teaching support such as undergraduate teaching assistants or university-employed or university-sponsored students that can extend faculty teaching (Iwasiw and Goldenberg, 2015). Students services such as personal support, academic skills assessment and development, health recreation, and financial assistance that are fundamental aspects of an educational entity will be endorsed for the student’s favorable outcome. Student services for advising and counseling, disciplinary matters, remediation and study skills, work-study programs, career counseling, job placement, and financial aid, including accommodations for students with learning disabilities and special needs must also be considered. (Keating &DeBoor, 2018). Academic support services such as the library, academic advisement, teaching-learning resources, and instructional technology contribute to the maintenance of a quality education program and student success.Deming’s Continuous Quality Improvement Model.