Teaching Systems Transformation
Authors: Flatt Margaret M. 
Published: August 2004

BACKGROUND Students in the undergraduate and graduate programs at Saginaw Valley State University (SVSU) are taught to use NANDA, NIC, and NOC to guide their practice. The nursing faculty developed a population‐focused, phenomenon‐based curriculum incorporating standardized nursing languages. The population focus of the undergraduate program changes each semester. Students begin by learning to intervene with individuals, and spend their final semester focusing on special populations and health systems. The graduate program expands on previous learning, focusing on leadership activities with special populations, communities, and health systems. Students in both undergraduate and graduate programs build competence in systems change while completing assignments based on the NIC Health System and Community Domains. The complexity of assignments and expected outcomes vary by the level of student, with undergraduates learning how to influence health system transformation and graduate students learning how to lead the transformation process.

MAIN CONTENT POINTS Seniors in the nursing program have three assignments that provide experience with health system transformation. The professional issues class has an assignment based on the NIC intervention of “health policy monitoring,” which is found in the classes of “information management” and “community health promotion.” Students learn to access action alerts on nursing organization Web sites and use them as a guide for communicating with legislators, with the goal of transforming health policy. In the practicum course, seniors use case studies to describe how NANDA, NIC, and NOC guide their clinical practice related to the several NIC classes, including those of “health system mediation” or “health system management.” Another practicum assignment requires utilization of “health policy monitoring” interventions for health system transformation that is community based and population specific.

Master's students also have multiple assignments providing experience with health system transformation. One of the required core courses contains an assignment comparable to that used to teach seniors to influence health policy, but also provides the opportunity to develop skill in policy analysis. In addition to analyzing legislative policy, all graduate students learn to evaluate and develop organizational policy using national standards (including the Health System Domain of NIC) as a guide. Students in the Health System Specialist track are preparing for positions in nursing administration, education, and informatics. They have a three‐part assignment that requires analysis of NIC's usefulness for decision support by nurse educators, administrators, and informaticists. They evaluate learning process and management process roles as they relate to selected NIC “health system management” interventions. They also evaluate the information process role as it relates to selected NIC “health system management” and “health information management” interventions.

CONCLUSIONS The learning activities engaged in provide experience in practical application of standardized language. This model of applied learning can be used in any setting to facilitate staff or student understanding of NIC's applicability to situations where system improvement is desired. NANDA, NIC, and NOC have been well developed when it comes to guiding clinical practice. While NIC has incorporated Health Systems and Community into its taxonomic structure, the linkages of those interventions with diagnoses and outcomes need further refinement.