Meeting Patient Expectations: A Challenge for Nurses

Topic: Nursing
Words: 1292 Pages: 5


Nurses usually perform their duties by directly interacting with the patients. As such, they must possess the necessary skills and knowledge required to provide safe and high-quality care (Oldland et al., 2020).

Patients visit the hospital with expectations that nurses, among other health professionals, are competent enough to fulfill their responsibilities.

In that case, the appropriate measures begin with higher education institutions that must train nurses to collaborate, communicate, and perform their duties efficiently.

Problem Statement

Research conducted by Girmay et al. (2018) observed that many patients held a poor perception of the nursing services received inwards and hospitals.

The participants in the Girmay et al. (2018) study argued that nurses treated the patients as inferior, resulting in poor services and negative perceptions. Additionally, the nurses did not provide adequate information to help the patients understand their condition and the treatment required.

The failure of nurses to meet patients’ expectations could mean they were not adequately trained to handle specific problems within nursing care practice. As a result, this presentation explores available instructional design models for online and classroom-based clinical studies.

Instructional Design Models and Theories

Online Learning Classroom Learning Clinical Modalities Setting
Community of inquiry Social constructivism Behaviorism
Connectivism Behaviorism Constructivist
Online collaborative learning Cognitivism Observational
Caring theory

Learning theories explain the process of how people learn (Picciano, 2017). Generally, some learning theories could be used across different teaching modalities, including online, classroom-based, and clinical settings. Besides the online collaborative learning model, the theories and models presented here could be applied in any of the three learning environments. Online collaborative learning theory focuses on Internet facilities and resources that foster collaborative learning and knowledge building (Picciano, 2017). Knowledge generation follows three phases, including:

  • Idea generation through brainstorming to gather divergent ideas.
  • Idea organizing involves comparing, analyzing, and categorizing ideas through discussions, debates, or arguments.
  • Intellectual convergence allows for consensus and the synthesis of ideas (Picciano, 2017).

Instructional Design Models and Theories Explained

The community inquiry model incorporates cognitive, social, and teaching aspects that facilitate interactions between students and instructors (Picciano, 2017).

Behaviorism focuses on behaviors and asserts that observing learners’ stimuli provides necessary feedback.

In the constructivist model, the students actively participate in knowledge acquisition through practice and making sense of complex concepts. In this approach, the instructor is more of a coach or facilitator, allowing the students to learn from one another in groups.

The cognitive theory emphasizes the mind’s capability to understand, store, and retrieve information in the learning process (Picciano, 2017).

Caring theory teaches people to care for one another by equipping them with solid morals, ethics, and kindness foundations. This approach is essential in nursing care because students learn to value and respect human dignity.


Accurately presenting learning materials to learners through an appropriate instructional model enhances the effectiveness of training programs.

ADDIE model is an instructional design that offers instructions on areas linked to improved job performance. This model has five stages explained as follows:

  • Analysis: It is the initial stage that identifies learning needs, objectives, gaps, learners’ existing knowledge, resources available, and possible delivery options (Bouchrika, 2020).
  • Design: This process involves mapping out how the learners will meet the set objectives by highlighting instructional strategies.
  • Development: The instructional designers execute the adopted strategy and organize course materials, resources, and tools.
  • Implementation: This phase delivers the course to the targeted learners by training instructors, setting an environment, and organizing students to access class.
  • Evaluation: The final stage measures the efficiency and effectiveness of the learning program (Bouchrika, 2020).

Strengths and Weaknesses of the ADDIE Model

Strengths Weaknesses
It covers learners with different needs It is rigid and too detailed.
Variety of evaluation techniques It is linear
Follows a set structure and systematic approach It takes too much time

The systematic nature described in the ADDIE model enables instructional designers to design and develop high-quality courses (Bouchrika, 2020). The ADDIE model contains specific principles designers can follow to execute their ideas.

Once developed, instructors can use various evaluation techniques, such as formative or summative assessments, making them essential in educational programs (Abd et al. Surat, 2020).

Educators can create programs that cover students with varied learning needs.

Conversely, the ADDIE model also has some limitations that affect its efficiency. For instance, it is described as too detailed and rigid, significantly hampers creativity.

The execution process is linear, indicating each stage has to be completed before proceeding to the next (Bouchrika, 2020). The developers can take much time in one phase and cannot proceed to the next.

Compare and Contrast

The five processes in the ADDIE model follow a linear approach, starting with the analysis phases to the evaluation. The first stage identifies the learners’ needs, objectives, and materials to help set the class. The design phase maps these resources to ensure learners will meet the goals, development focuses on executing instructional strategies, and implementation involves the course program delivery to the students. The final phase measures the success/failure of the course (Bouchrika, 2020).

The Kirkpatrick model begins with the reaction stage, which assesses a student’s reaction to the instructions, and the next phase evaluates whether the students understood these instructions. The behavior phase evaluates if the students can transfer acquired knowledge and skills. The last stage determines whether the lessons benefit a business (Alsalamah & Callinan, 2021).

The Dick and Carey model is subdivided into ten stages compared to ADDIE’s five. Instead of the analysis phase, Dick and Carey’s model has instructional goals, instructional analysis, and entry behaviors and learners characteristics at the beginning (Basu, 2018). Therefore, Dick and Carey’s approach allow the instructional designers to write the program’s objectives in two stages compared to one phase in the ADDIE model. The following four stages of Dick and Carey (performance objectives, criterion-referenced test items, instructional strategy, and instructional materials) represent the two phases of design and development in the ADDIE model. Following the implementation, Dick and Carey’s approach performs summative and formative evaluation, which differs from ADDIE’s model that combines the two stages.

Effective Instructional Design Method

The instructor should be present to guide the students to meet the desired program’s objectives. Therefore, the educator should provide factual information through lectures, which can be done through oral presentations, pre-recorded videos, or handouts.

The debates and discussions around a given topic encourage student participation and collaboration and boost understanding of a subject (Billings & Halstead, 2019).

Simulations, demonstrations, and games in a given area enable the learners to practice their skills, solve problems, and apply critical thinking to address the issues provided. These methods allow learners to showcase their understanding and include room for the educator or peers to offer feedback.

Case studies enable the students to address real-world problems, allowing them to apply theoretical understanding to practice (Billings & Halstead, 2019).

Reflections are appropriate as they allow the students to review lessons, practices, and everything learned, improving their self-awareness.

Accreditation Standards

Accreditation standards ensure learning institutions follow an approved program in educating nursing students. For an institution to receive certification, operate uninterrupted, or acquire funding, it must consistently follow the laid standards when offering learning programs (Billings & Halstead, 2019).

Currently, the two common standards in American nursing programs include the Accreditation Commission for Education on Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE) (Billings & Halstead, 2019). Each focuses on different aspects of every institution. For instance, ACEN mainly ensures that each learning institution meets the following capacities: mission, administrative capacity, faculty and staff, students, curriculum, resources, and learning outcomes.


Nursing educators must find the right approach to instruct their students to ensure successful nurses understand and perform their responsibilities well. An instructional design will meet students’ needs and the program’s objectives, which allows the nurses to meet patients’ expectations.


Girmay, A., Marye, T., Haftu, M., Brhanu, T., & Gerensea, H. (2018). Patients expectation strongly associated with patients perception to nursing care: hospital based cross sectional study. BMC Research Notes, 11(1), 1-6. Web.

Oldland, E., Botti, M., Hutchinson, A. M., & Redley, B. (2020). A framework of nurses’ responsibilities for quality healthcare—Exploration of content validity. Collegian, 27(2), 150-163. Web.

Rosenfield, M. N., & Bernstein, M. (2021). The importance of patient expectations: A mixed-methods study of US psychiatrists. Frontiers in Psychiatry, 2154. Web.

Picciano, A. G. (2017). Theories and frameworks for online education: Seeking an integrated model. Online Learning, 21(3), 166-190. Web.

Basu, R. (2018). Instructional design models: Benefits and challenges. UGC Approved Journal, 41, 31-36.

Bouchrika, I. (2020). The ADDIE Model Explained: Evolution, Steps, and Applications. Research. Web.

Abd Razak, A. Z., & Sahlan Surat, R. A. M. (2020). The Design of GIFTED Motivation Module Using the ADDIE Model Approaches Among the Gifted and Talented Students. International Journal of Academic Research in Progressive Education and Development, 9(2), 509-17. Web.

Alsalamah, A., & Callinan, C. (2021). Adaptation of Kirkpatrick’s four-level model of training criteria to evaluate training programmes for head teachers. Education Sciences, 11(3), 116. Web.

Billings, D. M., & Halstead, J. A. (2019). Teaching in Nursing e-Book: A guide for faculty. Elsevier Health Sciences.

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