A Textbook Replacement Success Story: Transforming a Prelicensure Nursing Program With More Engaged Learning
When the faculty at Mount Carmel College of Nursing in Ohio decided to restructure the prelicensure curriculum, they chose a concept-based approach that focuses on clinical judgment and uses competency-based approaches to evaluate students. Textbook replacement has been an important component of this process.
Mount Carmel’s decision to transform its curriculum grew out of the call for competency-based education across nursing roles. The American Association of Colleges of Nursing (AACN, n.d.) — along with multiple other education organizations — recommend competency-based education for many reasons.
Among them is that it allows schools to adapt to the dynamic nature of the healthcare environment and welcomes the incorporation of healthcare technology innovations being used by nurses in practice settings. In addition, the development of clinical judgment is critical for new nurses (Manetti, 2019).
Textbook replacement as an agent of transformational change
Transformational change involves significant shifts in thinking, structure, and processes (Miller, 2020). One of the most substantive shifts Mount Carmel undertook was replacing textbooks with the Engage™ Series from ATI.
The faculty recognized that students were not completing assigned textbook readings, said Lori Hill, PhD, RN, CNE, APRN-WHNP, an associate professor in the prelicensure program.
In addition to being unprepared for classroom discussion based on textbook assignments, students were struggling to distinguish “need-to-know” information from “nice-to-know” information in content-dense textbooks, she said. The faculty also recognized that information necessary for nursing practice evolves more quickly than new textbook editions are released.
Considering the disadvantages of textbooks and the characteristics of today’s learners, who tend to be technology-driven and respond to engagement and immediate feedback (Phillips et al., 2023), the Mt. Carmel faculty viewed the Engage™️ Series as a potentially valuable alternative.
What is the Engage Series?
ATI developed the Engage Series to provide interactive, compelling content for today’s diverse learners. This immersive learning resource focuses on the essential information necessary for nursing practice and is updated frequently to reflect current practice. Using multimedia, virtual simulations, activities and challenges, EHR documentation practice, podcasts, and more, each Engage solution provides a resonating learning experience.
As of November 2024, the Engage Series includes 6 solutions:
- Engage™️ Adult Medical-Surgical
- Engage™️ Community & Public Health
- Engage™️ Fundamentals
- Engage™️ Maternal, Newborn, and Women’s Health
- Engage™️ Mental Health
- Engage™️ Pediatrics.
How Mt. Carmel implemented the Engage Series
To support faculty and promote the best possible outcomes, Hill said that Mount Carmel integrated the Engage Series in an intentional, organized manner (see below).
Hill emphasized that Mount Carmel faculty were cautious not to compromise students’ learning or success on exams and, ultimately, the NCLEX. In keeping with that strategy, they approached the implementation of the Engage Series as a quality improvement project for fundamentals, community health, and medical-surgical courses.
Before fully committing to adoption, the faculty reviewed outcomes from proctored assessments in ATI’s Content Mastery Series (CMS), which are required after students complete each content area, Hill said. They also considered the perspectives of their students.
Results of textbook replacement with the Engage Series
After implementation, Mt. Carmel faculty compared before-and-after data for the program’s fundamentals, community health, and adult medical-surgical classes.
The impressive results are displayed below, with discussion and explanation following the image.
Mount Carmel implemented Engage™ Fundamentals in its Second-Degree Accelerated Programs (SDAPs), which are provided in 13-month and 18-month formats.
Next, Mount Carmel implemented Engage Fundamentals in its Traditional Undergraduate Program (TUG).
Then, Mount Carmel implemented Engage™ Community & Public Health with TUG and Satellite students. At the time, the TUG program experienced faculty turnover and a course redesign that impacted the results. Program faculty have begun updating their best practices for Engage Community & Public Health.
Next, Mount Carmel implemented Engage™ Adult Medical-Surgical with TUG students. And during the 2024-2025 academic year, Mount Carmel began integrating Engage™ Mental Health, Engage™ Maternal, Newborn & Women’s Health, and Engage™ Pediatrics.
Students have benefited from the Engage Series in multiple ways
The integration of the Engage Series has benefited Mount Carmel students in many ways. In surveys, students report positive perceptions that include:
- preference for Engage over textbook readings
- identifying Engage as useful in helping to meet course objectives
- comfort in navigating the product
- and more.
Given that the flow of information today is constant, it’s no wonder students struggle to focus and retain textbook information, Hill said. With the Engage Series, students learn the information that is essential for nursing practice. And most importantly, they retain it through built-in reinforcement activities, she said.
“The nation is in desperate need of nurses,” Hill said. “Now is the time for educators to meet students where they are — by ensuring that solid, reinforced learning occurs. The Engage Series can help faculty achieve that goal.”
References
American Association of Colleges of Nursing. (n.d.). A guide to curricular transition for competency-based education. https://www.aacnnursing.org/Portals/0/PDFs/Essentials/Guide-to-Curricular-Transition-for- Competency-Based-Education.pdf
Manetti, W. (2019). Sound clinical judgment in nursing: A concept analysis. Nursing Forum, 54(1), 102–110. https://doi.org/10.1111/nuf.12303
Miller, K. (2020, March 19). 5 critical steps in the change management process. Harvard Business School Online. https://online.hbs.edu/blog/post/change-management-process
Phillips, B., Johnson, J., Khalid, N., Zapparrata, N., & Albright, G. (2023). Benefits of an online interactive educational program over traditional textbooks. Nurse Educator, 48(5), 270–275. DOI: 10.1097/NNE.0000000000001398
