Substance Use Disorders: A Curriculum Response

Marian L. Farrell, PhD, PMH-NP, BC, PMH-CNS, BC, CRNP


Online J Issues Nurs. 2020;25(1) 

In This Article

One Possible Solution

Expanding the time allotted for instruction about SUD in nursing education programs may offer part of the solution to the substance abuse crisis. Exposure to individuals experiencing SUD in different settings will allow nursing students to build competencies throughout their educational experiences. This diverse exposure will also increase students' awareness of the impact of SUD on individuals in multiple settings across the lifespan. Conceptual frameworks provide an integrated approach throughout the curriculum to address student learning needs. Fink's (2013) integrated approach provides a conceptual framework suitable to teach students about substance use disorders. Fink's taxonomy creates a lifespan approach and does not limit teaching or learning to one specific course, but rather as an ongoing opportunity for competency building.

Fink's Integrated Approach

Fink (2013) describes a taxonomy of significant learning designed to create learning experiences that are "engaging" and "high energy" but also result in "lasting change" and "value in life" while preparing students for the "world of work" (pp. 8–9). Fink (2013) created the taxonomy of significant learning for each course with the following intersecting major categories: foundational knowledge, application, integration, human dimension, caring, and learning how to learn. Fink provides verbs and learning goals for each category of the taxonomy.

Foundational knowledge involves the ability of students to "understand and remember specific information and ideas" (Fink, 2013, p. 34). The section focuses on content information (i.e., remembering and understanding), thus creating a deeper understanding about the subject. Foundational knowledge is the basis of other learning (Fink, 2013). The second category, application, is "[l]earning how to engage in various kinds of thinking (critical, creative, practical) is an important form of application learning but this category of significant learning also includes developing certain skills or learning how to manage complex projects" (p. 35). Application "…allows other kinds of learning to be useful" (p. 36). Integration occurs "[w]hen students are able to see and understand the connection between different things" (p. 36). Integration provides intellectual power (Fink, 2013).

Human dimension results "[w]hen students learn something important about themselves or about others, it enables them to function and interact more effectively" (p. 36). Human dimension creates an understanding about the human significance of learned content (Fink, 2013). Caring results when "…. a learning experience changes the degree to which students care about something. This may be reflected in the form of one's feelings, interests, or values. Any of the changes means students now care about something to a greater degree than they did before or in a different way" (p. 36). Students' ability to care about something creates energy for learning (Fink, 2013). Learning how to learn describes how "…. students can learn something about the process of learning itself. They may be learning how to be a better student, how to engage in a particular kind of inquiry or how to become a self-directed learning" (p. 36). Learning how to learn allows students to effectively continue the learning process (Fink, 2013).

Synthesis of Essential Content

Blending the recommendations of the Psychiatric Mental Health Substance Abuse Essential Competencies Taskforce of the American Academy of Nursing Psychiatric Mental Health Substance Abuse Expert Panel (2012) with Fink's (2013) integrated approach and taxonomy of significant learning provides a framework to change baccalaureate nursing education about substance use disorders. It is important to consider not only the content and the time allotted, but also the teaching strategies to teach this content regarding substance use disorders. The following tables (Table 1, Table 2, Table 3 and Table 4) list the core nursing content and synthesize essential PMHN content; learning outcomes defined as clinical competencies; and the emphasis from Fink's (2013) taxonomy of significant learning.