Neonatal Intensive Care Nursing Curriculum Challenges based on Context, Input, Process, and Product Evaluation Model: A Qualitative Study

Mansoureh Ashghali-Farahani, Fatemeh Ghaffari, Sara-Sadat HoseiniEsfidarjani, Zahra Hadian


Background: Weakness of curriculum development in nursing education results in lack of professional skills in graduates. This study was done on master’s students in nursing to evaluate challenges of neonatal intensive care nursing curriculum based on context, input, process, and product (CIPP) evaluation model.

Materials and Methods: This study was conducted with qualitative approach, which was completed according to the CIPP evaluation model. The study was conducted from May 2014 to April 2015. The research community included neonatal intensive care nursing master’s students, the graduates, faculty members, neonatologists, nurses working in neonatal intensive care unit (NICU), and mothers of infants who were hospitalized in such wards. Purposeful sampling was applied.

Results: The data analysis showed that there were two main categories: “inappropriate infrastructure” and “unknown duties,” which influenced the context formation of NICU master’s curriculum. The input was formed by five categories, including “biomedical approach,” “incomprehensive curriculum,” “lack of professional NICU nursing mentors,” “inappropriate admission process of NICU students,” and “lack of NICU skill labs.” Three categories were extracted in the process, including “more emphasize on theoretical education,” “the overlap of credits with each other and the inconsistency among the mentors,” and “ineffective assessment.” Finally, five categories were extracted in the product, including “preferring routine work instead of professional job,” “tendency to leave the job,” “clinical incompetency of graduates,” “the conflict between graduates and nursing staff expectations,” and “dissatisfaction of graduates.”

Conclusions: Some changes are needed in NICU master’s curriculum by considering the nursing experts’ comments and evaluating the consequences of such program by them.


Curriculum, educational models, evaluation, intensive care, neonatal, nursing, nursing program, qualitative research

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Dighe MP, Muckaden MA, Manerkar SA, Duraisamy BP. Is there a role of palliative care in the neonatal intensive care unit in India?. Indian journal of palliative care. 2011;17:104.

LeFlore J, Thomas PE, Zielke MA, Buus‑Frank ME, McFadden BE, Sansoucie DA. Educating neonatal nurse practitioners in the 21st century. J Perinat Neonatal Nurs 2011;25:200‑5.

Ebadi A, Tabanejad Z, Pazokian M. Clinical competence among MSc students of critical care nursing. Iranian J Med Educ 2015;14:1036‑46.

Safari M, Khodavisi M, Torkaman B. The viewpoints of nurses towards applicability of nursing curriculum in hospitals affiliated to Hamedan University of Medical Sciences. Iranian J Med Educ 2009;8:205‑11.

Kermansaravi F, Navidian A, Imani M. Nursing students’ views toward quality of theoretical and clinical nursing education: A qualitative study. J Med Educ Dev 2013;7:28‑40.

Mohammadi F, Momennasab M, Yektatalab S, Kouchaki Z, Mozafari F. The effectiveness of doctoral program in nursing in Iran based on the Patrick model. Nursing and Midwifery Studies 2016;5:e33726.

Jahanpour F, Azodi P, Vahedparast H. Nursing students’ perception of the learning experiences in neonatal intensive care units. Interdisciplinary Journal of Virtual Learning in Medical Sciences (IJVLMS) 2012;3:17‑23.

Joolaee S, Jafarian Amiri SR, Ashghali Farahani M, Varaei S. Iranian nursing students’ preparedness for clinical training: A qualitative study. Nurse Educ Today 2015;35:e13‑7.

Vajari TD, Sorkhabi MY, Arefi M, Fardanesh H. Conceptualization of curriculum development models in higher education. Journal of Shahid Beheshti University 2011;8:48‑62.

Iwasiw CL, Goldenberg D. Curriculum development in nursing education: Jones & Bartlett Publishers; 2014.

Khodaveisi M, Pazargadie M, Yaghmaei F, Bikmoradi A. Requirements for effective evaluation in nursing education: A qualitative study. J Res Med Sci 2012;17:710‑7.

Campos CJ, Turato ER. Content analysis in studies using the clinical‑qualitative method: application and perspectives. Revista latino‑americana de enfermagem 2009;17:259‑64.

Polit DF. Essentials of nursing research: Appraising evidence for nursing practice. 2014. 9th ed. Philadelphia: Wolters Kluwer/ Lippincott/Williams & Wilkins Health.

Obeidi N, Motamed N. Comparison of students’ and teachers’ viewpoints about clinical education environment: A study in paramedical and nursing and midwifery schools of Bushehr University of Medical Sciences. Strides in Development of Medical Education 2011;8:88‑93.

Delaram M, Reisi Z, Ali DM. Strengths and weaknesses of clinica education from the viewpoints of nursing and midwifery students in Shahrekord University of Medical Sciences, Shahrekord, Iran. 2012. QOM University of Medical Sciences Journal 2012;6.

Rafiee G, Moattari M, Nikbakht AN, Kojuri J, Mousavinasab M. Problems and challenges of nursing students’ clinical evaluation: A qualitative study. Iran J Nurs Midwifery Res 2014;19:41‑9.

Ghorbani F, Rahkar Farshi M, Valizadeh L. Comparison of master’s curriculum of pediatric nursing in Iran and United states. Journal of Nursing Education 2015;4:41‑7.

Hanifi N, Parvizy S, Joolaee S. The role of clinical instructor in clinical training motivation of nursing students: A qualitative study. 2012;7:23‑33.

Nikfarid L, Ashktorab T. Understanding of neonatal intensive care nurse practitioner students of situation of their profession in Iran: A qualitative study. IJNR 2013;8:37‑46.

Ajani K, Moez S. Gap between knowledge and practice in nursing. Procedia‑Social and Behavioral Sciences 2011;15:3927‑31.

Cheraghi M, Salsali M. To understand the process of theory and practice gap in nursing education in Iran. Iranian Journal of Public Health 2005;34:26‑7.

Heydari A, Soudmand P, Hajiabadi F, Armat M, Rad M. The causes and solutions of the theory and practice gap from nursing education view point: A review article. Journal of Medical Education Development 2014;7:72‑85.

Aghebati N, Mohammadi E, Ahmadi F. The experiences of the lectures and nursing students in the implementation of the curriculum for master students in Critical Care Nursing: a qualitative research. Journal of Nursing Education 2015;4:48‑60

Cheraghi MA, Salasli M, Ahmadi F. Factors influencing the clinical preparation of BS nursing student interns in Iran. Int J Nurs Pract 2008;14:26‑33.

Khoshrang H, Salari A, Dadgaran I, Moaddab F, Rouh‑Balasii L, Pourkazemi I. Quality of education provided at the clinical skills lab from medical students’ viewpoints in Guilan University of Medical Sciences. Research in Medical Education 2016;8:77‑83.

Abdal M, Alavi NM, Adib‑Hajbaghery M. Clinical self‑efficacy in senior nursing students: A mixed‑methods study. Nurs Midwifery Stud 2015;4:e29143.

Khosravi S, Pazargadi M, Ashktorab T. Nursing students viewpoints on challenges of student assessment in clinical settings: A qualitative study. Iranian Journal of Medical Education 2012;11:735‑49. 28. Dehghan‑Nayeri N, Ghaffari F, Shali M. Exploring Iranian nurses’ experiences of missed nursing care: A qualitative study: A threat to patient and nurses’ health. Med J Islam Repub Iran 2015;29:276.

Ashghaly Farahani M, Oskouie F, Ghaffari F. Factors affecting nurse turnover in Iran: A qualitative study. Med J Islam Repub Iran 2016;30:392‑4.

Masoudi R. Prospective critical care master science graduated nurses of clinical competency: A content analysis. J Med Edu Dev 2016;8:106‑14.

Ashghali Farahani M, Ghaffari F, Oskouie F, Tafreshi MZ. Attrition among Iranian nursing students: A qualitative study. Nurs Educ Pract 2017;22:98‑104.

Mohtashami J, Rahnam H, Farzinfard F, Talebi A, Shorideh FA, Ghalenoee M. A survey of correlation between professional identity and clinical competency of psychiatric nurses. Open Journal of Nursing 2015;5:765.


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