Curriculum Evaluation: Measuring the Students’ Achievement of a Program Level Learning Outcomes in the Baccalaureate Degree of Nursing

Abstract

Background: Excellence in teaching and the quality of outcomes are the targeted goals of higher education, specifically the higher education of Nursing, and is a requirement of the accreditation commissions. To achieve these tasks, regular evaluations of the program curricula is required. Purpose: This study aims to provide an innovative way of measuring students' achievement of the nursing courses learning outcomes, explicitly providing one example of the fourth year students' achievement of specific course learning outcomes as part of the accreditation requirement for the nursing curriculum evaluation. Methodology: A descriptive cross-sectional design was used to collect the end of semester course evaluation survey of 28 students and document analysis of the final assessment results and assess the course syllabus of the targeted nursing course. A conceptual framework was adopted from Goff, et al. Result: The nursing course syllabus provided detailed information about the course learning outcomes, the assessment tasks, and the roles of the curriculum. The final exam analysis revealed that the average mean of the correct answers designed to evaluate the learning outcomes ranged between (88.7%-94%). The students' end of semester course evaluation survey revealed a general satisfaction of the students with a mean (4.54). Conclusion: Assessing the course syllabus, analyzing the final assessment exam, and collecting student feedback provided a strong base for supporting the achievement of the intended course learning outcomes. Recommendation: Based on the review of the assessment items, the authors recommended increasing the difficulty level of the final exam and adding short answer questions. Furthermore, other research methodologies are recommended for better outcomes, such as using a mixed methodology.

Full text

Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
1Volume 4; Issue 10
Research Article
Curriculum Evaluation: Measuring the
Students’ Achievement of a Program Level
Learning Outcomes in the Baccalaureate Degree
of Nursing
Nathira Al Hmaimat1*, Omar Melhem1, Annie Rosita1, Briliya Devadas1,
Hadya Abboud2
1Fatima College of Health Sciences, Abu Dhabi Campus, UAE
2Fatima College of Health Sciences, Al Ain Campus, UAE
*Corresponding author: Nathira AI Hmaimat, Fatima College of Health Sciences, Abu Dhabi Campus, UAE
Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Abboud H (2021) Curriculum Evaluation: Assessing the Students’
Achievement of a Program Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267.
DOI: 10.29011/2688-9501.101267
Received Date: 10 December, 2021; Accepted Date: 16 December, 2021; Published Date: 21 December, 2021
International Journal of Nursing and Health Care Research
Al Hmaimat N, et al. Int J Nurs Health Care Res 4: 1267.
www.doi.org/10.29011/2688-9501.101267
www.gavinpublishers.com
Abstract
Background: Excellence in teaching and the quality of outcomes are the targeted goals of higher education, specically the
higher education of Nursing, and is a requirement of the accreditation commissions. To achieve these tasks, regular evaluations
of the program curricula is required. Purpose: This study aims to provide an innovative way of measuring students’ achievement
of the nursing courses learning outcomes, explicitly providing one example of the fourth year students’ achievement of specic
course learning outcomes as part of the accreditation requirement for the nursing curriculum evaluation. Methodology: A
descriptive cross-sectional design was used to collect the end of semester course evaluation survey of 28 students and document
analysis of the nal assessment results and assess the course syllabus of the targeted nursing course. A conceptual framework
was adopted from Goff, et al. Result: The nursing course syllabus provided detailed information about the course learning
outcomes, the assessment tasks, and the roles of the curriculum. The nal exam analysis revealed that the average mean of
the correct answers designed to evaluate the learning outcomes ranged between (88.7% - 94%). The students’ end of semester
course evaluation survey revealed a general satisfaction of the students with a mean (4.54). Conclusion: Assessing the course
syllabus, analyzing the nal assessment exam, and collecting student feedback provided a strong base for supporting the
achievement of the intended course learning outcomes. Recommendation: Based on the review of the assessment items, the
authors recommended increasing the difculty level of the nal exam and adding short answer questions. Furthermore, other
research methodologies are recommended for better outcomes, such as using a mixed methodology.
Keywords: Nursing curriculum; Curriculum evaluation;
Learning outcomes mapping; Assessment tasks; Accreditation;
Higher education
Introduction
Excellence in teaching and in the quality of outcomes are
the targeted goals of different programs in higher education,

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
2Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
specically in each nursing program, which can be achieved
by regular evaluation of the program. The evaluation process
can inform the decision-makers and guide the plan of possible
improvement [1]. Furthermore, the goals of each curriculum
provides specic guidelines and directions to the ultimate learning
outcomes and concepts the students have to achieve, and though
the learning outcomes need to be evaluated for their effectiveness
[2,3]. With the continuously and rapidly changes in the health
care sector, the undergraduate nursing curricula are continually
changing based on the requirement of the health sector. Currently, it
emphasizes on the learner and measurement of learning outcomes,
integration into the curriculum of quality and safety concepts,
evidence-based practice, translational science and research, and
the application of technology to the delivery of the program
provide thrilling challenges and opportunities for nurse educators
[2,3]. For that, the nursing faculty and educators should consider
all of these factors when examining the curriculum and consider
any change. Today and tomorrow’s curricula call for an integration
of learner- and consumer-based processes and, at the same time,
ensure excellence by building outcome measures to determine the
program’s quality [2,3].
The information about the effective curriculum started
by the end products, for that dening each Course Learning
Outcomes (CLOs) to be achieved by the graduate is the rst step
for proper planning of the future evaluation of the curriculum [4,5].
Furthermore, the primary Program Learning Outcomes (PLOs)
focus on integrating the students’ learning abilities, wherein, it has
to be easily measurable, transferable and socially oriented [6]. As a
requirement of the UAE Commission for Academic Accreditation
(CAA), an entire process of how the academics have to evaluate
the course learning outcomes (CLOs) and how to link it with the
Program Learning Outcomes (PLOS) is one important part of the
quality assurance process. As one criteria is to have “An account of
the improvements made at course level as a result of regular course
evaluation p.11)” [7]. After an in-depth search for a research based
information regarding this aspect, merely lack of quantitative
research that explains the process in how to evaluate CLOs using
the results of the assessment items per course and linking it to the
PLOs’ achievement, provoke this paper.
The primary aim of this study is to provide an innovative
way to assess the students’ achievement of the CLOs to be the base
of the nursing curriculum evaluation. Moreover, the second aim is
to evaluate the achievement of the CLOs of one of the year four
nursing courses to serve as an example. For that, the researchers
chose to provide an example of one course to help in clarifying
the new method of evaluation. The research question guided this
article was: Are the assessment methods appropriate for measuring
the achievement of the CLOs and PLOs in a fourth-year level
course?
Literature Review
The learning outcomes measurement needs prior planning
and an in-depth understanding of the evaluation method. The
academic faculty need to follow a standardized way in evaluating
their CLOs’ achievement to be able to compare and contrast the
students’ achievement from different courses. Many methods
can be used to serve this purpose, such as tests. Aiming to ensure
that the students’ exam results inform the educators about the
students’ performance regarding specic curriculum anticipations,
the development and application of alignment exist in the eld
of education [8,9]. Furthermore, the curriculum mapping with
the assessment tasks can improve the quality of the curriculum
delivered [10,11].
Some researchers described a complete process of how
they developed and implemented a design to evaluate the nursing
curriculum following their national accreditation standards [12].
The researchers followed hierarchy steps starting from mapping
the course objectives with the major program goals; then
evaluating course content; after that reviewing the schedule; the
fourth step is evaluating the teaching strategies; then analyzing the
student performance; reviewing the textbooks and other resources;
collecting and analyzing the students’ feedback; nally validating
the education requirements. In conclusion, following the context,
content, and conduct model helps continuously evaluate the
nursing program.
Alignment of the program level objectives with the
assessment items and the clarity of the instructions provided to
the students is considered a crucial step in providing a realistic
evaluation and improvement of the curriculum. For example, some
researchers argued the assessment to follow the No Child Left
Behind (NCLB) law [9]. Their argument included the reduced time
of teaching, the tapered curriculum, the fewer chances to assess
higher order of thinking skills, and reduced drive of teachers and
students affected the students’ performance [9]. Based on this
argument, the researchers discussed different methods and types of
curriculum alignment, aiming to help policymakers, educators, and
assessment developers, to improve their curriculum, assessment,
and curriculum instructions. They reviewed three widely used
evaluation methods, the Webb, Achieve, and SEC. They concluded
that alignment is a useful method for evaluating the educational
processes to support the curriculum objectives [9].
As support to have a link between the CLOs and the
assessment, one researcher summarizes the importance of having
the intended learning outcomes in improving the veterinary
curriculum [4]. Taylor supported the need to map the learning
outcomes vertically and horizontally to help the students gain
the needed competencies for each specic eld. Furthermore,
Taylor concluded that the constructive linking of learning with the

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
3Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
assessment items increases the dedicated time required to develop
the major program outcomes [4].
In another study, the researchers provided a curriculum
evaluation by mapping the learning outcomes with the assessment
items, aiming to recommend specic instruction in pharmacy
education [10]. The researchers used a descriptive cross-sectional
design to study 209 Pharm D students during the academic year
2004/2005. The researchers provided a condensed report using
color shading for the competencies taught during the study period.
They highlighted the taught competencies in each course; the more
covered, the more the condense of the color. They found a harmony
between the intended and delivered learning outcomes [10].
While other efforts from pharmacy staff aimed to evaluate the
fourth-year program-level learning outcomes in a pharmacy degree
[6] the researchers used the mixed methodology to evaluate the
successful implementation of a pharmacy degree program. Based
on the interview with the faculty, they found that accreditation is
the main factor in evaluating the program. The feedback of 1176
second-year students about aligning CLOs with the instructions
provided; revealed a 70% agreement on the alignment. The
researchers used the students, stakeholders, and faculty feedback
to conclude the importance of having good leadership, resourced
faculty team, and scholarly approaches.
In summary, the literature consulted in this article supported
the mapping between the CLOs and the assessment items. They
provided evidence of the effectiveness of linking the results of
the assessment to measure the achievement of the course learning
outcomes and review the clarity of the course materials and the
feedback of the students. However, the quantication of the
achievements of each learning outcome needs further exploration.
Theoretical Framework and Conceptual Framework
To guide the process of this study, the researchers adopted
the conceptual framework from Goff, et al. [13] to evaluate the
CLOs, in which the researchers followed a four-stage cycle. The
rst stage is to identify the expectation; the second is to map the
assessment tasks, the third is to gather and analyze assessment
results. Finally, to make program improvement (Illustration
1). In addition, the researchers considered the revised Bloom’s
Taxonomy to guide the content of the assessment of the fourth
year level course [14]. Bloom’s Taxonomy is a theory developed
by Benjamin Bloom and others in the early 1950s [14]. The
theorist provided a classication of the educational curriculum
learning outcomes to guide the learning process (Illustration 2). In
higher education, Bloom’s Taxonomy is widely used in different
educational settings and is used in nursing education in specic
[15,16].
Illustration 1: Four- Stage Cycle for the Assessment of Program-
Level Learning Outcomes [13].
Illustration 2: Bloom’s Taxonomy and the revised Blooms
Taxonomy classication.
Combining Bloom’s Taxonomy theory to guide the difculty
of the assessment items and the conceptual framework of Goff, et
al., the researchers developed the conceptual framework of this
study as shown in Illustration 3. The researchers used Bloom’s
Taxonomy theory to map the assessment items by explaining
the difculty level of the assessment following the hierarchy or
classication of the cognitive dimension and the affective and
psychomotor dimensions, which were mainly covered in clinical
practice and clinical practice skills (Illustration 2, Illustration 3).
The researchers followed the conceptual framework
(Illustration 3), wherein stage one was devoted to setting the
evaluation criteria. The criteria identify the course expectation
by mapping the CLOs to the expected percentage of the correct
answers (average) for all questions used to measure each specic
CLO (Table 1). In the example provided, the students have to
achieve 70% of correct answers (average) of the questions assigned
to measure each learning outcome (Table 1). Furthermore, the

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
4Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
researchers reach a consensus regarding the mapping between the CLOs and PLOs to complete the planning phase that will guide the
evaluation of the students’ achievement of each CLOs and link it to the achievement of the PLOs (Table 2).
Illustration 3: Conceptual Model for the Study.
Abbreviation At the end of this unit students will be able to: Expected Students’
Achievement
CLO1 Describe the most important inuences on health and wellbeing among the ageing population 70%
CLO2 Identify standard ageing patterns, age-related and age acquired illnesses, including chronic conditions. 70%
CLO3
Critically analyze at a basic level physiological parameters in association with illness in the older
person. Develop a working knowledge of pharmacological agents and factors as they inuence the care,
treatment, and comfort of older adults.
70%
CLO4 Demonstrate an awareness of ageist stereotypes, personal attitudes, beliefs and cultural inuences and
how they affect ageing and care of older persons. 70%
CLO5 Assess, plan and implement effective communication and intervention strategies for the safe nursing
care of older adults with compromised cognitive function. 70%
CLO6 Demonstrate client-centered nursing care of older adults in acute, specialty and community settings. 70%
CLO7 Demonstrate critical thinking in the delivery of evidence-based nursing practices 70%
*CLO: Course Learning Outcomes
Table 1: Fourth-Year Level- Course Learning Objectives.

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
5Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
After the planning was completed, stage two guided the
researchers to implement a strategy to evaluate the students’
achievement. The strategy was to map the CLOs to the nal
assessment items. The nal assessment was an exam with 60
multiple-choice questions (Table 3, Table 4). The researchers
developed the nal assessment following Bloom’s Taxonomy
classication of difculty index. In which, assigning the low level
of difcult questions to measure the students’ ability to remember
(knowledge) and understand (comprehension) knowledge of
different concepts. At the same time, the medium level of difculty
questions to measure the students’ ability to apply (application)
and analyze (analysis) certain case studies related to the course
intended outcomes. Finally, the high level of difcult questions
to assess the student’s skills in evaluating (synthesis) and creating
(evaluation) individualized nursing care for specic scenarios,
including complicated health-related cases.
Furthermore, the researchers considered the assessment
guidelines of the institution to develop the nal assessment.
The difculty index of the nal examination was formulated to
match the institution’s requirements. The guideline species the
percentage of questions per each difculty level (Table 2). After
nalizing the assessment item, the researchers tested the validity
of the test through the review process of the assessment committee.
The actual data collection phase started by administering the
nal exam and collecting the students’ feedback. The researchers
followed the research-based to gather and analyze the achievement
of the CLOs by analyzing the results of the nal assessment and
the students’ feedback, which is the focus of the discussion in
this article, representing stage three of the conceptual framework.
Finally, stage four targeted the evaluation of the CLOs achievement
by comparing the results to the criteria planned, linking it to the
PLOs achievement, and setting recommendations for a possible
change in future, based on the results and ndings.
*PLOs Specic **CLOs Average Percentage of
Achievement
PLO-1 1,2,5,6,7 Average achievement=70%
PLO-2 1,2,5,6,7 Average achievement=70%
PLO-3 1,2,3,5,6,7 Average achievement=70%
PLO-4 3,4,5,6,7 Average achievement=70%
PLO-5 1,4 Average achievement=70%
PLO-6 1,3,4,7 Average achievement = 70%
PLO-7 3,7 Average achievement = 70%
*PLO: Nursing Program Learning Outcomes; **CLO: Course
Learning Outcomes
Table 2: The Course Learning Outcomes (CLOs) mapping to the
Program Learning Outcomes (PLOs).
Methodology
Design of the Study
A descriptive quantitative, cross-sectional survey design was
used to collect the feedback from the fourth-year nursing students
and document analysis to analyse the students’ responses to the
nal assessment and the course syllabus. The researchers analyzed
the course syllabus and benchmarked the ndings with Grifth
university course syllabus as one of the top nursing schools in the
world.
Population, Sample and Sampling Technique
The sample followed the convenience technique to collect
the survey from the fourth-year nursing students of one of the
higher education institutions in Abu Dhabi (AD) and Al Ain (AA).
The sample size was 28 students with a response rate of 93%, in
which 12 (42.9%, n=28) students were from AD and 16 (57.1%,
n=28) students were from AA. While the nal exam sample was 30
(100%) as all the fourth-year nursing students who are registered
in the specic course completed the exam. Since this study aims to
analyse the achievement of specic course learning outcomes and
the course was taught only in the rst semester on two different
campuses, the researchers have no other options to use other
sampling techniques other than recruiting the current students
registered in the course. The researchers analyses and assessed
the nal exam results and the course syllabus for the document
analysis.
The Instruments-Reliability and Validity
The researchers used two instruments: the nal assessment
exam, consisting of 60 multiple-choice questions. The instrument
face and content validity were checked by an expert faculty
member of the assessment committee of one of the higher
education institutes in AD. The researchers used the expert panel
consensus on the nal exam. The process started by developing
the exam questions to measure the Course Learning Outcomes
(CLOs) by expert lecturers. Then the initial draft was sent to
the assessment committee chair (the academic responsible for
ensuring the quality of the assessment items) to review the nal
exam. The assessment chair assigned anonymous reviewers from
the assessment committee who are experts on the topic of the
exam. The nal exam of the specic nursing course was moderated
by two experienced staff before administering to the students.
The expert panel recommended some minor modications. The
researchers completed the modications and received the approval
of the assessment committee. The researchers covered all the
course learning outcomes in the nal exam, and the mapping aimed
to measure the students understating of the concepts delivered
by measuring the learning outcomes achieved. Furthermore, the
researchers used the classication of Bloom’s Taxonomy to help

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
6Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
in specifying the difculty index for each question, wherein the number of the low difculty questions was 33 (55%), the number of
the medium difculty questions was 20 (33.3%), and the number of the high difculty questions was 7 (11.7%) (Table 3). Besides, the
researchers ensured that delivering the exam matched the institution guidelines.
The Institutional Guidelines of the Level of Questions Difculty per each Exam Abbreviation
30-35% of low difculty questions (knowledge) *L
50% of medium difculty questions (analysis) **M
10-15% of high difculty questions (synthesis) ***H
*L: Low Difculty Level; **M: Moderate Difculty Level; ***H: High Difculty level
Table 3: The Institutional Guidelines of the Level of Questions Difculty per each Exam.
The second instrument is the end of semester course/teaching evaluation. The researchers used the End of Semester Evaluation
(ESE) survey of the higher education institute- to collect the students’ feedback about their experiences while studying this course. The
ESE survey consists of six questions with a Likert scale ranging from very poor (1) to very good (5). The questions were developed to
collect information about the students’ experiences with the course organization, clarity of the assessment items, the feedback from the
instructor, the quality of the teaching strategies and nally, their overall satisfaction. The researchers measured the reliability of the ESE
survey by Cronbach’s Alpha and was 0.89 (Table 4), which is highly reliable [17]. A plan to add a structured interview will be benecial
in understanding the students’ lived experience regarding achieving the course objective, and if so, using the triangulation method in this
research will increase the results validity and reliability [18].
Difculty of
****MCQ
Actual
MCQ No. Percentage
*L 33 out of 60 55 %
**M 20 out of 60 33.3 %
***H 7 out of 60 11.7%
*L: Low Difculty Level; **M: Moderate Difculty Level; ***H: High Difculty level; ****MCQ: Multiple Choices Questions
Table 4: Difculty Index-Aged Care Nursing Final Exam.
Method of Data Collection and Ethical Considerations
The researchers obtained ethical approval from one of the
higher institution colleges. Then collected the students’ responses
to the nal assessment exam by the end of the academic semester.
Each end of semester exam is controlled by the institution policy
in which it ensures the allocation of the private hall, students’
identication, providing invigilators to maintain the credibility
of the exam, and control the time allocated for each exam. The
students used the computer bubble sheet (Scantron sheet) to ll
in the responses to each question. The academic faculty used the
computer bubble sheets to analyze the students’ responses using
the Scantron machine (a scanner machine that electronically
analyses the students’ answers). Using hard copies, the researcher
collected the ESE survey to the students before the nal exam. The
researchers gain the verbal consent of the students to participate
in this survey after explaining to them the research objective.
Furthermore, they considered that the returned survey as an
agreement to participate. To keep the anonymity of participants, the
researchers presented the exam results using the average of correct
answers only, and the questionnaire lacked any demographic
data to ensure the anonymity of the responses [17]. Besides, the
researchers assured the participants that this information would be
condential and used for research and quality improvement of the
course [17].
Furthermore, all information was saved on the principal
investigator’s laptop. A password locks the computer; only
the researchers have access to the information to keep all the
information condential. To ensure the accuracy of the data
collected, the research team completed an extensive review of

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
7Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
the nal assessment exam results. Two researchers summarized
the results into tables and rechecked the data after one day to
double-check and conrm the accuracy of the presented data. The
students’ results were reviewed anonymously in which all students’
information was covered. Only the average correct responses for
each question were presented in the exam analysis.
Similarly, the average of the students’ responses to the ESE
Survey was used for analysis. Finally, the achievement results were
presented anonymously as the average response rate. For the course
syllabus, two researchers analyses the document individually and
benchmark it with Grifth University as one of the top nursing
schools in the world. Then the two analysis were compared and
contrasted to ensure the credibility and trustworthiness of the
analysis.
Method of Analysis
Analyzing the specic course achievement followed the
conceptual framework described previously. In which the nal
assessment questions were mapped with the course learning
outcomes. Furthermore, the researchers developed the questions
to match the difculty levels of the institution guideline (Table 2)
and follow the Blooms Taxonomy (Illustration 2). The researchers
chose specic questions to measure each learning outcome using
different difculty levels. Table 5 listed all the 60 questions with
their mapping to the course learning outcomes and the difculty
level. In addition, the researchers added the response of the correct
answers after analyzing the students’ responses to the exam.
The analysis found that the total number of students who
completed the exam was 30 (100%). The researchers used the
Scantron machine to provide the descriptive statistics of the
students’ correct answers to each question, in which the Scantron
machine provided a student response report with the average
percentage of the correct answer per question (Table 5). After that,
the average correct answer (Percentage %) for each question was
summarized in Table 5. The next step is to measure the average
of the students’ responses to each difculty level of the questions
(Table 6) using the descriptive equation of the mean ( = (Σ xi)
/n). In this step, the researchers collated and grouped all the correct
answer percentages for each difculty level and measured the
average (mean) of the correct answer per each difculty group.
Case Processing Summary N %
Cases Valid 28 100.00
Excluded 0 .00
Total 28 100
Reliability statistics
Cronbach’s Alpha No of Items
.89 6
Table 5: Questionnaire Reliability.

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
8Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
9Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
Table 6: Mapping of the nal exam with the course learning outcomes.
Finally, the students average of correct answers per the
difculty level were benchmarked with the course learning
outcomes and the analysis of the students’ achievement of the course
learning outcomes (Table 7). The researchers counted the number
of questions of each level of difculty for each learning outcome
vertically. Then the average percentage for each difculty level
was multiplied by the number of the questions designed to achieve
the learning outcomes and then divided by the total number of the
questions. Course Learning outcome (CLO) achievement = CLOi
(no. of questions with low difculty assigned to measure CLOi
X percentage of the correct answer of the low difculty) + (no.
of questions with moderate difculty assigned to measure CLOi
X percentage of the correct answer of the moderate difculty) +
(no. of questions with high difculty assigned to measure CLOi X
percentage of the correct answer of the high difculty) all divided
by the total number of questions assigned to measure CLOi.
Results
The overall nal exam results were; the maximum score
is 98%, the minimum score is 83%, the average is 91%, SD=5.
However, the analysis focuses on the average percentage of the
correct answers. The researchers found the average of correct
answers for all questions grouped under each difculty level to
be 100% (no. of MCQs=33 out of 60) for the low difculty level,
86.6% (no. of MCQs=20 out of 60) for the moderate difculty
level and 61.3% (no. of MCQs=7 out of 60) for the high difculty
level (Table 4, Table 7). While the vertical analysis for the average
of correct answers assigned to measure each CLO was found to be
89.6% for CLO1 (example of analysis: Low difculty (13 MCQs
x100%) + Moderate Difculty (7 MCQs x 86.6%) + High difculty
(4 MCQs x 61.3%) / total number of questions (24 MCQs)), 92.7%
for CLO2, 89.9% for CLO3, 88.7% for CLO4, 92.9 for CLO5,
93.5 for CLO6, and 90.8 for CLO7.

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
10 Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
Difculty
Index Students Response Percentage Number of
Answers
*LAverage = (33x100%)/33= 100% 33 out of 60
**MAverage =(7x82%)+(11x92%)+(2x73%) /20 = 86.6% 20 out of 60
***HAverage = (1x64%)+(1x55%)+(1x36%)+(1x73%)+(1x64%)
+(1x73%)+(1x64%) / 7= 61.3% 7out of 60
*L: Low Difculty Level; **M: Moderate Difculty Level; ***H: High Difculty level
Table 7: Students Response Percentage (Correct Answers% ).
The results of students’ achievements of the specic course
outcomes ranged between 88.7% to 93.5%. The highest average
of the correct answers was toward achieving CLO6 with 93.5%
of correct answers, which was “Demonstrate client-centered
nursing care of older adults in acute, specialty and community
settings”. Almost 94% of the students showed their ability to
demonstrate client-centered nursing care [19]. This skill was built
accumulatively from year two and was part of the ve prerequisite
courses. Though measuring their ability to achieve this learning
outcome was as expected to be high.
The second-high average of correct answers was toward
CLO5 with 92.9%. The intended learning outcome was to measure
the students’ ability to demonstrate effective communication
and intervention strategies for safe nursing care for elderly with
compromised cognitive function. The materials to achieve this
learning outcome was delivered over two weeks, and though the
weight of the questions was less in comparison with the questions
allocated to measure the achievement of CLO2. Almost 93% of the
students achieved higher than 70%.
The third high average was toward achieving CLO2 with
92.7% of the correct response. CLO2 was formulated to identify
the standard ageing patterns and age-related health issues. The
major component of this course was to provide the students with
the needed knowledge about the ageing process and its related
health problems, including all body systems. For that, around 40
questions from the three difculty levels were assigned to measure
the achievement of these learning outcomes [20]. Around 93% of
the students could synthesis the knowledge and provide correct
answers that indicate their ability to achieve CLO2.
The seventh Course Learning outcome was achieved by 90.8%
of the students who correctly answered the question measuring it.
The fourth-year students showed their skills in critically analyzing
the evidence-based nursing practices and critically synthesizing
the nursing care by creating a specic nursing care plan based on
elderly health-related scenarios; considering that the students had
the research and evidence-based practice related skills part of the
nursing curriculum.
The correct response to achieve the third Course Learning
outcome was 89.9%. Almost 90% of the students were able
to analyse the basic physiological parameters and develop a
working knowledge of pharmacological agents to help the elderly
population. The information covered by CLO3 was covered in all
course lectures as part of the disease management and nursing care
needed for each illness. For that, the number of questions allocated
to measure CLO3 was relatively high [21].
The percentage toward achieving CLO1 was 89.6% which
was “Describe the most important inuences on health and
wellbeing among the ageing population”. Almost 90% of the
students were able to show their ability to solve problems related
to the critical inuences on the elderly health. Even though this
information was relatively new to them, by benchmarking the
average of the correct answers to the planned, expected outcomes
(70%); the students achieved CLO1.
Finally, the lowest average went toward CLO4 with 88.7%.
The content delivered to achieve this learning outcome was only
one lecture, with tutorial sessions to identify the ageist stereotypes,
the students’ attitudes, beliefs, cultural inuences, and how they
affect ageing and care of older persons. The weight of questions to
measure the achievement of these objectives was limited based on
the material weight. However, around 89% of the students could
correctly answer the questions assessing CLO4. As provided, the
benchmarking criteria for measuring the achievement of the CLOs
was 70%; positively, the CLOs for the Aged care-nursing course
were achieved.
Results of the Students’ Feedback
The researchers collected 28 responses for the ESE survey
from two different campuses of one of the higher education

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
11 Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
colleges in Abu Dhabi; the attrition rate was very minimal and
represented only 6.6% of the fourth year cohort. The response
rate was 93.3% which is considered a high response rate. The
SPSS software version 20 was used to analyse the results. The
descriptive statistics of mean, frequency and Standard Deviation
(SD) were used to present the results. As shown in Table 8, the
mean of the students’ responses ranges from 4.54 (SD=0.51) to
4.68 (SD=0.48). The highest mean was the participants’ responses
to the survey item indicating the assessment clarity. All the
students provided an excellent score that indicated the students’
general satisfaction with the assessment items of this course. A
second-high score went to the survey items about the organization
of the course. The results indicated that the students agreed and
were satised with the course organization with a mean of 4.64
(SD=0.49).
The participants indicated that the academic faculty
provided continuous feedback about the assessment items, with
a mean of 4.57 (SD=0.5). Furthermore, the participants agreed on
the valuable course materials with a mean of 4.57 (SD=0.5). The
learning motivation of the course was given the lowest mean of
4.54 (SD=0.51). In general, the participants indicated their overall
satisfaction with the course with a mean of 4.54 (SD=0.51).
To look in-depth at the participants’ feedback, the frequency
distribution was tested for each survey item presented in Table
9. The frequency of the good (4) responses ranges from 9 to 13
responses for all survey items. While the frequency responses for
the very good (5) ranges from 15 to 19 responses. This indicated
that most of the respondents were toward providing very good
feedback.
To look into the frequency of each survey item, the
participants were satised with the course organization, with
either good (35.7%) or very good (64.29%) organization, with a
mean of 4.64, SD=0.49 (Table 8). These results indicated that the
course syllabus, the instructions, and the assessment items were
organized. At the same time, the second item targeted the students’
experiences with the type of feedback received from the course
instructors. Almost all students responded by either good (42.86%)
or very good (57.14%) with a mean of 4.57, SD=0.5. Obviously,
the students’ responses supported the good feedback they received
from the course instructors.
CLOs No. of MCQ based on Difculty
index for each CLO
CLOs Achievement
Average
% Correct
Answer
*L=100% **M=86.6%
***H=
61.3%
****CLO.1 13 7 4 (13x100%)+(7x86.6%)+(4x61.3%)/24= 89.6%
CLO.2 24 13 3 (24x100%)+(13x86.6%)+(3x61.3%)/40= 92.7%
CLO.3 14 8 4 (14x100%)+(8x86.6%)+(4x61.3%)/26=89.9%
CLO.4 3 3 1 (3x100%)+(3x86.6%)+(1x61.3)/7=88.7%
CLO.5 8 4 1 (8x100%)+(4x86.6%)+(1x61.3)/13=92.9%
CLO.6 7 2 1 (7x100%)+(2x86.6%)+(1x61.3)/10=93.5%
CLO.7 10 8 2 (10x100%)+(8x86.6%)+(2x61.3%)/20=90.8%
*L: Low Difculty Level; **M: Moderate Difculty Level; ***H: High Difculty level; ****CLO: Course Learning Outcomes
Table 8: Analysis of the students’ achievement of the CLOs.

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
12 Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
To evaluate the students’ perceptions regarding the quality of the course materials and the teaching strategies. The majority
(57.14%) responded by very well, while less than half of the participants (42.86%) responded by good. Overall the students were happy
with the course materials and teaching strategies with a mean of 4.57, SD=0.5. The clarity of the assessment items was well perceived,
with the responses being either good (32.14%) or very good (67.8%) with a mean of 4.68, SD=0.48. Besides, the students’ engagement
in the course learning activities were high as the responses were either good (46.43%) or very good (53.57%) with a mean of 4.54 and
standard deviation of 0.51. Finally, the students were satised with the course in general by either good (42.43%) or very good (57.57%)
with a mean of 4.54, SD=0.51 (Table 10).
Table 8: Descriptive analysis of the End of Semester Evaluation (Students’ Feedback) survey.
Survey Items Value Label Value Frequency Percent Valid
Percent Cum Percent
This Course was well organized
Good 4.00 10 35.71 35.71 35.71
Very Good 5.00 18 64.29 64.29 100
The assessment was very clear and fair
Good 4.00 9 32.14 32.14 32.14
Very Good 5.00 19 67.86 67.86 100
I received helpful feedback on my assessment
work
Good 4.00 12 42.86 42.86 42.86
Very Good 5.00 16 57.14 57.14 100
The course engaged me in learning
Good 4.00 13 46.43 46.43 46.43
Very Good 5.00 15 53.57 53.57 100
The teaching (lectures, tutors, online, etc.) on
this course was effective in helping me to learn
Good 4.00 12 42.86 42.86 42.86
Very Good 5.00 16 57.14 57.14 100
Overall, I am satised with the quality of this
course
Good 4.00 13 46.43 46.43 46.43
Very Good 5.00 15 53.57 53.57 100
Table 9: Descriptive frequency of the End of Semester Evaluation survey.

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
13 Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
Criteria of Comparison One of Abu Dhabi Higher
Education Institutions
International Institution
(Grifth University) Comments
Course description Yes Yes
Course Learning Outcomes Yes Yes
The assessment plan and weight Yes Yes
Updated Textbooks and other resources Yes Yes
Clear Roles and Responsibilities of the students, Yes Yes- Hyperlink
The rubrics Clear Clear
Table 10: Course Syllabus- Evaluation Criteria.
Course Syllabus Analysis Results
The course syllabus was read and re-read by two researchers.
The document analysis aims to assess the clarity of the information
about the course learning outcomes and the assessment items.
The researchers used specic criteria to compare and contrast the
course syllabus with Grifth University. The document analysis
criteria were about the course description, the learning outcomes,
the assessment plan and weight, the textbooks and other resources,
the roles and policies of the students, and the rubrics.
The specic course is a fourth-year course offered during the
rst semester over 16 weeks. The content of this course focuses
on the needed concepts to understand the nature of the health-
related issues of the elderly population. This course requires the
completion of ve prerequisite courses. All the prerequisites are
core nursing courses that equip the students with the knowledge
and skills regarding nursing care. The theory part introduces
the normal ageing processes of the elderly life span; to help the
students understand the health-related changes in the elderly,
in addition to helping them to understand and use the different
adaptive or coping strategies the elderly and their families may
need to continue their life with fewer complications. To apply the
concept of elderly care, the students have to register concurrently
in the clinical course. The two courses help equip the students with
the needed skills and competencies to deal with different clinical
situations related to elderly nursing care, congruent with a fourth-
year student level.
After benchmarking the content of the course syllabus,
the researchers found that the course syllabus included clear
information about the course description that provided the readers
with the nature of the course. The course syllabus started by
describing the main aims and what is expected from the students;
next the learning outcomes were listed. The learning outcomes
were similar to the learning outcomes of the international schools.
The assessment items then were listed in which there a table was
summarizing all the assessment items. After that, the assessment
items were described clearly, including the college’s policy. In
contrast, the international nursing school provided a hyperlink to
the policy rather than listing it in the course syllabus.
The course syllabus then provided a table with the students’
attributes. In summary, the academic faculty provided the students
with a clear guide, and maybe we can call it a course guide rather
than a course syllabus because all the needed information was
listed in this syllabus.
Discussion
To provide a numerical estimation of the course learning
outcomes’ achievement is quite confusing, specically if you are
looking to measure it manually. However, after analyzing the nal
assessment of the specic nursing course, the achievement of the
learning outcomes was tested using different methods. Initially,
assigning the end of semester exam to measure the achievements
of the learning outcomes is considered acceptable under the
condition of the exam covering all the course’s learning outcomes.
Furthermore, the end of semester exam weighs 40% of all
assessment items, which may indicate the students’ achievement.
Besides, using different difculty levels of questions ensured the
students’ ability to memorize, understand, analyse, evaluate and
retain knowledge about the course-related concepts; the method
adopted is similar to the SEC methodology to enhance the validity
of the nal assessment content [9].
In the example provided, the average of the correct students’
responses to answer the nal exam was used to evaluate their course
learning outcomes. Each Course learning outcome was assessed
using the three levels of difculty index to ensure that the students
could synthesis the learned materials. For example, to assess the
CLO1, there was (13) low difculty, seven medium difculties,
and four high difculty questions. Furthermore, the questions
weight per each CLO was assigned according to the materials
covered. For instance, CLO4 was toward specic stereotypes
of ageism which represent only one portion of a lecture-based
material. Considering ageism for the written assignment as part of

Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
14 Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
the assessment items; led to a decrease in the number of questions
allocated to measure the achievement of CLO4.
Considering the initial planning for evaluating the CLOs,
is one important task to guide the evaluation of the students’
achievements of the specic CLOs. The academic can provide
an estimated percentage to judge the students’ achievement with
proper planning.
The Course Syllabus Assessment
The course syllabus was reviewed to assess the clarity of
instructions regarding the Aged Care Nursing information about
the course learning outcomes, the assessment matrix, and the roles
and regulations of the course. The assessment ndings supported
the clarity of information in which the course learning outcomes
were presented on the rst page of the syllabus, and also it was
aligned with the assessment items. The assessment plan and weight
were presented in two forms; rst, it was listed in a table and then
it was narratively explained, directing the students toward the
course learning outcomes to be achieved. The roles and policies
of the course, the rubrics, and the resources needed were listed in
clear formatting. By these ndings, the second research hypothesis
was met.
Conclusion
Using the Goff, et al. four-stage cycle to evaluate a program-
level curriculum was helpful. The author identied the expectations
of the students’ achievement, mapped the assessment tasks to the
learning outcomes, gathered and analyzed the assessment results
and nally recommended specic improvement points. In addition,
assessing the course syllabus, analyzing the nal assessment exam,
and collecting the students’ feedback provided a strong base for
supporting the achievement of the intended learning outcomes of
the specied course [13].
Recommendations
The quality of each course needs to be considered to increase
the academic faculty accountability for their work. The evaluation
of each course learning outcome can be cross-mapped with the
nursing program goals and objectives. Moreover, the researchers
found the importance of evaluating the course achievement using
the quantitative approach. For the specic sample included in
this study, they recommend increasing the difculty level of the
nal exam and adding short answer questions. Furthermore, to set
a future recommendation to use a mixed methodology for better
outcomes.
Contributors
All authors have made substantial contributions to this paper
regarding the study’s conception and design.
Ethical Approval
The study was approved by the ethical committee where
the study took place. Reference number: FCHS/RECA/#
INTSTF001BSN20.
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Citation: Al Hmaimat N, Melhem O, Rosita A, Devada B, Aboud H (2021) Curriculum Evaluation: Measuring the Students’ Achievement of a Program
Level Learning Outcomes in the Baccalaureate Degree of Nursing. Int J Nurs Health Care Res 4: 1267. DOI: 10.29011/2688-9501.101267
15 Volume 4; Issue 10
Int J Nurs Health Care Res, an open access journal
ISSN: 2688-9501
19. Graham RW (2005) Illustrating triangulation in mixed-methods nursing research: Nurse Res 12: 7-18.
20. Kurz A, Elliott SN, Wehby JH, Smithson JL (2010) Alignment of the intended, planned, and enacted curriculum in general and special education and
its relation to student achievement. The Journal of Special Education 44: 131-145.
21. One of the higher institution in Abu Dhabi (2017) Assessment Moderation Policy 1-3.
Question Very Poor
(1)
Poor
(2)
Average
(3)
Good
(4)
Very Good
(5)
This course was well organized □ □ □ □ □
The assessment was very clear and fair □ □ □ □ □
I received helpful feedback on my assessment work □ □ □ □ □
The course engaged me in learning □ □ □ □ □
The teaching (lectures, tutors, online, etc.) on this course was effective in
helping me to learn □ □ □ □ □
Overall, I am satised with the quality of this course □ □ □ □ □
Appendix 1: End of Semester Evaluation (ESE)-Student’s Feedback Survey.