The shifting sands of health care delivery: curriculum revision and integration of community health nursing.

The health care delivery system in the United States is moving from an institutionally driven and controlled medical care model toward the Primary Health Care model described by the Alma-Alta Conference (World Health Organization [WHO], 1978) as community-driven comprehensive health care. However, nursing education still remains institutionally based, anchored in a medical model. Dynamic curricula must be developed that prepare nurses to practice in an ever-changing health care delivery system that is becoming more community based. The purpose of this article is twofold: to provide an overview of the revised curriculum of Brigham Young University's College of Nursing (BYU-CON) as one example of a faculty's attempt to develop a program that prepares graduates skilled in providing health care in the 21st century; and to examine closely the integration of community health nursing into the curriculum.