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Accessible, Affordable, Attainable: Reinventing Curriculum Delivery in Health Care Education

Adult college students who have made significant progress in their careers don’t have time to go back and start all over from the beginning. Although they may lack formal credentials, in many cases they have much of the knowledge and skills needed to excel in their field. What if adult students could simply take a test to determine their skill level and skip ahead to where they need to be in the curriculum? They would only need to pay for the credits they need, allowing them to finish early for less.

At The University of Memphis, we have been using the “credit-by-exam” model (also referred to as competency-based education) for a number of years in our Loewenberg College of Nursing and School of Health Studies. Rather than taking a course, students who have previously mastered content pay $60 to take a prior learning assessment exam. For example, nursing students who come to our BSN program with an associate’s degree and RN licensure already have a great deal of experience and knowledge. The credit-by-exam option makes it easier for them to apply their skills and get their degree at lower cost and in less time – in some cases, in as little as one year.

However, we know we could be doing more to share these ideas and bring them to scale across the university. That’s why we applied for the Collaborative Opportunity Grant (COG) from Collaborating for Change. The COG grant will help us expand what we’re currently doing in nursing to other programs on campus, including our Healthcare Leadership program. We’ve already begun the process of collaborating across units. Instructional designers with the Center for Innovative Teaching and Learning are helping us construct the exams and incorporate practical as well as academic components. In addition to the credit-by-exam model, we will be implementing adaptive learning techniques and an experiential learning credit process across schools to decrease the number of required traditional course credits our students will have to take.

All of these efforts will increase workforce capacity in high-needs fields in the region. In order to maximize the benefits for employers, we have partnered with West Tennessee Healthcare in Jackson, TN to help them meet community workforce needs in a timely manner. We support them by educating nurses and healthcare administration professionals with the skill sets they need, and they support our students through scholarships, tuition reimbursements, and release time for working students seeking new credentials.

We are already planning ahead for program evaluation. Right now, we are doing an adaptive learning pilot and comparing the results with the traditional learning model at the end of the semester. Our metrics include student grades, success on exams, mastery of required competencies, and feedback from students and faculty. We are also using learning analytics to identify at-risk students early and close gaps in the curriculum.

Our ultimate goal is to bring this model to scale across the university, by demonstrating through evaluation of our students that this process works. Students are mastering the content and graduating sooner, and we have data to support it. We hope other colleges and schools at the university will see these data and adopt this effective practice.


Richard Irwin is Vice Provost, Academic Innovation & Support Services, at The University of Memphis.  In this role one of Irwin’s major responsibilities are to provide leadership in strategic curriculum planning including implementation of innovative methods to deliver and acquire professional and college-level knowledge.  More specifically, he oversees the Academic Counseling Center which includes learning communities; the Center for Academic Retention and Enrichment Services which houses the Academic Coaching for Excellence or ACE program as well as the ACAD academic success seminars; the Center for Athletic Academic Services; the Crews Center for Entrepreneurship; and, the Center for Innovative in Teaching and Learning comprised of the following units:  Prior, Experiential and Professional and Continuing Education or PACE; the Finish Line degree completion initiative; and, Distance Education which includes U of M Global along with Instructional Technology and the satellite education centers. 

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