From Gap to Goal: Writing Outcomes and Objectives for a High-Flow Nasal Oxygen Continuing Education Program
Student Name
Master of Science in Nursing Program, Aspen University
N584: Curriculum Development, Implementation and Evaluation
Instructor Name
Month Day, Year
From Gap to Goal: Writing Outcomes and Objectives for a High-Flow Nasal Oxygen Continuing Education Program
The needs assessment in the previous module found that medical-surgical nurses at a composite 300-bed hospital operate high-flow nasal oxygen equipment well but are less able to recognize when therapy is failing and to escalate in time. Only 12% of charts documented a combined oxygenation and respiratory rate index, and three safety reports described delayed escalation while saturation stayed near target. This paper converts that gap into a program outcome and a set of learning objectives, explains the frameworks used to write them, and links each objective to how it will be measured.
Outcomes Versus Objectives
Continuing education planners distinguish between the outcome of a program, the change in practice or results that the program aims to produce, and the learning objectives of its sessions, the specific knowledge and skills learners will gain. Moore et al. (2009) proposed a framework for planning and assessing continuing education in which outcomes range from participation and satisfaction, through declarative and procedural knowledge and competence, to performance in practice and, ultimately, patient and community health. Their central argument was that planners should begin with the desired level of outcome, ideally performance or patient health, and design learning activities that lead there, rather than stopping at knowledge. The program's outcome is therefore written at the level of performance, while session objectives address the knowledge and competence that support it.
The Program Outcome
The program outcome is: within three months of completing the program, nurses on the two medical-surgical units will document respiratory rate and the combined index at least every two hours for every patient receiving high-flow nasal oxygen and will escalate according to unit criteria when the index falls below the threshold or work of breathing rises. It will be measured by chart audit, with a target of documentation in at least 85% of audited patient-hours, and by review of safety reports for delayed escalation. The outcome describes observable performance in practice, the level Moore et al. (2009) recommend, and it directly addresses the gap found in the chart review and safety reports.
A secondary outcome addresses the patient level. Over the six months after the program, the units will track whether every escalation for a patient on high-flow therapy occurs before an emergency, such as a rapid response call triggered by a saturation below 85% or a cardiac arrest, rather than after one. This outcome cannot be attributed to education alone, since staffing, the documentation prompt and physician response also matter, but it keeps the program's attention on the result that matters most to patients.
Session Objectives
Objectives are written with verbs matched to the intended level of cognitive complexity using the revised taxonomy, which runs from remembering through understanding, applying, analyzing, evaluating and creating (Anderson & Krathwohl, 2001). Because the gap concerns interpretation and decision-making, most objectives are at the applying, analyzing and evaluating levels. The table lists the eight objectives with their level and measurement.
| Objective (each nurse, on completing the program, can) | Level | Measurement |
|---|---|---|
| 1. Explain how high-flow nasal oxygen improves oxygenation and why it can maintain saturation while a patient tires | Understand | Post-test item |
| 2. Calculate the combined index from saturation, inspired oxygen and respiratory rate | Apply | Post-test calculation items |
| 3. Interpret serial index values at 2, 6 and 12 hours as improving or failing therapy | Analyze | Case-based post-test items |
| 4. Identify signs of increasing work of breathing on assessment | Apply | Simulation checklist |
| 5. Determine when unit escalation criteria are met in an unfolding case | Evaluate | Simulation checklist |
| 6. Communicate a concern about therapy failure to the provider using a structured format | Apply | Simulation checklist |
| 7. Document respiratory rate, the index and actions taken in the electronic record | Apply | Simulation record and chart audit |
| 8. Describe the patient and family teaching appropriate during high-flow therapy | Understand | Post-test item |
Objectives 2 and 3 rest on the clinical evidence behind the index. Among 191 adults in a validation cohort who received high-flow therapy for pneumonia, Roca et al. (2019) found that lower index values at 2, 6 and 12 hours predicted failure and the need for intubation, while an index of at least 4.88 signaled a lower likelihood of intubation. Teaching nurses to calculate and trend the index therefore gives them a validated way to see what saturation alone can hide. Equipment operation is not an objective because the needs assessment found no gap there; including it would lengthen the program without addressing the problem.
Alignment With the Needs Assessment
Each objective links back to a finding. Objectives 1 through 3 address the survey result that nurses scored only 48% on items about signs of failure and escalation. Objectives 4 through 6 respond to what nurses said in interviews, that they tend to escalate on a dropping oxygen reading instead of on harder work of breathing, and the safety reports of delayed escalation. Objective 7 addresses the chart review. Objective 8 was added after respiratory therapists noted that patients and families are often alarmed by the device's noise and flow, which can affect cooperation. Alignment in this way ensures that the program targets the real gap and that its evaluation can show whether the gap closes.
The objectives were reviewed by two respiratory therapists and a charge nurse from each unit before being finalized, a step that tested whether they described what competent practice actually looks like. Their feedback changed one objective: the original version of objective 5 asked nurses to recognize failure, which reviewers noted could be met without any action, so it was rewritten to require a decision about escalation. Objectives that describe decisions and actions, rather than recognition alone, are more likely to translate into the performance outcome the program is designed to produce.
Conclusion
A continuing education program is only as focused as its outcomes and objectives. Writing the program outcome at the level of practice performance, and the session objectives at the application and analysis levels where the needs assessment located the gap, keeps the program aimed at recognizing and escalating failing high-flow therapy rather than at the equipment nurses already manage well. Each objective is measurable and linked to a finding, which prepares the ground for the program design and the evaluation plan in the modules that follow.
References
Anderson, L. W., & Krathwohl, D. R. (Eds.). (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives. Longman.
Moore, D. E., Green, J. S., & Gallis, H. A. (2009). Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. Journal of Continuing Education in the Health Professions, 29(1), 1-15. https://doi.org/10.1002/chp.20001
Roca, O., Caralt, B., Messika, J., Samper, M., Sztrymf, B., Hernández, G., García-de-Acilu, M., Frat, J.-P., Masclans, J. R., & Ricard, J.-D. (2019). An index combining respiratory rate and oxygenation to predict outcome of nasal high-flow therapy. American Journal of Respiratory and Critical Care Medicine, 199(11), 1368-1376. https://doi.org/10.1164/rccm.201803-0589OC
How this N 584 Module 4 example is structured
Aspen does not publish N584 module prompts, so check your classroom for the exact instructions. This example restates the gap, distinguishes outcomes from objectives, writes a performance-level program outcome, lists eight objectives with levels and measures, explains the clinical evidence behind key objectives and shows how each objective aligns with the needs assessment.
N584 Module 4 questions, answered
What does N584 Module 4 usually ask for?
After a needs assessment, N584 typically asks for the outcomes and objectives of the continuing education program being developed. Check your classroom for the required number and format of objectives.
What is the difference between a program outcome and a learning objective?
A program outcome is the change in practice or results the program aims to produce. Learning objectives state the specific knowledge and skills learners will gain in the sessions that lead to that outcome.
What level should continuing education outcomes target?
Frameworks for continuing education recommend aiming beyond participation and knowledge, toward competence, performance in practice and, where possible, patient outcomes, and designing the activity to reach that level.
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