Taxonomy of Learning
A good source to use in the development of learning outcomes is the American Association of
Colleges of Nursing (AACN) Essentials at the baccalaureate, master’s, and doctoral levels. An
understanding of both Bloom’s and Dee Fink’s taxonomies of learning guides the development of
our learning outcomes. Benjamin Bloom led a group of researchers to initially formulate the three
domains of learning in 1956. Bloom and his colleagues (Krathwohl, Bloom, & Mases, 1964) further
developed the cognitive domain. The affective domain was broadened to include five behavioral
categories: (1) receiving, (2) responding, (3) valuing, (4) organization of values, and (5)
characterization by a value or value complex (Krathwohl et al., 1964). The psychomotor domains
were further developed by Anita Harrow, among others (Hoque, 2016).
The domains of learning are well known among educators. L. Dee Fink’s (2013) work is less known or
used in nursing education, but we found his work to be an excellent resource for nursing education,
which is also discussed in Chapter 7. See Table 8-2 comparing Fink’s integrated taxonomy of
significant learning to Bloom’s domains of learning, along with verbs and behaviors to help in the
writing of learning outcomes. An example is provided for each. In this table, we are comparing a
linear process to an integrated one. Both models are excellent resources for the development of
learning outcomes.
Assessment
In keeping with backward design, the next step is to develop assessment strategies that are
appropriate based on the learning outcomes. The key to this element of the design process is to
create a variety of strategies that will demonstrate progress toward achieving the learning outcomes
(formative assessment) as well as achievement of the course outcomes (summative assessment).
Table 8-3 provides examples of formative and summative assessments.
Further, when considering the design of assessments, all three domains of learning need to be
considered (Kirkpatrick & DeWitt, 2020; Stavredes & Herder, 2014). Developing the assessments at
this time in the design process ensures that learning activities are in alignment with what is required
to demonstrate that the learning outcomes have been met. However, the assessments may be
revisited at any time during the design process.
We do want to mention that in the literature, assessment and evaluation may be considered
separate concepts, and both are important aspects of course design. The main difference between
the two concepts lies in how the completed work by the student is used. Faculty use the information
from assessments to assess current learning that may result in a need to make revisions. Evaluation,
on the other hand, involves judgment and occurs at the end of the course or program (Oermann,
2017). Kirkpatrick and DeWitt (2020) encourage educators practicing in clinical fields to “evaluate
student attainment of course outcomes and defined program competencies to ensure that
graduates are prepared for safe practice” (p. 451).
We believe evaluation is particularly important for prelicensure and advance practice nursing
programs, given the emphasis on preparing graduates for direct patient care, clinical practice, and
national licensure exams. Other postlicensure programs have more of an emphasis on the cognitive
and affective domains of learning, in which grasping the role of nursing within the bigger picture of
health care is important. Postlicensure programs build on prelicensure programs to advance higher-
level thinking. Advance practice programs also have an emphasis on higher-level thinking, but
students are required to learn and demonstrate higher-level skills in direct clinical care. For the
purposes of this text, we refer to this element of the design process as assessment. This is not to
negate that, as faculty, we need to evaluate students’ work because grading is a requirement for
progression. However, we want to ensure there is an emphasis on continual, progressive student
learning, which requires ongoing assessment.
Dee Fink (2013) also discusses assessment as auditive versus educative assessment, a concept
initially posited by Grant Wiggins in 1998. We thought it was important to highlight this distinction
as something to think about compared with how assessment and evaluation are discussed in the
previous paragraph. Auditive assessment mainly consists of a midterm and a final exam. It serves the
purpose of providing a grade based on whether students were able to pass, indicating that they
learned the content. In other words, it is a backward-looking assessment. Educative assessment, on
the other hand, is ongoing, with the aim of helping students to learn better. It needs to be frequent,
immediate, based on clear criteria, and delivered in a caring way.