Nursing ‘new normal’ education: an investigation of barriers and strategies of curriculum planning to meet national standards

Nursing ‘new normal’ education: an investigation of barriers and strategies of curriculum planning to meet national standards Janes Jainurakhma1,2*, Ali Imron1, Nurul Ulfatin1, Imron Arifin1, Zaenal3, Sekarini2 Introduction: The COVID-19 pandemic has a major effect on nursing education in Indonesia, it needs for adaptation of the curriculum to achieve competent nursing graduates meet national and international standards. The aim of this study is to explore the barriers and strategies of nursing education of private institutions, in curriculum planning in the new normal era during the COVID-19 pandemic. Methods: This qualitative study was conducted in five nursing study programs in East Java. Data collection was carried out by in-depth interviews, observations, documentation studies of 25 participants, with the criteria of lecturers being actively involved in curriculum planning based on Indonesian national standards. The data used purposive sampling and snowball sampling. The data validity is carried out with four criteria: credibility, dependability, confirmability, and transferability. Data analysis was carried out using the model approach of Miles, Huberman & Saldana. Data records from interviews, observations and documentation then carried out data selection, reducing, focusing on data findings (data condensation). Results: The study found five themes: (1) barriers from human resources, (2) barriers during the curriculum planning process, (3) barriers for Nursing Study Program lecturers in obtaining information sources related to Indonesian Qualification framework-based curriculum planning, (4) strengthen the pro-active leadership of study programs; (5) foster dynamic communication between curriculum teams. Conclusion: The results showed, in pandemic crisis COVID-19, the need for a curriculum planning workshop with clear technical guidelines in producing an effective, efficient, adaptable nursing curriculum, the effective one of planning has high potential in producing high quality nursing graduates.


INTRODUCTION
The nursing study program curriculum has an important function in the academic process, both as a blue print, quality plan, guidance and reference, therefore nursing education curriculum planning is a complex process that involves many components including design, implementation and evaluation. 1, 2 The entire academicians of the nursing study program including nursing lecturers have important role in curriculum development, including playing an active role in planning the curriculum, providing input for curriculum improvement and finding new ideas for curriculum improvement. [3][4][5] The success in raising awareness of the active role of all educational staff in curriculum planning is inseparable from the role of a leader or chairman of the nursing study program itself in mobilizing all components in it, including advisory boards, patrons, external support staff who help, and important roles. from the lecturer team, so that a conducive organizational culture and organizational strategy in educational institutions can be well realized. 6 Lecturers as educators have a central role in curriculum development in educational dynamics, 7-9 lecturers participate in assessing the ongoing curriculum, so they can see the advantages and disadvantages of the educational curriculum process, 4,10 the Indonesian National Qualifications Framework (IQF)-based nursing education curriculum that has been running so far requires input from within and outside the institution, so that it is able to become an input for the planning of the nursing education curriculum towards a better curriculum that is able to answer various the challenges of the times, from needs at the local, national, to global levels. 2,11-13 Nursing education includes a competency program that prepares its graduates to become a productive, creative, and capable workforce in their respective fields professionally, 14 with a student centered learning approach. 14, 15 Based on observations made by researchers directly in the field, at the end of 2019 the COVID-19 pandemic had spread in China, and this had an impact on all sectors of people's lives in Indonesia, including nursing education in early 2020 around the end of February. Nursing education which is mostly practice-based with full face-to-face education experiences ORIGINAL ARTICLE responsibilities. 12, 24 To meet national standards and maintain the quality of nursing graduates in Indonesia, nursing graduates in Indonesia need a Registration Certificate (STR) obtained from the government after passing the National competency test. Public Relations data of the Directorate General of Higher Education, Ministry of Education and Culture (2020)  IQF-based curriculum development requires the active role of all internal and external nursing education providers, especially the active role of a lecturer, this is because lecturers play a role as curriculum administrator, as well as support the guidance and development of the nursing education curriculum in the Study Program. 3,25,26 However, based on preliminary studies in five nursing education provider study programs in East Java province in 2018, based on interviews with 10 nursing lecturers, all of them stated that they did not understand about IQF-based curriculum planning, and the lack of resources for lecturers in their institutions who understand and deepen the science of planning. curriculum in particular based on IQF. The obstacles experienced by nursing education lecturers are the potential for fatal errors that impact nursing graduates, this is because the quality of the nursing curriculum is determined by the curriculum design that has been produced, on the other hand the demands of the IQF-based curriculum are very responsive to the times and demands of the nursing work industry.
This study aims to explore the barriers and strategies of private nursing education institutions, in curriculum planning in the new normal era during the COVID-19 pandemic to meet national standards (the Indonesian National Qualifications Framework).

METHODS
This research used a qualitative approach with the research method adopted holisticsingle case design from Yin. 27 The research took the case of private nursing education institutions, in curriculum planning in the new normal era during the COVID-19 pandemic based on the Indonesian National Qualifications Framework (IQF) in East Java, Indonesia. Three bachelor nursing-study programs from Sekolah Tinggi Ilmu Kesehatan (STIKes) Panji, STIKes Taras and STIKes Huda were selected from private institutions, where each institution has a characteristic curriculum, so that each study program develops a curriculum characterized by study programs in accordance with the vision and mission of each.
Participants used in this study were lecturers who were involved in the planning process of the IQF-based nursing education curriculum, with a total of twenty-five participants. Data collection for this research was carried out for 1 years (2020-2021), from three study programs that provided nursing education in East Java-Indonesia.
Data collection was carried out by semi-structured interviews with each lecturer as nursing curriculum developer to capture general problems and challenges and strategies of nursing study program regarding IQF-based nursing education problems in learning, where students have difficulty understanding basic knowledge about nursing practice and abilities in nursing caring, where caring requires experience and applications that can be applied directly to patients, 16-19 and this not fully felt by nursing students during education in the midst of a pandemic. In the new normal era, restrictions on interactions were applied in the world of nursing education in particular, where the Ministry of Education in Indonesia also issued a policy, namely by closing higher education institutions and replacing the lecture process by using an online system. 20,21 By using this online learning system, sometimes problems arise in curriculum implementation faced by students and lecturers, such as lecture material that has not been completed by the lecturer, the number of skills or competencies for nursing students that are not fulfilled, then the lecturer replaces it with other tasks without understanding of nursing students. This is a challenge for nursing institutions, especially in planning a more effective curriculum amidst the COVID-19 pandemic.
Based on the results of observations in nursing study programs at three private institutions, East Java, it shows that in the new normal era (early July 2020), learning is not entirely done face-to-face, because the corona virus is still spreading in the East Java region, so this makes nursing education institutions think hard to design a curriculum that still produces quality graduates in the COVID pandemic, based on implementation evaluations carried out by nursing education institutions during the COVID-19 pandemic. Nursing education curriculum planning, it is necessary to formulate the quality of nursing graduates who are competent and competent in terms of skills, knowledge, and understanding of graduates of the world of nursing, so that in the future graduates will have good confidence while in the world of work in accordance with the demands of stakeholders, 11,22,23 including planning a nursing education curriculum in Indonesia based on the IQF which focuses nursing graduates on four qualifications, including attitudes and values; mastery of knowledge; nursing graduate employability; rights and ORIGINAL ARTICLE curriculum planning, then observation and documentation study were carried out on the results of each lecturer curriculum planning.
Data analysis was carried out using the model approach of Miles, Huberman & Saldana. 28 Data records from interviews, observations and documentation then carried out data selection, reducing, focusing on data findings (data condensation). The results of this condensation are then presented in a table and the sub-themes are searched, then the themes are searched between the sub-themes. In this study, the relationship between themes is used to gain an understanding of the barriers of the Nursing Study Program in planning a nursing education curriculum to meet the Indonesian National Qualifications Framework as a nursing education national standard.

RESULTS
Cross-case findings are related to the obstacles of the Nursing Study Program in IQF-based curriculum planning, in general, including obstacles from human resources, obstacles during the curriculum planning process, and obstacles for the Nursing Study Program lecturers in obtaining adequate information sources related to IQF-based curriculum planning.
Research findings on the constraints of human resources in the IQF-based curriculum planning process: (1) Most of the academics involved in the Nursing Study Program curriculum planning have a background in nursing education, the lack of human resources who understand IQF-based curriculum planning can lead to design ineffectiveness The resulting Nursing Study Program curriculum, which has an impact also on nursing graduates, (2) There are no academics in the Nursing Study Program who are engaged in curriculum management in nursing education, causing obstacles to the curriculum planning process, so that in working on the planning process the development team is full of doubts. doubt, and the Head of the Study Program could not guide and evaluate with certainty regarding the resulting "blue print", (3) The academic team involved in the nursing Study Program curriculum planning did not understand IQF-based curriculum planning, who do not know how to plan an IQF-based curriculum, this can result in obstacles to the curriculum planning process, so that in carrying out the planning process the development team is full of doubts, and the Head of the Study Program cannot guide and evaluate with certainty the resulting "blue print".
Research findings on the obstacles in terms of the IQF-based curriculum planning process, show: (1) The curriculum development team has difficulty understanding and compiling learning outcomes because there is no technical guide in carrying out the curriculum planning process, this is an obstacle to the curriculum planning process, so that in working on the planning process of the development team is full of doubts, and results in inefficient time and energy in the process, (2) The Nursing Study Program curriculum development team has difficulty understanding and compiling graduate learning outcomes this is due to the absence of technical instructions in carrying out the curriculum planning process, this hinders the effectiveness of the work and the resulting curriculum design products, (3) the Nursing Study Program curriculum development team does not yet understand the technicalities of arranging the distribution of courses and the semester credit system, this is a separate obstacle to the performance of the development team, and errors in the curriculum blueprint for the Nursing Study Program, (4) The Nursing Study Program curriculum development team has difficulty in compiling the institutional curriculum, due to the lack of understanding of the curriculum development team and the lack of information sources "resource persons" who do not explain the technical planning, so this is a fundamental obstacle to the process of planning the IQF-based Study Program curriculum.
Research findings on the barriers of information sources in the planning process of the IQF-based nursing education curriculum, show: (1) barriers from human resources, (2) barriers during the curriculum planning process, (3) barriers for Nursing Study Program lecturers in obtaining information sources related to Indonesian Qualification framework-based curriculum planning, (4) strengthen the pro-active leadership of study programs; (5) foster dynamic communication between curriculum teams. Barriers experienced and faced by the nursing faculty when planning a national qualification framework based curriculum Indonesia shown in Figure 1 scheme, this has an impact on product quality curriculum that becomes less effective and efficient. The barriers experienced nursing courses include: (1) barriers from human resources, (2) barriers during the curriculum planning process, (3) barriers for Nursing Study Program lecturers in obtaining information sources related to Indonesian Qualification frameworkbased curriculum planning. Figure 2 shows theme: (4) strengthen the pro-active leadership of study programs; (5) foster dynamic communication between curriculum teams. The strategy carried out by the study program which is driven by the active role of a head of the nursing study program, where the head of the study program becomes a leader who contributes actively as a motor, innovator, facilitator, controller and evaluator and it needs dynamic communication between curriculum teams. The strategy undertaken by the study program is aimed at producing an effective, efficient and globally competitive IQF-based curriculum plan. With all the limitations during the COVID-19 pandemic, the nursing study program optimizes online facilities that are effectively utilized in the midst of the pandemic, to continue to produce quality and competitive graduates both nationally and internationally, in accordance with the demands of the national IQF standard.

DISCUSSION
The COVID-19 pandemic has created many quality crises for nursing education, this forces the nursing curriculum implementing team to think hard to design a nursing curriculum that is resistant to outbreaks, and in its implementation has sensitivity to environmental conditions (pandemic COVID-19), so that it remains able to answer stakeholder demands and continue to innovate in accordance with national standards. Nursing graduates who want to be achieved in the IQFbased curriculum with the development of student-centered methods, are expected to be nursing graduates who have creativity, capacity as a nurse, personality, independent in seeking and finding knowledge. Competent and professional nurse graduates must be able to adapt to the work environment of nurses and the needs of society, master professional communication ethics that reflect nursing ethics, master skills in providing nursing care, and be able to think critically, respond quickly and demonstrate the ability to decide a problem in the environment. work in accordance with their authority. 29- 31 The sensitivity and ability of the nursing study program to be adaptive and able to develop the quality of the learning curriculum in nursing is able to maintain the quality of learning for nursing students in the midst of the COVID-19 pandemic. [32][33][34] Various obstacles experienced by three nursing study programs in private institutions in East Java in planning an adaptive, effective and efficient curriculum include: (1) barriers from human resources, (2) barriers during the curriculum planning process, (3) barriers for Nursing Study Program lecturers in obtaining information sources related to Indonesian Qualification framework-based curriculum planning.

Barriers from human resources
Barriers from the human resource side, the lack of curriculum experts from nursing study program lecturers or academics who master IQF-based curriculum planning, where most of the lecturers have a nursing science education background who does

ORIGINAL ARTICLE
not discuss how to manage and develop an IQF-based curriculum. The curriculum planning process requires good planning, this can be realized if human resources, especially the teaching team (lecturers), play an active role in curriculum planning, because the teaching team is needed to contribute to the development of teaching and learning creativity integrated in the curriculum itself. 2,13,35, 36 The obstacles faced by nursing study programs, including lecturers as curriculum designers during the process of planning the IQF-based curriculum, include: (1) obstacles in translating stakeholder input which are then integrated into nursing courses, (2) obstacles for nursing Study Program lecturers in planning institutional curricula to match the program's vision and mission Studies, (3) the inability of lecturers to combine student centered learning methods, will determine the achievement and potential of students, (4) during the process there is a lack of control and direction from the Study Program leaders in planning, IQF-based curriculum preparation, and the lack of academics (lecturers), who understand the curriculum planning process in the institution will have an impact on the quality of nurse graduates, this results in lecturers' hesitation in planning curriculum. The obstacles that occur to nursing lecturers, both directly and indirectly, will affect the quality of curriculum products and the quality of nurse graduates from the study program, therefore with a productive, creative and innovative team of educators who are able to produce quality curriculum documents and clearly describe progress and development. competencies of the resulting graduates. 37-39 This obstacle needs to be solved by holding dissemination and online curriculum workshops (virtual meetings) with expert nursing curriculum of nursing education providers association of national institutions (curriculum management experts), this method needs to be done to improve the quality of knowledge and understanding of the curriculum planning team, in a way that effectively and safely carried out during the COVID-19 pandemic, this requires solid teamwork and the role of the head of the study program to motivate and encourage the curriculum development team.
Nursing education study programs in conducting IQF-based curriculum planning often still make mistakes, especially in determining the curriculum structure, determining the number of credits, and creating an institutional or superior curriculum that characterizes each Study Program. Skills in curriculum planning require precise and accurate analysis, by synergizing the needs of stakeholders, characteristic of institutions and study programs, with quality as determined by the study program accreditation team, government policies in the administration of nursing study programs, applicable health laws, organizational policies nursing education associations and nursing professional organizations, all of which can be done by conducting curriculum mapping. 40, 41 One of the causes of the mistakes made by this Study Program is the lack of conducting seminars or workshops in the Study Program, so that there are still Study Programs that originate in compiling a blue print by looking at or imitating the content of the curriculum from nursing study programs of other institutions, besides several nursing education study programs. has conducted a curriculum planning workshop, but only superficially delivered by the speaker, not how the skills or practical skills process stakeholder needs analysis into a course and learning outcomes.
The Association of Indonesian Nurse Education Institutions (AIPNI) and Association of Indonesian Nursing Vocational Education Institutions (AIPViKI) as nursing education associations in Indonesia have a much needed role in developing an applicative IQF-based curriculum development design model, so the Study Program looks for its own IQF-based curriculum design development model without direct supervision and direction from AIPNI.
Differences in workshop or seminar resource persons when providing explanations about the IQFbased curriculum planning design in the Study Program also make differences in the perceptions of the curriculum development team and managerial at the nursing Study Program level, resulting in doubts, even errors in the preparation of curriculum structures when planning the educational curriculum blue print nursing is common. Nursing study program lecturers are one of the most important parts and dominant sources in planning the IQF-based nursing education curriculum, this is because lecturers are proactive in class, nursing departments, scientific groups, at the Study Program level and at the college level.
Obstacles in the field when planning the curriculum show that the number of Nursing Study Program lecturers, both seniors and juniors, most of whom have a background in nursing education, do not understand the essence of the curriculum in the IQF-based education system, the development of learning materials contextually becomes less developed, the lecturers do not understand it must be planned so that most of them are still monotonous using lectures and discussions in general, lecturers do not understand how to formulate learning outcomes, do not develop creativity in giving lectures both in terms of strategies and learning methods, the use of learning evaluation using scores which results in a lack of stimulation opens up self-potential student of nursing. Lack of understanding of a lecturer in understanding the curriculum, will have an impact on curriculum planning and the creativity of an educator. 2,7,9,42,43 Therefore, it is necessary to follow up the performance of the curriculum development team and lecturers on an ongoing basis (every week until the expected goals are achieved), so that the quality of the curriculum produced is able to answer the challenges in the new normal era of the COVID-19 pandemic.

Barriers during the curriculum planning process
The nursing study program and the curriculum planning team including the lecturers of the nursing study program have an important role in planning a quality nursing education curriculum, especially the creativity and sensitivity of a lecturer are needed in designing a clinical experience for nursing graduates later with an effective learning approach in sharpening the "caring" sensitivity of nursing graduates in terms of knowledge, skills. nursing, especially training in terms of affective nursing graduates. 22,44, 45 Nursing study program through curriculum planning are expected to have sensitivity to the needs of students, one of which is a "real" clinical experience, all of which need to be designed in detail in the blue print of the IQF-based nursing study program curriculum while prioritizing the characteristics or excellence of each study program. The curriculum will continue to develop in accordance with developments and demands in the surrounding environment or according to the needs of stakeholders, 2,46,47 this is also experienced by the world of nursing education in Indonesia which is now required to use IQF-based curriculum which is expected to be able to answer and answer the challenges of national and global market demands, and continue to spur the improvement of the quality of Indonesian professional nurses.

Barriers for Nursing Study Program lecturers in obtaining information sources related to Indonesian Qualification framework-based curriculum planning
Most nursing study programs bring in curriculum experts to assist lecturers in disseminating the IQF-based nursing education curriculum and IQF-based curriculum planning system, but the phenomenon that occurs in the field is the inability of curriculum workshop resource people to provide IQF-based curriculum information to its application, which will have an impact on quality curriculum products and graduate nurses later.
Permenristekdikti (Indonesia regulatory ministry of research and higher education) no.44 of 2015 article 11 states that the characteristics of the learning process are expected to be interactive, holistic, integrative, scientific, contextual, thematic, effective, collaborative, and student-centered. The characteristics of nursing graduates will be achieved and fulfilled properly, when the lecturer understands the curriculum planning process properly, is able to determine the relevant nursing student learning outcomes assessment pattern according to the measurable learning outcomes as stated in the curriculum blue print. Proper curriculum planning will make it easier for lecturers to implement the curriculum, and develop a curriculum in a better direction.
A curriculum expert needs to be brought in to provide training to the academic community including lecturers (teaching teams) who are involved in curriculum planning, so that the difficulties experienced in the process of curriculum development and planning can be resolved properly and the best solution is found tailored to the organizational culture of the educational institution. 3,9,35,48,49 Quality curriculum training and workshops for IQF-based nursing education are urgently needed by a team of lecturers and all academics involved in curriculum design development, with a good curriculum development design at the time of curriculum planning being able to accommodate and improve the quality of lecturer creativity and innovations needed in developing a nursing education curriculum that has a future vision in accordance with the demands of the globalization of the nursing industry. The role of the head of the study program who is sensitive to the needs of his team in solving high-standard curriculum planning problems is one of the important keys in achieving the success of the IQFbased curriculum planning process.

Strengthen the pro-active leadership of study programs
The barriers for nursing study program in planning the nursing education curriculum for the IQF-based Nursing Study Program for curriculum management indicate the need a good leadership that could improve human resources and the existence of a curriculum control system in an internal quality assurance system, a support system for human resource governance, facilities and infrastructure, learning environment, service system, monitoring and evaluation of learning, and followup on evaluations that have been carried out and found. When the control over the performance of the study program is good, it is hoped that there will be a curriculum development that is more meaningful for graduates, students, institutions, and the entire academic community in it. A leader of the nursing study program is needed to properly oversee the implementation of the curriculum, his role as an activator and motivating the team in curriculum planning and development, able as a facilitator in meeting the needs of the study program curriculum development team, and as an evaluator who is able to follow up the performance of the curriculum development team and lectures on an ongoing basis to produce an effective, efficient, adaptive and competitive curriculum design. The role of a curriculum developer leader: as curriculum coordinator, supervises curriculum plans and implementation,

ORIGINAL ARTICLE
and finds creativity in improving the courses or curriculum programs applied in the Study Program. 4,53, 54 Educators have a very important role in curriculum formation and who play an active role in institutional development 4,55 so that they can shape and create effective learning from an effective curriculum. 38, 56 Barriers for Nursing Study Program lecturers in obtaining adequate sources of information related to IQF-based curriculum planning, training and curriculum dissemination based on the IQF have not provided a good understanding in implementing curriculum planning based on the Indonesian National Qualifications Framework. Different sources often lead to errors in determining the structure of the Nursing Study Program curriculum, so that in a higher education institution, this is often difficult for universities to undertake university accreditation. The workshops with different sources often result in errors in determining the structure of the curriculum in a tertiary institution, this is often difficult for universities to carry out university accreditation. Resource persons in curriculum management, especially IQF-based nursing education, are needed in guiding and guiding lecturers when compiling curriculum planning, with a quality curriculum design that is expected to produce quality nursing graduates in accordance with the demands of the times in the era of globalization. So it is necessary to have an effective curriculum socialization strategy and workshops that are conducted regularly related to the IQF-based nursing education curriculum management. This phenomenon is in line with Retnawati 42 which states that an implementation of a new curriculum in education needs to be accompanied by professional development training for educators, and there is a need for intensive training or workshops, so that this effort is able to support the implementation of a quality education curriculum planning. 42,57

CONCLUSION
The study indicated the need for workshops and intensive mentoring from nursing education curriculum experts in curriculum planning among nursing education academics regarding IQF-based nursing education curriculum planning.
The process of socializing the IQF-based curriculum which is expected not only to socialize the IQF-based curriculum, but to the realm of technical guidelines for curriculum planning for academics and curriculum formulation teams, so it is hoped that an effective curriculum planning process is able to reduce the error rate of the curriculum formulating team in determining the curriculum structure, determine the amount of SKS load, and design the institutional curriculum as a feature of the Nursing Study Program. An effective, efficient and adaptable nursing curriculum planning has high potential in producing high quality nursing graduates even in pandemic crisis COVID-19.
The importance of clear technical instructions designed for the curriculum formulation team and the lecturers involved, this is an effort to produce an effective and efficient nursing curriculum, being one of the solutions in producing a quality curriculum, with effective curriculum planning having high potential in producing nursing graduates with superior quality and competitive to global demands. Clear technical guidelines on curriculum planning also help the head of the Nursing Study Program as the leader of the curriculum formulator to control, direct, and evaluate the performance of the formulating team and the teaching team involved in the IQF-based nursing education curriculum planning process. curriculum planning workshop with clear technical guidelines in producing an effective, efficient, adaptive nursing curriculum,

DISCLOSURE Conflict of Interest
None.

Funding
None.

Ethic Statement
The ethical conduct of research was followed in the entire duration of the research. Initially, written permissions to conduct the study were secured from appropriate academic heads of the College and the head of the research and community service institute. Informed consent was then obtained from the participants as a manifestation of their voluntary involvement in the research. No formal ethics review, because there was already an agreement from the nursing study program (participant) to be studied, agreed with the permit that had been given, and did not violate the ethics and values of the institution they applied in the organization, nevertheless, full disclosure of the study was given and the participants were assured of their confidentiality and anonymity. There is an official permit from the head of the Faculty of Education-State University of Malang, for this research: no.3.2.84/UN32.1/LT/2020, as a sign of request and willingness of participants in the research carried out out.