New directions in teaching and learning within nursing education
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New Directions in Teaching and Learning Within Nursing Education. New Mexico Statewide Nursing Faculty Conference June 3-4, 2009. Jean Giddens, PhD RN, Professor Interim Senior Associate Dean for Academic Affairs College of Nursing, University of New Mexico. Student Centered Learning.

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New directions in teaching and learning within nursing education

New Directions in Teaching and Learning Within Nursing Education

New Mexico Statewide Nursing Faculty Conference

June 3-4, 2009

Jean Giddens, PhD RN, Professor

Interim Senior Associate Dean for Academic Affairs

College of Nursing, University of New Mexico


Student centered learning

Student Centered Learning

Decades of educational research have shown that learning is most effective when…….

  • Students are engaged

  • Learning incorporates emotion

  • Learning activities are purposeful and perceived by students as useful


Integrative teaching

Integrative Teaching

  • Integrative Teaching is practice of minimizing the distance between theory and clinical instruction.

  • Benner calls integrative teaching a “signature pedagogy” of excellent instructors


Emergence of new paradigms

Emergence of New Paradigms

  • Conceptual Approaches to Teaching and Learning

  • Virtual Experiential Communities

  • Student centered learning

  • Integrative teaching


Teaching and learning differently the conceptual approach

Teaching and Learning Differently: The Conceptual Approach


Example concepts as categories

Example: Concepts as Categories

  • What concepts do the shapes below represent?

  • What other concepts can you identify?


Example concepts as categories1

Example: Concepts as Categories


What is conceptual teaching and learning

What is Conceptual Teaching and Learning?

The difference between concept- and content-focused learning is… “the difference between facts of the Alaska oil spill and an understanding of the importance of environmental sustainability”(Erickson, 1998 p. 50).


Conceptual teaching means

Conceptual teaching means….

  • Focusing on big ideas – students anchor to specifics.

  • Fostering deep learning, and deep understanding through connections and reflection (as opposed to surface learning).

  • Developing student-centered learning with a purpose.


New directions in teaching and learning within nursing education

Concept: Oxygenation and possible exemplars

Pulmonary

Edema

Pnuemothorax

Anemia

PE

RDS

AMI

Pneumonia

COPD

Asthma

RSV

Oxygenation


New directions in teaching and learning within nursing education

Concept: Oxygenation & selected exemplars

Oxygenation

Other

Exemplars

Exemplars

RSV

Other

Concepts

Asthma

COPD

Pneumonia


Teaching conceptually

Teaching Conceptually

Focus on Concept

Exemplars provide content knowledge

Application of content to interrelated concepts

Application of other content to the concept


Concepts for nursing education

Concepts for Nursing Education

  • In nursing education, a concept should be clinically useful to guide student learning and clinical practice.

  • What are the Concepts for Nursing Practice?

  • Concepts vs. Exemplars

  • Concepts vs. Medical Diagnoses


Additional thoughts on conceptual teaching

Additional Thoughts on Conceptual Teaching

  • A focus on concepts in itself does not guarantee conceptual learning.

  • Faculty must adopt activelearning strategies to enhance conceptual learning.

  • Ideally, concepts are woven throughout the curriculum - incorporated into clinical and didactic courses.


Example long term complications of dm

Hypertension

ASHD

Renal Failure

Diabetic Retinopathy

Peripheral Neuropathy

Peripheral Artery Disease

Example:Long-term complications of DM

How could you teach this so students can understand the underlying concept or concepts could explain this?


Example skill acquisition securing an iv catheter

Example:Skill Acquisition- Securing an IV Catheter

What concept(s) apply?

How could you apply this to your skills lab teaching?

After starting an IV, what steps are necessary to properly secure the IV?


What is a concept based curriculum

What is a concept-based curriculum?

  • Concepts provide organizational structure for the curriculum and courses.

  • Concepts represent nursing practice.

  • Concepts drive content through selection of exemplars.


New directions in teaching and learning within nursing education

CURRICULM FRAMEWORK


Knowledge concepts theory

Knowledge, Concepts & Theory

  • Knowledge is represented through concepts

  • Concepts are building blocks of theory

THEORY

Concept

Concept

Concept

Concept

Concept

Concept

Concept

Knowledge


Hallmarks of good concepts for curriculum and teaching

Hallmarks of “Good” Concepts for Curriculum and Teaching?

  • Represent important spectrum of conditions or situations representing nursing practice

  • Logical and used consistently

  • Useful for education

  • Application across multiple courses and contexts


Benefits

Benefits

  • Content management

  • Focus on concepts as opposed to content

  • Emphasis on learning

  • Focus is on Nursing

  • Concepts cut across disease categories and populations

  • Emphasis on recognition of concepts across populations and practice settings


Drawbacks

Drawbacks

  • Resistance to change

  • Requires a different level of organization

  • Students may be resistant (at first)

  • Lack of literature detailing steps

  • What about NCLEX?


Virtual experiential communities

Virtual Experiential Communities


Mr ocampo

Mr. Ocampo

Mr. Ocampo is short of breath, experiences intermittent chest pain, and is fatigued.

He obviously should seek medical attention, but he won’t.

Why won’t he seek medical care?


Anthony martin

Anthony Martin has been arrested for indecent exposure at a local park.

He is taken to the ED because he is combative and disoriented.

What is causing Anthony to act this way?

Anthony Martin


Kelsey young

Kelsey Young has a new baby sister.

What is Kelsey's family like? Does she have adequate support systems?

What things trouble her?

Kelsey Young


What is a virtual experiential community

What is a Virtual Experiential Community?

  • Extension of technology-enhanced learning

  • Representation of individuals in context of community setting – with impact to group and individuals.

  • In health care, focus on individuals and health related issues and health care providers.

  • Examples:

    • The Neighborhood (USA)

    • Stillwell (UK)


New directions in teaching and learning within nursing education

Giddens - ODU, 2008


Household characters

Household Characters

  • 34 characters who live in 11 households within The Neighborhood.

  • Character stories reflect health-related situations based on incidence and prevalence.

  • Stories reflect individual and family responses to health-related problems over time.

  • Stories told from the perspective of the character.


Nurse characters

Nurse Characters

  • 6 featured nurse characters that work in 4 health-care agencies

    • 3 Hospital Nurses, School Nurse, Midwife, Geriatric Nurse in senior center

  • Stories reflect contemporary issues in nursing practice and issues within the local community.

  • Stories of household characters interwoven into nurse stories as applicable.


New directions in teaching and learning within nursing education

Biographical Information

  • Each character has biographical information that serves as an introduction.

  • Updated each semester to reflect previous semester story.


New directions in teaching and learning within nursing education

Weekly Story

Each character has a story update each week.

Stories unfold weekly over 3 academic semesters.


New directions in teaching and learning within nursing education

Photos & Video Clips

  • Stories are extended with photos, and video clips as applicable.

  • These media enhance understanding beyond text.


Medical record

Medical Record

  • Abbreviated medical records included to provide an understanding of health care.


New directions in teaching and learning within nursing education

Newspaper

  • The newspaper links individual characters to the community

  • Is reflective of contemporary social, ethical, and health related issues.


Benefits of learning with virtual experiential communities

Benefits of learning with virtual experiential communities


Changing the focus and context

Changing the Focus and Context

  • Focus shifts away from content and toward the characters’ lived experiences

  • Context is story of individual and relationships within the home, community, and health care settings.

    • Enhanced understanding of issues associated with vulnerable populations and individuals with complex, chronic conditions.

    • Enhanced understanding of diversity (i.e. cultural, age, socioeconomic, sexual orientation).


Comparisons heart failure

Comparisons – Heart Failure

Traditional Approach

Virtual Experiential Communities

Story of individual with HF

Story depicts issues associated with disease management and navigating health care system

Multimorbidity

Changes in status depicted time over weeks; acute exacerbation not primary focus of story – just an event within the story.

  • A & P

  • Pathophysiology

  • Signs/Symptoms

  • Dx tests

  • Treatment

  • Nursing Interventions & patient teaching

Context = acute phase; perspective of the nurse

Context = daily life; perspective of individual


What is the link to nursing

What is the Link to Nursing

PHASE OF NURSING CARE

  • Clinical Judgment Model (Tanner)

    • Notice (potential for problem)

    • Recognize (problem has developed or is developing)

    • Respond (nurse knows what to do)

    • Reflection-in-action

    • Reflection-on-action

  • Health Promotion Model

    • Primary Prevention

    • Secondary Prevention

    • Tertiary Care


Common teaching strategies

Common Teaching Strategies

Incorporated in Lecture

Case Study

Role Play

Games

Care Plan

Creative Writing

Simulation

Compare and Contrast

Concept Map

Debate

Concept Analysis

Policy Analysis


What do you want students to do

What Do You Want Students To Do?

Learning Activities that are Purposeful

Individual Assessment

Family Assessment

Community Assessment

Calculate medication dosages

Analyze medication or treatment plan

Develop a Care Plan

Develop a Teaching Plan

Identify Risk Factors

Identify Interventions

Evaluate Interventions

Hold a Team Meeting

Analyze a Medical Record

Plan a Home Visit

Analyze payment structures

Develop a Policy or Protocol

Propose a Community Health Plan

Identify a researchable problem

Apply principles of ethics to an ethical dilemma

Apply evidence-based standards to situation

Develop Discharge Instructions

Plan a Health Fair

Identify Safety Hazards


Future directions

Future Directions


Outcomes and evidence

Outcomes and Evidence

  • Research conducted at pilot sites Fall 08

    • Perceived engagement

    • Perceived benefits (students)

    • Perceived benefits (faculty)

  • Future research ???

    • Faculty work-life

    • Enhance cultural competence

    • Differences in health care delivery


Alternative applications

Alternative Applications

  • Population specific virtual communities

  • Application for multidisciplinary health care education

  • Application for other disciplines

    • K-12

    • Social Work

    • Construction Management


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