Joan

01/29/201212

Nursing 121/122

"Prepares the student to assist diverse populations with common health disturbances in single or multiple systems. An emphasis is placed on caring for adults of all ages." (BTC NUR 121 curriculum, pg 9.)
 * Course Description:**


 * Situational Factors:**

This is a cohort of 15 Practical Nursing students who are working towards certification in June of 2012. This course is a first step in nursing for the majority of the students, as they plan to continue and complete their RN education in the future. The class meets 5 days/week, 5-7 hrs/day, and it is taught concurrently with NUR 122, a 7 credit clinical practicum. Clinical scheduling is very challenging, as we share our site with two other colleges, and the clinical schedule dictates the organization and scheduling of all theory content/assessments for the quarter.
 * 1. Specific Context of the Teaching and Learning Situation:**

Nursing is a licensed profession because we have a duty owed to protect the public. Nurses are the most trusted profession, and the public expects that nursing education provides appropriate training and education so that students will not only pass their boards and obtain a license, but continue to maintain excellent standards in their ongoing practice.
 * 2. Expectations of External Groups:**

The practice of nursing is based on certain core principles and ideas and our challenge is to apply these principles in a constantly changing environment. All nurses must be inquisitive, engaged life long learners to succeed in practice, and that is a key skill we need to demonstrate to our students on a daily basis.
 * 3. Nature of the Subject:**

Each cohort of nursing students has its' own personality, and because the students stay together for a year they become quite close. This cohort is composed of 14 caucasian females and one african male. The average age is about 25, and most of them work in addition to attending school full time. The students are very prompt, professional, and serious about succeeding in the course, and it is a pleasure to work with them. This cohort keeps a very busy outside schedule, and they make really good use of our Angel platform, where we carry on discussions, have quizzes and games, and work on group projects when we are not together in class.
 * 4. Characteristics of the Learners:**

The instructor has 30 years industry experience, and this is my fourth year teaching this course. My specialty areas are geriatrics and adult health/health disturbances, and my skills are solid in these areas. I love working with students, and I like to challenge them to do their best practice at all times. My goal is to leave them with a core set of principles to follow as they solve the multiple problems they will encounter in their professional practice.
 * 5. Characteristics of the Teacher:**

Clinical seats are exceptionally tight at our current site, and the staff there is often tired, cranky, and less than receptive to students.
 * 6. Special Pedagogical Challenge:**

I don't have any other relevant questions/answers at the moment. The course is well established and designed to meet criteria established by the Washington State Nursing Commission, and the cohort is stable and highly functional. I have a good grasp of the basic content and scheduling, and my goal is to improve my instructional strategies as we proceed through our lessons.
 * Other relevant questions and answers:**

One extremely relevant question I initially overlooked was student input. My students have given me feedback this evening that they like and need lecture in the class to review information prior to doing group projects. They are participating in self assessment and voicing their opinions, and I am respecting their input. We have now negotiated to do some combination lecture/video/discussion sessions so we can cover a great amount of material in a relevant time frame, following with projects prior to exams. It is critical to remember that students are the customer, and they are always the priority.
 * Update 01/31 Re Relevant questions:**


 * Learning Goals, Fink's Taxonomy:**

Given situations regarding surgical asepsis, perioperative care, respiratory, cardiovascular, gastrointestinal, genitourinary, endocrine, musculoskeletal, and integumentary disorders, the student will remember and identify with 80% accuracy clinical signs of disorders and associated nursing interventions.
 * 1. Foundational Knowledge:**

Demonstrate lesson specific skills safely in lab prior to clinical practice. Apply knowledge and skills safely in the clinical setting.
 * 2. Application:**

Identify interactions between nursing interventions and patient outcomes. Develop and implement patient specific plans of care. Evaluate patient responses to nursing interventions and adjust plans of care accordingly.
 * 3. Integration:**

Communicate effectively as a member of a peer group by participating in group process. Share knowledge and skills with peers. Demonstrate leadership by encouraging and motivating others. Recognize personal boundaries of self and others.
 * 4. Human Dimension:**

Utilize techniques of therapeutic communication. Exhibit respect for the cultural background and spiritual beliefs of others. Verbalize pride in the profession of nursing and an ongoing commitment to practice improvement throughout a career.
 * 5. Caring**

Demonstrate responsibility for own actions by using common techniques of problem solving and decision making to plan and organize learning. Seek learning opportunities in the clinical setting. Communicate assertively and effectively with faculty, peers,, patients, and clinical staff. Participate effectively in self assessment.
 * 6. Learning How to Learn:**

02/04/2012

Refer to Nur 122 Critical Thinking and Prioritizing Care Assignment as model. I am referring to this and other clinical assignments completed during Nur 122 below.
 * Step Three: Feedback and Assessment**

Learning objectives for each assignment require integration of physical and psychosocial skills in the work environment. Objectives are reviewed with the large group prior to each clinical rotation and progress is assessed daily during the three day rotation.
 * Forward Looking Assessment**

Electronic rubrics are attached to each assignment in Nur 122. Students are encouraged to review the rubrics prior to assignment and work to the standards for maximum success. The basic clinical rubric is also available in the the clinical curriculum.
 * Criteria and Standards**

Students self assess skills and performance throughout the rotation, discussing progress with instructors daily. Students reflect on their practice and submit a comprehensive self assessment at the end of each clinical rotation.
 * Self Assessment**

Clinical instructors provide ongoing feedback during rounds, special procedures, and at pre and post clinical conferences. Clinical instructors recognize that students are very new in their practice, and the clinical setting can be extremely intimidating. We make every attempt to maintain excellent standards of nursing practice through compassionate and supportive communication with students and clinical staff.
 * FIDeLity**


 * Step 4 Teaching and Learning Activities 02/23/2012**


 * I speak in present or past tense when addressing these activities, as these are things we have done in class and also things I am incorporating into the design of this course.**


 * 1. Information and Ideas:**


 * **Assigned Readings**-Each unit starts with a set of learning objectives, which are reviewed in class at the beginning of the unit. At this time, students are assigned specific readings from text and supplements specific to unit objectives. Students are instructed to complete assigned readings prior to large group discussion so they are prepared to participate, and they are allotted time to perform this task prior to the start of the next class.


 * **Prequizzes:** After students complete readings, and before we begin large group discussion, students take a 10-20 question prequiz, which we then review as a large group prior to beginning the unit.


 * **Online video and written information review using Assessment Technologies Institute (ATI) data:** The ATI program is designed to prepare students for the NCLEX exam they must pass to obtain their first nursing license. Students are assigned specific units to review and instructed to study videos, terms review, and best practice standards/evidence as part of the unit study.


 * **Lecture/Large Group Discussion-**Key topics/objectives for each unit are reviewed in class with instructor leading large group discussion. Students in the cohort have specifically requested this activity, stating they find it very helpful to guide their studies and focus on the key concepts of the unit.


 * **Internet Links/Assignments:** Students are provided topic specific internet links and encouraged to use these links to supplement their text learning. For example, during the study of Gastrointestinal disorders, with one of the key topics being Gastroesophageal Reflux Disease (GERD) students are provided with a link to the American Health Research Quality (AHRQ) website and instructed to review current research and findings on the topic of GERD.


 * **Practice Quizzes:** Each unit provides 3-5 practice quizzes, 5-20 questions in length, which are drawn from objective specific test banks. Students are encouraged to take practice quizzes as part of their study; correct answers are not provided. We discuss the quizzes and take 1-2 of them together as we prepare to finish the unit.


 * 2. Experiences:**


 * **Clinical Lab Practice:** Students are in clinical lab approximately 6 hours/week. During this time they practice hands on skills that we are studying in theory and clinical practice. For instance, when we are studying heart and lung disorders in theory, students are learning and practicing tracheostomy suction and care in the clinical lab.


 * **Clinical Site Practice:** Students are provided with 20 days of on site clinical practice, caring for real patients, each quarter. Students request patient assignments that are related to our current course of theory study; for instance, if we are studying GI disorders in theory, students request patients suffering from a disorder of the GI tract during their clinical rotation.


 * **Field Trips:** The class takes 2-4 field trips/quarter, again, related to our current unit of study. For instance, when we study renal disorders, kidney failure is a key concept. We visit the Mt Baker Kidney Center for a one hour training/tour, and observation of real patients receiving dialysis treatments.


 * **Case Studies:** Clinical case studies are integrated into theory content, often into large group discussion. For example, during lecture/LGD we will cover a key concept, and then take a break to work on a clinical case study. The students work together in small groups for approximately 30 minutes, then we reconvene and review the case study as a large group.


 * **Interactive Demos/Practice with industry experts:** No instructor is a topic specific expert on every aspect of nursing practice, and it is very valuable for students to interact with experts from industry. This activity is organized by the instructor, who participates as more of a learner than an expert during this session. For example, when we study care of the newborn and mother, we have a practicing nurse from the Mother-Baby Center at the hospital come and do an interactive demonstration with students in our clinical lab. These are limited experiences, as experts are not generally reimbursed for their time with more than a thank you card from our students and faculty.


 * 3. Reflection:**


 * **What have you learned today:** A quick exercise where students are given one minute to reflect on what they learned and write it down. Students then share their reflections with the group via a pop corn style read or a stand up sit down read.


 * **Self Evaluation:** Students complete a 10 point evaluation of their strengths, weaknesses, and learning achieved at the end of each three day clinical rotation (5 evaluations/quarter.) These are submitted and reviewed with feedback given by the instructor at the end of each rotation.


 * **Discussion Boards:** Students share their learning moments and tips with each other via online discussion boards throughout the course. For example, if we are studying GI disorders at theory, students will discuss their clinical activities and integrate their own learning moments in discussion during our clinical rotations. This encourages students to reflect on their learning and share it in a concise and articulate manner with others.


 * **Pre and Post Conferences:** The class meets for a 30 minute preconference prior to each clinical day, and we meet for a one hour post conference at the end of the shift. The agenda includes student presentations of their clinical cases and learning moments, shared in 5 minute reports with the large group.


 * **Group Feedback:** Students evaluate themselves and their peers by completing a written survey at the end of each quarter. The survey addresses preparation, communication, and team work in the group, which are key components of successful life long learning in nursing.

02/24/2012 Assignment 5

SourceURL:file://localhost/Users/joanhumen/Desktop/edu209%20Fink5.doc
 * Learning Goals || Feedback and Assessment || Teaching and Learning Activities ||
 * Foundational Knowledge

Given situations regarding surgical asepsis, perioperative care, respiratory, cardiovascular, gastrointestinal, genitourinary, endocrine, musculoskeletal, and integumentary disorders, the student will remember and identify with 80% accuracy clinical signs of disorders and associated nursing interventions. || Students must pass each theory exam with a score of 80% or greater to complete the course. Students may attempt each exam a maximum of three times to achieve the score of at least 80%. (Nursing Student Program Handbook.) || Information and Ideas: See assignment 4 for full detail of each category-


 * Assigned Readings-
 * Prequizzes:
 * Online video and text review using Assessment Technologies Institute (ATI) data:
 * Lecture/Large Group Discussion-
 * Internet Links/Assignments:
 * Practice Quizzes:
 * Games, i.e. topic related Jeopardy ||
 * Application

Demonstrate lesson specific skills safely in lab prior to clinical practice.

Apply knowledge and skills safely in the clinical setting. || Students are required to demonstrate unit specific clinical skills, i.e. tracheostomy care or administration of enemas, prior to attending clinical rotations and performing skills on actual patients.

Students then are observed by instructors and “checked off” again while performing new skills on actual patients in the clinical setting. . || Assigned Readings-
 * Prequizzes:
 * Online video and text review using Assessment Technologies Institute (ATI) data
 * Clinical Lab Practice
 * Clinical Site Practice
 * Field Trips
 * Case Studies
 * Interactive Demos/Practice in Industry ||


 * Integration

Identify interactions between nursing interventions and patient outcomes.

Develop and implement patient specific plans of care.

Evaluate patient responses to nursing interventions and adjust plans of care accordingly. || **Criteria and Standards** Electronic rubrics are attached to each assignment in Nur 122. Students are encouraged to review the rubrics prior to assignment and work to the standards for maximum success. The basic clinical rubric is also available in the the clinical curriculum.Sample criteria


 * Sample criteria from Nur 122 Clinical Rubric, File Attached:**

•completely and correctlyanalyzes client findings •actual or potential problem evolving from client data •3part statement •lists problems in logical order •Goals are client specific and measurable •interventions are client specific, minimum 5 || **Clinical Assignments-** Each student completes 5 specific 3 day assignments during the course. Each assignment has specific learning objectives, and performance evaluation with FIDeLity feedback is provided. Refer to Sample Assignment, file attached, for more specific detail.

What have you learned today Discussion Boards Pre and Post Conference ||
 * Reflection Activities:**
 * Human Dimension

Share knowledge and skills with peers.

Demonstrate leadership by encouraging and motivating others.

Recognize personal boundaries of self and others.

Communicate effectively as a member of a peer group by participating in group process. || **Self Evaluation**: Students complete a 10 point evaluation of their strengths, weaknesses, and learning achieved at the end of each three day clinical rotation (5 evaluations/quarter.) These are submitted and reviewed with feedback given by the instructor at the end of each rotation. Refer to attached file, Clinical Self Evaluation, Personal/Professional Responsibility for detail.


 * Group Feedback**: Students evaluate themselves and their peers by completing a written survey at the end of each quarter. The survey addresses leadership and preparation, communication, and team work in the group, which are key components of successful life long learning in nursing. Group feedback is worth 10% of the theory grade (BTC Nursing Student Handbook.) || * Clinical Pre and Post Conferences
 * Students are assigned to different units in small groups and they support one another in clinical practice.
 * Ongoing Group Feedback; formal and informal. ||
 * Caring

Utilize techniques of therapeutic communication.

Exhibit respect for the cultural background and spiritual beliefs of others.

Verbalize pride in the profession of nursing and an ongoing commitment to practice improvement throughout a career. || Students are observed in clinical practice and their expertise in this area is assessed. Instructors provide ongoing feedback as outlined below.

FIDeLity

Clinical instructors provide ongoing feedback during rounds, special procedures, and at pre and post clinical conferences.

Skills are evaluated against the clinical rubric (file attached) when assignments are graded. || * As outlined above, in clinical assignments.
 * Caring is an integral part of nursing, and everything we do is a direct learning experience in this area.
 * Refer to attached clinical assignment for one specific example. ||
 * Learning How to Learn

Demonstrate responsibility for own actions by using common techniques of problem solving and decision making to plan and organize learning.

Seek learning opportunities in the clinical setting.

Communicate assertively and effectively with faculty, peers,, patients, and clinical staff.

Participate effectively in self assessment. || **Self Assessment**


 * Students self assess skills and performance throughout the rotation, discussing progress with instructors daily.**


 * Students reflect on their practice and submit a comprehensive self assessment at the end of each clinical rotation.**


 * Sample from Clinical Self Evaluation, File Attached:**
 * Self-EVALUATION**: Seeks out experiences, knows limitations, seeks guidance when needed, accepts constructive criticism, and recognizes mistakes and takes actions to correct them || * Learning activities outlined above and on my WIKI page,
 * Information and Ideas
 * Experiences
 * Reflection
 * Instructors role model professional behavior and life long learning skills
 * Instructors provide ongoing coaching and mentorship as students progress throughout the course.
 * Instructors recognize that students are very new in their practice, and the clinical setting can be extremely intimidating.
 * We make every attempt to maintain excellent standards of nursing practice through compassionate and supportive communication with students and clinical staff. ||