Teaching New Graduates: What are Today s Best Practices to Promote Thinking?

Transcription

1 Teaching New Graduates: What are Today s Best Practices to Promote Thinking? Donna D. Ignatavicius, MS, RN, CNE ANEF donna@diassociates.com Need to Know = Need to know/think to be a safe beginning nurse Does your program suffer from TMI?? Do you have to lecture to get through your content? Do students forget what you said in class last week? Need to Know = Need to know/think to be a safe beginning nurse Do you keep adding new content but never take anything out of your curriculum? Are you barely keeping up with all you have to do? 1

2 Need to Know = Need to know to be a safe beginning nurse Beginning nurse generalist vs. advance practice nurse Decrease specialty content/credits (each area 2 3 credits); what about GERONTOLOGY?? Increase adult health credits (national average is credits) Need to Know? OR Nice to know? Pair Activity Tetralogy of Fallot Hemophilia Marfan s Syndrome Scleroderma Pica syndrome/disorder Postpartum PTSD Myasthenia Gravis Need to Know? OR Nice to know? Textbooks in your BSN program: Are they used for APN programs? Are there too many student assignments considered by students as busy work? Is there too much reading? 2

3 Meet the Lesson Plan (see handout #1) Best Practices for Preparing New Graduates Be student centered and passionate. Use evidence based teaching learning strategies. Focus on essential nursing concepts in curriculum that are clinically relevant and thinking like a nurse. Best Practice #1: Be Student Centered. Consider Learning Preferences of Adults and Adult Learning: V A R K Self directed and motivation Connect new knowledge with previous learning or life experience 3

4 Best Practice#1: Be Student Centered. Role model professional behaviors: Ensure consistent academic standards/polices between and among faculty. Best Practice#1: Be Student Centered. Role model civil and caring behaviors; be available and approachable. 4

5 Best Practice#1: Be Student Centered. Communicate expectations clearly and timely, especially changes. Remember that the syllabus is a legal contract!!! Best Practice#1: Be Student Centered. Include student representation on committees and faculty meetings. Include students when revising curriculum. Best Practice#2: Use Evidence Based Teaching Learning Strategies. Be a guide on the side flipping and scrambling as learning partners! Make students accountable for their own learning! 5

6 Best Practice#2: Use Evidence Based Teaching Learning Strategies. Use simulation not just for the lab anymore to replace lecture! Use the classroom and online didactic learning as a time of clinical imagination. Best Practice#2: Use Evidence Based Teaching Learning Strategies. Align classroom and clinical activities to ensure application and reinforcement of knowledge (Hermann, 2016). Include Direct Care Activities and Focused Learning Activities in clinical/simulation settings. Focus on nursing and nursing care, not medicine and medical diagnoses! NCLEX tests safe nursing practice. 6

7 Do not let commercial testing products guide or be your curriculum. Design the course, then find the best fit learning resources. Be aware that standardized test items are aligned with textbooks/nclex test plan. Focus on learning related to safety and quality; i.e. need to know! Use current health care language and initiatives not restricted to nursing lingo. Help students to learn how to think like a nurse. Clinical judgment, not nursing process (Tanner, 2006) Practice noticing, interpreting, responding, and reflecting. 7

8 Focus on professionalism and professional behaviors, including integrity. Increase emphasis on leadership and management of care concepts. Provide opportunities to learn teamwork and collaboration. Emphasize the attributes of patientcentered/family centered care and cultural awareness. Include quality improvement processes and provide opportunity to be involved in CQI clinical project/activities. 8

9 Emphasize measures to prevent FTR! Failure to recognize clinical deterioration Failure to communicate escalating concerns Failure to physically assess the patient Failure to diagnose and treat appropriately What could kill your patient today? What complications will you prevent, monitor for, or report if they occur? 9

10 Teach the 3 Rs for managing FTR: Rescue, respond, and resuscitate. Teach when and how to use the RRT. Teach systems to prevent FTR, such as the Modified Early Warning Score (MEWS) system. Selected Bibliography Hermann, J.W. (2016). Creative teaching strategies for the nurse educator (2 nd Ed.). Philadelphia: F.A. Davis. Oermann, M. H. & Gaberson, K. B. (2017). Evaluation and testing in nursing education. Ed.) New York, NY: Springer. Tanner, C.A. (2006). Thinking like a nurse: A research based model of clinical judgment in nursing. JNE, 45(6), (5 th PAIR ACTIVITY 10

11 LESSON PLANS NUR 320: Nursing Concepts I EXEMPLAR Gas exchange: COPD STUDENT LEARNING OUTCOMES 1. Recall the introduction to gas exchange, including anatomy and physiology. RELATED CLOs LEARNING ACTIVITIES/ ASSESSMENT 1, 2, 5 Before Class: *Complete gas exchange worksheet and bring to class #1). (NOTE: May use as an Admit Ticket.) *Review respiratory system with focus on ventilation and diffusion of gases. EVALUATION METHODS *Worksheet worth a possible 1 point. Unit exam questions on Exam #1 *Read COPD section in Iggy. *Review chapter on end-of-life in Iggy. During class: 2. Explain the pathophysiology of COPD as it affects gas exchange, including risk factors. *Have students pair and draw graphic to demonstrate what happens the pathophysiology of COPD. Be prepared to explain this graphic in class. (#2) 3. Outline the role of the nurse in caring for patients with COPD having diagnostic testing to measure gas exchange. *i-clicker questions (#3)

12 4. Apply knowledge of pathophysiology to document assessment findings for the patient with COPD to determine the status of gas exchange. 5. Use nursing judgment to plan safe, evidence-based care to promote gas exchange in the patient with COPD. 6. Apply knowledge of pharmacology to delineate nursing implications for administering drug therapy used to promote gas exchange in the patient with COPD. 7. Plan how to collaborate with the health care team for care coordination to improve gas exchange in the patient with COPD. 8. Apply knowledge of pathophysiology to reduce potentially life-threatening complications of COPD that impact gas exchange and perfusion. 9. Provide health teaching for the patient and family to manage transitions in care, including smoking cessation if applicable, to promote gas exchange. 10. Explain the professional role of the nurse in assisting patients *Unfolding case study in small groups (#4-#6, #9) *Create drug cards for assigned selected prototype bronchodilators. *NCLEX Practice Test Items (#6-#7) *3Rs (Recognize, Respond, and Rescue) activity on cor pulmonale in small groups (#8). After class: Online discussion forum about ethics and EOL care (#10). Discussion forum due prior to next class; 3 points possible (see rubric)

13 Gas exchange: Asthma Mobility: OA Mobility: Fractures Nutrition: Peptic ulcer/gerd Nutrition: GB disease Perfusion: Hypertension and families with end-oflife and palliative care for patients with COPD.