Using student nurses as teachers in inquiry-based learning

BACKGROUND: Traditionally, teaching in nurse education colleges and universities in the United Kingdom (UK) has relied substantially on didactic, large group, teacher-led approaches. Emerging literature identifies a shift towards student-centred learning in a variety of formats, such as problem- and enquiry-based learning. These approaches require students to take greater responsibility for both their own learning and that of others. Internationally, and in a number of academic educational disciplines, use of peer-assisted learning, supplemental instruction and peer tutoring as curriculum initiatives has aided improvement in student retention and academic performance. There is, however, a paucity of literature exploring the use of undergraduate student nurses as peer teachers. AIM: To explore the viability of using student nurses as teachers in an inquiry-based nursing curriculum and to ascertain the value students place on this teaching and learning method. METHOD: The first phase of the study involved observation of 'parallel resource sessions': teacher-led sessions that addressed a theoretical component of the curriculum. In the second phase, student feedback of these sessions to their peers was observed. This was followed by focus group interviews (with a total of 240 participants), which were analysed using thematic analysis. FINDINGS: The findings suggest that student nurses were uncomfortable with being used as teachers, often questioned the intrinsic worth of this approach as a developmental tool, and considered the responsibility for teaching the content of parallel resource sessions to lie with nurse educators. CONCLUSION: Nurse educators must continue to explore innovative approaches to improve both student nurses' experience and their fitness for practice. The strategy of using student nurses as teachers may be appropriate in some circumstances but requires further research, considerable support and continual evaluation.     

Changes to teaching and learning about medication administration within a diploma of nursing course due to the Covid-19 pandemic: A staff and student multi-method evaluation

AimThis project aimed to evaluate student and staff satisfaction with, and perspectives on, changes to delivery and format of the Medication Unit of Competency within a Diploma of Nursing Program.BackgroundMedication safety is an integral component of learning for pre-registration nursing students. The COVID-19 pandemic required rapid changes to be made to the medication competency unit being taught to students within a Diploma of Nursing, pre-registration course. Changes to sequencing of theory, mode of education delivery, class sizes, available resources and learning support were required.DesignA multi-method evaluation process was conducted. The project is reported as per SQUIRE-EDU guidelines.MethodsFocus groups and survey data were obtained from staff and students in December 2020, to evaluate responses to the changes. Student exam results and the number of learning support consultations accessed were also assessed to identify impact of changes.ResultsStaff and student evaluation identified mixed responses but overall, the change in sequence of theory and mode of delivery was positively received. Crude comparisons of final assessment results revealed improved marks compared to the previous cohort. The addition of an online medication resource was utilised by most students. The agility of staff in responding to the challenges was highlighted in the staff focus group and additional, flexible learning support was favourably received by students.ConclusionsDespite the need for rapid changes being made to the course, positive responses were received from both staff and students. Some students preferred the traditional sequencing of learning as they felt it matched their learning style. An added online resource and extra learning support supported student self-efficacy development of medication competency; however further research is needed to ascertain any associations. The online resource is still being utilised within course curriculum.     

Enabling interprofessional education: the role of technology to enhance learning

Interprofessional education (IPE) in health and social care undergraduate education is a key governmental driver [DOH, 2001. Working Together, Learning Together. A Framework for Lifelong Learning in the NHS. HMSO, London]. In the UK, IPE has been advocated and developed as a means to encourage effective collaboration in order to improve public sector services [Barr, H., Ross, F., 2006. Mainstreaming interprofessional education in the United Kingdom: a position paper. Journal of Interprofessional Care 20 (2), 96-104]. An IPE curriculum was introduced at the School of Health & Social Care for undergraduate students (n=600) from a variety of health and social care disciplines. As a part of this process, there was a demand for ways to allow students and staff to interact and collaborate through learning resources at different locations and times in order to learn interprofessionally. Blended learning was the chosen approach leading to the development of a simulated web-based community learning resource - Wessex Bay. This paper considers the development of Wessex Bay from technical and pedagogical perspectives. The curricular context for the development is considered and the role of simulation in meeting educational needs is explored. The technical development is outlined followed by an overview of an evaluation of its use in the first two years of the IPE programme. Conclusions are drawn around the strengths and limitations of this approach, including a consideration of further opportunities for developmental work.     

Migrating to the web: the transformation of a traditional RN to BS program

BACKGROUND: Evaluation of our school's self-study data pointed to the need to offer creative distance learning options for students in the registered nurse to bachelor of science (RN to BS) program. METHOD: Selected courses in the RN to BS curriculum were offered to students in both the traditional classroom and via an online format. RESULTS: End-of-course evaluations and course grades showed no significant difference between the learning experiences of the traditional classroom students compared with those of the online students. CONCLUSION: This successful pilot encouraged our school to migrate the curriculum of a traditional RN to BS program to an online format.     

Strategies for teaching nursing research online

BACKGROUND: Nursing, like many disciplines in university settings, is experiencing increasing demand for online courses. Development and implementation of online courses with the quality of education nursing students experience in traditional classroom settings, is essential to maintaining integrity of the educational process. Nursing research has been offered in the online format in the RN-BSN programme for 2 years. This course has an average enrolment of 80 to 90 students each semester. PURPOSE: This article presents strategies used in teaching an RN-BSN nursing research course online. CONCLUSIONS: Feedback from faculty and students indicates that these strategies have been successful in facilitating this writing intensive course through distance learning.     

Competency-Based Nurse Practitioner Education: An Overview for the Preceptor

Many health care disciplines, including advanced practice nursing, are moving to competency-based curriculum designs for preparing their future professions. Moving from content-based to competency-based infers a shift from a focus on teaching and imparting faculty or preceptor knowledge to a focus on students and outcomes of their learning. Preceptors are key to the success of student learning in competency-based frameworks. This article orients the preceptor to the drivers of a competency-based curriculum and provides tips for preceptor success as a partner in educating NP students within programs that have adopted a competency-based approach.     

Designing an oral health module for the Bachelor of Midwifery program at an Australian University

Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.     

Redesign of clinical nurse specialist role course for distance education. Development,implementation, and outcomes

The purpose of this article is to describe a collaborative effort to redesign a clinical nurse specialist curriculum for distance education among 4 regional state universities in southern Louisiana. The multisite approach was implemented to increase access to educational opportunities in advanced practice nursing for location-bound professional nurses. Course development, challenges to implementation, and success of the redesign are discussed. Additional topics described are online technical requirements and strategies for role socialization through distance learning. Success of the effort included an enhanced ability to recruit students to this specialty area.     

Supporting biosciences in the nursing curriculum: development and evaluation of an online resource

AIMS: The aim of this project was to develop and evaluate an online resource designed to improve the biosciences knowledge of preregistration nursing students. BACKGROUND: A number of studies have identified lack of biological subject knowledge and anxiety about studying biosciences as serious problems for nursing students. The availability of a contextualized biological information resource prior to and early in their studies might help to reduce this fear and anxiety. METHODS: The project used an action research approach, involving an initial analysis of the extent of the problems with biosciences encountered by our nursing students, followed by the development and evaluation of a biology-based open learning resource (entitled Headstart) in collaboration with preregistration nursing students and nurse educators. FINDINGS: The students in this study expressed a high level of concern about studying biology, and perceived this to be the most difficult aspect of their nursing programme (significantly more difficult than nursing practice). A significant correlation was also found between previous level of biological qualification and confidence in passing module tests. Evaluation of the new online resource illustrated the willingness of nursing students to use such a package, and general approval of its content and mode of delivery, despite a number of problems related to computer access and students' inexperience with information technology. CONCLUSIONS: This project has provided further evidence of the need for additional resources in biosciences for nursing students. It has also illustrated the way in which a targeted online resource has the potential to provide substantial benefits in terms of supporting the nursing curriculum. Whilst further evaluation is needed, the findings suggest that Headstart has the potential to address a number of issues identified both by this study and by previous research in nurse education.     

Reflective journaling: developing an online journal for distance education

Reflective journal writing can be a useful heuristic tool to foster critical thinking skills and develop reflective clinical practice in nursing. When combined with a distance education delivery format, the online journal helps to leverage the strengths of reflective learning with educational technology as well as provide a seamless record of learning outcomes across the curriculum. The authors discuss the incorporation of an online reflective journal into a distance education clinical course and provide guidelines for educators considering a similar approach.     

A Novel Student-Led Approach to Multiple-Choice Question Generation and Online Database Creation,With Targeted Clinician Input

Problem: Multiple-choice questions (MCQs) are the main method of assessing medical student knowledge. As a result there is a high demand from medical students for formative MCQs. However, teaching staff rarely have the time or incentive to develop high-quality formative questions, focusing instead on material for high-stakes assessments. Intervention: We have developed a novel student-led approach involving an interactive online question database, created by medical students for medical students. We adopted a staged approach to create an online bank of formative MCQ questions. First, students write MCQs following a standardized format. Questions are then peer-reviewed by other students, discussing relevant clinical topics, guidelines, and journals to improve question quality. The questions are then scrutinized by specialist doctors and academics. Next, questions are piloted online. Finally, question performance is evaluated statistically. This 5-stage student-led process produced a bank of more than 200 MCQs in three months. Context: This intervention was carried out by two final-year medical student leads at Cardiff University School of Medicine, UK. Final-year students were recruited to write and peer-review questions, and senior content specialists were recruited from the department. After piloting and evaluation of the questions, the question bank was made available as a learning resource to all medical students at Cardiff University. Outcome: Objective analysis of the created MCQs (discrimination indices and distractor analysis) indicated that the random sample of questions piloted were of high quality. When the questions were made available as online tests to approximately 600 students, usage data revealed that 2,800 tests were taken over a 3-month period, indicating that the resource was popular. In addition, subjective feedback from students question writers/reviewers was gathered via free text feedback forms and was invariably positive. We plan to continue the question generation process in Cardiff and would encourage other medical schools to adopt this approach. Lessons Learned: Our 5-stage approach can generate a large volume of high-quality MCQs, addressing the demand from students for formative MCQ questions, with minimal teaching staff input. The project's benefits go beyond the creation of the resource, as involving students in the writing, review, and presentation of questions itself is useful pedagogically.     

Three model curricula for teaching clinicians to use the ICF

PURPOSE: Three systematic programmes to train health professionals to use the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) are described, along with efforts to evaluate their effectiveness. METHODS: The first programme was a randomized study comparing the effects of a 2-hour instructor-led programme and a self-directed learning module on ICF-related knowledge, attitudes, and coding skills among occupational therapy graduate students. The second programme was a series of intensive 3.5-day workshops for public sector rehabilitation professionals in South Africa. The third programme involved a series of internet-based teaching modules regarding the ICF for graduate students in rehabilitation counselling. RESULTS: The first project found that both instructor-led and self-guided training formats were effective in improving basic ICF-related knowledge, but only instructor-led training led to a significant improvement in coding skill. It also had more positive effects on ICF-related attitudes. This approach to learning assessment was generalizable to multidisciplinary health professionals in South Africa, who achieved a relatively high degree of coding accuracy after the 3.5-day workshop. Participant evaluations supported the structure, content, and length of the training. Students in the third programme also reported a very positive learning experience and positive views of the ICF. CONCLUSIONS: An empirical basis is important for identifying the best and most efficient training methods for particular audiences and specific purposes. The length and format of training can be differentially related to specific training goals (i.e., knowledge, attitudes, and coding skills). Interactive distance learning methods may help to overcome the weaknesses of self-directed training in comparison to face-to-face training.     

Data-driven graduate curriculum redesign: a case study

This article discusses the use of Knowles' adult learning theory as the framework for a curriculum redesign within the leadership and management track of a master's of science in nursing program. Health care executives within the university service area were surveyed regarding their organizational needs for advanced practice nurses. A second survey was mailed to a sampling of all RNs in the university service area. In response to perceived community needs, the curriculum of the leadership and management track was redesigned to allow for role specialization within the program. In addition, the university has an infrastructure to support distance learning and an experienced staff able to support distributive learning, providing wide geographical access to students in distant locations.     

Using a problem-based learning format to teach CLS students interdisciplinary health care practice.

OBJECTIVE: To simulate interdisciplinary collaborative practice using a problem-based format so students can increase their knowledge and understanding of health care disciplines other than their own. The basic premise of this approach is that learners are more likely to master necessary subject matter if it is presented in a manner that is realistic. SETTING: University of Kentucky Center for Rural Health. PARTICIPANTS: Eight student participants-three undergraduate clinical laboratory science students, three students in the masters degree nursing program, one family practice resident, and one visiting student from a physician's assistant program. MAIN OUTCOME MEASURES: Group discussion, peer review, and student questionaires. CONCLUSION: The interdisciplinary, case-study approach to learning offers the clinical laboratory science student an opportunity to work with other health care providers in an informal setting as an introduction to group interaction, interdisciplinary health care, and evaluation of health care access in any community.     

Web-based teaching in nursing: lessons from the literature

Many in nurse education have partially adopted the Internet as a pedagogical approach. This has highlighted serious contentious issues for educators. These include, pedagogical vs. technological approaches to teaching, face-to-face vs. online communication and classroom vs. online teaching. This paper attempts to reassure educators about this new Internet-based pedagogy, by applying traditional educational theories and discussions on curriculum to web-based teaching. In particular, cognitive learning theories such as constructivism and the process model of curriculum development are discussed. These provide a solid theoretical framework from which to expand the Internet-based pedagogical approach among those whose interest is the promotion of learning. The paper concludes with the implications of web-based teaching for the personal and professional development of nurse educators.     

Three model curricula for teaching clinicians to use the ICF

Purpose. Three systematic programmes to train health professionals to use the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) are described, along with efforts to evaluate their effectiveness.

Methods. The first programme was a randomized study comparing the effects of a 2-hour instructor-led programme and a self-directed learning module on ICF-related knowledge, attitudes, and coding skills among occupational therapy graduate students. The second programme was a series of intensive 3.5-day workshops for public sector rehabilitation professionals in South Africa. The third programme involved a series of internet-based teaching modules regarding the ICF for graduate students in rehabilitation counselling.

Results. The first project found that both instructor-led and self-guided training formats were effective in improving basic ICF-related knowledge, but only instructor-led training led to a significant improvement in coding skill. It also had more positive effects on ICF-related attitudes. This approach to learning assessment was generalizable to multidisciplinary health professionals in South Africa, who achieved a relatively high degree of coding accuracy after the 3.5-day workshop. Participant evaluations supported the structure, content, and length of the training. Students in the third programme also reported a very positive learning experience and positive views of the ICF.

Conclusions. An empirical basis is important for identifying the best and most efficient training methods for particular audiences and specific purposes. The length and format of training can be differentially related to specific training goals (i.e., knowledge, attitudes, and coding skills). Interactive distance learning methods may help to overcome the weaknesses of self-directed training in comparison to face-to-face training.     

A multidisciplinary online educational database

BACKGROUND: Before the introduction of the Trent online educational database there was no central resource that potential purchasers could use to access information on clinically relevant courses and programmes of professional development. The online database enables cancer centres, cancer units, and education and training confederations to identify current provision of cancer education and training courses in Trent. CONCLUSION: The electronic online evaluation identified that the majority of users felt the information they found was relevant and that they would recommend the database to colleagues. They also felt that it was easy to find the information they required and the information was presented in a useful and appropriate format.     

Student perspectives on problem-based learning in an occupational therapy curriculum: a multiyear qualitative evaluation.

OBJECTIVES: Problem-based learning (PBL) is increasingly being used within health care professional educational programs to develop critical thinking skills via a learner-centered approach. However, few studies have evaluated the effect of participation in a PBL-centered curriculum on occupational therapy knowledge and skill development over time from the perspective of the students involved. This study examined student evaluations of the first three class cohorts participating in a PBL-based curriculum. METHOD: A participatory action design study involving qualitative, student-led focus groups was conducted with 154 students across 2 years of the education program. Fourteen focus groups were audiotaped, and those audiotapes were transcribed by an outside expert, followed by two levels of analysis by program faculty members and a member check by student participants. RESULTS: Themes that emerged from the data analysis related to (a) defining elements of PBL, (b) the role of students and faculty members, (c) learning strategies used by students in a PBL versus traditional education program, (d) the challenges of a PBL approach, and (e) PBL's relationship to clinical reasoning and occupational therapy practice. CONCLUSIONS: Students perceived that a PBL approach adopted consistently across the curriculum contributed to the development of information management, critical reasoning, communication, and team-building skills; however, identified challenges were time and role management, information access, instructor versus PBL expectations and practices, and coping with the ambiguity of knowledge and reasoning.     

Flexible monitoring in the management of patient care processes: one year after the pilot study

A pilot study at a large metropolitan hospital in Auckland identified a specific group of patients that can be safely monitored outside the Coronary Care Unit using Flexible Monitoring technology. This article describes the project management processes used to further develop the remote monitoring system into a hospital network of remote monitoring. The educational and staff support resources required throughout the project are described as are the strategies adopted to meet those needs including the utilization of online learning. Outcomes from the introduction of the system include improved electrokardiogram interpretation by nursing staff and improved ECG resource allocation.     

An educational curriculum used to improve the knowledge and the perceptions of certified registered nurse anesthetist clinical educators

An educational curriculum using adult learning principles in an active learning format was developed for Certified Registered Nurse Anesthetist clinical educators (CRNACEs) to help improve the quality of the clinical learning experiences for student nurse anesthetists (SNAs). This exploratory study sought to determine the extent to which an 8-hour educational course modified the behavioral perceptions and the knowledge of CRNACEs. The effects of the CRNACE course were measured using a questionnaire that consisted of 22 Likert scale items and 8 open-ended questions. The study population included 33 CRNACEs. Their responses were assessed before the course, after the course, and during a 2-month follow-up. It was determined that the CRNACE course positively modified participants' perceived behaviors and knowledge after instruction and at the 2-month followup. Additional findings included that information provided during the CRNACE course did not change the perceptions of CRNACEs related to their ability to communicate with students or their willingness to modify their teaching practices. Providing instruction incorporating principles of adult learning using an active learning format for CRNACEs may improve the clinical learning experiences for SNAs. As a result, SNAs would be better prepared to make the transition to clinical expert.