Graduate School Beginnings

The first day and overall impression of a new graduate entering into an MSN program with a concentration in nursing education.                        

Last week, I began the next step in the education process. The Master's of Science in Nursing program at California State University, San Bernardino offers concentration in Academic Nursing Education. Like many advanced degree programs, a hybrid, class and on-line format, is utilized to allow time for continuing in professional careers.

At first I struggled with attending a smaller graduate program. Over the past summer, I looked into many larger and reputable schools across the country. I quickly learned that many schools require (recommend) at least a year as a professional licensed nurse prior to admission into a graduate program. Many other personal factors also played a role in choosing to return to my Alma Mater.

After a full day orientation followed by another full day of classes, I immediately felt like the CSUSB MSN program is going to be exactly what I need right now. The professors are very knowledgeable and experienced. The curriculum is designed to allow for a tailoring to meet your academic/professional goals. Most importantly, the class size is small but diverse allowing for future opportunity to foster strong friendships and connections in the community.

I'm glad that I was able to avoid the temptation of going to a larger school for the shear recongition rather than relying upon my own individual achievements to build a solid resume for future plans and goals. After all, I would have had to move an 8 month pregnant wife half way across the country and then try to find a job in an unfamiliar area.

Using Web with class instruction

Evidence showing a Web-based program offering a learning opportunity for nursing students to enhance skills beyond their normal lectures.              

Article review from CIN: Computers, Informatics, Nursing: The Effects of a Web-Based Supplementary Program for Facilitating Nursing Students' Basic Nursing Skills (full reference below)

Situation
"The aim of the present study was to examine the effects of asynchronous Web-based supplementary learning program on students’ real performance of basic nursing skills."

Background
E-learning, also known as web-based learning, is a modern movement in all disciplines of education. As technology and Internet becomes more widely available around the world, educators are quickly learning how to embrace new tools available to them. Nursing education is right in the middle of this digital revolution. Cost limitations, lack of training/support, and other causes often prevent nursing schools from exploring newer technologies.

Abstract
This study examined the effects of an asynchronous Web-based supplementary learning program on the performance of nursing students’ basic nursing skills. A post test quasi-experimental design was used. Students in the intervention group (n = 62) were given login information to access the online program, while the control group (n = 99) was not. Data from both groups were collected before and 4 weeks after the intervention. An objective assessment of basic nursing skills was used to evaluate the level of skill demonstrated by the participants. Results indicate that the Web-based supplementary learning program is effective at strengthening students’ basic nursing skills (P = .002). The findings also reveal that students in the intervention group showed higher-than-average satisfaction with the supplementary program (mean, 3.80 [SD, 0.81]). Thus, this Web-based program offers a learning opportunity for nursing students to enhance their skills beyond their normal lectures.

Review
Nursing skills are defined as "fundamental clinical techniques performed by nurses while taking [care] of patients." "Knowledge and skill disappear if not regularly enforced." A literature review indicate that though several studies has research web courses to replace traditional courses, but few, if any, exists that use web learning as a supplement to traditional course study. "Studies show that nurses can transfer their learning from Web-based systems to practical situations." However, an ongoing debate with skeptics argues that inconsistent study results hinder the e-learning movement.

Statistical analysis of a control group and "intervention" group found that the "web-based learning program proved to be effective for nursing students." A disadvantage identified was the training and extra time required by instructors to maintain the program. This is all to common as the majority of an "older generation" of educators fail to incorporate technology with traditional didactic lecture methods.

Chuang, Y., & Cheng, H., & Ya-shu F., & Miao-Chen, & Yu-Ping. (2010). The Effects of a Web-Based Supplementary Program for Facilitating Nursing Students' Basic Nursing Skills. CIN: Computers, Informatics, Nursing, 28(5), 305-310.

8 traits every nurse educator should have

Article review from Nursing Management: 8 traits make great nursing instructors.                                  

Nursing instructors are always struggling in finding the tipping point between cutting edge and complacency. In many ways, nursing education is coming a long way from “that’s how it was when I was in school” mentality. However, there is still a long way to go. A recent article in Nursing Management, identifies 8 traits that every nursing instructor should have. Each trait is summarized and commented on below.

1. Appropriate education

Summary - The requirements for classroom and clinical instructors vary from state to state and by institution. Nursing instructors should seek educational opportunities that are current with research and developing standards.

Comment - Today the amount of available nursing faculty continues to remain low as does enrollment in advance degree nursing programs. This may be due, in part, to a relatively new role in nursing known as the nurse educator.

2. Teaching skills

Summary - Students are looking for a teacher who knows how to effective combine experience, theory, and teaching strategies into an engaging learning environment. Professors and instructors facilitate critical thinking through assignments and questions.

Comment - New innovative strategies and equipment should be continually investigated for coursework integration. The learning style of students is steadily transforming as the era of “hands on” coupled with technology progressively gains acceptance.

3. Ability to work with others
Summary - Working with others is a straight-forward by necessary attribute for nursing faculty. Educators will come across a wide variety of students, each with a unique set of skills.

Comment - Many nursing programs ask faculty to advise students to monitor course planning for graduation requirement. Those who take the opportunity and time to also mentor students towards their professional goals, find students motivated and grateful for the guidance received.

4. Expertise

Summary - Expertise can be considered the most important qualification for an instructor to possess. It is expected by nursing students, nursing staff, and patients. Nursing faculty also need to be experts in safety.

Comment - Experience fades with time. The best instructors are those who find ways to pick up a shift on the floor once in a while or continue to develop relevant research.

5. Assessment skills

Summary - Assessment of patients transforms into the ability to assess the learning needs of students. Educators monitor student progress to ensure readiness for handling patient care.

Comment - Often, highly qualified clinical nurses are recruited for part time teaching positions. These educators will often lack the extended training and experience in assessing student learning. Senior faculty members must remain vigilant to

6. Love of nursing

Summary - Having a passion for nursing and nursing's value will make teaching easier and more effective.

Comment - Those who really enjoy what they do, make the best teachers. It's a simple and logical statement to agree with. Nurses generally have a natural desire to teach. Therefore, it is very likely that instructors will develop a passion for nursing and teaching.

7. Communication skills

Summary - Fostering a good working relationship with a student requires a positive attitude. As methods of communication continue to evolve with technology, educators should explore all communication tools available.


8. Skills beyond the clinical setting

Summary - Get involved with university affairs and other local community organizations. Developing acquaintances in multiple settings is a benefit and tool for educators.

Comment - Having connections will expose opportunities that may assist in student learning or school growth.


Parsh, B. (2010). 8 traits make great nursing instructors. Nursing Management, 41(3), 46-47.

Improving Test Scores with Online Discussions

Article review from CIN: Computers, Informatics, and Nursing: Pretest Online Discussion Groups to Augment Teaching and Learning.                          

Situation
Statistical analysis showed the pretest online discussion activity had a generally positive impact on tests and final examination scores, when controlling for a number of possible confounding variables, including instructor, cumulative grade point average, age, and credit hours.

Background
A debate between vocal and digital communication continues to exist. Vocal allows for real-time feedback while digital allows extra time for comprehension. Difficulties arise as ability and standards of each vary by geographical location, age, education, and more. However, online learning is developing into a powerful tool. When used correctly, it can enhance and prove beneficial to students and instructors. Educators must be cautious to be properly trained and thoroughly committed before implementation. Students also must be prepared and required to adhere to new methods of instruction.

Abstract
Tests and final examination scores of three semesters of control students in a nursing foundation course were compared with tests and final examination scores of three semesters of participating students. Participating students were offered access to an asynchronous pretest online discussion activity with a faculty e-moderator. While the simplified Bloom's revised taxonomy assisted in creating appropriate preparatory test and final examination questions for pretest online discussion, Salmon's five-stage online method provided direction to the e-moderator on how to encourage students to achieve Bloom's higher-order thinking skills during the pretest online discussions. Statistical analysis showed the pretest online discussion activity had a generally positive impact on tests and final examination scores, when controlling for a number of possible confounding variables, including instructor, cumulative grade point average, age, and credit hours.

Review
Online collaborative learning is introduced as a recent beneficiary advancement allowing “more opportunity for thinking space.” Proper training is emphasized so that “goals and objectives [are] developed to effectively design and interactive learning experience.” Critical thinking along with application of skills and knowledge, is stated at more important than simply having students memorize facts and figures.

Participating students (PSt) had a slightly higher GPA than nonparticipating students. Also, the average age of PSt was slightly older and among PSt, older students generally participated more than younger PSt. Test results show that PSt performed better than non-PSt. The study demonstrated that “students can achieve higher levels of cognitive processing and knowledge from online teaching if a faculty member acts as an e-moderator. However, “overall average test scores were not significantly difference among PSt and non-PSt. 


Kuhn, J., Hasbargen, B., & Miziniak, H. (2010). Pretest Online Discussion Groups to Augment Teaching and Learning. CIN: Computers, Informatics, Nursing, 28(5),  297-304.

Stunurse.com

Also published in print and freely distributed to accredited schools of nursing, Stunurse.com serves as a resources for helpful tips for nursing students. Also, they offer a beginning look at available employment opportunities for after graduation.

allnurses.com

Perhaps the most widely used nursing discussion board on the internet, allnurses.com offers resources for just about everyone.                                            

The discussion board is ad supported but content with postings are monitors and regulated. If you are a students, faculty, or staff nurse looking for information allnurses.com is a great place to begin your search.

Tell Me A Story - Bettering healthcare education

An ancient tradition transformed into a modern tool for application in even the most advanced curriculum.                        
        
Article review from Nurse Education Today: Tell me a story -- a conceptual exploration of storytelling in healthcare education (full reference below)

Situation

This conceptual paper:

• “explores the principles of storytelling”
• “evaluates use of storytelling techniques”
• “acknowledges role of storytelling in healthcare delivery”
• “identifies skills learned and benefits derived from storytelling”
• “speculates upon use of storytelling strategies in nurse education”

Background

Using story as anecdotal introductions in teaching is used in everyday life. With more and more nurse educators looking for evidence based practice, some have defended this millennia old tradition with research and supporting literature. Advances with computers, internet, and mobile devices have made digitally recording and sharing stories much easier and quicker with the ability to reach a worldwide audience instantly. In trying to harness this power for educational purposes, educators must not only promote but also define an agreed-upon standard.

Abstract

The importance of storytelling as the foundation of human experiences cannot be overestimated. The oral traditions focus upon educating and transmitting knowledge and skills and also evolved into one of the earliest methods of communicating scientific discoveries and developments. A wide ranging search of the storytelling, education and health-related literature encompassing the years 1975–2007 was performed. Evidence from disparate elements of education and healthcare were used to inform an exploration of storytelling. This conceptual paper explores the principles of storytelling, evaluates the use of storytelling techniques in education in general, acknowledges the role of storytelling in healthcare delivery, identifies some of the skills learned and benefits derived from storytelling, and speculates upon the use of storytelling strategies in nurse education. Such stories have, until recently been harvested from the experiences of students and of educators, however, there is a growing realization that patients and service users are a rich source of healthcare-related stories that can affect, change and benefit clinical practice. The use of technology such as the Internet discussion boards or digitally-facilitated storytelling has an evolving role in ensuring that patient-generated and experiential stories have a future within nurse education.

Review

The history of storytelling and its success is used to introduced the idea that it can also be beneficial for the health sciences. Skills identified are:

• “Identifying key messages”
• “Summarizing and précising”
• “Communicating to an audience”
• “Attentive listening and group participation underpin attitudes such as respect”
• “Openness and a sense of being part of a team”

“Whilst storytelling in the generic or managerial education settings is focused upon the communication of organizational norms and values, nurse education differs in a desire to access stories that provide insights into healthcare experiences.” Advantages listed include:

• “cost effective”
• “is not dependant upon being literate”
• “does not require equipment or access to a reliable energy supply”
• “requires imagination”
• “requires understanding of the cognitive structures of the target society”

If used effectively in healthcare education, storytelling can develop advanced communication skills such as:

• “development of the skills required to follow a narrative thread, tolerating ambiguity and surrendering to the story”
• “the adoption of multiple and contradictory points of view”
• “an ability to enter the storytellers' reality and to understand how the story teller makes sense of that reality”
• “to gain insight into the use of image and metaphor”
• “to acknowledge the use of imagination in being transported to the storytellers' reality”

New technologies allow multiple methods in which stories can be shared by using photos, video, music, and voice.

Example: Patient Voices Programme

Haigh, C., Hardy, P.(2010). Tell me a story -- a conceptual exploration of storytelling in healthcare education. Nurse Education Today, Corrected Proof, Available online.

Decrowding Cirriculum

Article review from Nurse Education Today: Learning to let go: the challenge of de-crowding the curriculum.                     

Situation
1. “Provide an overview of learning-centered education as a context for de-crowding the curriculum”
2. “Present a method for de-crowding the nursing curriculum based on our assumptions and experience”
3. “Alert you to difficulties faced by nursing faculty who move from conventional to learning-centered education models with the consequent need to de-crowd the curriculum”

Background
Overwhelmed nurse educators respond to the amount of growing knowledge by adding more information to the curriculum without removing any content. Thus, time available for activities to develop student abilities in critical thinking, problem solving, and clinical decision making (skills necessary for graduates to function in today’s complex health care environments) is decreased.


Abstract
Nurse educators often lament there is not enough time to teach all the content students need to learn… Typically, educators…increase content without removing outdated information resulting in overcrowded courses. Little time is left for meaningful learning of concepts and life-long learning skills to sustain graduates throughout their careers. Innovation begins by shifting focus from massive amounts of content to teaching essential concepts and abilities necessary for today’s health care environment. Decreasing the overload of content is imperative when moving from a teaching centered to a learning-centered curricula. Instead of concentrating on rote memorization, students engage in meaningful learning. The challenge is to consider both faculty philosophical beliefs and assumptions about how students learn. The authors present an overview of learning centered education, a systematic method for de-crowding the curriculum, and a discussion of challenges encountered. (content shortened and italics added)

Review
The article discusses methods for teaching quality, not quantity, content.

• Provide an overview of learning-centered education
• Present a method based on assumptions and experience
• Identify difficulties faced by moving from conventional to learning-centered education models
• Offer possible solutions for making the transition less difficult
• Highlight examples of how faculty can overcome some of the obstacles

Dalley, K., Candela, L., & Benzel-Lindley, J. (2008). Learning to let go: the challenge of de-crowding the curriculum. Nurse Education Today, 28(1), 62-69.

Getting Help from Part Time Faculty

Article review of "Ready, set, teach! How to transform the clinical nurse expert into the part-time clinical nurse instructor."                        

Situation
“This article discusses issues that part-time clinical instructors face and proposes a checklist for orientation [staff nurses transitioning into the part-time instructor role].”

Background
Nursing students quickly learn how to work as part of a larger collaborative team. In many programs, qualified personnel shortages burden full-time faculty with heavy teaching assignments. As a result, part-time instructors are relied upon for clinical education and training.

Abstract
Many schools of nursing are hiring part-time clinical instructors with little or no teaching experience. Although they contribute greatly to student nurses’ clinical experience, many do not realize the commitment they are making when they accept such a position. If key issues are addressed before new part-time clinical instructors begin teaching, the transition could be made more smoothly. An in-depth orientation, awareness of the need for preparation for clinical rotations, and strategies to assist students in achieving course objectives can guide new instructors as they begin this venture. Preparing new part-time clinical instructors from the beginning will give them a more accurate picture of clinical education, increasing their recruitment and retention and providing students with quality learning experiences.

Review
The article list several suggestions along with supporting evidence. Many of the suggestions for programs hiring new part-time faculty (PTF) are listed below.

• “Be aware of the course content, objectives, learning outcomes, and sequence of courses”
  
• Possess copy of all course materials
  
• “Emphasize the application of classroom concepts” instead of relying on own personal experiences
  
• ifferentiate guidelines in working with licensed new graduate nurses and policies associated with nursing students. i.e. Medication Administration
  
• “Mentored guidance in selecting student assignments”
  
• “Keep a log book with the types of patients each student cares for”
  
• “Designate a set amount of time every week to plan for clinical activities”
  
• “Review information such as how to conduct a pre- or post-clinical conference”
  
• “Learn about the process of clinical teaching, grading, and helping students learn in the clinical setting”
  
• “Work with mentor to closely while grading those first few assignments”
  
  Adequate orientation and mentor support are thoroughly discussed. Although not mentioned, these suggestions hinted at possibly increasing faculty retention.
  
  Hewitt, P., &Lewallen P. (2010). Ready, set, teach! How to transform the clinical nurse expert into the part-time clinical nurse instructor. The Journal of Continuing Education in Nursing, 41(9), 403-407.
  
  
  
  
  

In the News: Better Times ahead

Students preparing to graduate are going to have to tough it out as they seek for employment.                                  

While only a few years ago, there seemed to be a nursing shortage panic, the recent economic downturn hits the health care industry hard. Adding to the problem, current research trends still indicate that extensive, and costly, new graduate training programs are still highly recommended.

The Washington Post recently came out with a news article highlighting ideas and tips for current students while suggesting hope for a future turn-a-round in nursing jobs.


Click here to read the article

Nurse Educator and Clinical Credibility

Article review from Nurse Education Today: The clinical credibility of nurse educators: Time the debate was put to rest (full reference below)

Situation: 
Nurse educators struggle to maintain clinical credibility. Teaching efforts and time commitment often limit clinical practice. Therefore, it is commonly argued that time away, causes skills to fade away. "This article ... argues that any soul searching on the part of lecturers in respect of clinical credibility is for the purposes of student learning an unnecessary distraction."