Archives: Flexible Learning

Event invitation: Journal and Book Club Brown Bag

April Journal club

Maura MacPhee, Elizabeth Kenny McCann Education Scholar, will lead the discussion of a paper* on analytical rubrics.

*Shipman, D., Roa, M., Hooten, J., & Wang, Z. (2012). Using the analytic rubric as an evaluation tool in nursing education: The positive and the negative. Nurse Education Today, 32,246-249.

Read about past brown bags here:

March: https://blogs.ubc.ca/teachingmatters/2015/03/19/recap-case-base-learning-and-simulation-brown-bag/

February: https://blogs.ubc.ca/teachingmatters/2015/02/24/recap-threshold-concepts/

 

Question? Comments? Suggestions?

Contact:
Khristine Carino, DMD, PhD

Flexible Learning Coordinator

School of Nursing | Faculty of Applied Sciences | The University of British Columbia

khristine.carino@ubc.ca

 

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Recap: Case-base learning and simulation brown bag

march 17 imageBy Maura MacPhee

Please see the outline of key points from the March 17th Brown Bag article. We had a good discussion about using case-based learning and high fidelity simulation in our undergraduate nursing program. We also discussed the importance of having measurable indicators for student competency assessment. We are currently working on a project in the School of Nursing to level core practice competencies so that we can better assess student learning gaps and provide supports proactively—before students get too far along in the program. Stay tuned…. Maura

 

EKM Brown Bag March 17, 2015

Raurell-Torreda, M., Olivet-Pujol, J., Romero-Collado, A., Malagon-Aguilera, M., Patino-Maso, J., & Baltasar-Bague, A. (2015). Case-based learning and simulation: useful tools to enhance nurses’ education? Non-randomized controlled trial. Journal of Nursing Scholarship, 47(1): 1, 34-42.

Key findings from article

  1. European Schools of Nursing are trying to standardize education and licensure requirements. Bologna Process-European Ministers of Higher Education.
  2. Shift from rote memorization to focus on competencies needed for safe practice.
  3. Came up with 6 categories.
  4. Exploration of methods to best teach core concepts/competencies. Problem-based, cooperative, case-based, role play, simulations.
  5. Case-based learning and simulation used in this article.
  6. Case-based: students feel more connected to reality and learn how to plan for care delivery. Increases autonomy, bridges theory-practice, increases student motivation. Considered the best ‘low tech’ way to help students integrate and apply competencies (KSA)
  7. Simulation-main principle is safe practice with debriefing/feedback. Decreases pressure.
  8. In the US, the National Council of State Boards of Nursing have been using simulation to help prepare students for making accurate decisions, work in team, communicate better, consider outcomes of incorrect choices.
  9. Used Lunney’s (2010) case study outline to create cases for 8 areas of nursing knowledge:
  10. Medications, med diagnosis, history, current disease info, nursing diagnostics, intervention, physician orders, lab data and tests (p. 36)
  11. Students worked in groups of 3-5 students to do a care plan.
  12. Randomly assigned to groups of 2-3 for simulations.
  13. “Blinded” professor scoring performance of Yes/No
  14. Used 5 purchased medical-surgical scenarios from NLN.
  15. Student/nurse performance was scored for:
    1. Patient safety and communication
    2. Patient assessment
    3. Recognition of signs and symptoms
    4. Problem identification
    5. Nursing diagnostics and interventions to address key problems
  16. Findings:
    1. Experimental better than Control group on patient assessment
    2. Experienced nurses superior on nursing evaluations and interventions to Controls: same as Experimental group
    3. Nurses with more years of experience did better with assessments and interventions.
    4. Trend: Both groups of students outscored nurses on patient safety (e.g., rules-based policies, such as checking ID bands, allergies)
    5. Trend: Control group showed worse critical thinking than the other two groups

 

Design

Control (Traditional classroom)→simulation performance: 80 minute lecture and discussion (66)

Experimental (Case-based)→simulation performance. 50 minute lecture/discussion and 30 min case work (35)

Experienced nurses→simulation performance (59)

Students 2nd year in clinical core course: Adult Patients 1. Had not had any clinical practice in hospital. Course focus is on nursing process.

OSCE with checklist-tested it for validity/reliability.

Implications from Authors

  1. Assessment is considered the most critical phase of nursing process—identifying the problem. (American Association of Colleges of Nursing, 1998).
  2. Case-based learning may be one way to help students standardize patient assessment protocols (and other aspects of nursing process). Students need to “always receive patient information in the same manner and learn to structure this information systematically” (p. 40).
  3. Case-based learning resulted in superior assessment skills among students; some evidence of enhanced critical thinking skills.
  4. Patient safety needs to be taught in schools of nursing-and reinforced in practice to ensure transfer of learning. If patient safety standards are not being consistently met by nurses in practice, simulations for students and nurses should be used to reinforce patient safety practices.
  5. Case-based learning should be used in tandem with simulation. “…the student who fails in a simulation will most likely not be competent in clinical practice. Therefore, we must identify the category in which failure occurred in order to strengthen aspects of the undergraduate curriculum and apply this feedback to improve academic preparation of students entering the professional environment.
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Workshop summary report: How to “Flex” your way with teaching and learning innovations

By Maura MacPhee

What: Teaching Scholarship/Flexible Learning Workshop
When: February 11, 2015 (1:00-4:00 PM)
Where: Rm T182, UBC School of Nursing

dan pratt workshop posterGuests: Dan Pratt, Jeff Miller, Namsook Jahng, Lucas Wright

Participants included: Academic/Clinical faculty and teaching assistants from SoN; practice partners from Fraser Health Authority and Providence Health Care.

In a nutshell: We worked in small groups throughout the afternoon—interspersed with large group discussions. We began with a simple exercise to share people’s perspectives of flexible learning: “Create a title/description of flexible learning in 6 words.”  The consensus was that flexible learning provides opportunities for teachers to better meet the needs of adult learners with diverse backgrounds at different stages of learning. By the end of the day, participants discovered that flexible learning strategies provide pedagogical and logistical flexibility.

Several nursing faculty contributed examples of how they are using flexible learning in their courses: Joanne Ricci and Ranjit Dhari from community/public health (N336); Farah Jetha and Cathy Ebbehoj from maternal care (N333); Lynne Esson from adult medical/surgical care (N337); Maura MacPhee (myself) from leadership, ethics and policy (N306); and Suzanne Burns from the undergraduate capstone project (N344)—Suzanne is an affiliate faculty with the School of Nursing.

The faculty agreed that flexible learning can be very useful when content is complex and difficult to deliver through lecture; when subject matter experts are difficult to schedule into the students’ tight class schedules; or when specialty courses, such as community health, repeatedly offer the same content in 6 week blocks (e.g., dental health). In these instances, it’s been helpful to use online videos of lecturers or course content that students can watch as many times as needed to familiarize themselves with the content. To assist student learning, these online content/lecture modules need to be accompanied by “guiding questions.” As a follow-up, class time should be used for student and faculty engagement– for deeper discussion, for clarification of any misconceptions.

Dan Pratt stated that this approach allows faculty to use class time for “teaching students about real-world applications” through shared problem-solving (e.g., cases to work through individually/in small groups). Class time should not be wasted through delivery of passive content.

Faculty examples also demonstrated how traditional testing or evaluation is transformed through flexible learning approaches. According to Dan, “testing is re-positioned for learning.” By embedding quizzes and questions in online content or by doing quizzes in class for participation grades, students have an opportunity to gauge their own learning. Formative feedback to students gives them more responsibility for their own learning. Dan referred to this as “self-regulation.” Lynne Esson pointed out how we can use our NCLEX preparatory materials and practice quizzes (e.g., the ATI), to enhance students’ independent learning.

Ranjit shared that when community health lectures were converted to online modules with guided questions and practice quizzes, class time was also freed up for office hours. Since then, more students have come to her with specific learning needs that they have identified on their own.

Dan described how flexible learning approaches complement the theory of “zone of proximal development” (ZPD). The ZPD is a zone where learners grow and develop. This is the zone between what students can do on their own and what they can’t do. In the ZPD, teachers can employ flexible learning strategies (in class, outside of class) that close the gap between do/can’t do. Note: The concept of ZPD is credited to a Russian psychology, Lev Vygotsky.

Lucas Wright and Namsook Jahng from the Centre for Teaching and Learning Technology (CTLT) showed how they have assisted faculty with the redesign of their course websites—to improve navigation and usability of content on these sites. They also provided examples of traditional lecture content that they helped convert into online modules for students to view and re-view outside of class.

Groups shared ideas for incorporating flexible learning into their course work. One issue for further discussion: How can we use flexible learning to enhance teaching in clinical contexts? For students, new grads, continuing education? There was consensus from the group that we need to work collaboratively (clinical and academic faculty, practice partners) for better educational outcomes. Too often-we separate theory from practice. One promising area for collaborative work: deciding on “threshold concepts” for new learners in nursing.

As described by Dan, threshold concepts are absolute or core concepts that transform how people think about a given topic or area of knowledge. What are those threshold concepts that transform students’ perception of nursing? Dan also referred to these concepts as “troublesome knowledge” that students must work through (to become nurses). Dan tasked the group with identifying 2-3 threshold concepts of significance to nursing. In addition, he emphasized that we have a choice: rather than transferring passive knowledge, flexible learning approaches may enable us, as educators, to assist students with knowledge transformation around a few threshold concepts: student transformation to nurses. Note: For more on threshold concepts, see the work of Jan Meyer and Ray Land.

Dan is well known for his work with the Teaching Perspectives Inventory (TPI). http://www.teachingperspectives.com/tpi/. Participants were asked to complete their TPIs to share with Dan during the workshop. Dan provided us with a snapshot of our teaching perspectives profiles-there were two predominant camps: a) nurturing (caring, encouraging, supporting students); and b) apprenticeship (skill practitioners who role model for new learners). Dan challenged us to examine our TPI scores: “Are there incongruities between your beliefs about teaching and flexible learning? “ It’s important to be aware of our own biases and potential resistance to new teaching approaches.

Jeff Miller helped to facilitate discussion about use of flexible learning resources at UBC and we closed with an overview (a flow chart) of supports/resources available in the School of Nursing, the Center for Teaching and Learning Technology, and Applied Sciences (e.g., Learning Tech Rovers). A good place to begin your potential course conversion: contact Dr. Khristine Carinothe, SoN Flexible Learning Coordinator at khristine.carino(@)ubc.ca

Dan had one final comment—he urged us to check out a book called, Make it Stick: The Science of Successful Learning by Brown, Roediger & McDaniel. Khristine is ordering a few copies of the book to be available to faculty as an EKM resource. Note: Khristine will be setting up a small library of hard copies of articles, books, etc., that she will be housing in T280. We’ll post available resources on the Teaching Matters Blog.

Many thanks to the workshop participants-everyone was engaged and enthusiastic. A great place to begin…

 

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Welcome 2015—a message from the new EKM Scholar

Maura ImageHappy 2015!!!

I am Maura MacPhee, the new EKM Scholar for UBC School of Nursing.

Thank you to Bernie! I would like to acknowledge Bernie’s many contributions to teaching and learning scholarship within the UBC School of Nursing (SoN), the UBC community and the greater academic community. Bernie and I have done several teaching/learning collaborations in the past, and we will continue to do so—to smooth the transition of the Elizabeth Kenny McCann (EKM) scholar award from Bernie to me. Our official hand-over happens on February 10th.

I would also like to acknowledge Dr. Khristine Carino, the Flexible Learning (FL) project coordinator for the SoN. Khristine’s appointment lasts through July 2015. Khristine and I are in the process of assessing learning outcomes related to FL activities within the SoN—and planning new FL projects with our faculty. We are working closely with CTLT and the Learning Tech Rovers. Khristine is located in the SoN Rm T280 beginning Feb 21st. You can contact her at khristine.carino(@)ubc.ca

Plans for this Blog: I would like to encourage critical discussion of teaching/learning scholarship. The value of the Blog is its capacity to share ideas and pose questions among a community of teaching/learning scholars.

My Confessions: I am a learner-not an expert in education. My expertise is healthcare leadership—I do leadership development, and I use a variety of adult learning strategies to engage healthcare professionals in their own and others’ leadership development. I am always interested in teaching/learning innovations I can apply to leadership. I confess that I try out new pedagogical approaches on my undergraduate and graduate students—to see what works with them.

Questions for You: I do health services research and program evaluation. Change is constant in healthcare, and leaders have to know how to assess the impact of change on the quality and safety of healthcare delivery. There are specific assessment techniques that we use in healthcare.

How about in education? I’ve been surprised by the lack of formal assessment related to changes in course content, learning activities, and learner evaluation.

Q: When you make changes to your course work or curriculum, what assessment strategies do you use?

Q: Do student grades and feedback provide us with enough information?

Q: What else is needed to ensure an effective impact on student learning?

EKM Activities to be continued from Bernie’s leadership:

  • Monthly brown bags with informal discussions of scholarly articles
  • Mini-workshops with UBC ToL scholars and guest speakers from outside UBC
  • Research awards/scholarships for students and faculty to support educational innovations and educational research
  • An annual EKM forum (usually November, December) to build ToL connections

New Projects:

Collaborative work with the UBC Flexible Learning (FL) team and the UBC Community Engagement team. Stay tuned….

 

 

 

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