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New Directions in Teaching and Learning Within Nursing Education New Mexico Statewide Nursing Faculty Conference June 3-4, 2009 Jean Giddens, PhD RN, Professor.

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Presentation on theme: "New Directions in Teaching and Learning Within Nursing Education New Mexico Statewide Nursing Faculty Conference June 3-4, 2009 Jean Giddens, PhD RN, Professor."— Presentation transcript:

1 New Directions in Teaching and Learning Within Nursing Education New Mexico Statewide Nursing Faculty Conference June 3-4, 2009 Jean Giddens, PhD RN, Professor Interim Senior Associate Dean for Academic Affairs College of Nursing, University of New Mexico

2 Student Centered Learning Decades of educational research have shown that learning is most effective when……. Students are engaged Learning incorporates emotion Learning activities are purposeful and perceived by students as useful

3 Integrative Teaching Integrative Teaching is practice of minimizing the distance between theory and clinical instruction. Benner calls integrative teaching a “signature pedagogy” of excellent instructors

4 Emergence of New Paradigms Conceptual Approaches to Teaching and Learning Virtual Experiential Communities Student centered learning Integrative teaching


6 Example: Concepts as Categories  What concepts do the shapes below represent?  What other concepts can you identify?

7 Example: Concepts as Categories

8 What is Conceptual Teaching and Learning? The difference between concept- and content- focused learning is… “the difference between facts of the Alaska oil spill and an understanding of the importance of environmental sustainability” (Erickson, 1998 p. 50).

9 Conceptual teaching means…. Focusing on big ideas – students anchor to specifics. Fostering deep learning, and deep understanding through connections and reflection (as opposed to surface learning). Developing student-centered learning with a purpose.

10 PneumoniaCOPD Anemia Pulmonary Edema Pnuemothorax Oxygenation PE RSV RDS AMI Asthma

11 Pneumonia COPD Oxygenation RSV Asthma Other Concepts Other Exemplars

12 Teaching Conceptually Focus on Concept Exemplars provide content knowledge interrelated concepts Application of content to interrelated concepts other content to the concept Application of other content to the concept

13 Concepts for Nursing Education In nursing education, a concept should be clinically useful to guide student learning and clinical practice. What are the Concepts for Nursing Practice? Concepts vs. Exemplars Concepts vs. Medical Diagnoses

14 Additional Thoughts on Conceptual Teaching A focus on concepts in itself does not guarantee conceptual learning. active Faculty must adopt active learning strategies to enhance conceptual learning. Ideally, concepts are woven throughout the curriculum - incorporated into clinical and didactic courses.

15 Hypertension ASHD Renal Failure Diabetic Retinopathy Peripheral Neuropathy Peripheral Artery Disease Example: Long-term complications of DM How could you teach this so students can understand the underlying concept or concepts could explain this?

16 Example: Skill Acquisition- Securing an IV Catheter What concept(s) apply? How could you apply this to your skills lab teaching? After starting an IV, what steps are necessary to properly secure the IV?

17 What is a concept-based curriculum? Concepts provide organizational structure for the curriculum and courses. Concepts represent nursing practice. Concepts drive content through selection of exemplars.

18 Courses and Course Objectives Class SessionsClass Session ObjectivesClass Learning Activities Level Objectives/Competencies NURSING PROGRAM Mission StatementGoalsPhilosophy INSTITUTION Mission StatementGoalsPhilosophy CURRICULM FRAMEWORK

19 Knowledge, Concepts & Theory Knowledge is represented through concepts Concepts are building blocks of theory THEORY Concept Knowledge

20 Hallmarks of “Good” Concepts for Curriculum and Teaching? Represent important spectrum of conditions or situations representing nursing practice Logical and used consistently Useful for education Application across multiple courses and contexts

21 Benefits Content management Focus on concepts as opposed to content Emphasis on learning Focus is on Nursing Concepts cut across disease categories and populations Emphasis on recognition of concepts across populations and practice settings

22 Drawbacks Resistance to change Requires a different level of organization Students may be resistant (at first) Lack of literature detailing steps What about NCLEX?


24 Mr. Ocampo Mr. Ocampo is short of breath, experiences intermittent chest pain, and is fatigued. He obviously should seek medical attention, but he won’t. Why won’t he seek medical care?

25 Anthony Martin Anthony Martin has been arrested for indecent exposure at a local park. He is taken to the ED because he is combative and disoriented. What is causing Anthony to act this way?

26 Kelsey Young Kelsey Young has a new baby sister. What is Kelsey's family like? Does she have adequate support systems? What things trouble her?

27 What is a Virtual Experiential Community? Extension of technology-enhanced learning Representation of individuals in context of community setting – with impact to group and individuals. In health care, focus on individuals and health related issues and health care providers. Examples: The Neighborhood (USA) Stillwell (UK)

28 Giddens - ODU, 2008

29 Household Characters – 34 characters who live in 11 households within The Neighborhood. – Character stories reflect health-related situations based on incidence and prevalence. – Stories reflect individual and family responses to health-related problems over time. – Stories told from the perspective of the character.

30 Nurse Characters 6 featured nurse characters that work in 4 health- care agencies – 3 Hospital Nurses, School Nurse, Midwife, Geriatric Nurse in senior center Stories reflect contemporary issues in nursing practice and issues within the local community. Stories of household characters interwoven into nurse stories as applicable.

31 Biographical Information  Each character has biographical information that serves as an introduction.  Updated each semester to reflect previous semester story.

32 Weekly Story Each character has a story update each week. Stories unfold weekly over 3 academic semesters.

33 Photos & Video Clips  Stories are extended with photos, and video clips as applicable.  These media enhance understanding beyond text.

34 Medical Record Abbreviated medical records included to provide an understanding of health care.

35 Newspaper The newspaper links individual characters to the community Is reflective of contemporary social, ethical, and health related issues.


37 Changing the Focus and Context Focus shifts away from content and toward the characters’ lived experiences Context is story of individual and relationships within the home, community, and health care settings. Enhanced understanding of issues associated with vulnerable populations and individuals with complex, chronic conditions. Enhanced understanding of diversity (i.e. cultural, age, socioeconomic, sexual orientation).

38 Comparisons – Heart Failure Traditional Approach -A & P -Pathophysiology -Signs/Symptoms -Dx tests -Treatment -Nursing Interventions & patient teaching Virtual Experiential Communities -Story of individual with HF -Story depicts issues associated with disease management and navigating health care system -Multimorbidity -Changes in status depicted time over weeks; acute exacerbation not primary focus of story – just an event within the story. Context = acute phase; perspective of the nurse Context = daily life; perspective of individual

39 What is the Link to Nursing Clinical Judgment Model (Tanner) – Notice (potential for problem) – Recognize (problem has developed or is developing) – Respond (nurse knows what to do) – Reflection-in-action – Reflection-on-action Health Promotion Model – Primary Prevention – Secondary Prevention – Tertiary Care PHASE OF NURSING CARE

40 Common Teaching Strategies Incorporated in Lecture Case Study Role Play Games Care Plan Creative Writing Simulation Compare and Contrast Concept Map Debate Concept Analysis Policy Analysis

41 What Do You Want Students To Do? Individual Assessment Family Assessment Community Assessment Calculate medication dosages Analyze medication or treatment plan Develop a Care Plan Develop a Teaching Plan Identify Risk Factors Identify Interventions Evaluate Interventions Hold a Team Meeting Analyze a Medical Record Plan a Home Visit Analyze payment structures Develop a Policy or Protocol Propose a Community Health Plan Identify a researchable problem Apply principles of ethics to an ethical dilemma Apply evidence-based standards to situation Develop Discharge Instructions Plan a Health Fair Identify Safety Hazards Learning Activities that are Purposeful



44 Outcomes and Evidence Research conducted at pilot sites Fall 08 – Perceived engagement – Perceived benefits (students) – Perceived benefits (faculty) Future research ??? – Faculty work-life – Enhance cultural competence – Differences in health care delivery

45 Alternative Applications Population specific virtual communities Application for multidisciplinary health care education Application for other disciplines – K-12 – Social Work – Construction Management

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