1. Use of the Flipped Classroom To Think Like a Nurse Connie Barbour, MSN, RN Georgia Highlands College Doctoral student at University of West Georgia Email: connbarb@comcast.net

2. Introduction  Classroom – practice gap exists Institute of Medicine (2011) and the National League for Nursing (2005) Evident by graduate nurses struggle with the transition from school to practice  Objective in nursing education is to promote a successful transition from school to practice for nursing graduates  Integrating the student’s clinical experiences into the classroom promotes the use of clinical judgment in the classroom

3. Introduction  Previously, didactic lecture was the delivery method used by the educator This method of teaching can make it difficult for students to transfer their knowledge from classroom to the clinical setting This is because they are not actively using the skills which are being promoted in the content (passive learner)  Use of the “flipped classroom” promotes the use of active learning strategies which in turn promotes application of knowledge

4. Description of the Learning Environment  Flipped Classroom Been used in the K12 and college settings effectively Content that was previously delivered using a traditional lecture is now completed outside the classroom as “homework” The time spent in the classroom remains the same; however, active learning strategies are now the focus Benefits increased test scores increased levels of learner engagement increased awareness of personal learning and metacognitive skills as well as creating more meaningful interaction with the course content

5. Hughes, H. (2012). Introduction to flipping the college classroom. In World Conference on Educational Multimedia, Hypermedia and Telecommunications (Vol. 2012, pp. 2434–2438). Retrieved from http://www.editlib.org/p/41097/

6. Description of the Learning Environment  Why the Flipped Classroom Challenges nursing students to use higher order thinking which is necessary to improve their critical thinking skills Critical thinking skills are primary in building the necessary clinical judgment skills used by nurses critical thinking in nursing students can be increased by using active learning strategies Hoffman (2008) stresses that active learning strategies “equip students in learning ‘how’ to find the answers, not merely ‘what’ are the answers” (p. 234). In other words, practicing clinical judgment skills helps the student “think like a nurse”

7. Adult Learning Principles  Knowles, Holton, and Swanson (2011) 1.Adult learners need to know why and how the learning is beneficial to them 2.The educator need’s to considered the adult learner’s self-concept of learning 3.Adult learners come with prior experiences that impact their learning 4.The adult learner needs to be ready to learn 5.The learning needs to be relevant and applicable to the adult learner (orientation to learning) 6.The adult learner’s motivations need to be considered

8. Adult Learning Principles Applied to the Learning Environment  Need to know Instructor provides a narrative story in the online lecture on what it means to “think like a nurse”. Vocalize the need to close the classroom-practice gap by empowering students to be thinkers and not just test takers Students need to be encouraged to transition from dependent learners to self-directed learners and life –long learners  The learner’s self-concept Highlighting the role transition the student needs to make to practicing nurse by using the reverse case study and concept mapping “Think Like a Nurse”

9. Adult Learning Principles Applied to the Learning Environment  Build on the learner’s prior experiences Gained in the fundamentals course Skill of measuring blood pressure Previous clinical experiences ARS multiple-choice question learning activity Reverse case study and concept mapping will also build on the learner’s prior clinical experiences

10. Adult Learning Principles Applied to the Learning Environment  Motivation Knowles et al. (2011) points out that motivation for adult learners is not passive but that learners need to take responsibility to be active with their readiness  The learning activities will motivate the students to Increase their clinical judgment skills Prepare them for their licensure exam Ultimately be a graduate nurse who is ready for the demanding healthcare environment that exists today

11. Learning Activities  Online, audiovisual PowerPoint Content as “homework” – flipped classroom  Student submits one multiple choice question with rationale to instructor for in class activity  Use of audience response system (ARS) with student generated multiple choice questions  Reverse Case Study Small group work Generate the case study Plug into a concept map

12. Reverse Case Study & Concept Map 3 Sentence Patient Scenario (GIVEN to students) Medication List (GIVEN to students ) Previous History (student to fill in) Assessment Data (student to fill in) Nursing Diagnosis (student to fill in) Interventions: Nursing and Collaborative (student to fill in) Lab/Diagnostic Tests and Results (student to fill in ) Outcomes from interventions (Student to fill in )

13. Research Gaps and Future Nursing Education Research  Flipped classroom has been successfully used in K12 and higher education settings “flipped classrooms” in the nursing literature – only 2 studies exist  Flipped classroom method needs to be studied in pre licensure nursing programs to teach content topics such as fundamentals, pharmacology, and medical-surgical concepts  Future research needs to clarify the differences between blended, hybrid, and flipped methods of presenting course content  Nurse educators need to determine the best methods to implemented with pre-licensure core nursing concepts to provide effective instruction that adequately prepares graduate nurses for practice.

14. Closing the Gap  The IOM (2011) has challenged nurse educators to close the classroom – practice gap Nurse educators can no longer rely on delivering content laden curriculums using traditional lecture style delivery methods  Nurse educators need to implement active learning strategies that use andragogy principles To improve the critical thinking and clinical judgment skills in pre- licensure nursing students Doing these things will prepare students to “think like a nurse”  This flipped classroom method will Implement active learning strategies congruent with andragogical principles to improve clinical judgment nursing students The learning activities will bring clinical experience into the classroom, provide nursing students with the opportunity to practice making clinical judgments Address the classroom-practice gap

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