1. Why Not Try TBL to Improve Student Nurses Clinical Reasoning & Communication? Tracy L. Brewer, DNP, RNC-OB, CLC Crystal Hammond, MSN,CNM Deborah Ulrich, PhD, RN
Introduction
Nursing has long been searching for creative ways to assure students’ abilities to improve clinical reasoning and communication.
Strategies to relate didactic content to clinical application has been a challenge for nursing educators.
Students entering the clinical site are ill prepared to connect concepts from didactic lecture for clinical application.
An immediate need for change in pedagogical strategies was identified.
Year Class Taught
Number of Students in course
Mean Course Grade
Mean OB Specialty HESI
National Mean OB Specialty HESI
Course Changes
Winter 2010 97 79
759
833
First time Dr. Brewer and Crystal Hammond taught course together
Completion of Evolve case studies was optional
Taught traditional lecture format in 10 week quarters
Spring 2010
110 80
741
Completion of Evolve case studies became mandatory
Winter 2011* 78 83
888
839
Traditional lecture format with added NCLEX type questions during lecture with verbal audience response*
Winter 2012 98
895
840
Introduced high & low fidelity simulation to a pilot group of 16 students
Conducted a final exam review session
Fall A 2012** 44 89
921
867
Converted to semesters with 7 weeks of OB and 7 weeks of PEDS
Introduced team-based learning** in the class room
No care plans in clinical, but 5 reflective journals related to QSEN competencies.
All students attend high/low fidelity simulation
Fall B 2012 39 87
912
Spring A 2013 41 88
942
Peer evaluations were added as part of the total grade
Spring B 2013
970
The Steps to Success
Grading Scale
93.0 –100 = A
84.0 – = B
75.0 – = C
66.0 – = D
< = F
**TBL Started
*Interactive Teaching
The Steps to Change
Commitment and perseverance to change teaching strategy to team-based learning (TBL) despite others saying it could not be done
Full support of administration
Development of iRATs, gRATS, & applications
Selling the TBL strategy to the students through a TBL orientation
Doing it!
Conclusions
Students receptive to TBL stated, “I felt like I really learned how to think like a nurse!”
Some students felt there was too much time spent out of class for preparation.
There was more resistance to implementation of TBL by faculty colleagues NOT teaching in the course than students who participated in the course using TBL strategies.
TBL strategies improved overall course grades, standardized test scores, clinical reasoning, and communication.
Further assessment of student learning and performance in the TBL environment is needed.
Implementation
Nursing students participating in TBL applications
Faculty Goal
**TBL Started
*Interactive Teaching
Acknowledgements
Dr. Dean Parmelee, Associate Dean of Academic Affairs, Boonshoft School of Medicine Wright State University for his continued mentorship with implementation of team-based learning.
NUR 3440 Nursing Students!
Each team decided on a team name based on OB concepts