PME Module 4

I have been a nurse educator in the Bachelor of Science in nursing degree program for the past 7 years. During this time, I have witnessed great conflict in the ideologies and thereby curricular conceptions of my colleagues.  I was curious what philosophies or curricular conceptions might I find threaded through the various online nurse educator professional communities?  I decided to check-out the Canadian Association of Schools of Nurses as a starting point.  They had a list of specialized nurse educator ‘interest groups’; however, they wanted $50 for a registration fee… so I moved on.  I went to Facebook and found that there were many nurse educator professional groups to choose from.  I wanted to find one that demonstrated a high number of users, was currently active, was a ‘closed’ group, and that I felt would be of interest and helpful in my journey to evolve as an educator. 

Professional Community:

The online professional community that I settled on is “Teachers Transforming Nursing Education’ https://www.facebook.com/groups/transformnursinged/. I had no difficulty joining. There were three questions to answer, then a short waiting period (24h) to see if would be accepted, and then I was accepted and received a welcome notice from the facilitator of the group. 

I will copy the summary from the ‘About This Group’ page:

According to a recent study, despite passing the NCLEX, most graduate nurses (77%) are unable to think like a nurse. This is unacceptable and why the status quo of infobesity and passive learning in the classroom (spoonfeeding) needs to go!

Transforming nursing education is a process like the metamorphosis of a butterfly and requires teachers who recognize the need to change.

How do you transform nursing education?

One educator at a time!

If that’s you, then you have found a safe place to be supported, encouraged and learn from other educators who have stepped out of their comfort zone and were able to better prepare students for real-world practice as a result! This is a community to share, grow, and learn from each other!

This group is lead and facilitated by Keith Rischer (https://www.keithrn.com) who started his journey as an experienced nurse and new educator to transform nursing education after reading Educating Nurses: A Call for Radical Transformation in 2012 (https://www.facebook.com/groups/transformnursinged/about/)

The overarching message is that as nurse educators our responsibility is to teach clinical reasoning skills to prepare students for the realities of the profession.  The group leader and facilitator has created unique clinical reasoning case studies, tools, and the student textbook ‘THINK Like a Nurse’ (https://www.keithrn.com/strengthen-student-transition/) and educator text ‘TEACH Students to THINK Like a Nurse’ (https://www.keithrn.com/teach/) (these are not free).  The general posts within the group are to share ideas, ask questions, and post resources that all appear to be supportive of the premise that we need to assist our students with real-life clinical reasoning skills.

Analysis and relationship to course concepts:

As you can see from the opening statement, “despite passing the NCLEX, most graduate nurses (77%) are unable to think like a nurse.”  The philosophy of the professional group is one that does not support teaching to the test (or subject-based design) as being sufficient in preparing nursing students.   This got my attention.

What really attracted me to this group was idea of transforming nursing education to prepare students for the realities of the profession.  I believe there is great value in finding ways to teach students to ‘think’ like a nurse, and the book, ‘Educating Nurses: A Call for Radical Transformation’ by Patricia Benner (which inspired the founder of the group) asserts this as a necessary change to meet the evolving health care systems requirements. 

The philosophical base from which this type of idea arises is reconstructivism and pragmaticism.  The instructional objective of this educational philosophy is based on the needs of society.   In this case it is the needs of the health care system, and the thereby the need to adequately prepare nursing students to function within it, and over time, to improve it.

The curricular conceptions that most directly enact this philosophy are social reconstructive relevance, and the development of cognitive processes.  Social reconstructive relevance is described by Eisner and Vallance (1974) as having an emphasis on the role of education and curriculum within the larger social context.  What are the societal needs?  How do we best prepare student to be active and responsible members within that society?   How do I, as a nurse educator, best prepare my students to meet the needs of the health care system and to be active and responsible members within it?  The development of cognitive process is primarily concerned with the refinement of intellectual operations (Eisner & Vallance).  This professional learning community is highly focussed on how to teach the students clinical reasoning skills through the contextual case-study style learning activities.  The emphasis is on the development of specific cognitive skill development of clinical reasoning that can then be applied to real-life situations.

How does this play-out in planning, instruction and assessment?  I will be curious to see the specific recommendations that I uncover overtime interacting with this group.  For now, I will speak from my experience and knowledge of these curricular conceptions (from our course readings)for how this can be realized.

I believe that the best way to enact most of these conceptions is in a learner and problem-centered/Society focused design.

Planning will involve understanding the current needs of society and health care, emerging technologies, advancements in diagnostics, pharmacology, and the role and responsibility of the nurse within it.  Courses will have to be up to date with the emergence of new health care trends and expectations and include the intention of cognitive development through the planning of appropriate learning activities.  Planning to meet the individual learning needs of the students should be incorporated.  Back mapping, planning activities based on the desired outcomes would be appropriate.

Instruction will involve repetitive solving of contextual case studies to develop the desired clinical reasonings skills.   These case studies need to be based on, utilize, and integrate the most current information available in the health sciences.  Real life application occurs and is facilitated by the clinical instructor in the care setting (hospital/residential/long-term care). Formative assessment to inform ongoing evolving lesson plans would be appropriate to ensure instruction is meeting the individual needs of each student.

Assessment should challenge students to demonstrate the clinical reasoning skills for which the instruction was based (back-mapping).   For learner centered design, specific meaningful feedback will be essential to the individualized growth of each student.  According to Hayes, (2003) problem centered and society focussed designs will assess the students “capacity to exercise judgement and responsibility in matters of morality, ethics and social justice (p.230). 

I am excited to see what learning I can gain from participating in this community.  I must admit that I was attracted to it as it is in line with my philosophies and pedagogy.  I teach applied nursing science and use a multitude of application type activities including case studies and simulation.   I believe that I can be an active member and contributor to this group.  I have suggestions for many of the discussion questions, and I have already downloaded a learning activity that was posted.   I believe my involvement will benefit my practice as a nurse educator, and I will have the opportunity to assist others. 

References:

Hayes, D. (2003) Making learning an effect of schooling: aligning curriculum, assessment and pedagogy, Discourse: studies in the cultural politics of education, 24(2), 225-245McNeil, J. D. (2009).  Contemporary curriculum in thought and action (7th ed.).  Hoboken, NJ:  John Wiley.  Pages 1, 3-14, 27-39, 52-60, 71-74.

Ornstein, A. C., & Hunkins, F. P. (2013). Curriculum: Foundations, principles, and issues (6th ed.). Boston, MA: Pearson.  Read Chapter 6, pp. 149-173.

Shepard, L. A. (2000). The role of assessment in a learning culture. Educational Researcher, 29(7), 4-14. doi:10.3102/0013189X029007004

Sowell, E. J. (2005). Curriculum: An integrative introduction (3rd ed., pp. 52-54, 55-61, 81-85,103-106). Upper Saddle River, NJ: Pearson.