Effective Teaching for Health Professionals

Introduction

One of the most important responsibilities of an educator is selecting teaching and learning strategies that are related to the desired aims and outcomes of the curriculum, appropriate to the student’s level of skills and knowledge and challenging enough to motivate learning (Gardner & Suplee, 2010). The curriculum that I have designed for ‘Professional Certificate in Musculoskeletal Casting and Splinting’ will be integrated into the ‘Certificate in Emergency Nursing’ course in Waterford Institute of Technology; it will be worth 10 ECTS credits, Level 8 NQF with 200 contact hours for the students.

Rationale for proceeding

Having completed a comprehensive review of all the courses available in Ireland for nurses, I found the only one in Ireland is in the Royal College of Surgeons Ireland (RCSI) in Dublin, which would make it less accessible for nurses around the country. The rationale for the proposed curriculum is as follows:

• There is a substantial need for orthopaedic education in the South East of Ireland.
• There is only one available course like my proposed curriculum that is available in Ireland which is in Dublin and as previously mentioned is less accessible to nurses outside of Leinster.
• To provide a quality service to patients.
• To reduce the financial costs to the Health Service Executive (HSE) by giving nurses specialised education. According to An Bord Altranais (2000) it is essential for each nurse/midwife to engage in continuing professional development following registration in order to acquire new knowledge and competence, which will enable him/her to practice effectively in an ever changing health care environment.

Teaching and Learning Strategies

Fink’s model for course design (2003, 2004) can be used to develop new courses or redesign existing courses. As I was considering how to design my Professional Certificate in Musculoskeletal Casting/ Splinting I came up with 7 learning outcomes (see Appendix 1). The choice of learning outcomes was personal and based on research in the area of teaching and learning. Based on my previous experiences in the classroom, I wanted to get away from all lecture-based learning; this was achievable by having a limit of 15 students for the curriculum. As a nurse, I have a wealth of case studies to draw upon. My aim is to get students to respond well to real-life examples. In addition, I really liked the idea of building the skill base of my students in the hopes that they would take those skills with them beyond the classroom. The teaching-and-learning literature strongly emphasized the enjoyment and benefits of active learning (Goss Lucas, 2008; Knight, 2008).

I turned to Finks (2003) taxonomy which provides the structure for assessing both course content and higher order thinking in six taxonomies which include;

1. Foundational knowledge
2. Application
3. Integration
4. Human dimension
5. Caring
6. Learning how to learn

Instead of assessing the learning outcomes (see Appendix 1) through context based examination, I designed the curriculum to incorporate assessment through the six taxonomies as mentioned above (see Appendix 2). Foundational knowledge will be assessed through a multiple choice question examination. Application and integration will be assessed through case studies in the online discussion forums. Here the students will be presented with real life problems and will be asked to show understanding and knowledge of same. Human dimension will be assessed through the written assignment which will incorporate new ideas and insights. Caring will be assessed at the end of the curriculum when the students will be asked to write a reflective piece about the course, its content and humanity in general.

Effective teaching is imperative for student learning. Clinical application for students in which classroom learning is continued into professional practice is critical to nursing education programmes. The clinical learning environment can significantly impact student learning. Sharples et al (2012) states that “seamless learning occurs when a person experiences a continuity of learning across a combination of times, technologies or social situations”. As facilitators of nursing education, we need to ensure that our learners are processing the new knowledge delivered to them through our educational programmes (Xu, 2016). As nurse educators, it is important that we recognize and select appropriate teaching strategies in order to engage our learners and ensuring that they effectively process the information that we are teaching them to deliver high quality education.

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Blended learning will be used throughout the curriculum. Higher Education Academy (2017) states that blended learning can be used to deliver course content using a wide variety of methods including online activities, face to face interaction and ‘flipped classroom approach’. Chen, Lui & Martinelli (2017) believe that the ‘flipped classroom approach’ in comparison to traditional teaching methods where students attend a lecture, tutorial or seminar, where the learning is delivered to the students during and after the teaching, the flipped classroom turns this round so that most learning comes first, allowing the teaching session to reflect on the material and build on prior learning. Students will participate in a wide variety of assessments with different weighting for the course (see Appendix 2).

The teaching strategies that I have chosen for my curriculum are;

Online course content/ E-learning videos

Online learning can be defined as learning that takes places partially or entirely online (Grant & Courtoreille, 2007). It is helpful to nurses due to its flexibility, accessibility and cost effectiveness. The Professional Certificate in Musculoskeletal in Casting/ Splinting will be aimed at new graduates or “Generation Z”. Geck (2006) states that Generation Z students are the most electronically connected generation. Online course content will be posted every week.I will release specific readings in the resource area every week that will correlate with the next class content. By doing this I design to contribute to the student’s ability to develop critical thinking to the subject. These will be released 5 days prior to each class and will be discussed during the scheduled tutorials.

Concept Mapping

A concept map is a graphic arrangement of key concepts related to patient care. The use of concept maps can help to cover content, student assessment and knowledge. This type of learning strategy is great for visual learners. This learning strategy helps learners to note the ways that different ideas interlink. Concept maps can help students acknowledge their current understandings and form new ideas (Senita, 2008). Concept maps help learners to organise or process their knowledge logically. Each week there will be a different topic for the students to develop a concept map for e.g. care of an orthopaedic patient, orthopaedic emergency etc.

Concept maps have many uses in the clinical learning environment. Firstly, the students will be asked to complete a concept map from their pre class reading, allowing them to link new information to their patients. Vacek (2009) believes that the readings the students complete contain a vast amount of information, concept maps allows students to process the information in a meaningful way, linking new and existing ideas.

Objective Structured Clinical Exam (OSCE)

Objective structured clinical examinations (OSCEs) have been used for many years within healthcare programmes as a measure of students’ and clinicians’ clinical performance. OSCEs are a form of simulation and are often summative but may be formative. This educational approach requires robust design based on sound pedagogy to assure practice and assessment of holistic nursing care. An OSCE provides a mean of evaluating performance in a simulation laboratory rather than in the clinical setting. Newble & Reed (2004) identify three different types of stations that can be used for OSCE, these include; clinical stations, practical stations and static stations. For the purpose of my curriculum both clinical and practical stations will be used to assess the student. It is expected that the students will have completed the pre class learning materials. Students will also be given copies of three OSCE’s that they could be assessed on (see appendix) this will allow students to use their psychomotor skills. The OSCE will allow the students to link theory into practice. It will have a weight of 25% (see Appendix 3).

The examination usually takes the form of a circuit of stations around which each candidate moves after a specified time interval (5–10 minutes) at each station. Stations are a mixture of interactive and non interactive tasks. Each station will have a patient for assessment of communication or history-taking skills and a manikin of a specific part of the body (e.g. to demonstrate application of splints). Each station has a examiner and the stations are standardized with specific marking criteria, thus enabling fairer comparison with peers.

Student Support

Nowadays, the provision of student support services including personal and financial counselling, support for students with disabilities and career guidance is an established part of support services available to all students in higher education institutions (Avramidis & Skidmore, 2004). It is imperative for students to have support services available to them. With the increasing diversity and number of students entering higher education institutions it has resulted in additional support being made available to support both the personal and academic development of students (Casey et al, 2003). Hill et al (2003) believes that additional support made available to students can increase the quality of the students learning experience and to their educational development

On the first day of the curriculum, the students will be welcomed and orientated to the lecture hall, simulation labs and seminar rooms that will be used throughout the course. They will be given a brief overview of the aims and learning outcomes for the curriculum (see Appendix 1) and run through of the curriculum which will incorporate many universal design learning components to cater to the diverse students learning needs. Students will be informed of all student supports available to them. . As educators we should not attempt to offer these resources to the students. Attempting to offer these support services ourselves to the students may bias us as educators and influences judgement to the students clinical performance throughout the curriculum (Nitko & Brookhart, 2007). Some of the support that will be available to the students include;

• Student advisors
• Student counselling service
• Peer mentors
• Programme officers
• Universal Design Learning
• Student desk
• SU Welfare Officer
• UCD estate services

Advice Line/ Help lines

• Samaritans
• Rape Crisis Centre
• UCD estate services
• UCD counselling service
• Peer mentors

Financial Issues

• SUSI Grant
• UCDSU Book Fund

Religious

• Chaplains- available for all or none religions offering a free and confidential service.

Health Emergencies

• UCD student health line

Philosophy

My philosophy is heavily influenced by my Socratic oath in respectfully acknowledging previous educators and their pedagogic contribution. I acknowledge that all students are unique and provide the learning opportunity to fulfil their learning potential in a stimulating learning environment. I will fulfil my role as an educator to the best of my ability, enhancing the knowledge and skills of the learners, enabling them to deliver high quality and holistic care. I will ensure the delivery of a high standard evidence-based education through a commitment of lifelong learning and professional development. My role as an educator will be to assist each student to develop their potential and learning styles, I will incorporate different learning styles to cater to student needs.

As a nursing educator, I will respect my professional obligation to students. I commit to advance the nursing profession by fostering high standards of nursing education therefore allowing students to realise their full potential. I will create a positive environment for students, facilitating them to maximise their full potential in the area of musculoskeletal casting and splinting and the overall holistic care of an orthopaedic patient.

Nursing education is a transformational experience for the students. The nurse educator is a facilitator for learning and growth. My teaching philosophy focuses heavily on building both a respectful and compassionate relationship between myself and the students with the teaching-learning experience being built on a relationship of safety and trust. Elements of Adult Learning Theory, self-determined learning and constructionist learning will all contribute different elements in to my approach to teaching. I am passionate about creating curriculum and content that respects the learners, learners’ needs and their own learning process. When educators have respect of the learner it creates an environment of trust and collaboration.

Conclusion

For this curriculum report my aim was to develop a curriculum ‘Professional Certificate in Musculoskeletal Casting and Splinting’ that will be implemented within an existing course in Waterford Institute of Technology worth 10 ECTS credits and 200 contact hours from the students. I discussed, the rationale of the curriculum, how Fink helped me in developing my learning outcomes, teaching and learning strategies that would be used throughout the curriculum and my philosophy.

References

• An Bord Altranais (2000) Review of Scope of Practice for Nursing and Midwifery Final Report. Dublin. An Bord Altranais.
• Avramidis, E., and D. Skidmore. (2004) Reappraising learning support in higher education. Research in Post-Compulsory Education 9, no. 1: 63–82.
• Casey, L., J. Quinn, K. Slack, and L. Thomas. (2003) Student services project: effective approaches to retaining students in higher education – directory of practice. London: DfES.
• Chen, F., Lui., A. M., & Martinelli, S.M. (2017) A systematic review of the effectiveness of flipped classrooms in medical education. Medical Education. 51 (6): 585 – 597.
• Gardner, M.R. & Suplee. P.D. (2010) Handbook of clinical teaching in nursing and health sciences. Sudbury, MA: Jones and Bartlett.
• Fink, L., D. (2003) Creating significant learning experiences: An integrated approach to designing college courses. San Francisco: Jossey- Bass.
• Fink, L. D. (2004) A self-directed guide to designing courses for significant learning. Retrieved: April 15th, 2019 from http://trc.virginia.edu/Workshops/2004/Fink Designing Courses 2004.pdf.
• Geck C. (2006) The Generation Z connection: Teaching information literacy to the newest net generation. Teacher Librarian. Vol, 33, Iss. , pp. 19-23.
• Goss Lucas S.G. (2008) A Guide to teaching Introductory Psychology. Blackwell Publishing. Garsington Road, Oxford.
• Grant, K., and M. Courtoreille (2007) Comparison of fixed-item and response-sensitive versions of an online tutorial. Psychological Record 57 (2):265–72.
• Hill, Y., L. Lomas, and J. McGregor. (2003) Students’ perceptions of quality in higher education. Quality Assurance in Education. Vol.11, iss. 1, pp 15–20.
• Knight, P.T. (2008) Being a Teacher in Higher Education. Buckingham: SRHE/OU Press.
• Xu, J.H. (2016) Toolbox of Teaching Strategies in nurse education. Chinese Nursing Research. Vol. 3, Iss. 2, pp 54-57.
• Nitko, A. J., & Brookhart, S.M. (2007) Educational assessment of students. 5^th Ed. Upper Saddle River. New Jersey: Pearson Education.
• Senita, J. (2008) The use of concept maps to evaluate critical thinking in the clinical setting. Teaching and Learning in Nursing. Vol.3. Iss. 1, pp 6-10.
• Sharples, M., McAndrew, P., Weller, M., Ferguson, R., FitzGerald, E., Hirst, T., Mor, Y., Gaved, M. and Whitelock, D. (2012) Innovating Pedagogy 2012: Open University Innovation Report 1 Milton Keynes: The Open University.
• Vacek, J. (2009) Using a conceptual approach with a concept map as an exemplar to promote critical thinking. Journal of Nursing Education. Vol. 2. Iss. 48, pp49-53. Appendix 1

An overview of module descriptor as per NMHS43640

Appendix 2

Appendix 3

Purpose: For the Emergency Department Registered Nurse to understand and demonstrate the appropriate placement and correct application of:

1. Volar cast
2. Dorsal Cast
3. Posterior short leg cast

Plan:

1.  The Registered Nurse will review the training videos (links provided below) that include both the product information and instructions on how to apply each of the three (3) splints mentioned above:

1. 3M Scotchcast Quick Step Splint Application
2. 3M Volar Short Arm Splint
3. 3M Scotchcast Posterior Short Leg Splint

2.  The RN will read the 3M Scotchcast Splinting Guide handout prior to the skill session.
   1. 3M Scotchcast Splinting Guide
3. The Registered Nurse will have completed the one on one orthopaedic validation session prior to attendance of the splinting application session.
4. The Registered Nurse will review the attached checklist prior to attending the casting validation session.

Outcomes: The outcome is that the prerequisites will be completed prior to attending a session in order for validation to occur. Please sign verifying that you have completed steps 1 – 4 of the plan mentioned above. Your signature is an attestation that you are prepared to validate your skills in the demonstration of splint application.

X ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­__________________

Volar Splint:

Dorsal Splint:

Posterior Short Leg Splint: