02/24/2017

WNMU Faculty Team:James Vigil, RN, MSNRachel Owen, RN, MSNSasha Poole, PhD, RNVicki Hawkins, RN, MSNJennifer White, RN, CNM/FNP-BCCharnelle Lee, RN, MSN

James Vigil

Where did NMNEC come from and where is it going?◦ NMNEC beginnings in 2009◦ Coalition and Leadership development (grants)◦ Concepts were realized (Giddens, Brady)

Why did NMNEC need to go there?◦ IOM, HED

Is WNMU there yet?◦ First ADN cohort 5/17 first BSN cohort 12/17

Presenter

Presentation Notes

Curriculum has a strong basis in the concepts for student accomplishments. Exemplars are tailored to help the student think out of the box. I tell the students “Do not memorize”, understand, especially the inter-related concepts. Tying didactic lecture to clinical and simulation is helping to bring it all together. Consider life span outliers Trust your instincts. Communicate with your faculty.

Curriculum has a strong basis in the concepts for student accomplishments

Exemplars are tailored to help the student think out of the box◦ “Do not memorize”

Local response Former student response Hospital response

Tying didactic lecture to clinical & simulation brings it all together

Consider life span outliers Trust your instincts Communicate with your faculty

Level I Level II

Principles of Nursing Practice (1d/3c)

Introduction to Nursing Concept (3d)

Evidence-based Practice (3d)

Assessment & Health Promotion (1d/3c)

Health & Illness Concepts I (3d)

Health Care Participant (3d)

Nursing Pharmacology (3d)

How will the rotation affect your faculty? How will this affect your clinical resources? How will you implement simulation? How will you adjust from ADN to ADN & BSN

students?

Sasha Poole

The curriculum is there…

How do you design your course to present the curriculum to the students?

ConceptHealth & Illness Concepts I Exemplars

Pharmacology Medications

Assessment & Health Promotion Exemplars

Nutrition Obesity & Malnutrition

Folic Acid, H2 Blockers, PPIs, Antacids,

HP: Obesity in Children & BMI in Adults Assessment: Ht/Wt/BMI

Reproduction

FamilyPlanning/ Contraception, Intrapartum Care

Hormonal Contraceptives, Tocolytics, Uterine Stimulants

Fundal Height Assessment, Fetal Heart Rate

AnxietyAnxiety continuumincluding panic

Benzodiazepines Mental Health Assessment

Individual Family Community Development Functional Ability Culture Spirituality Health Care

Disparities

Health Care Disparities

CultureCommunity

Introduce concept of culture in a self & family assessment assignment early in semester

Culture as a concept covered about halfway through

Spirituality taught right after culture◦ Spirituality and religion tied for some clients◦ Religion & culture intertwined

Health Concepts

Clinical Courses

Prof. Nsg Concepts

Outliers

Level I Princ. of NsgPract.

Intro to Nsg Conc.

EBP

Level II Health & Illness I

Assess & H.P. HealthCare Part.

Level III Health & Illness II

Care of Pt w/ Chron. Cond.

Prof NsgConc. I

Level IV Health & Illness III

Clin. IntensiveI & II; ADN Capstone

Level V Concept Synthesis

Clin. Intens.III; BSN Capstone

Prof Nsg Conc. II

(Patterson et al., 2016, p. 469)

Take fierce notes of + / -

Reach out to faculty/schools that have been doing this for a while

Stick to the NMNEC curriculum

Trust in the process

Vicki Hawkins

We discovered that education is not something which the teacher does, but that it is a natural process which develops spontaneously in the human being.

“Team-based learning (TBL) is a structured form of small-group learning that emphasizes student preparation out of class and application of knowledge in class” (Brame, 2017, para. 1).

Requires active participation Student takes responsibility for learning Allows for development of interpersonal

skills

A version of the flipped classroom

Before class◦ Required to complete

readings◦ Individual test was

given Mini lecture

Teams of 5-6 students◦ Given topic to work together on for a

presentation◦ Worked on an assigned area◦ Presentation from each group

Q & A time after each presentation Team test was given at the end of class

Fosters cooperation of group members Presentation of interesting issues in

healthcare◦ Tasked with resolving the issues◦ Critical thinking is required to reason through the

situations Based on real or hypothetical situations

Ideal for moral, ethical, no clear ‘right’ topics Enhances oral presentation skills Foster abstract thinking, organization,

teamwork and collaboration Multimodal learning activity Students◦ Learn to consider multiple viewpoints ◦ Learn to obtain facts for both sides before making

a decision◦ Stimulated to do further research

Places the learner in situations resembling a real life environment◦ Rehearsal of real healthcare scenarios

Requires analysis the situations ◦ Need to interpret what is going and react to the event◦ Requires synthesis and apply concepts to a new setting

Must constantly evaluate the effectiveness of their actions

Peer review to point out the strengths and weaknesses observed

Role playing helps the learner empathize with the interdisciplinary team members

Tell me and I forget. Teach me and I remember. Involve me and I learn.

Rachel Owen & Charnelle Lee

Fall 2015 Fall 2016

Evolve/Kaplan/Clinical RN

CNA required 5 lab groups (8:1) Medication simulation Front-loaded skills

first 8 weeks Clinical sites◦ Nursing homes◦ Elementary schools◦ Flu clinics

Pearson/ATI/NICU NP CNA not required Larger lab groups Medication simulation Lab work (+) Clinical sites◦ Senior centers◦ Schools/daycares◦ Flu clinics

Benefits 2015◦ Hands on ADLs on

patients◦ Hands on skills

practice◦ Observation med

passes Challenges◦ Med administration

Benefits 2016◦ More lab time for

practice◦ Increased focus on

peds (lifespan) Challenges◦ Med administration◦ Weak on CNA skills◦ Larger lab groups

Spring 2016 Spring 2017

Evolve/Kaplan/CNM, FNP

5 lab groups (8:1) Heavy perinatal/peds

emphasis Clinical sites◦ Hospital perinatal unit◦ Headstarts/School◦ Flu clinics

Pearson/ATI/CNM, FNP Larger lab groups (8:1

in clinical settings) Increased geriatric

emphasis Clinical Sites◦ Hospital perinatal unit◦ Elementary schools◦ Senior centers◦ Nursing homes

Benefits 2016◦ Introduction to

maternal/newborn w/ CNM/FNP

Challenges◦ Assessments in

pieces◦ Working with hospital

perinatal unit◦ Level of assessment

beyond RN at times

Benefits 2017◦ Message in lab more

consistent◦ Same course

coordinator◦ ??

Challenges◦ Incorporating senior

centers◦ ??

Fall 2016 L3: Care Pt w/chronic conditions◦ 80hrs skills labs & sim, 60hrs clinical (6:30-15)

Front loaded skills labs Simulations (4)- skill based ◦ 1 small group all day assessment & skills sim◦ IV/CL, blood transfusion, gestational diabetes, &

general MS sim Clinical sites◦ 3 Med Surg rotations ◦ 3 other rotations (Infusion/chemo, OR, HH)

L3 Assessments:◦ Assigned Evolve/ATI modules◦ 2 NCP◦ Reflective journal each clinical◦ Pre/Post sim work◦ Med Math exam

Tried new clinical instructor arrangement◦ 1 instructor overseeing non MS clinical sites◦ 1 clinical group scheduled all for non MS sites

Remediation◦ Skills – high % needed remediation ? Because they did not use in Level 2?

Plan clinical for entire program◦ Get all faculty to agree◦ Where been and where going

Work w/clinical agencies◦ New expectations & rotation changes

Faculty participant from course to all simulations

Make skills/clinical evaluation forms with weight◦ Failure: students go to remediation practice

Larger lab groups (not 1:8) or not Alternating skills labs and clinical rather than

front loading Same instructor for a skill check-offs for all

students

Starting Level 4 divided simulation groups by ADN and BSN◦ Keep groups the same throughout the semester

Rotating faculty throughout the clinical groups at both clinical agencies◦ Takes more communication, meetings

Hand written nursing care plan Course coordinator for CI 2 will do all sims

and all grading (14 students), no clinical rotations

ADNs weak in clinical exposure Emphasize medical term and pharmacology

throughout Revamping assessment to keep reviewing

all systems within concepts How to balance community sites & enough

M/S clinical exposure Faculty vary in life span expertise and

clinical exposure areas for students

Simulation NMSBON Facts

Simulation as a clinical hour replacement

Faculty simulation training a must

50% of clinical hours per course can be simulation (NMSBON, n.d., p. 6).

“In the simulation setting there shall be nursing faculty who has received focused training in simulation pedagogy and techniques” (NMSBON, n.d., p. 6).

Provides the environment and opportunity to assess and care for a patient in a risk-free environment (Durham & Alden, 2008).

Goal◦ Promote critical thinking and clinical decision

making ability with development of psychomotor skill performance (Durham & Alden, 2008).

Exemplars are provided in every level to guide the effective concept learning experience

Following this guide ensures the learning objectives and outcomes are met

Simulation cases are available that support these exemplars

Use of simulation cases that are peer-reviewed

Match the exemplar Pre-populated with learning objectives and

outcomes Simulator compatible

Simulation 1 Ruth Livingstone ◦ (Concepts Mobility, Integrity, Elimination &

Caring) (Adult) Simulation 2 Johnny Parker – Pediatric

Tylenol OD◦ (Concepts – Med Safety/Med

Administration/Caring/Communication) Simulation 3: Skylar Hansen (Adolescent) ◦ (Concepts – Diabetic Teaching, Communication,

Safety in Medication Administration (Insulin drawn up and given).

Simulation I : Charles Jones (CHF) Physical Assessment of the patient with CHF ◦ Concept Medication Adherence

Simulation II: Jesus Garcia (Colostomy Care) Assessment of the patient with a colostomy◦ Concept Motivation/readiness to change

Simulation III: Johnny Parker (Tylenol OD) Assessment of the pediatric patient with an NG tube◦ Concept Teaching/Learning Principles

Borrow faculty expertise to cover a concept or exemplar

Limit the number of changes during first go around◦ Don’t switch publisher and standardized testing

company at the same time Consider level teams◦ Facilitates communication between faculty

Keep thinking concept and across the lifespan, even in clinical

COMMUNICATION

Charnelle Lee

Durham, C. F., & Alden, K. R. (2008). Enhancing patient safety in nursing education through patient simulation. In R. G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (Chapter 51). Rockville (MD): Agency for Healthcare Research and Quality. Available from https//www.ncbi.nlm.nih.gov/books/NBK2628/

Kennedy, R. (2007). In-class debates: Fertile ground fro active learning and the cultivation of critical thinking and oral communication skills. International Journal of Teaching and Learning in Higher Education, 19, 183-190. Retrieved from http://www.isetl.org/ijtlhe/pdf/IJTLHE200.pdf

NMBON. (n.d.). NMBON pre-licensure nursing programs annual report fiscal year 2016. Retrieved from http://nmbon.sks.com/fy16-pre-licensurefy2016-pre-licensure-nursing-programs-annual-report-updated-with-signature.pdf

Patterson, L. D., Crager, J. M., Farmer, A., Epps, C. D., & Schuessler, J. B. (2016). A strategy to ensure faculty engagement when assessing a concept-based curriculum. Journal of Nursing Education, 55, 467-470. doi:10.3928/01484834-20160715-09

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