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Tech and teaching tools change nurse education
EDITOR’S NOTE: Maureen Habel, MA, RN, is the original author of this educational activity, but has not had an opportunity to influence the content of this current version. Ann Kim, MSN, MPH, RN, CNS, and Nancy Schoofs, PhD, RN, are past authors of this educational activity, but have not had an opportunity to influence the content of this current version. OnCourseLearning.com guarantees this educational activity is free from bias. Take the rest of this continuing education module online. Rosalinda Alfaro-LeFevre, MSN, RN, ANEF, is president of Teaching Smart/Learning Easy in Stuart, Fla. She’s known nationally and internationally for her books and programs on teaching critical thinking and improving personal and professional performance.
Tell me and I forget, teach me and I may remember, involve me and I learn.” — Chinese Proverb
Behind every good nurse is an inspirational educator — or perhaps many. As gatekeepers who ensure safe nursing practice, faculty members have a rich history of providing knowledge, teaching essential skills and inspiring students to set high standards for patient care. Today’s faculty members face unparalleled challenges as they prepare students for increasingly complex nursing roles in a rapidly changing world. This module discusses innovative approaches educators use to meet the challenges of transforming education and preparing nurses who will succeed in this millennium. It also describes forces driving changes in nursing and nursing education, how educators meet the learning needs of diverse students, and the rewards and challenges of being a nurse educator.

Not your mother’s program
Gone are the days of sitting in three-hour lectures trying to stay awake after pulling an all-nighter. Educators today work to promote meaningful, interactive learning by using a variety of strategies. From using technology to designing collaborative learning experiences that focus on “real world” issues, educators aim to ensure that their students remain engaged in learning every step of the way.
Technology impact Not surprisingly, technology affects what happens in today's classrooms. Laptops, iPads, smart phones, web-based videos, webinars, and other uses of the internet are commonplace.1 Many programs use e-learning management systems, such as Blackboard. These systems let faculty members give online examinations and quizzes, use software to identify plagiarized papers, and post resources for reinforcement and enrichment.

Students have easy access to materials and information, such as grades, lecture materials, readings and syllabi. Students also use handheld remote devices, clickers, to let the instructor know immediately how well they understand a lecture. (With clickers, students key in answers to quizzes given during lectures. The instructors have a receiver device through which they can see immediately how many students passed the quiz.)

Some classes are going “clickerless” by using polling response systems. With polling response systems, students enter their responses to teachers’ questions on their smart phones or computers. These systems help faculty to engage students, assess students’ previous knowledge, and probe how well their students understand particular content. For example, a polling question may ask, “On a scale of 0-10 (0= not prepared; 10 = well prepared), how well prepared do you feel to teach people about their colostomies?”2 Many instructors record lectures so students can listen to them on their iPods or smart phones. Online discussion boards allow students to post assignments and information for classmates and faculty. The ability to share information promotes great online discussions and allows constructive peer evaluation.

Blogs (online personal journals) facilitate peer support and can document individual reflections on courses for faculty review. Wikis, collaboratively constructed websites that allow content to be added and edited, are used by students to share information and work together on reports and projects.1 Interactive teaching strategies using computer-based instruction — including computer-assisted instruction, computer simulations, interactive video instruction, and tutorials to enhance lecture content — promote active learning.

Technology also affects students’ clinical learning. Students use smart phones and personal digital assistants to access information about disease processes, evidence-based nursing, and drug and treatment information.
How to earn continuing education
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Read the Continuing Education article.
This continuing education course is FREE ONLINE until November 30, 2018, courtesy of Nurse.com. To take the test for FREE, go to https://www.nurse.com/ce/teaching-tomorrows-nurses. After that date, you can take the course for $12 at the same link. If you have a CE Direct login and password (generally provided by your employer), please login as you normally would at https://cedirect.continuingeducation.com and complete the course on that system.
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If the course you have chosen to take includes a clinical vignette, you will be asked to review the vignette and answer 3 or 4 questions. You must answer all questions correctly to proceed. If you answer a question incorrectly, we will provide a clue to the correct answer.
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Once you successfully complete the short test associated with the clinical vignette (if there is one), proceed to the course posttest. To earn contact hours, you must achieve a score of 75%. You may retake the test as many times as necessary to pass the test.
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All users must complete the evaluation process to complete the course. You will be able to view a certificate on screen and print or save it for your records.
In support of improving patient care, OnCourse Learning is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
OnCourse Learning is also an approved provider by the Florida Board of Nursing, the District of Columbia Board of Nursing, and the South Carolina Board of Nursing (provider # 50-1489). OnCourse Learning’s continuing education courses are accepted by the Georgia Board of Nursing. OnCourse Learning is approved by the California Board of Registered Nursing, provider #CEP16588.
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Teaching tomorrow’s nurses: What’s happening in the classroom?
By Rosalinda Alfaro-LeFevre, MSN, RN, ANEF
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This course is 1 contact hour
Course must be completed by February 15, 2020.
Goals and objectives: The goal of this nursing education continuing education program is to provide nurses with information about changes in nursing education that influence how today’s students are being prepared for practice. After studying the information presented here, you will be able to:
  1. Describe four teaching strategies that nurse educators use to meet the learning needs of diverse students
  2. Identify trends in healthcare and education that challenge educators to prepare students for changing RN roles
  3. Discuss the rewards and challenges of being a nursing faculty member
Nurse.com educational activities are provided by OnCourse Learning. For further information and accreditation statements, please visit Nurse.com/Accreditation. The planners and authors have declared no relevant conflicts of interest that relate to this educational activity. OnCourse Learning guarantees this educational activity is free from bias. See “How to Earn Continuing Education” to learn how to earn CE credit for this module or visit http://ce.nurse.com/instructions.aspx.
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Creating learning cultures
Increasingly, schools today are accountable for creating a learning culture that embraces the motto that “everyone teaches, everyone learns.” Building learning cultures — school and work environments that encourage learners and employees at all levels to ask questions, share information freely, and create teaching/learning opportunities — is the foundation for developing critical thinking, improving outcomes, and keeping patients safe.3
Concept-based curriculum
Knowledgeable and experienced, both in practice and education
Dedicated and passionate about both learners and patient care
Clear and able to clarify and simplify course content and objectives
Organized, with good resources for students (e.g., handouts and PowerPoints)
Patient, approachable, and open to new ideas
Responding to the call for education reform, many schools of nursing are considering changing to a concept-based curriculum.4 Concept-based curriculums aim to promote critical thinking and reduce content overload by teaching big ideas that can be transferred from one situation to another. For example, a student in a concept-based curriculum may learn the concepts of oxygenation and inflammation in adult nursing, and then when they study pediatrics, discuss how these change in children’s bodies.

In the past, content focused on facts. Concept-based curriculums focus on making sense of those facts. Faculty can’t possibly teach everything, but they can teach the big ideas. Content can change. Concepts stay the same. Successful implementation of concept-based curriculums requires educators to transform learning from traditional teacher-focused delivery of information to student-centered teaching in which students are engaged actively in learning. As part of curriculum development, faculty must select the concepts, competencies, and exemplars on which to build courses and base content. Then they must organize the concepts in a way that facilitates learning. This is challenging intellectually, and takes a lot of work and a commitment to making changes.
Simulation and debriefing
With the use of high-fidelity human simulators — life-like mannequins that mimic many of the human body’s processes, such as heart rate and blood pressure — the worlds of laboratory and clinical learning merge. Using simulators, students can practice complex assessment skills, and hone their ability to set priorities, make decisions, and take appropriate action when things go wrong.

Simulated experiences offer a controlled-learning environment and provide students with immediate feedback, allowing for self-correction and remediation if needed.3,5,6 (Level B), 7 Students learn from their own mistakes, which is a powerful way to learn, in a safe environment. When well-designed simulated experiences are followed by debriefing on what went well and what could be done better, students learn to manage common clinical issues before they care for real patients.3,5,6
Problem-based learning and flipped classrooms
Problem-based learning is another educational process that engages students actively. With problem-based learning, the teacher presents a patient scenario to a small group of students and asks the group to decide what information is needed to address the patient’s issues. Group members pair off to conduct an independent inquiry that they later share with the group. A faculty member serves as a learning facilitator and guide.5 To increase student engagement, some faculty use a “flipped classroom” (time allotted for lecture and homework is reversed).8 (Level C) In a flipped classroom, students learn content online before coming to school, and then they do homework in class, with teachers and students discussing and solving questions together.

Teacher interaction with students is more personalized, and guidance is used instead of lecturing. While some teachers believe the flipped classroom is more engaging, school’s still out (pardon the pun) on how well it works. A study that aimed to determine the effects of a flipped classroom found that exam scores were higher for students in flipped classrooms than those in traditional lecture classes.

But students in flipped classrooms indicated lower satisfaction with learning than those in the lecture classes.8 You can find informative YouTube videos on how to flip the classroom by entering “flipped classroom” into the search field at http://www.youtube.com.
Concept mapping
Today’s learners are likely to spend quite a bit of time creating concept maps, sometimes called “mind maps.” The use of concept maps as an effective learning tool is confirmed in an integrative review of the evidence supporting teaching strategies.9 (Level C) When using concept maps, learners create a map that shows the connection between ideas, thoughts, and information. This visual representation of learners’ thinking can be a discussion point and also a way to promote and evaluate critical thinking.3

Drawing concept maps uses the right side of your brain (creative hemisphere) to enhance your ability to understand information and solve problems.3 Unlike outlining, which uses the left brain (logical hemisphere), concept mapping is flexible, has few rules, and is easy to learn and teach. If you don’t know how to create concept maps, download Nuts and Bolts of Concept Mapping (Getting in the “Right” State of Mind).

There are also numerous YouTube videos on this topic as well as a good explanation with examples at The Texas Collaborative for Teaching Excellenc website.
More diverse than ever
Classrooms today are full of students who are ethnically diverse. Faculty must know how to reach out to all students equally. There are also more men in nursing than ever before. Because of their socialization, some men may have a different, but valid, approach to particular elements of nursing.3 For example, some men have a harder time expressing emotion and may not establish therapeutic relationships with patients in the same way that most female nurses do.

Men may be more likely to use humor and less likely to use touch. Based on their female expectations for communication, women may view this way of relating as inattentive and nontherapeutic.3 You can learn more about issues facing men in nursing and education on the American Association for Men in Nursing website. The organization provides a framework for nurses as a group to meet, discuss and influence factors that affect men as nurses.
Faculty members also face the challenge of meeting learning needs of students from different generations. A generation refers to a group of people who share birth years and have lived through the same significant events. The beliefs, culture, and values of each generation are shaped by historical, political, and social events that occur during the formative years of its members.10 For example, generation X learners, born between 1964 and 1981, had different life experiences as children than their baby boomer teachers.

Generation Xers grew up during a time of rising divorce rates, rapid movement of women into the workforce and a faltering economy. Many members of this generation were “latchkey” children while both parents worked. As a group, members of Generation X are self-reliant and resourceful, and they are sometimes described as “working to live.” In general, they want to learn content in a quick and direct way.10
The newest generation
Meeting the learning needs of nursing’s newest generation, the millennials (those born after 1981), is a challenge.10 They have characteristics different than those of students of previous generations. Millennials share two key life experiences that affect how they view the world: intensive parental involvement during their formative years and the technology revolution that occurred during their childhood.

Members of this generation have led highly structured lives that were organized and supervised by adults. As a result, they may need support in balancing the demands of a nursing program. Technology is their native language; they are comfortable with multitasking and switch easily from completing an assignment, listening to their iPods, writing or reading a blog, texting friends and talking on their cell phones.10

As children, they participated in interactive computer activities and are often more comfortable getting information from the Web than from a library. In general, they prefer active and engaging activities, such as simulations and group work, rather than lectures.10
Join the ranks
Being a nurse educator is unlike any other role. Nursing faculty must prepare students for nursing practice while providing them with knowledge they need to pass state licensing examinations. Becoming a nursing faculty member requires education, experience, and the desire to share knowledge with others. Most nursing programs seek faculty members who are educated at least one level higher than the students they will teach, with most requiring a master’s degree. In a BSN program, both full- and part-time faculty must have at least a master of science degree in nursing; a doctoral degree is generally required for appointment to tenure track at most schools of nursing. Many nurse educators take the certified nurse educator examination to verify their qualifications.
What makes a great teacher?
Many publications address what it takes to be a great teacher. Teaching is a challenging job, especially in context of the current rapid changes in both nursing education and healthcare. Think about the following qualities in relation to the good teachers you have had in your life:11,12
Excellent communicators, listening deeply and speaking clearly
Professional and scholarly, valuing the importance of research
Connected (has solid relationships with colleagues, other professionals, and students)
Excellent role models who “walk the talk”
Confident and able to nurture learners’ confidence
Emotionally intelligent; able to understand students’ struggles and concerns
Able to find humor and enjoy a good laugh
Effective educators are knowledgeable about generational and learning style differences, and tailor learning activities accordingly. They make links between theory and practice, teach simple concepts before complex ones, give constructive feedback, and build trusting relationships with students.

Good teachers apply coaching principles to help learners realize their potential.  Rather than telling learners what to do, they help learners tell themselves what to do. Instead of delivering expertise, they help learners bring forth their own expertise. 13,14
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