Promoting ESL Student Success in Nursing: Tutoring with Simulation

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Promoting ESL Student Success in
NursingTutoring with Simulation

• Sue Herm, RN, MSN, BC
• Kim Scott, RN, MSN
• St. Cloud State University

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Why is Increasing the Number of Diverse Nurses
Important?

• US minority population 22 to 25
• 8 to 10 of RNs are of ethnic descent
• Inequitable balance may lead to health disparity
  for ethnic minority groups

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Learning Styles

• Growing body of research that demonstrates the
  cultural component of learning style differences
• Differences in information processing, memory,
  problem solving, and thinking between individuals
  of ethnically diverse heritages vs. individuals
  of European heritage
• European/EuroAmerican worldview-- survival of
  the fittestconflict and competition are
  necessary for survival and self-development
• African, Hispanic, Native American and
  otherssurvival of the groupholistic,
  interdependence

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Comparison of Learning Styles

• Analytical, Field- Independent

• Relational, Field- Dependent

• Sequential, structured thinking
• Auditory, linguistic
• More easily learns information that is inanimate
  and impersonal
• Not greatly affected by opinions of others
• Concerned about content, emotional attachment not
  important
• Prefers individual competition (survival of the
  fittest worldview)
• Prefers formal, lecture-oriented approach
  (inactive, instructor is authority, expert)

• Intuitive
• Visual/sensory
• More easily learns information that has
  experiential relevance
• Influenced by authority figures expression of
  confidence or doubt in students ability
• Concerned about human relational interaction and
  communication style of instructor as they are
  about delivery of content
• Prefers group competition (survival of the
  group worldview)
• Prefers informal approach, class discussion,
  group work, simulation, role plays (active,
  student-centered, instructor is facilitator)

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Learning Styles (cont)

• White females, African American, Native American,
  and Hispanic American males and females fall
  toward the relational, field-dependent end of the
  continuum
• Euro-American and Asian American males fall
  toward the analytical, field-independent end of
  the spectrum
• Many diverse students are sensory/relational
  rather than analytical learners

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ESL Students

• Language identified as primary barrier in nursing
  education for ESL students
• Basic Interpersonal Communication Skills (BICS)
  social communication, takes 2-3 years to
  develop
• Cognitive Academic Language Proficiency (CALP),
  takes 5-7 years to develop, academic, analytical
  conversation, independently acquire factual
  information to find relationships, make
  inferences and draw conclusions. Necessary for
  literacy obtainment and academic success

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ESL Students (cont)

• Context-embedded student has access to
  additional visual and oral cues
• Context-reduced no other sources of help than
  the language itself, most difficult for ESL
  students

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Strategies to Promote Success with Diverse, ESL
Students

• Faculty Advocacy, Support, Mentoring
• Peer Support
• Study Groups (learning communities)
• Remedial and Tutorial Support
• Active, Context-embedded, Student-centered
  Teaching Pedagogies

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Tutoring with Simulation

• Simulation supports sensory, visual
  learners--allows learners to see, hear, touch,
  interpret and analyze data (context-embedded)
• Simulation is active, student-centered teacher
  plays role of facilitator and evaluator
• Students involved in active learning retain
  knowledge longer
• Active engagement enhances students critical
  thinking skills
• Simulations present situations requiring
  problem-solving, decision making, and critical
  thinking, fosters development of cognitive skills
  and allows for self-reflection outside of
  stresses of clinical environment

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Simulation Scenario Development for Remediation

• Rather than practicing skills as isolated tasks,
  nursing skills and concepts are integrated into a
  simulation scenario
• Simulation scenarios include operationalization
  of the nursing process assessment and
  interpretation of data, problem identification,
  planning and implementation of appropriate
  interventions, evaluation
• Debriefing critical component self-reflection
  is where insight is gained and learning occurs

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Sample Simulation Case Scenario

• 72-yr-old male with history of gall bladder
  disease and alcoholism presented to ER with
  abdominal pain, diarrhea X3 days, and syncopal
  episodes, admitted to hospital for IV fluids and
  diagnostic testing, ultimately diagnosed with
  pancreatitis. Report from night shift nurse
  indicated patient developed nausea, vomiting
  overnight, physician ordered an NG tube placed to
  gastric suction, prn antiemetic and diet changed
  to NPO.

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Skill Integration

• Therapeutic communication
• Physical assessment
• IV push medication administration
• IM injection medication administration
• NG tube medication administration
• Interpretation of lab values

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Student Feedback

• Students consistently state how much they learn,
  and request more simulation opportunities. I
  learned more from one simulation than any other
  assignment.
• I like simulation scenarios because you have to
  think about everything
• 11 simulation is helpful, non-threatening
  environment is conducive to learning
• Diverse, ESL students should meet with
  remediation specialist or tutor on a regular
  basis from the beginning of program
• Remediation specialist or lab coordinator/tutor
  is an advocate and support person

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References

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  (1999). The Cummins model A framework for
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• Anderson, J., Adams, M. (1992). Acknowledging
  the learning styles of diverse student
  populations Implications for instructional
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  Teaching for diversity (49, 19-35). San
  Francisco Jossey-Bass.
• Amaro, D. J. Abriam-Yago, K., Yoder, M.
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  students in nursing programs. Journal of Nursing
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• Bell, Y. R. (1994) A Culturally Sensitive
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• Stinson, S. (2009). Maximizing minority student
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• Sutherland, J. A., Hamilton, M. J., Goodman, N.
  (2007). Affirming at-risk minorities for success
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