Stop Lecturing and Start Facilitating Learning

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Stop Lecturing and Start Facilitating Learning

• Presented by Sonja Mack MSN, RN
• Assistant Professor of Nursing
• Skills and Simulation Laboratory Coordinator
• College of Graduate Nursing
• Western University of Health Sciences

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Workshop Objectives

• Upon completion of this workshop, the participant
  will
• Understand the planning process involved with
  incorporating simulation into curriculum
• Understand the five different roles assigned to
  the students during the simulation session
• Understand the implementation process involved
  with incorporating simulation into curriculum and
  implementation of the simulation sessions
• Understand the role of the faculty member as
  facilitator of the learning process
• Understand the process of evaluating simulation

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Appreciation for Nursing Profession

• Personal motivation stemmed from desire to
  improve awareness and appreciation for the
  complexity of RN role
• Original long-term goals
• Develop/improve critical thinking skills
• Improve clinical judgment and decision making
• Socialize the students into the RN role
• Increase knowledge level

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The Planning Process Simulation Part of
Curriculum

• Determine the purpose teaching method vs.
  evaluation method
• Intuition
• Evidence supporting this learning environment
• Timing

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The Learners

• Adult-learners
• Self-directed learning
• Experience-based learning
• Problem-centered learning
• Reflection
• Uniqueness of the MSN-E students
• Psychomotor, affective and cognitive learning
  domains

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The Best Classroom Learning Experience

• Facilitator is organized and knowledgeable
• Facilitator clarifies time on task
• Facilitator encourages cooperative learning
• Facilitator promotes active learning
• Halstead, J.A. ed. (2007). Nurse educator
  competencies Creating an evidence-based practice
  for educators. National League of Nursing. New
  York.

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Disposition for Critical Thinking

• The seven habits of mind that dispose one toward
  critical thinking
• Truth-seeking
• Open-mindedness
• Analyticity
• Systematicity
• Critical thinking self-confidence
• Inquisitivness
• Maturity of judgment
• PJRF Instrument Manual (2006). Insight
  Assessment, The California Academic Press LLC.

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Core Critical Thinking Skills by Facione et al.

• Analysis
• Interpretation
• Inference
• Evaluation
• Explanation
• Self-correction
• There are two dimensions of professional
  judgment ability to think and willingness to
  think

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Teaching Critical Thinking

• Educational exercises should
• Model critical thinking skills and disposition
• Create a culture of inquiry
• Diversify problem contexts
• Reward good CT
• Challenge poor CT
• Guide reflection on the thinking process
• Engage students in thinking
• Facione, N.C., Facione, P.A. (2006). The Health
  Sciences Reasoning Test HSRT. A test of Critical
  Thinking Skills for Health Care Professionals.
  Insight Assessment and The California Academic
  Press.

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The Planning Process Simulation Session

• What are the course objectives?
• What are the simulation scenario objectives?
• What are the learning outcomes for this session?
• What are the long term goals?
• Will students be performing any skills during the
  simulation session?
• Must be a purposeful goal oriented learning
  experience, not a haphazard scheduled event

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Planning the Simulation Session

• Provide students with scenario objectives ahead
  of time
• Two instructors one facilitator the other to
  run the instructor workstation and perform voice
  of the mannequin
• Use moulage to enhance scenario realism
• Run the scenario prior to the actual session
• Students should know whether they will be
  receiving points for correct answers

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Student Roles

• Each simulation group has 8-10 students
• Divide in two groups one group at bedside and
  the other is the observing group
• Right before the start of the session, assign the
  following roles
• Primary RN
• Assessment RN
• Medication RN
• Laboratory/Diagnostic Findings RN
• Communication RN

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The Implementation Process Instructor as the
Facilitator

• The facilitator understands the desired student
  outcomes and the process of achieving those
  outcomes
• Pose questions that prompt students to critically
  think, analyze problem situations and make
  decisions
• Ask the leading questions, but dont give out the
  answer
• Ask students to think out loud example - give
  rationales for inferences and proposed
  interventions
• Call on different RN role to provide the
  information necessary in order to advance in the
  scenario

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Facilitator, Students and the Nursing Process

• As a team, the students should apply the nursing
  process
• as a foundation for executing the scenario
• Assessment
• Problem identification interpret and analyze
  information gathered
• Planning identify course of action
• Implementation
• Evaluation
• Emphasize the important points

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Qualities of the Facilitator

• Willing to engage in self-reflection
• Enduring learner
• Respectful, non-threatening, caring demeanor
• Flexible
• Models critical and reflective thinking
  (Halstead, 2007)
• Shows enthusiasm for teaching, learning, and
  nursing that inspires and motivates students
  (Halstead, 2007)
• Halstead, J. ed. (2007). Nurse educator
  competencies Creating an evidence-based practice
  for nurse educators. National League of Nursing.
  New York.

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As the Facilitator, Dont Forget to

• Enjoy it have fun!
• Keep track of time
• Take notes during the session to facilitate
  debriefing
• Switch groups

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The Debriefing Process

• Instrumental for effective simulation sessions
• Dedicate at least fifty percent of planned
  session time to debriefing
• Reflective thinking
• Timely and constructive feedback enhancing
  knowledge retention

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The Evaluation Process

• Evaluate effectiveness of the simulation session
• Evaluate effectiveness of the facilitator
• Evaluate clinical learning
• Evaluate classroom learning

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Evaluation of Simulation SessionMETI Simulation
Effectiveness Scale

• Instructors questions helped me think critically
• Feel better prepared to care for real patients
• Feel like it was OK to make a mistake
• Feel more confident in my decision making skills
• Feel more confident determining what to tell HCP
• Assessment skills improved
• Feel more confident in ability to recognize
  changes
• Feel better prepared to predict changes in real
  pts
• Have better understanding of classroom
  information
• Feel challenged in my thinking and
  decision-making skills

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Evaluate Effectiveness of the Facilitator

• The college/university course evaluation tool
• Simulation effectiveness scale by METI
• Peer evaluation
• Seek and be receptive to constructive
  student/peer feedback look for opportunities to
  improve

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Evaluate Knowledge Gain

• Verbal questioning during the scenario and during
  the debriefing process
• Ask questions that trigger discussing connections
  between concepts
• Written exams multiple choice questions should
  be written at application, analysis and synthesis
  levels

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Words of Advice

• Be willing to try
• Accept that it will not be perfect from the start
  
• Get buy in from peers
• Network
• Strive to improve

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Knowing is not enough we must apply.Willing is
not enough, we must do.

• Goethe

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References

• Facione, P.A., Blohm, S.W., Facione, N.C.,
  Giancarlo, C.A. (2006). Professional Judgment
  Rating Form. Novice/Internship Level. A
  Measure of Critical Thinking Abilities and Habits
  of Mind. Raters Manual. Millbrae, CA The
  California Academic Press LLP.
• Facione, N.C., Facione, P.A. (2006). The Health
  Sciences Reasoning Test HSRT. A test of Critical
  Thinking Skills for Health Care Professionals.
  Insight Assessment and The California Academic
  Press.
• Facione, P.A., Facione, N.C., Giancario, C.A.F.,
  Blohm, S.W. (2002). Teaching for Thinking.
  Critical Thinking as Reasoned Judgment, The
  Album. Insight Assessment and The California
  Academic Press.
• Halstead, J. ed. (2007). Nurse educator
  competencies Creating an evidence-based practice
  for nurse educators. National League of Nursing.
  New York.
• Jeffries, P.R.(ed.) (2007). Simulation in nursing
  education. New York, NY National League of
  Nursing.