Fundamentals of Nursing Practice Course

1.0    Four Competency Statements

1. The learner will be able to apply the nursing process to interpret and manage human responses to actual or potential health problems.
2. The learner will demonstrate professional and therapeutic communication techniques and decision-making skills in their practice.
3. The learner will demonstrate knowledge of professional nursing roles and the ethical-legal standards of nursing practice.
4. The student will be able to describe the theoretical basis of nursing and the accompanying models.

 1.1 Explanation of the Competency Statements

The fundamentals of nursing practice course aims at equipping learners with knowledge and skills to use the nursing process in the management of patients. The learners should be able to care for patients by conducting assessment, formulating a nursing diagnosis, planning of care, implementation of the planned measures and evaluation of nursing care by the end of the course. Communication is a very essential component for nurses thus the learners will be taught about professional and therapeutic communication skills for their daily practice. The students will also acquire decision making skills for dealing with difficult choices and ethical dilemmas in the nursing profession.

The students will be taught about the scope of nursing practice and the roles they are expected to perform in the profession. The learners will also be equipped with knowledge on the ethical and legal obligations of the nurses. There are several theories and models of nursing which any given student nurse should know. The learners will be taught on the different nursing theories and ways of applying the theories to their practice. At the end of the course the learners will be able to describe the nursing theories and how they can apply them to practice.

 

 

 

 

 

1.2 Alignments of the Competencies with Commission on Collegiate Nursing Education (CCNE)

The skills are congruent with the requirements of the Commission on Collegiate Nursing Education. The competencies have a clear expectation of the student outcomes which are in line with the mission and goals of the program. The skills outline the specific achievements which the students should acquire at the end of the course. The CCNE states that the competencies should reflect the professionals nursing standards and guidelines (Commission on Collegiate Nursing Education, 2013). The above core competencies demonstrate the fact that students should be able to show the professional nursing roles and also the ethical and legal issues required for practice. The core competencies are in line with the Essentials of Baccalaureate Education for Professional Nursing Practice as outlined by the CCNE.

1.3    Learning Objectives for teaching the nursing process

1. The learner should be able to define and state the functions of the nursing process by the end of the lesson.
2. The student will be able to describe the steps of the nursing process by the end of the lesson
3. The student will be able to formulate a nursing care plan for a patient by the end of the course.

1.3.1 Criterion for selecting learning resources for the objectives

The selection of learning materials will begin with the analysis of the content of different sources to determine the level of accuracy, currency, coherence, and clarity (Billings& Halstead, 2015). The scope and sequence of topics will be evaluated to find out whether the material is deep and broad enough to cover the mentioned objectives. Also, the level of difficulty interest for the learners will be evaluated to ensure that the first level students will comprehend the information. The conceptual orientation of the material will be analyzed to ensure that the selected books are appropriate in relation to medical education.

Materials with a high quality of writing regarding how the author communicates with the learners should be chosen to meet the objectives. A trainer should also select the materials whose pedagogical design enhances meaning in that the headings and subheadings are clear with high-quality images and diagrams (Billings& Halstead, 2015). Moreover, it is essential to evaluate reviews of a course material by other faculties who have used it in the past and select those with an excellent review.

1.4    Blended Approach to the course

The fundamentals of a nursing course will take the blended approach whereby there will be a combination of the traditional methods of learning with the contemporary ones. Students will apply the aspects of classroom learning, online learning and also simulated learning. They will get an opportunity to interact at the classroom level and enjoy the socialization opportunities. Also, the students will benefit from embracing the technologically enhanced online learning platforms at the university in the online environment (Porter et al., 2014). The learners will be able to interact at the skills lab for a simulation where they will acquire hands-on skills. The blended approach, therefore, gives students an opportunity to tap a broader range of strategies and also solve pedagogical problems.

2.0    Strategies for Evaluating Learning Outcomes

2.1    Portfolio

Portfolios can be used as an end of course strategy to evaluate the achievement of learning outcomes. The approach is used to for course-specific evaluation for individual learners and forms an integral component of most programs. Portfolios, whether electronic or not allow access to different self-selected student work and also self-reflection which is based on the learning goals. A portfolio is used to represent the work of a given student in a purposeful collection. It exhibits the efforts, progress, and achievements for one or more areas of study (Oermann&Gaberson, 2016). Learners will, therefore, be required to develop a group for the course which will outline the progress and demonstrate the understanding gained. A portfolio is a collection of a self-reflection by an individual student on a particular course objective.

2.2    Papers and essays

Papers and essays are used to evaluate the ability of students to select, organize and integrate material for a given topic. Examiners present learners with a given question or issue for which they are required to develop an essay. An essay assesses the ability of learners to recall information and also the ability to organize such information in a manner which is orderly and easily understood. An essay topic is derived from the course objectives, and a learner is expected to write comprehensively regarding the given issue (Oermann&Gaberson, 2016). Essays are capable of testing the writing skills of students and the ability to present arguments logically. Learners demonstrate the ability to develop cases and use of evidence to support their side of the story. Essays may be as short as one page or very long making up to even ten pages. Students may write essays under timed exam conditions while other essays might be given as research assignments for learners to handle slowly and submit at a given date.

2.3    Advantages of the Strategies

Portfolios make way for significant involvement of students in the learning process and also arouse responsibility for learning among the students. In-context student learning is assessed through the presentation of portfolios by students. Portfolios also encourage self-assessment and reflection among the students. They also facilitate the evaluation of multiple skills and outcomes which include generic skills(Oermann&Gaberson, 2016). Students get an opportunity to showcase skills and achievements when they write portfolios. Portfolios are also comprehensive, multidimensional and flexible and can be applied in a wide range of course contexts.

Essays help learners to develop writing skills in addition to the knowledge of concepts for the particular course. A trainer can identify errors in understanding or misconceptions among the students while marking and take corrective action to facilitate clarification. Essays and papers take less time to set as compared to other strategies such as multiple choice questions (Oermann&Gaberson, 2016). Moreover, the requirement that students should write an essay or term paper improves understanding of the given topic. Learners can also develop information literacy skills when they are required to write papers and essays.

2.4    Disadvantages of the Strategies

One of the main obstacles of portfolios is that they might deem time-consuming to develop and also to assess given that they concern individual learners. It is also difficult to determine the assessment criteria for learners because learners might concentrate on different aspects of the course based on what they best understood. Portfolios are subjective which interferes with fair grading as there are no objective criteria for evaluation of the course objectives. Portfolios may require additional resources for compilation which implies extra work for both the learners and the trainer(Oermann&Gaberson, 2016). It is difficult to compare the performance of students using portfolios because the learners might give entirely different portfolios.

The primary shortcoming of essays is the fact that they may not evaluate a wide range of content because most of them assess a single topic or objective. Most questions given as essays may not be well thought of by examiners which challenge them when determining how to mark them. The trainers might not provide adequate thought on the possible answers and also probable obstacles which students might face when answering the questions.  The marking of essays is influenced by other factors including legibility for the written papers and essays. As a result, examiners might be diverted from the content of the essay by other factors (Oermann&Gaberson, 2016). A lot of time is required to mark and grade essays and this is a significant drawback of the essay strategy of outcome evaluation. It is also tricky to maintained consistency while assigning marks to students in papers and essays.  Subjectivity might also affect fair grading while marking essays and papers.

3.0    Use of criterion- and norm-referenced tests in the course

3.1    Criterion-Referenced Tests

These tests are used to measure the performance of a student in comparison with a fixed set of criteria which has already been predetermined. Criterion-referenced tests in the fundamentals of a nursing course will involve establishing a standard measure against which the work of each student will be compared (Lok, McNaught& Young, 2016). An evaluation of learning standards which include concise work and a written description of the expectations set aside for learners is done.

The criterion-referenced tests are used to establish whether learners learned a specific body of knowledge or acquired particular skills required. The ability of students to perform at or above the set expectations makes them classified as having passed the test. The test for the fundamentals of a nursing course will, therefore, be obtained from the learning objectives and an evaluation procedure made guided by the same purposes(Lok, McNaught& Young, 2016). The proficient learners in the fundamentals of nursing course are the ones who will perform at or above the expectations previously established.

3.2    Norm-Referenced Tests

Norm-referenced tests are used to compare the performance of an individual learner with the rest of the examinees. All the examinees are ranked from the lowest to the highest, and the marks entered to form a bell curve in which few people are scoring the lowest marks, few getting very high scores and the majority lies within the average. The norm-referenced method can be applied in the fundamentals of nursing course to establish whether the results are usually distributed (Lok, McNaught& Young, 2016). It is expected that there will be few students who will get few marks, few who score the highest marks whereas the most significant number lies in the mean.

Norm-referenced tests rank students I comparisons with others and discriminate between the high and low performers. The tests will help to determine the most top performing and lowly performing students in the fundamentals of the nursing course. Broad skill areas will be measured by the use of norm-referenced tests among the students taking the course(Lok, McNaught& Young, 2016). The examiners will select various items which vary in difficulty to compare the high and low performers.

4.0 Construction of Test Items and Responses

4.1    Advantages of True-False Test Items

True-false tests are appropriate to test for all the levels of cognitive ability of a learner. The criteria are objective and therefore provide a reliable way of testing for knowledge among the learners. The tests have efficiency when it comes to testing recall and comprehension of a content area that is broad as compared to other strategies of testing. An examiner can, therefore, prove knowledge and understanding extensively unlike different methods (Oermann&Gaberson, 2016). The true-false tests are appropriate for testing simple logic or intelligence such as in the case of causal and because of statements.

The tests are sufficiently reliable and valid instruments for the examination of learners. Exact false tests can include most test items within a short span which makes the tests more reliable. The real false tests are most reliable when it comes to automated scoring since marking can be quickly done. Marking for the true, false tests is simple and does not consume a lot of time as compared to other methods of testing such as essays(Oermann&Gaberson, 2016). True, false tests can be used for item analysis whether internal or over time.

4.2    Disadvantages of true-false test items

Scoring tends to be high in true, false test items as guesswork leads to a 50-50 score as a baseline. It is evident that a student who knows half of the content can guess half of the rest and get it right which enables him or her to score three-quarter of the total despite knowing only half of the test. Guesswork in true, false tests can be done since the stem can act as a cue to the right answer. True false tests cannot provide diagnostic information in terms of why a student got an answer wrong since the tests only demands the correct answer (Oermann&Gaberson, 2016). It may be easy to cheat in a true-false test as the learners can get the answers at a glance,it is also possible for the contents of a true-false test to be simplistic and even trivial which interferes with the ability of the test to test knowledge accurately.

4.3    Advantages of multiple-choice test items

Multiple choice questions are quick and easy to score therefore results can be provided within a very short time. The approach facilitates scoring a large number of tests within a short time as compared with other test methods such as essays. Different ways can be taken in scoring multiple choice questions be it electronic or manually which makes work more comfortable for the examiner. Various choice questions can test a wide range of higher order thinking skills. An examiner can design multiple-choice tests in a way that it will prove several skills in a go(Oermann&Gaberson, 2016). The tests have the capability to cover a lot of content areas within a single exam. Multiple choice questions can be covered within a single sitting despite the fact that they can carry a lot of content with them.

4.4    Disadvantages of multiple choice test items

Multiple choice questions test literacy skills most of the times, and therefore a student can get the answer by reading, the problem carefully even if they know very little about the subject. Answers to multiple choice questions are prone to being recognized by any keen learner. The test approach offers students who are unprepared for exam to guess and getting the right guesses makes them get credit for what they don’t know (Oermann&Gaberson, 2016). Students are prone to making assumptions when they are convinced that they do not know the answers and they might be right at sometimes, and they get marks which they did not deserve.

There are chances that students exposed to misinformation in multiple choice questions might be influenced to employ the same later (Oermann&Gaberson, 2016). Various choice questions are prepared with wrong information which seems correct, and therefore learners might adopt the misinformation unconsciously. Multiple choice questions are time-to consume and require a lot of skill to construct which may interfere with the ability to build good questions.

5.0    Multiple choice questions for one objective

The nurse should do one of the following when establishing realistic goals:

1. base the targets on the nurse’s knowledge
2. know the resources of the healthcare facility, family and the client
3. must have a client who is physically and emotionally stable
4. must have client’s cooperation

5.1    Critical Considerations in Item Stem Construction

The first consideration in constructing a stem for multiple choice questions is the determination whether the stem is meaningful or not. An individual should build a stem that is meaningful and presents a definite problem. A stem bearing fixed problem allows the examiner to focus on the learning outcome. The stem should not contain irrelevant material as these can reduce the reliability and validity of the test. An examiner should include the material which enhances the answering of the question (Oermann&Gaberson, 2016). The stem should be positively stated and negative phrases should only be, used when significant learning outcomes are demonstrated.

Stems with negative phrasing are difficult for most students to handle. An examiner developing a stem for multiple choice questions should write a question or partial sentence to allow learners to focus on the question instead of keeping the incomplete sentence in working memory in a bid to find an answer (Oermann&Gaberson, 2016). It is also important that an instructor avoids stem construction with an initial or interior blank. Such construction leads to increased cognitive load and therefore affects the ability of a learner to answer the question.

5.2    Critical Considerations in Developing Response Options

An examiner should set alternatives which are plausible. The incorrect choices should only serve as a way to distract the learners from the correct answer. The other options could be selected by those learners who never achieved the learning outcome while those who completed the learning outcome will ignore the incorrect choice. Implausible alternatives cannot meet the ability to distract the learners from the correct answer (Oermann&Gaberson, 2016). The examiner should also state the other options in a clear and concise manner and should not be excessively wordy.

The alternatives should be mutually exclusive such that there is no overlapping of answers. The responses should be homogeneous as far as the content is concerned because heterogeneous responses give clues to the solution. The instructor should ensure that none of the alternatives provide an idea about which is the correct alternative. He or she should also avoid responses such as all of the above and none of the above as students can have partial knowledge but get the answer (Oermann&Gaberson, 2016). Examiners should present the alternatives logically and can use a variable number of other options for different questions if they are plausible.

5.3    Benefits of Post-Test Reviews for Students

Post-test reviews are measures for encouraging improvement and also measure progress. Learners can evaluate themselves on whether there is a significant difference before and after a given test. They can also determine progress through comparison with previous scores. Reviewing results provides an opportunity to discuss strengths and weaknesses with students and how they interpreted a particular question (Oermann&Gaberson, 2016). The reviews also offer a chance to the learners to plan on how to improve in future tests and achieve higher scores.

Post-test reviews enable students to identify the references they can use for a question that they missed. A learner identifies whether the question came from the text or verbal statements that were made without them having the necessary concentration. Post-test reviews help learners to identify the strategies which they could have applied for particular questions to get them right. Learners also identify measures which they could embrace to enhance retention and recall of information in post-test reviews (Oermann&Gaberson, 2016). Students can communicate to examiners about what they feel as errors in test construction which could improve the nature of future tests when examiners get feedback.

6.0    Cultural and Societal Factors that May Impact Students’ Learning

Learning is impacted by a number of cultural and societal factors.  The culture of an individual influences the socialization of a learner and his or her response to teaching. Students who come from minority communities may not benefit from learning like others due to discriminatory practices which are culturally-based. The overall attitude of the society towards education impacts the willingness of learners to learn such that society’s which hold education with high regard will have members who are very willing to learn. Students may be discouraged about learning if the society does not hold education with high esteem. The presence of a culture that highly upholds education will motivate the students to learn and get high achievements.

6.1    Impact of Cultural and Personal Background

The cultural and own background of a learner affects his or her learning ability in the classroom. Teachers should be aware of the lived experiences of learners including their cultural backgrounds, their dialects, family, home and community to enhance classroom activity. The cultural and personal background impacts the ability of a learner to participate in class as some students are introverts while others are extroverts (Dörnyei&Ushioda, 2013). As a result, some students will tend to speak a lot in class while others want to be coerced to answer.

The personal background of a student determines his or her commitment to a given course and therefore impacts the willingness to pursue the same. The learners ho come from the minority groups might be isolated in the classroom, and this calls upon the teacher to ensure inclusive learning which does not exclude learners (Dörnyei&Ushioda, 2013). The teacher must ensure that all the students felt learning and accommodated in the classroom environment without discrimination and bias which could lead to underperformance.

7.0    Facilitating Learning through Objectives and Related Activities

7.1    Learning Activity

The learners will formulate a nursing diagnosis on a hypothetical client given the assessment cues.

7.1.1    How the Activity Meets the Goal

The objective mentioned above was to ensure that the learners are capable of formulating a nursing care plan for different patients by the end of the lesson. A nursing care plan comprises of assessment, formulation of a nursing diagnosis, goal and outcome criteria, interventions, rationale, and evaluation. A nursing diagnosis, therefore, makes up one of the components of a nursing process and the learners will consequently partially meet the objective. Formulating nursing diagnosis is a second step in the formulation of a nursing care plan, and the students will, therefore, develop nursing diagnosis from the cluster of cues provided for hypothetical clients in a bid to improve a nursing care plan.

7.2    How the Learning Activity Meets Visual Learning Style

The visual learning style is all about learning through hearing. Such a learner sees information which helps him or her internalizes and learns in the process (Knoll et al, 2017). The visual learning style will facilitate learning of how to formulate a nursing diagnosis. The learners will visualize the NANDA list of nursing diagnosis from which they can obtain a diagnosis. The learners will also view the provided cluster of cues which they will use to formulate the most suitable nursing diagnosis for the hypothetical client. The visual learning style will, therefore, be essential in the analysis of the cluster of cues and the eventual development of a nursing diagnosis.

8.0    Importance of Creating a Learning Activity that Promotes Critical Thinking Skills

8.1    Simulations in Development of Self-Reflection Skills

Simulation involves the creation of an environment which is similar to the clinical area for the development of skills by the learners. Simulation enables learners to embrace a hands-on strategy to learn the required skills before they can be sent to the clinical area for actual practice. The simulation will be essential for the students taking the fundamentals of nursing course since there are several areas which require a hands-on experience (Shin, Park & Kim, 2015). The simulation can be done at the skills lab as the learners are prepared to take up activities such as history taking, counseling and drug administration. The learners, therefore, can apply the knowledge derived from simulation in the management of actual patients. The information obtained from the simulation can thus be utilized in self-reflection by the students to help them internalize the information they have learned.

8.2    Implementation of Simulation in Classroom to Facilitate Development of Self-Reflection Skills

Simulation can be applied in the classroom by restructuring the classroom in a way that is similar to the clinical environment. The learners can be divided into groups in which they can practice the skills they have learned in theory. The students can be paired to perform procedures like history taking and physical examination as taught in the fundamentals of the nursing course (Shin, Park & Kim, 2015). The simulation in the classroom environment will also encourage the learners to reflect on the learning experiences and enhance understanding.

9.0    Best Practice for Providing Feedback to Students in the Clinical Setting

Clinical practice is a significant component of the curriculum for nursing practice. The fundamentals of nursing practice course form the basis for clinical practice in nursing and students, therefore, need frequent feedback about activities they engage in during the course. Students need feedback bearing current information and offer advice on how to improve in the indemnified areas of weakness. Written feedback is the best strategy for giving feedback to learners in the clinical area as students can continuously refer to them to make changes. Forms of written feedback include portfolios and ongoing achievement records and placement mentors commentary (Boswell et al, 2015). Written feedback gives future mentors an opportunity to evaluate the achievements of the learners and adjust accordingly.

References

Billings, D. M., & Halstead, J. A. (2015). Teaching in Nursing-E-Book: A Guide for Faculty. Elsevier Health Sciences.

Boswell, J. F., Kraus, D. R., Miller, S. D., & Lambert, M. J. (2015). Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychotherapy research, 25(1), 6-19.

Dörnyei, Z., &Ushioda, E. (2013). Teaching and researching: Motivation. Routledge.

Knoll, A. R., Otani, H., Skeel, R. L., & Van Horn, K. R. (2017).Learning style, judgements of learning, and learning of verbal and visual information. British Journal of Psychology, 108(3), 544-563.

Lok, B., McNaught, C., & Young, K. (2016). Criterion-referenced and norm-referenced assessments: compatibility and complementarity. Assessment & Evaluation in Higher Education, 41(3), 450-465.

Oermann, M. H., &Gaberson, K. B. (2016). Evaluation and testing in nursing education. Springer Publishing Company.

Porter, W. W., Graham, C. R., Spring, K. A., & Welch, K. R. (2014). Blended learning in higher education: Institutional adoption and implementation. Computers & Education, 75, 185-195.

Shin, S., Park, J. H., & Kim, J. H. (2015). Effectiveness of patient simulation in nursing education: meta-analysis. Nurse education today, 35(1), 176-182.

Zorek, J., &Raehl, C. (2013).Interprofessional education accreditation standards in the USA: a comparative analysis. Journal of Interprofessional Care, 27(2), 123-130.