Innovation Grant Application
Type of Request: Instructional Technology
Daira Munn Nursing Full-time 223-6109 firstname.lastname@example.org RVS
Helen Harkreader Nursing Full-time 223-6121 email@example.com RVs
Developing Critical Thinking Through Patient Vignettes
Degree or Certificate Program
1. Instructional Need or Problem
| The National League of Nursing Accrediting Commission (NLNAC) includes
in its criteria for accreditation that nursing students demonstrate critical
thinking skills relevant to good nursing practice. This has led colleges
and universities that offer associate, baccalaureate, and advanced degrees
in nursing to make the development of critical thinking skills an explicit
educational goal and to strive to introduce viable modes of assessing
the critical thinking skills of their students. At the same time, the
trend in higher education has been to move away from the model of a single
course and generic tests in critical thinking as the vehicle for helping
students develop critical thinking skills and for assessing how well they
do this, and rather to endorse infusing the teaching and assessing of
critical thinking into regular content courses. Even though the NLNAC
mandate on critical thinking is close to a decade old, and much has been
written on this topic, many nursing programs in higher education are still
struggling with how to best accomplish these goals.
The ADN faculty is exploring a variety of methods for teaching critical thinking in nursing. The case study method lends itself to both individual and collaborative learning experiences in the classroom. McDade (1995) describes this method as the teacher presenting a case (or story) to the class without a conclusion. Using prepared questions, the teacher then leads students through a discussion, allowing students to construct a conclusion for the case.
While several resources are available that present written case studies, the faculty wanted to find resources that presented cases in a more realistic way through video. The video presentation of a patient situation would simulate closely the types of experiences students confront in the clinical teaching setting. Instead of getting written cues from a print-based case, students would have to rely on observation and assessment skills to begin problem solving. No such resources could be found except those associated with specific textbook adoptions.
This multiphase project will utilize instructional technology to develop digital video clips of real world nursing practice situations through patient care vignettes. The vignettes can be used in each course in the ADN Program for a variety of purposes including initial patient assessment skills, developing a list of possible nursing diagnoses, developing a nursing care plan, practicing observation skills, simulating communication skills, identifying important safety measures, prioritizing patient care; etc. The vignettes can be used with students of all skill levels to simulate patient situations in the clinical setting.
The development plan for the entire project is briefly described below:
This grant application pertains to Phase 1 only.
McDade, S. A. (1995). Case study pedagogy to advance critical thinking. Teaching Psychology, 22(1), 9-10.
2. Audience and Number Affected
|Associate Degree Nursing students (> 250 students/semester) enrolled in any of the seven nursing theory courses and 23 full-time faculty could potentially use the vignettes.|
3. Project Goal(s)
|Develop interactive critical thinking learning experiences that can be used across the Associate Degree Nursing Program with students of all levels to develop critical thinking skills related to nursing practice and patient care.|
4. Objectives / Outcomes
| Phase 1:
| The patient care vignettes will be written and filmed in such as way as too avoid "dating" the material. Patients will be dressed in hospital gowns or classic clothing, hair styles and cosmetic make-up will be minimal. Medical equipment and furniture will be used only as needed for the vignette and will not be the focus of attention. Nurses will not be shown since the vignettes should be seen from the nurse's perspective.
The Educational Resources Committee (a standing committee of the ADN Faculty Organization) will be charged with periodic review of the vignettes and manual to ensure currency and accuracy of the scenarios and accompanying written material.
7. Project Evaluation
| The project will be evaluated by comparing student scores on the HESI Exit Exam for students participating in the interactive patient care vignettes with the scores of previous students who did not participate in the vignettes. The HESI Exit Exam is accepted as an appropriate tool for measuring critical thinking in nursing.
In addition, student and faculty surveys will be used during the initial implementation to ascertain satisfaction with the vignettes. The results of the surveys will be helpful in designing subsequent phases of the project.
Statement of Qualifications
Daira Munn, RN, MSN, Associate Professor has been a Registered Nurse for seven years including 2 years experience in baccalaureate nursing education and 2 years in associate degree nursing education. Her clinical expertise includes medical surgical nursing, pain management, home health nursing, and medical-legal consultation.
Daira is the Assistant Chair of the ADN Faculty Distance Learning Committee. She values the opportunities for learning provided by various instructional technologies. She was one of three team members that developed the first online course for the nursing program and is in the midst of developing the second online course.
Daira continues to practice in the clinical setting on a part-time basis and understands what real-world nursing entails. As a promising drama student in high school, Daira has a special understanding of this project and has graciously accepted the role of team leader.
Jere Hammer, RN, MSN, Associate Degree Nursing Program Coordinator has 23 years experience as a Registered Nurse including 10 years experience in associate degree nursing education. Jere has expertise in the administration of associate degree nursing programs. She represents associate degree nursing on a number of statewide committees, including, the Nursing Education Policy Coalition sponsored by the Texas Nurses Association and the Field of Study Curriculum for Nursing Advisory Committee sponsored by the Texas Higher Education Coordinating Board.
Jere recognizes the potential uses of technology in nursing education and is an early adopter of technology in the classroom. She introduced technology across the nursing program by creating departmental and course web sites, implementing online testing throughout the curriculum and creating the ADN Program faculty committee for Distance Learning. She was one of three team members that developed the first online course for the nursing program.
Jere is currently completing a Certificate in Distance Education at Capella University.
Helen Harkreader, RN, PhD, Professor has been teaching nursing at Austin Community College since January 1984. Prior to 1984 she has taught in four other nursing programs and has practiced nursing in a variety of medical surgical settings.
Additionally Helen has:
1) Expertise in learning styles using the Myers Briggs Type Indicator. Is a qualified administrator of this instrument and has used it with over 700 nursing students to assist them in recognizing their strengths and weaknesses in academics, in test taking, and clinical practice.
2) Beginning expertise in online learning. Attended a four day workshop on online learning at UIPUI and has read widely on online learning. Has participated with a team to develop Foundations for Nursing Practice (RNSG 1513) as an online course.
3) Knowledge of use of photography and line illustrations for educational purposes. Has developed an art program for Fundamentals of Nursing: Caring and Clinical Judgment consisting of 970 illustrations. This work included included supervision of a photographer and graphic artist to insure correct representation of nursing procedures.
4) Skill in written communication. Author of Fundamentals of Nursing: Caring and Clinical Judgment. This is a 1700 page textbook for professional nursing students. Published by W. B. Saunders. Has also published two student study guides and two instructors manuals, and a CAI that presented 5 case studies
for student learning. Is currently working on a project to develop a study guide for a virtual hospital that has 14 patients.
The costs involved in this project are those associated with production of the videos. The attached budget was prepared by video services at the request of the grant participants. Video services provides ACC in-kind contributions for everything they can provide, but must pass on the cost of outside equipment rentals and contract personnel. It is also an industry standard to provide food and travel costs for contractual personnel in the video production industry.
Video quality is of utmost importance to each phase of the project. The vignettes will be of broadcast quality that will be placed onto VHS in phase 1 and streaming video in phases 2 & 3.