This presentation session will outline how an online, self-directed, course titled ‘Diagnostic Reasoning and Care Planning’ was developed for undergraduate second year nursing students. The course was delivered in Semester 1 2014 and completed by 220 students. The course design successfully employed a range of tools in Blackboard to engage students in active, self-directed learning, supported by a series of scaffolded learning activities completed online in Blackboard, with students receiving timely, effective feedback via Grade Centre as activities were completed.

1. Maximising the potential of
Blackboard Learn to improve
student learning and engagement in
an online self-directed course
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Orla Daly
Educational Technologist
School of Nursing, Midwifery and Health Systems

2. Context
• BSc (Nursing) General (4 years)
• Year 2 Semester 1 - 196 students
• General Nursing Med-Surg. I (5 ECTS)
• Respiratory
• Cardiovascular
• Haematological
• Delivery over 12 weeks
– 41 hours large group lectures
– 15 hours labs
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School of Nursing, Midwifery and Health Systems

3. Pedagogical Challenge
• Key Issues
– Modularised curriculum separates theoretical knowledge from the
organisation and processing of disciplinary knowledge
– Large group teaching - no tutorials
• The Challenge
– To develop an authentic learning resource that supports development of
nursing students’ diagnostic reasoning skills
• Move away from focus on knowing facts
• Move towards demonstrated analysis, evaluation and synthesis of disciplinary
knowledge applied in practice
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School of Nursing, Midwifery and Health Systems

4. Blended ID
• Identify desired results
– Develop students’ diagnostic reasoning and care planning skills
– Use a variety of nursing conceptual frameworks to process and organise nursing knowledge for nursing practice
• Determine acceptable evidence
– Collecting cues; processing information; hypothesising; developing understanding of patient situation, plan and
implement nursing intervention; evaluation nursing outcomes; reflection and learning through theprocess
• Plan learning experiences
– Map tasks to tools
• Develop learning resource(s)
– Pre-recorded mini-lecture; case studies; online supporting resources; ejournal article links; book chapters; websites;
glossary of terms; interactive webpage; templates; exemplar responses
• Evaluation
– Student Evaluation Questionnaire; Facilitator questionnaire
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School of Nursing, Midwifery and Health Systems

5. Learning Design
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School of Nursing, Midwifery and Health Systems
Supports
Task
Resources

6. Take a tour…
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School of Nursing, Midwifery and Health Systems

7. Student Comments
• Strengths
“I learned about NANDA labels and their
correct use in practice. I also learned
how to link theory and practice and
understand the nursing process which is
imperative. It was extremely relevant
(underlined three times!); had a
fabulous layout and I liked the allocation
of time to specific parts as it helped me
manage the assessments.”
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School of Nursing, Midwifery and Health Systems
• Weaknesses
“I would have liked more marks for it
(smiley face)”
Your previous knowledge and experience of:
Diagnostic reasoning process – limited
Nursing care planning – limited
(Age 19 General)

8. Student Comments
• Strengths
“This elearning unit was very beneficial.
Instructions were clear and concise. It
gave an overall picture of a situation and
I was able to link mentally with what
might happen when on placement. Gave
more confidence to face next
placement.”
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School of Nursing, Midwifery and Health Systems
• Weaknesses
“It was hard to understand what I was
being asked – maybe improve how
questions are phrased?”
Your previous knowledge and experience of:
Diagnostic reasoning process – limited
Nursing care planning – moderate
(Age 50 Children’s & General)

9. Student Comments
• Strengths
“This unit made everything clearer. I
learned how to make a hypothesis about
a patient’s condition; how to look at and
recognise all symptoms, including outside
factors and how to write a proper care
plan. It had just the right amount of
information and really made me think
and use my own head. It was also really
difficult which isn’t a weakness as it made
me use my own knowledge and think
things through.”
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School of Nursing, Midwifery and Health Systems
• Weaknesses
“Could do with including some more
example scenarios.”
Your previous knowledge and experience of:
Diagnostic reasoning process – limited
Nursing care planning – limited
(Age 19 General)

10. Summary of Comments
• Strengths
– Linking theory to practice
– How to hypothesise
– How to formulate a nursing
diagnosis
– Thinking process
– Increased level of confidence for
next clinical placement
– Time management
– Improved understanding of
respiratory problems
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School of Nursing, Midwifery and Health Systems
• Weaknesses
– Grade weighting too low!!!
– Too much content
– Took up far too much time
– Questions hard to understand
– Would like more videos, less reading
– More completed examples before
moving on to assessment tasks

11. What next?
• Assessment
• Feedback cycle - timing
• Exemplars
• Explore potential for more ‘socially’ situated learning
• Develop for different contexts
• Video case presentations
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School of Nursing, Midwifery and Health Systems

12. Contact Details
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School of Nursing, Midwifery and Health Systems
I would like to acknowledge and thank Ms Eileen Bohan (Lecturer) for her
dedicated work and support throughout the development of this course. If you
have any questions, please contact me at:
Orla Daly
Educational Technologist
UCD School of Nursing, Midwifery
and Health Systems
Health Sciences Centre
Belfield
Dublin 4
W: Blending Learning at UCD SNMHS
T: +353 1 716 6457
E: orla.daly@ucd.ie
@ucdsnmhs

13. References
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• NANDA International,. 'What Is Nursing Diagnosis - And Why Should I Care?'. N.p., 2012. Web. 9 Apr. 2015. http://nandainternational.typepad.com/nanda-international/2012/01/what-is-nursing-diagnosis-and-why-should-i-care.html
• Levett-Jones, T., Sundin, D., Bagnall, M., Hague, K., Schumann, W., Taylor, C., & Wink, J. (2013). Learning to Think Like a Nurse. HNE Handover: For Nurses And Midwives, 3(1). Available at: http://journals.sfu.ca/hneh/index.php/hneh/article/view/65
[Accessed 9 Apr. 2015]
• Levett-Jones, T., Hoffman, K., Dempsey, J., Jeong, S. Y., Noble, D., Norton, C. A., Roche, J. and Hickey, N. (2010). 'The ‘Five Rights’ Of Clinical Reasoning: An Educational Model To Enhance Nursing Students’ Ability To Identify And Manage Clinically ‘At Risk’
Patients'. Nurse Education Today 30(6), pp. 515-520.
• Merrill, M.D. (2007). First Principles of Instruction. Educational Technology Research and Development, 50(3), pp. 43-59
• Keppell, M., Suddaby, G., & Hard, N. (2015). Assuring best practice in technology-enhanced learning environments. Research in Learning Technology, [S.l.], v. 23, mar. 2015. ISSN 2156-7077. Available at:
http://www.researchinlearningtechnology.net/index.php/rlt/article/view/25728 [Accessed 09 Apr. 2015]
• Fink, Dee. (2003) A Self-Directed Guide To Designing Courses For Significant Learning. Available at http://www.deefinkandassociates.com/GuidetoCourseDesignAug05.pdf [Accessed 9 Apr. 2015]
• Lombardi, M. (2007). Authentic Learning for the Twenty-First Century: An overview. Educause Learning Initiative. ELI Paper 1: 2007. Available at: http://alicechristie.org/classes/530/EduCause.pdf [Accessed 9 Apr. 2015]
• Walmsley, H. (2015). Best Practice Models for e-Learning: Principles https://bestpracticemodels.wiki.staffs.ac.uk/Best_Practice_Models_for_e-Learning:_Principles
• Herrington, J., Reeves, T.C & Oliver, R. (2010). A guide to authentic e-learning. London and New York: Routledge
• Parker, J., Maor, D. & Herrington, J. (2013). Under the hood: How an authentic online course was designed, delivered and evaluated. In Design, develop, evaluate: The core of the learning environment. Proceedings of the 22nd Annual Teaching Learning
Forum, 7-8 February 2013. Perth: Murdoch University. Available at: https://ctl.curtin.edu.au/events/conferences/tlf/tlf2013/refereed/parker.pdf [Accessed 9 Apr. 2015]
• Tanner, C. (2006). Thinking like a nurse: A research based model of clinical judgement in nursing. Journal of Nursing Education, 45, pp. 204-211
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