Taking a radical departure from the traditional lecture-based approach and implementing an authentic and collaborative case-based learning model in an online nursing course resulted in a profound change in student attitudes towards course content, online technologies, teamwork, and nursing practice.
Authentic and Collaborative Case-Based Learning: A New Model for Teaching Family and Community Nursing Online
1. Authentic and CollaborativeCase-Based Learning:A New Model for TeachingFamily and Community Nursing Online Beth Register PhD, RN-BC, MPH, CCMVera Polyakova-Norwood MEdCollege of NursingUniversity of South Carolina
2. Graduate Nursing Programs at the University of South Carolina MSN and DNP degrees and NP certificate program are delivered primarily online PhD program is being adapted for online delivery
3. Course Objectives: Describe key concepts of advanced practice nursing with families and communities. Utilize relevant concepts, theory and current research to plan advanced practice nursing care with families and communities. Apply principles of cultural competence to advanced practice nursing with diverse family and community groups. Examine the role of the advance practice nurse as family and community advocate.
11. Traditional Lecture-Based Model Faculty Perspective: It can be awfully lonely in the studio classroom … Student Perspective: The course does not add to my preparation as nurse practitioner.
12. The Challenge Make the course feel relevant to future advance practice nurses Introduce authentic learning Overcome student biases and stereotypes Create excitement and engagement Enhance student skills set for critical thinking, collaboration, and problem solving
13. Authentic learning focuses on “real-world complex problems and their solutions, using role-play exercises, problem-based activities, case studies and participation in communities of practice.” (Lombardi, 2007, p.2)
14. Designing authentic learning Real world relevance Ill-defined problem Sustained investigation Multiple sources and perspectives Collaboration Reflection Interdisciplinary perspective Integrated assessment Polished products Multiple interpretations and outcomes (Lombardi, 2007)
16. Let students work on cases! Each Case Management Team is presented with an authentic patient record containing: Demographics Complete clinical information Family information Residence/community information
17. What did students have to do? Work in teams to create, implement and evaluate a patient-centered care plan Mobilize family and community resources to meet patient’s needs
18. Students learned about the patients and their families Live web meeting for case intake between the faculty and student case management team
20. Students made real referrals … we scheduled a tour of the MUSC Children’s Hospital for March 2, 2009, arranged for the parents to stay at the Ronald McDonald House during the induction phase, and arranged for a tour of the Ronald McDonald House on March 2, 2009. We referred the parents to the Leukemia, Lymphoma Support Group in Myrtle Beach, to the ALL-Kids Listserv for online support at http://listserv.acor.org/archives/all-kids.html, to the Candlelighters childhood cancer support group at http://www.inspire.com/groups/candlelighters-childhood-cancer/, and referred the family to Caring Bridge for online support to help keep them connected with friends and family - http://www.caringbridge.org/. This included a coordinated referral for Pediatric Hematology/Oncology. We spoke with Amy Strohecker, appointment coordinator for Pediatric Hematology/Oncology, at 843-876-0444 about an initial appointment for the Dawsons with Dr. JacquelinKraveka. According to Ms. Strohecker, the appointment will be on March 2nd at 1400 at 35 Rutledge Avenue, and Kyra will check in at MUSC Children’s Hospital on March 3rd.
21. Implementing the Plan: Oops…We need to re-group! Lesson Learned: Work with your patient. He is a real person and if you do not have him on board, your plan is not going to work no matter how brilliant it is.
22. Teams presented cases to the entire class for critique Team two has provided care for Mrs. Esther Bellantonio, an 81 year old patient with ovarian cancer, who is suffering the side effects of neuropathy. Our team has created a plan to help Mrs. Bellantonio resume her daily activites, as well as utilize community resources to enhance her living, while remainig in her home. We invite you view our wiki, and we welcome your feedback. Hope you enjoy!
23. Learning and making connections Faculty Virtual Patient and Family Student Members of the Team People in the Community Classmates Community Resources
25. Role-playing: Learning to work with patients, families, and communities Dr. Register, I have just a few more questions to ask you/Mrs. Bellantonio: Is she interested in us arranging rides to church services/activities? If so, does she mind if we contact the church to see if any of the members would be willing to provide transportation? Well, I don't want to bother anybody. I know a lot of people at the church. They asked me before if I needed a ride. I guess that would be nice. Yes. Maybe give them a call for me. Thank you. …
27. Instructional team! Course content knowledge and skills Instructional design Teaching experience Best practices in online education Technology expertise Willingness to try new approaches Teamwork
28. What did students take away from this course? End-of-course reflections
29. Understanding of Family and Community Health Nursing Nursing 708 has been an illustration of how patient care not only involves the patient, but also the community, family members, and support persons. Necessary medical treatment is only part of patient care. This class had demonstrated the mobilization of people and organizations to reach a projected outcome on a first hand basis. NURS 708 Student, Spring 2009
30. Patient advocacy The most important overall lesson learned in Family and Community Health is to always be a patient advocate. … A nurse is not just someone who passes out pills anymore. A nurse provides the link between client and everyone else. … Nurses’ roles have changed drastically over the past twenty years, and patient advocacy is a defining characteristic of an advanced practice nurse. NURS 708 Student, Spring 2009
31. Teamwork and online collaboration I learned how to work with an online group. This was very difficult because parts of the project had to be completed prior to progressing to the next step. This was very frustrating because you could not tell when things would be posted. I found myself doing other people’s work so I could complete mine. The positive side was that they, in turn, would critique my work and provide extra input. This resulted in a better product. The group members soon identified what each member excelled in and tapped into those talents. NURS 708 Student, Spring 2009
32. A new approach to learning The case-based learning approach stimulates creativity in the planning of care, regardless of the community setting. It affords the opportunities to apply different strategies to engage the patients and their families in their care. This approach provides valuable real world interaction with real patient scenarios and the resources available in the community with a focus on planning patient care according to where they are in their illness. This is not textbook “ideal” community health nursing, it is real “hands on” application of family and community health nursing. NURS 708 Student, Spring 2009
33. New learning skills This semester has taught me to look at the big picture initially and then systematically break it down to each medical problem/concern. An important new learning skill I have acquired over the course of the semester is simply learning how to tap into others knowledge base to learn more about a phenomenon I knew little about. Learning to use others know-how skills is an important tool to have to obtain the knowledge one needs. NURS 708 Students, Spring 2009
34. Increased self awareness … I became more aware of my own thoughts and how they may be perceived by others. I became more aware of my own beliefs and how acceptance of others beliefs can positively impact healthcare. This course has given me self awareness I will not only use in my practice as a nurse, but in life. NURS 708 Student, Spring 2009
35. Professional growth NURS 708 has been an invaluable course for my MSN preparation. The information and experiences obtained through this course will affect my everyday practice as a family nurse practitioner. … I felt as though I learned so much, and I am more confident in my ability to care for families and communities. … This was a wonderful course, and I am a better nurse for having taken it. NURS 708 Student, Spring 2009
36. Questions?Comments? Beth Register meregis@mailbox.sc.edu Vera Polyakova-Norwood vnorwood@mailbox.sc.edu The 15th Sloan-C International Conference on Online Learning October 29, 2009
Editor's Notes
adult learners who geographically dispersed, work part time or full time, and juggle multiple family responsibilities in addition to meeting academic obligations.
Both students and educators agree that learning by doing and solving real-world problems is more effective than other instructional approaches. Lombardi (2007) describes authentic learning as focused on “real-world, complex problem and their solutions, using role-play exercises, problem-based activities, case studies, and participation in virtual communities of practice” (p. 2).
Both students and educators agree that learning by doing and solving real-world problems is more effective than other instructional approaches. Lombardi (2007) describes authentic learning as focused on “real-world, complex problem and their solutions, using role-play exercises, problem-based activities, case studies, and participation in virtual communities of practice” (p. 2).
