Nursing has evolved over the years. Gone are the days when members of this profession relied on basic and crude methods and tools to attend to patients. Today, nurses use sophisticated equipment and techniques to rid patients of their illnesses. For example, modern technology has become a critical element of nursing care today. It has allowed nurses to improve the quality of care that they deliver to patients. Despite the gains that have been made, it is important to acknowledge that there are numerous challenges that the nursing profession still grapples with. One of these challenges is the lack of the competencies and skills that nurses need to keep up with the changes that are being witnessed in the profession (Zerwekh & Garneau, 2013). This challenge has been compounded by the fact that educational institutions lack the personnel and facilities that are required to train nurses. In an effort to address this issue, more and more institutions are developing curricula that are aimed at imparting the skills and insights that nurses need to address the challenges that are faced today. This paper examines the question of learning for nurses in the 21st century. The case of Hartford University which wishes to develop an introductory course is considered. Among other things, the paper identifies competencies that the course will develop, the objectives that the course will seek to achieve, the strategy that the course will adopt and the factors which may affect the learning outcomes for students taking the course.
Competency statements
As one develops a learning program for nursing students, it is important to identify core competencies. Essentially, these competencies refer to the skills and knowledge that students are expected to have acquired at the end of the course (Keating, 2014). The following are the four key competencies that the course developed for Hartford University will seek to enhance in the students:
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The students will be expected to be able to integrate technology into nursing practice
The students should be able to embrace different cultural perspectives in their engagement with different communities
The student should demonstrate an understanding of the professional standards that govern the conduct of nursing practitioners
At the end of the course, the students should exhibit an understanding of proper patient-practitioner interactions.
As it is clear from the list of competencies mentioned above, the course will be broad and wide-ranging. It will prepare students for the challenges faced in the workplace and equip them with the insight and attitudes that they need to interact with patients from diverse cultural backgrounds. In the following discussion, an examination of how the competencies measures up to guidelines laid out by the Commission on Collegiate Nursing Education (CCNE).
Alignment to guidelines and standards
The CCNE has developed standards that must be met by institutions which wish to receive accreditation for the programs that they offer. One of the standards that the commission requires that education programs should satisfy is that they must be aligned to the goals and mission of the institution offering them (“Standards for Accreditation”, 2013). The main mission of Hartford University is to supply the nursing professional with qualified and passionate practitioners. By pursuing the competencies listed above, the institution will be able to fulfill this mission. For example, one of the competencies is that the students should be able to incorporate modern technology into practice. This means that the course competencies are in line with the key mission of the university. The other standard that CCNE sets out in its guidelines is that education programs should allow for periodic review and assessment (“Standards for Accreditation”, 2013). When one examines the competencies mentioned above, they are able to recognize that it is indeed possible to assess whether the students have developed these competencies. An understanding of professional standards is one of the competencies that can be considered as an example. Exams can be administered to ensure that the students are familiar with the professional standards and that they are able to adhere to them in practice.
Student and faculty participation is another element in the guidelines released by the CCNE. The commission requires that education programs should encourage students to be active (“Standards for Accreditation”, 2013). The competencies mentioned above will allow the students to be aggressive and enthusiastic in learning. For example, it can be expected that students will warm up to learning how to engage with different communities and embrace modern technology. The other standard that CCNE demands that nursing education programs should meet is that proper documentation should be carried out (“Standards for Accreditation”, 2013). This means that the institution offering a program should maintain documents regarding such issues as student performance. Documentation facilitates assessment of student performance and progress. Overall, the competencies discussed above are in line with the professional standards that CCNE stipulates in its guidelines.
Learning objectives
Defining the competencies that students are expected to gain is a crucial element of curriculum development. However, it is not sufficient for preparing students. It must be accompanied by clear objectives. Cultural competency is one of the competencies that the course seeks to develop. This competency will be instilled through the pursuit of the following objectives:
The course will seek to enable students to understand the importance of cultural competence.
The course will also aim to prepare students for a multi-cultural workplace.
The program will additionally aim seek to enable students to recognize the devastation that can occur when cultural conflicts arise and are not well managed.
Criterion for selecting appropriate learning resources
The effectiveness of any education program is determined to a great extent by the availability of resources. If all the facilities and equipment that are needed are available, it is easier to achieve learning objectives and develop competencies. Cost is the primary criterion that will be used to select appropriate learning outcomes. While it is the desire of all educators to provide their students with all the resources that they need, it must be recognized that cost constraints make it difficult to provide all resources. In fact, the high cost of resources is one of the factors that is hindering the effective teaching of nursing programs (Callara, 2008). To ensure that the students derive maximum benefit, the most cost-effective tools and resources will be selected. A criterion that is based on cost considerations ensures that there are adequate finances to procure equipment and other tools.
Approach to be used
There are a number of approaches that have been developed to facilitate learning in nursing. The contemporary method is one of these approaches. Essentially, this approach involves incorporating modern principles, content and techniques in teaching (Zhang, Zhan & Finch, 2011). One of the key features of this approach is the integration of technology such as the internet into learning. This approach is effective because it ensures that the skills and competencies that students gain are applicable to modern situations. For instance, since it adopts modern technology, the contemporary approach enables students to embrace technology in clinical settings. This approach will be selected for the education program at Hartford University owing to the numerous advantages and benefits that it presents.
Strategies to be used for evaluating outcomes
It would be pointless to require students to take the course without assessing outcomes. There are numerous assessment methods that are traditionally used to evaluate whether students have developed the desired competencies and that the learning objectives have been met. Papers and essays and role playing are two of the strategies that the course will employ for evaluating outcomes. Papers and essays are rather traditional and they have been relied on for years to investigate if students have grasped concepts. The students who take the course at Hartford University will be required to write papers and essays. They will also be asked to engage in role playing activities. Basically, these are activities that simulate the real world situation. For example, the students could engage in an activity involving a nurse and a patient who are from two different cultural backgrounds. The goal of this activity will be to assess whether the students are able to demonstrate cultural competence and engage with patients from diverse backgrounds.
Advantages of strategies
Papers and essays have already been identified as one of the strategies that will be relied on for assessment. While it is true that they are not entirely reliable for assessing students, they offer insights which can enable educators to improve education programs (Webber & Lupart, 2011). This is the main advantage of papers and essays. In addition, papers and essays allow students to develop their critical thinking and analysis skills. The key advantage of role playing is that it offers students a peek at the situations that await them (Killen, 2007). Students are then able to ensure that they are adequate prepared to thrive in these situations.
Disadvantage of strategies
The strategies discussed above are not perfect since they possess flaws. One of the demerits of papers and essays is that they cannot be relied on to accurately determine the commitment and performance of a student. This strategy essentially assesses the capacity of a student to retain and cram information. It does not measure such other parameters as creativity which are important for holistic learning. The role playing strategy is not without its disadvantages. One of the disadvantages is that it can cause chaos (Kitten, 2007). During role playing sessions, only a few students take part. This could cause the other students to become disinterested and this hinders effective learning.
Criterion and norm-referenced tests
Criterion- and norm-referenced tests are some of the tools that educators rely on in their assessment of students. In the following discussion, how these tests will be used for assessment in the course is explored.
Criterion-referenced tests
Criterion-referenced tests are assessment tools and techniques which measure the performance of a student against established standards and expectations (Furr & Bacharach, 2007). For example, a student’s performance can be measured against the fulfillment of course learning outcomes. The criterion-referenced tests will be used in a variety of ways. One, the performance of students will be held up against the core competencies identified earlier. Two, since papers and essays will constitute the evaluation strategy, the students will be required to meet such standards as the following:
Responding to all questions satisfactorily
Adhere to principles and standards of college-level academic writing
Follow all rules and standards of grammar, among others.
Norm-referenced tests
Norm-referenced tests are yet another tool that educators used for assessing students. Basically, they refer to evaluation tool that involves comparing the performance of students to some established average (Furr & Bacharach, 2007). Since the course has never been taught before, no scores for students who took the test previously are available. Therefore, the norm-referenced tests will function by comparing the test scores of individual students with the average score for the class. This will allow the students to determine how they fare against their colleagues.
Construction of test items and responses
As part of the course, students will be required to sit for exams. These exams will take different forms. Some will require the students to supply true-false responses while others will be of the multiple-choice variety. The discussion that follows focuses on the advantages and disadvantages of these test items and responses.
Advantages of using true-false test items
True-false test items are some of the most commonly used in education and training settings. Essentially, students are needed to indicate if a statement is true or false (Haladyna & Rodriguez, 2013). One of the advantages of these test items is that they are simple. All that a student needs to do is to state whether they think that a statement is true or false. The other advantage of these test items is that it is fairly easy to collect and analyze the responses (Haladyna & Rodriguez, 2013). Since the responses are standard (yes or no), it is easy to carry out analysis as opposed to situations where students provide their own individual responses.
Disadvantages of using true-false test items
Whereas it is true that true-false items possess numerous advantages, it must not be forgotten that they also have flaws. The fact that these test items are unreliable is one of their disadvantages (Haladyna & Rodriguez, 2013). They are not holistic in their assessment of students since they focus on narrow and specific issues. The other disadvantage is that it encourages students to guess instead of thinking critically.
Advantages of multiple-choice test items
Multiple-choice is the other type of test items that is in common use. Students are supplied with a list of options and are required to identify the option that best applies to a given situation. The ease of administering questions with multiple choices is one of the advantages (Haladyna & Rodriguez, 2013). The other advantage is that multiple-choice test items allow educators to assess a wide range of skills and course content. This means that educators are able to pack much content into few questions.
Disadvantage of using multiple-choice test item
Multiple-choice items also have drawbacks that render them ineffective in assessing students. These test items share the same flaw that is found in the true-false items. They also encourage guessing since students can identify the correct option without necessarily understanding the issue (Haladyna & Rodriguez, 2013). The other flaw in these test items is that they are time consuming. The administrator has to commit a huge amount of time to constructing the questions. This demerit is compounded when the educator wishes to develop quality questions that possess depth.
Multiple-choice item for learning objectives
There are various learning objectives that the course will pursue. These objectives will incorporate multiple choice items to examine whether students are gaining insights. One of the learning objectives that the course will seek to pursue is to ensure that the students recognize the importance of cultural competence. The following multiple-choice item could be used in the pursuit of this objective:
Which of the following traits defines a nurse who lacks cultural competence?
Empathy
Friendliness
Arrogance
Open mindedness
It is true that the test item above is rather simple. However, it is important to understand that the simplicity of the item enhances understanding and allows students to provide correct responses. The test item above will allow students to demonstrate that they understand the character traits that they need to exhibit as they engage with patients from diverse cultural backgrounds.
Key considerations in item stem construction
The stem is one of the crucial components of multiple-choice test items. Essentially, it refers to the question that the students are required to respond to (Osterlind, 2012). In the item provided above, “Which of the following traits does define a nurse who possesses cultural competence?” is the stem. There are a number of considerations that should be made when constructing the stem. One, it is important to use clear language (Osterlind, 2012). Vague questions make it difficult for students to understand the question and identify the correct response. Two, the number of words is another consideration. The stem should not have too many words (Osterlind, 2012). Three, the stem should be expressed positively. This means that the stem should not contain such words as “not”.
Key considerations in response options
The response options are the choices that a student should select. As is the case with the stem, there are a number of considerations that should be made when constructing the response options. One, it is important to ensure consistency (Osterlind, 2012). All the options should be presented in a similar fashion. For instance, it is improper to combine full sentences choices with one-word options. Two, it is vital to ensure that the options do not point the student to the correct choice (Osterlind, 2012). This allows the student to arrive at the correct choice after critical thinking and a careful evaluation of the different options.
Benefits of posttest reviews
After administering tests and providing students with their scores, it is important to conduct reviews. These reviews present the students with a number of benefits. One of the benefits is that they allow students to identify their mistakes and the measures that they can institute to improve their test performance (Lelardi, 2014). The other benefit is that the reviews enable students to obtain higher scores when they realize that the teacher blundered during marking. The posttest reviews also provide students with an opportunity for offering recommendations that can be implemented to improve the test experience. For example, students can point out any flaws in the structure of the questions.
Cultural and societal factors and their impacts on learning outcomes
A student’s social and cultural environment plays an important role in determining their performance and overall experience. When these environments are conducive, positive outcomes can be expected. The value system is one of the cultural factors that impacts learning outcomes (Munro, n.d). If the factors encourage such values as community and collaboration, the student is likely to embrace group work. This enhances the learning outcomes. On the other hand, if the student is from a culture that places emphasis on personal space, the student is likely to shun away from others. This could impede effective learning. Perspective on the importance and the need for education is another societal factor that shapes learning outcomes. While more and more communities are recognizing the importance of education, there are some communities that are yet to understand that education provides individuals with the promise of a better tomorrow. If a student is from the latter community, they are unlikely to be enthusiastic about learning. This will have a negative impact on learning. On the other hand, if a student is from a community that cherishes and heavily invests in education, it can be expected that the student will warm up to learning.
Impact of social and cultural background
As is clear from the discussion above, social and cultural forces influence learning outcomes. These forces also have an effect on learning in the classroom. Cultural and social factors determine how individuals think and their preferred learning methods (Munro, n.d). As they engage with others, students are able to develop their unique thinking processes and learning methods. They carry these processes and methods with them to class. Such other issues as collaboration with colleagues, views on competitive learning and rewards for excellent performance are also influenced by one’s social and cultural background. If a student cherishes cooperation with others, understands that some degree of competition in the classroom is healthy and that rewards enhance performance, this student is likely to perform well.
Facilitating learning through learning objectives and related activities
It is common for educators to spell out the objectives that they will pursue as they teach. In the pursuit of these objectives, a number of learning activities form part of the curriculum. Learning objectives and related activities serve the important purpose of facilitating learning. Thanks to learning objectives, educators are able to specify the aims that students are supposed to seek to achieve. The learning objectives also enhance learning by allowing educators and learning institutions to focus their resources and efforts on the objectives. This means that adequate resources are set aside to ensure that the learning objectives are met. Related activities also enhance learning by stimulating the minds of students. For example, such activities as role-playing break the monotony of conventional teaching. They also introduce students to real situations that require them to apply the concepts and insights learned in class. Overall, learning objectives and related activities enable students and teachers to focus their energies on the core business of learning.
Learning activity to meet learning objectives
There are a number of learning objectives that the course will pursue. As already mentioned, one of these objectives concerns preparing students for a culturally diverse workplace. Different learning activities can be developed to facilitate the achievement of this objective. Visits to medical facilities are one of these activities. To provide the students with the exposure that they need, regular visits to healthcare providers will be organized. Exposing students to the real work environment allows them to understand the challenges that they are likely to face. Additionally, exposure enables students to witness the application of the theoretical concepts that they learn in the classroom.
How the learning activity meets learning objective
Preparing the students for a culturally diverse workplace is one of the objectives that the course wishes to achieve. In the discussion above, it has been noted that visits to healthcare facilities will facilitate the achievement of this objective. It does this by enabling the students to observe practitioners while they are at work. By allowing the students to observe practitioners in action, it will be possible to highlight how the practitioners engage with their colleagues and patients who are from different cultural backgrounds. The visits to healthcare facilities will also allow the students to determine if they are ready for the workplace. This will enable the students to take extra measures to ensure that they are adequately prepared to tackle the challenges that the workplace will present.
Learning activity and learning styles
There are many styles that teachers use to promote learning. The visual kind of teaching is one of these styles. Basically, this style involves stimulating the eyes by exposing students to situations that require observation. The discussion above has focused on visiting healthcare facilities. This activity exploits the visual learning style as it calls on students to use their eyes. For any learning to occur, the students must observe and understand what they see. The visits will particularly benefit students who learn best when their visual senses are stimulated.
Importance of creating learning activity that enhances critical thinking skills
The discussion so far has focused on creating activities and tools that will facilitate learning. One of the issues that learning focuses on is critical thinking. Educators need to ensure that students are able to critically evaluate situations and develop solutions (Winch, 2009). The learning activities that students engage in need to develop critical thinking skills. This is important because it allows students to solve the problems that they experience in their different worlds. Traditional education has been criticized for failing to create individuals who are able to solve problems. This can be changed by creating learning activities which force students to think and analyze situations. The other importance of learning activities that promote critical thinking skills is that the activities make learning more engaging. Students are able to actively participate.
Critical thinking strategies
Collaborative learning is one of the strategies that can be implemented to enhance critical thinking skills. This form of learning involves encouraging students to become active participants (Barkley, Cross & Major, 2012). Instead of sitting back and listening to a lecture, students take charge of the learning process. Collaborative learning has been shown to be effective in encouraging student participation. Furthermore, collaborative learning boosts the performance of students. It is more effective than the conventional approach where the teacher dominates learning.
Implementation of strategy
Collaborative learning has been identified as the strategy that will be implemented in a bid to boost the critical thinking skills of the students taking the course. There are a number of activities that will form the implementation process of this strategy. Group discussions and assignments are one of these activities. Group discussions and assignment allow students to join forces. They are able to learn from one another. Another activity that will be part of the implementation of the strategy is inviting the students to take over from the teacher occasionally. In addition to building the confidence of students, this activity will also allow the students to teach their colleagues. This is the essence of collaborative learning. The activities mentioned in this discussion will also develop the self-reflection skills of the students taking the course.
Best practice for providing feedback
Feedback is one of the crucial elements of learning. Through feedback, students are able to understand how they are performing. There are a number of best practices that teachers can adopt as they provide feedback to their students in clinical settings. Respect is among these practices (Ramani & Krackov, 2012). While it is true that there is a clear hierarchy in learning situations, there is need for teachers to demonstrate respect for their students. The teachers can do this by providing feedback in a confidential fashion. The teacher could also correct students with calmness and respect. This fosters trust and warmth among teachers and their students.
This paper has shed light on teaching for nursing students. The fact that the nursing environment is ever changing highlights the need for nurses and students to expose themselves to trends and insights. It is also important for educational institutions to develop programs that meet the needs of the nursing profession. It is also vital to ensure that the programs develop core competencies and enable students to pursue their learning objectives. There are a number of strategies that can be employed to ensure that students derive the most benefit from learning programs. As educators and learning institutions develop relevant and inspired curricula, they set the stage for the nursing profession to receive qualified members.
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