Instructional Plan

Denise Rohr

EDG 693 – Summer 2012

Instructional Plan

Title:

Experiencing Aging

Description of the students/course:

This unit will be used in the Gerontological Nursing course NUR-4954 at The Cincinnati State Technical and Community College Bethesda School of Nursing.  The students range in age from 19 to 59 years of age during most terms.  This plan will be taught by one instructor and one nursing lab manager to 16-24 students.  It will take place over three weeks of the term.

The course will use traditional and high fidelity simulation to provide experiences to increase the student’s knowledge of and sensitivity to the changes experienced as an individual ages.  During the first session, the students will “put on” the sensory and physical changes that occur with normal aging and select diseases/physical problems experienced frequently by older adults.  During the second session, the class will be held in the high fidelity simulation lab.  The high fidelity sim mannequin will be used to replicate clinical signs and symptoms.  The student will respond to the patient’s subjective and objective signs and symptoms.  The mannequin’s symptoms will improve or worsen based on the student’s interventions.  The final experience will be an exercise in therapeutic communication.  Volunteers will act the part of clients with hearing and visual deficits while the students interview them to obtain a medical history.  An interactive computer program will be used to assess therapeutic communication skills.  A virtual patient will provide answers to the student based on therapeutic communication techniques used in the data collection process.

Curriculum Threads Addressed by Program:

1.      Utilizes scientific principles and theoretical concepts as a basis to provide care for a variety of patient populations.

2.      Provides care which is congruent with the values and beliefs of the client/family.

3.      Utilizes appropriate decision making skills to provide safe, effective nursing care for a variety of patient populations.

4.      Utilizes therapeutic and professional communication skills to meet the needs of clients.

Student Learning Outcomes:

1.      Students will verbalize and document in journal entries their physical and emotional responses to experiencing the changes of normal aging and select deficits often experienced by older adults.

2.      Students will demonstrate competency in applying the nursing process to the care of the older adult in a simulated patient care setting as evidenced by response to client signs and symptoms and written plan of care.

3.      Students will verbalize own attitudes towards aging and elders and recognize the uniqueness of each older adult.

4.      Students will apply principles of therapeutic communication and demonstrate techniques to effectively communicate with elders experiencing sensory losses.

Desription of the assessments and rubrics

Assessment 1 – Journals

Students will receive credit by completing journals after each weeks experience and sharing with class via discussion board.. 

Assessment 2 – Simulation experience

Students will be videotaped during a high fidelity simulation experience.  The lab manager will program the simulator to respond to the students clinical decisions as an actual patient would respond in the hospital.  The assignment is worth 20 points.  The student will lose one point for each intervention is inappropriate and causes the patient’s condition to deteriorate.

Assessment 3 – Nursing Plan of Care or Care Map

The student will create a plan of care in a care plan or care map format.  The assignment will be worth 20 points. 

Correct problem identification -2 points

Measurable Patient outcomes identified -4 points

Evidenced based nursing interventions listed in priority order- 6 points

Rationale and references for interventions documented- 4 points

Evaluation of plan of care identified with identified revisions if needed.- 4 points

Assessment 4 - Communication

The student will complete a simulated patient interview.  The simulated patient will experience sensory deficits in hearing and vision and the student will need to demonstrate how they will effectively communicate in light of these deficits.  The student will also complete an analysis of the conversation between student and patient.  The student will identify therapeutic communication techniques used during the conversation/interview and why these were used.  The student will also identify therapeutic communication techniques which could have been used in the patient interview and discuss why these techniques would have improved the interview and data collection process.

Use of technology

Technology Component 1 – Normal Aging Changes Resources

Students will view the following online videos prior to the low tech simulation experience:

Hearing: http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000063.htm

Vision: http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000109.htm

Smell: http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000117.htm

Taste: http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000129.htm

Touch: http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000054.htm

Aging changes: http://www.ageworks.com/information_on_aging/changeswithaging/index.shtml

  

Technology Component 2 – High Fidelity Patient Simulation

Students will be separated into groups of 4 and attend a session in the simulation lab.  The simulator program and high fidelity mannequin will be used to provide a patient care experience during which the student  will provide nursing interventions based on the symptoms described by the mannequin and the physical assessment of that mannequin.  The program is designed to have the mannequins condition improve when evidenced based nursing interventions appropriate for the condition of the mannequin are delivered.  If the interventions are inappropriate the mannequins condition will worsen.  This will allow the students to fail tp save the client which cannot be allowed in the clinical setting, as well as see immediate results of choices which might take days in real time.

Technology Component 3 – Virtual Therapeutic Communication Program

Students will complete the Skills Lab Virtual Therapeutic Communication Program.  This is located on the computers in the Nursing Skills Lab.  These programs use computer adaptive technology to assess student communication with virtual patients.

Unit Timeline / Lessons

	Gognitive Learning Activities	Psychomotor Learning Activities
Week 1	·         Intro to Normal aging changes (30 minutes) ·         National Institute of Health Videos ·         Debriefing	·         Sensory loss Simulation Interpretation of hearing loss recordings Diminished touch/hot/cold simulation Vision lass glasses: cataracts, macular degeneration, glaucoma, yellowing lens ·         Physical deficit simulation Wheelchair, walker, transfer, simulated hemiplegia parasthesia
Week 2	·         Simulation Introduction ·         Preconference ·         Post Conference	·         NLN Simulation case studies
Week 3	·         Therapeutic Communication Review ·         Debriefing	·         Interview of “patients” with hearing and visual deficits ·         Virtual Communication Program

References

Hooks, B. (2010).  Teaching critical Thinking: Practical Wisdom.  New York: Rutelege

Jeffries, P. R.. (2007).  Simulation in Nursing Education:  From Conceptualization to Evaluation Washington: National League for Nursing

Meyers, C. & Jones , T. (1993).  Promoting active learning:  Strategies for the college classroom.              Jossey-Bass:  San Francisco.

Co-Teacher Plan

My plan Module 4: Locating and Partnering with Co-Teachers Plan My plan is to co-teach a course looking at growth and development accross the lifespan with a teacher from the Pre-school at the University of Cincinnati. The students cut a wide swath across developmental, cultural and socioeconimic levels. They are healthy living in families ranging from those that are homeless to those that are wealthy. It is my hope that seeing how Ms. Papin, an educator with over 30 years of experience, creates activities and plans to meet student needs will assist the student in understanding how to plan nursing care that does the same. This will also expose students to relatively healthy, community dwelling (rather than hospitalized) children. Plan Elements: Name the professional educator you plan to partner with. Include the following information: Name: Dena Papin Position: Pre-School Teacher Contact information papinda@uc.edu 513-703-6893 Describe the plan you have made with this person. How will you bring what they have to offer to your students? Ms. Papin works at the Arlett Education Center at the University of Cincinnati What technologies will you use? (video/voice technologies, etc?) The purpose of this plan is to expose students to healthy pre-school students who may or may not have developmental issues and are living in the community (not in the hospital) and are not in crisis. Students will visit the center and learn the philosophy of this resource that caters across cultural and socioeconomic levels from Head Start students to professor's children. They will meet with Ms. Papin as a group via Skype in the classroom each week. They will be free to ask questions about their student via email and scheduled visit to the center. Ms. Papin will tweet about activities at the center and issues such as site visits by regulatory agencies and what they are looking for on these visits. As this is an educational center, parents have provided consent for their children to be involved in educational activities such as this and students have been educated in principles of confidentiality. What are the school disciplines and specific national, state, district or school standards that it will address? This plan will meet the requirements of the Ohio Board of Nursing and the National League for Nursing Accreditation Commission that nursing programs provide as part of the curriculum activities that promote understanding of normal and abnormal growth and development, culture and socioeconomic diversity, as well as collaboration with clients and families. How will you assess what your students have learned? Students will create a plan of care for a student that they are assigned to for the duration of the course. This plan will focus on one health or developmental actual or potential deficit identified for that student. Students will right a weekly journal entry discussing what they learned during interactions with Ms. Papin and students from the center as well as how the educators use the center to identify and meet multiple student needs. The students will write a final paper elaborating on an area of concern/need for the student population at the center. This will run the gamut from not enough to eat/poor shelter to two busy working professional parents who do not always have the time to provide the attention the child/children may need. Ms. Pain will provide weekly discussion questions and Ms. Rohr and the nursing students will interact via discussion board as well as in seminar to answer the questions and comment on the thoughts of others in the course.

Civic Engagement: Senior safety Program

Title of Project: Senior Safety Project

Grade Level:  Students entering the second year of a two year associate degree nursing program

Number of Students Participating: 40

Contributed by:

            Teacher: Denise Rohr

            School:  Cincinnati State

Overview/Description of Project: Nursing students will make home visits to seniors living in a high rise senior apartment building located directly across from the college main campus.  Each student will make one visit per week over a 5 week period.  During the visit, the student will use a Senior Home Safe Check list to perform a home safety assessment with the senior citizens living in these apartments.  After performing the assessment, the student will sit with the senior or seniors and describe situations considered to be unsafe within the apartment.  The student will assist the senior in making any agreed upon changes that are within his/her abilities (e.g. removing carpet mats which could be tripped over).  Changes that may be suggested but are to extensive or expensive to implement will be discussed with the social worker employed in the high rise.  During week six, all of the students and seniors will participate in a celebratory luncheon and safety presentation in the multipurpose room in the high rise.

.Goals:

Increase awareness of senior safety issues in both senior nursing students and a selected group of senior citizens.

Expose nursing students to seniors living independently in the community rather than those who are sick and institionalized.

Provide a connection to the community of which the college is a part because of it’s location.

Core Content Areas:

Senior Safety, Home Safety, Medication Safety and Food Safety

PARC MODEL STEP-BY-STEP GUIDE

STEP 1: PREPARATION

Review of Gerontology Content related to home safety including, environment, medication and food safety.

Review of Senior Home Safe Check List.

Project orientation, meeting with high rise manager and social worker.

Determine which seniors will agree to participate in program.

STEP 2: ACTION

Brief students and provide them with assigned seniors and their apartment numbers each week.

Schedule appointment time with senior.  Instructor will be on site and available via cell phone.

Debrief students.  Review safety forms.  Review student interactions with client.  Discuss common/frequently seen safety issues.

Student journaling to be completed by following Sunday night.

Repeat weekly.

During final debriefing review problems commonly seen over the 5 weeks during the final debriefing and plan final presentation for next week.

STEP 3: REFLECTION  ( Reflection is not sequential; rather it is encouraged throughout the lesson)

Each student involved in this project will keep an online journal, The student will be required to submit a journal entry by Sunday at 11:59 pm each week of the project.  In the journal the student will be expected to discuss the findings of the safety assessment, actions implemented or planned, results if available and how helping the seniors made them feel. 

A final reflective 3 page paper is due at the end of the course describing the interventions,  outcomes and why the student felt the project was successful or unsuccessful.

STEP 4:  CELEBRATION/DEMONSTRATION

Project assessment form to be completed by both the senior and the student. after each appointment.

Overall project assessment to be completed by senior and faculty member

Home Safety Presentation to be complied by the students and travelers, used to present problems.

Celebratory lunch final week of program.

Week 2 Blog

The online resoure that I chose, http://www.merlot.org/merlot/ is a site which has extensive resources to improve online and face to face education through active learning strategies.  There are multi-media modules, and other resources to help add variety and student interaction to online sites or classroom presentations.  I have also used the resources to have students create patient education materials to use in the clinical setting, or presentations to share with their classmates.  This and other resources will make a permanent change in the way I teach by providing stratefies and materials that bring the student into the presentation through engaging resources and through the students involvement in developing resources to tech others.  The following link to a video from the CDC was accessed by students in a gerontology course this march to create information for families about influenza.  http://www.cdc.gov/flu/freeresources/video/flu-symptoms.htm

This information was used to teach families about influenza signs and symptoms so that they would not visit their elderly relatives and infect them if they were presenting with these symptoms.  The students enjoyed being able to use these sorts of resoources to teach patients and families.  This project helped the students to identify which materials engaged their audience and which materials they learn from best.

Active Learning Techniques I use

In nursing, you have to teach a lot of information.  Everything they need to know can not be presented in a lecture format. If there was enough time to deliver lectures with all the information a nurse needs to know, the students would disengage from information overload in the classroom.  This is particularly true in the community college setting where I teach.  There are several active learning techniques I use in class.  My favorite is probably in class or online discussions.  Most commonly, these will involve a case study applying concepts the students have learned to a situation or client presentation that has not been covered in class.  I give the students some leading questions, then let them loose in groups of around 4 students to answer the questions and think of new questions to ask each other to investigate the case ans discover what is going on with the patient.

I also at times have had the students write a one minute paper at the beginning of class to see where they are with understanding a concept. I then have them partner, read the other's paper and discuss how their understanding of the concept was similar and different.  This leads the students to see which outlook is most correct and we discuss as a class.

A third active learning technique my students and I have enjoyed is gaming.  I have created games from Jeopardy, to Millionaire (complete with phone a classmate) and Nursopoly over the years.  Although I have mostly used these for course review, I have occasionally used them earlier in the learning process.