Strategies for change 3. Because nursing schools have always emphasized clinical experience, faculty and students alike have historically depended on clinical experiences as the primary opportunity to integrate class and laboratory content into care for actual patients. However, multiple factors—increased complexity of patient care, related technological and research findings, consolidation of clinical facilities, the Covid-19 pandemic resulting in burnout of healthcare providers, and record high levels of staff shortages—have all changed the clinical experiences available to students. The current clinical environment alone may not be sufficient to produce nurses with good decision-making skills. The goal of the teaching-learning process is the same: to prepare novice nurses to make effective patient care decisions by recognizing and analyzing cues, prioritizing hypotheses, generating solutions, taking action (or not), and evaluating outcomes (https://ncsbn.org/clinical-judgment-measurement-model). To accomplish this, s tudents must be actively engaged in the learning process, even in classroom instruction . Some instructors may be so charismatic that students sit in rapt attention as they lecture. Most of us, however, do not have that talent so we must integrate other strategies to engage students in our classes. We must provide multiple, coordinated opportunities for using clinical judgment to plan care in a wide range of clinical scenarios, beginning in the very earliest nursing courses, including during class, laboratory opportunities, simulations, and clinical experiences. This type of active learning, or “flipping the classroom” is not new to nursing. However, nurse educators know that students often are lax about reading assigned material, particularly before the class where the topic is discussed. We also know that students today want information provided in small “chunks” and like it best when the instructor “just tells us what we need to know,” preferably in PowerPoint presentations given to them before class. Unfortunately, clinical judgment skills cannot be developed by studying PowerPoints. Memorized facts are not enough to analyze a complex situation. What can we do to encourage students to take the lead in moving from regurgitating knowledge using short-term memory, to integrating knowledge from various sources to make decisions to intervene appropriately in patient care? Use of learning materials 4. Today, published learning materials can help faculty engage students in their own learning. For example, F.A. Davis has developed a suite of products called Davis Advantage that provides material across the RN and LPN curricula to help students learn, apply, and assess their understanding of key content so they are prepared to “think like a nurse” and practice effectively in their first job. (FADavis.com/DavisAdvantage). LEARN Based upon a pre-assessment of students’ knowledge, Davis Advantage provides students with personalized learning assignments that include mini-lecture videos and interactive exercises that reinforce textbook learning and make connections among key concepts. Real-time data and analytics track performance, including time spent on assignments. Students can use these analytics to evaluate their own performances, more efficiently managing their study time and taking responsibility for their own learning. Faculty also have access to these analytics to support student remediation. Use of these resources reduces the faculty’s need to cover every important point in class which provides more time in class to reinforce key concepts, clarify students’ questions, pose discussion questions to broaden students’ thinking, and assist students in thinking through case studies (FADavis.com/DavisAdvantage).
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