Practicum End of Experience Reflection

The Learning Contract shows goal achievement. Briefly discuss the goals in relation to developing your role as a nurse educator and identify future goals you have established.

My goals in the development as a nurse educator primarily focused on creating an active learning environment, which was primarily completed by creating interactive teaching sessions using multiple modes of teaching, to foster student’s learning and development into a strong, competent nursing professional. At the beginning of this course, I wrote in a reflection that I wanted to be a mentor that developed a tiered curriculum for new hires with successful implementation and was developed on a solid framework. I believe I met this goal. The Tier curriculum was implemented and I received many positive feedback comments from my preceptor and participants of the class about how effective and beneficial it was. I met my goals of implementing multiple modes of teaching including simulation, hands-on skills, didactic learning and classroom lecture. I also created goals of verifying competency by utilizing assessment and evaluation techniques. I achieved this goal by using a needs assessment to guide my creation of content for the Tier orientation classes as well as utilizing self-evaluation forms for reflection and evaluation of learning from the classes. I verified competency through the use of worksheets that were completed after the content was taught. Students achieved an 85% of higher on the validation forms and those areas that were noted to be of more difficulty were reviewed with each individual participant to verbally discuss the area of difficulty and their thought process. I believe continual learning is essential for both nurses and educators. Utilizing competency validation and assessment methods will remain a part of my future practice.

Finally, I set a goal at the beginning of the practicum to learn and grow as a change agent. To meet this goal, I participated in various meetings that opened my eyes to public health concerns and identified ways nurse educators can make change other than by teaching in the classroom setting. Examples of these experiences were the Nebraska Action Coalition and the Health Advisory Committee meeting in which I was able to see committee members discuss public health needs, disparities, and plans to implement change and education to the local community. These experiences contribute to the development of future goals for myself. In my nurse educational career, I will create opportunities to engage students in community health and service opportunities. I will create diverse opportunities for students to see disparity and how societal factors impact public health, which affects all nursing roles in how they provide care to their patients. With the growing, aging population and increased chronic illnesses and health disparities, the role of the nurse educator is becoming more important to expose and educate nursing professionals on public health resources (Cowen & Moorehead, 2011). As a result of this experience, I am again reminded how our health is impacted so largely by socioeconomic and environmental factors. Whether in my career or volunteer opportunities, I will be a change agent and utilize my knowledge to instill the importance of public health nursing and public health education upon others.

What have you gained from this experience? Discuss some similarities and differences between classroom, online, and clinical teaching, providing a synthesis of what you have learned.

One of the biggest areas of knowledge I gained from the experience was the development of a competency-based education curriculum for orientation of new hires to the PICU at Children’s Hospital. Competency-based education curriculums offer education that is focused on the desired performance by establishing observable and measureable performances (Billings & Halstead, 2016). The creation of objectives provided me with direction and framework for what educational opportunities that needed to be presented to the students throughout the learning process to encourage achievement and success. I have learned from my practicum experience how to create and utilize objectives to guide my teaching. This is also an example of a similarity between classroom, online, and clinical teaching. According to McDonald (2014), clinical experience is an integral part of a nursing course and the objectives of the classroom and course should be developed with similarity to identify how students should develop by the end of the course. From my experience, all forums utilize needs assessments and objectives to create goals and evaluate the effectiveness of the learning based on whether or not those objectives are met. According to Gardner & Suplee (2010), a nurse educator should assess the student’s level of knowledge and “become familiar with the program’s curriculum so that you know what courses have come before the current clinical rotation and have an understanding of the content, skills, and processes that you students should have mastered before they came to you” (p. 40). The nurse educator should utilize this information when creating objectives by creating learner-based objectives that require multiple teaching methods and learning opportunities for a diverse population that will engage students in active learning. I will create objectives, present them to students, and continually monitor the progress throughout the set time-frame. I will hold personal responsibility to myself to create an environment that fosters learning, as well as provide ample opportunities and resources to the students to apply the critical thinking in the learning process in order to reach the objectives.

I have experienced learning the best practices and guidelines and then teaching students successfully in return requires the use of many resources and a lot of time and commitment. These resources can be in the form of books, videos, Internet resources, pictures, or publications and journals. A difference I have found between classroom, clinical, and online learning is that it is often harder for online learning to incorporate multiple modes of teaching. For example, classroom learning can use more interactive learning with case-reviews, question and answer sessions, story telling, or debates and the interaction is more personal and live. The most recent development in pedagogical learning is the flipped classroom, which is the active learning style where students practice application and receive feedback. This new method of learning is utilizing online technology as a tool to improve lectures and make them more stimulating (Billings & Halstead, 2016). Online forums are more difficult to develop into interactive forums because the degree of personal interaction among students is lowered. However, with the large number of students and the increased use of technology, online teaching is becoming a new design to better link classroom and clinical experiences. For example, the use of mobile devices can now be a way for students to access resources, such as textbooks, drug libraries, and laboratory value and disease process analysis, in the clinical and classroom setting (Billings & Halstead, 2016). There are also different methods of communication that are developed throughout the different learning formats. Online teaching relies primarily on written communication whereas classroom content is primarily verbal with visual learning from presentations, and clinical learning is primarily completed using kinesthetic learning. While classroom learning is the opportunity for students to learn the theoretical nursing knowledge, clinical learning is an opportunity for students to apply that knowledge to real nursing care and develop clinical reasoning and judgment (Billings & Halstead, 2016).

What are some differences you have observed between teaching and other areas of the nurse educator role? How does this compare to the readings?

As a nurse educator in the PICU at Children’s hospital, I have experience as a nurse educator in other areas other than the classroom environment. I can compare these two roles because both curriculums and roles focus largely on learning outcomes and continual education. I personally have used classroom-teaching experiences from my practicum to integrate into the clinical environment to increase staff retention of knowledge. Through the development and implementation of the Tier orientation process, I have witnessed how active learning in the classroom environment provides a safe, supportive learning environment for new hires in which they can take the information learned and apply it at bedside while caring for patients. This is important because of the critical state of health that these patients are in. A safe, supportive practice learning environment allows for nurses to explore their ideas and begin developing critical thinking without risking patient safety.

A difference of these roles is that as a nurse educator in a hospital organization, the educator focuses more on maintaining staff competency, rather than the initial teaching of content. For example, I experienced as nurse educator for NMC students in the clinical environment I was teaching them skills they were learning for the first time; however, as a nurse educator in a hospital setting, a large part of my role is having nurses perform skills as a competency verification to show they are able to safely and accurately perform skills within their scope of practice. The scope of practice that nurse educators in the hospital are verifying is a much more specific scope. The skills are directly related to the specific population of patients that they serve. Whereas, educators in the school setting must ensure students are competent to care for all types of patients and disease processes. This is similar to what the readings state “Educators must design curricula and learning experiences that attend to all necessary competencies” (Cowen & Moorehead, 2011, p. 77). I also recognize a difference in the role of the nurse educator in the hospital is largely policy driven, meaning skills and education is guided by current policy changes of that institution. Nurse educators in the school system are largely guided by current practice evidence and research, as well as learning frameworks that support a positive teaching-learning process.

What difficulties or challenges did you have and how did you address them?

As I have experienced in my career, change is hard and often not embraced; however, it is necessary to facilitate growth and advancement in the healthcare field. The importance of nurse educators to facilitating this growth is substantial. In my opinion, the most important roles that a nurse educator has to fulfill are empowerment and commitment. (Johnson-Farmer, B., & Frenn, M., 2009) Nurse educators have to be committed to continuous learning, research, and applying the knowledge gained through a variety of teaching methods to stimulate growth and development of future healthcare providers. As a future nurse educator, I realize that I will need to be committed as a lifetime learner and engaged in the process to positively influence the lives of the students. (Johnson-Farmer, B., & Frenn, M., 2009) The changes to healthcare are constant and nurse educators, in my opinion, are the leaders to facilitate the spread of the knowledge across curriculums. Continuous research, reflection, assessment, and professional evaluation of new standards of care and the nurse educator’s commitment to mentoring and nurturing new students facilitate growth of knowledge. (National League for Nursing Certification Governance Committee, 2005)

At the beginning of the semester, I expected a challenge with students becoming disengaged. I implemented many strategies to avoid this, such as frequently asking students questions and reviewing case studies, encouraging hands on skills, maintaining eye contact, and offering breaks from learning for movement in the classroom when I noticed students were becoming less active in the participation. Overall, I feel these strategies were successful. I also encountered the challenge of teaching in a small classroom environment for a large clinical group in post-conference. I initially prepared a classroom for a group of 9 and I was informed prior to the teaching session that two other clinical groups were joining for the session. In order to address this challenge, I rearranged the tables in the room to accommodate more people and I positioned myself in the classroom so I could move freely and make eye contact with all of the students at different times.

How has your vision of a nurse educator changed?

I have always believed a leader is somebody who influences others. My vision of a leader now includes a nurse educator because they influence those who they teach and use their vision to invest in the growth of an individual and an organization’s purpose. Nurse educators can enhance their leadership skills by surrounding themselves in an institution that fosters role-modeling, guidance training, and leadership/management opportunities. During my practicum experience working with NMC students in the clinical setting, I now visualize the passion and the drive to learn. The student’s are mostly eager to experience many firsts in their role as a nurse. My vision has also changed as a result of the development of a new orientation curriculum. I have experienced the challenges of developing a new program but also have seen the many benefits and the biggest impact that it has had on the orientee. I learned during my practicum experience developing a new orientation curriculum about the importance of utilizing a needs assessment and program outcomes to guide the teaching experiences as well as the importance of course evaluation to determine the effectiveness of the classes. My vision for my future includes utilizing these methods in various formats, both individually and across organizations, to assess learning needs and evaluate continuous learning and competency.

Finally, the most beneficial aspects of my practicum experiences were the times I spent in difference meetings in which I could see diverse educator roles outside of the classroom and clinical setting. For example, attending the Nebraska Action Coalition and Health Advisory Committee meeting in which I was able to see different educator roles in action, including public health education and the effects on policy development. This broadened my vision of a nurse educator’s role to more than just a clinical or classroom setting educator. Seeing the education spread through public policy and public health forums has shown me how great of an impact education can have on society.