Active learning strategies for today’s nursing students
Do you ever lament that teaching nursing care has been reduced to lecturing about every disease known to humankind? Is your brain weary from not being able to motivate students so that you can have a lively, more engaged classroom? Are you tired of students complaining that they didn’t pass board exams because you didn’t cover something that was on NCLEX? If you aren’t nodding your head yes, then perhaps you need a reality check in your classroom!
Today, there is such a variety of ways to engage students, to help them apply the knowledge they are gaining, and yes, be responsible and accountable for their learning. The use of interactive media, discussion boards, chat rooms, and games can help students realize that there are many active learning methods, and that having the instructor provide all of the information is not the best way. In fact, the latest research on learning demonstrates that students only retain 10% of what they hear, whereas they retain up to 75% of material that they have an opportunity to practice (Lalley & Miller, 2007). We know you have heard this a lot lately. Well, here are examples of how we have been able to do this in a way that is easy to execute and does not cause you to stay up all night thinking about what you are going to do with students for 2-3 hours of class.
Recently, we changed our curriculum, as well as our teaching strategies. The curriculum change drove us to select a way to teach that was unconventional for nursing schools. No longer did we provide an hour or two of Powerpoint slides and gloat over being the “talking heads.” We don’t cover fifteen diseases in two hours anymore. Instead, we began to incorporate activities that engaged the students, and required that they come to class prepared.
A key element of student preparation is completing the independent interactive learning modules provided by MyNursingLab. The four components of this online program are a diagnostic pre-test of six to ten questions, succinct review chunks of information, a few focused remember questions with rationales provided, two to three application questions from a case scenario, and finally a post-test that can be re-taken multiple times to help students retain the content.
The class time is usually shortened since students spend quite a bit of time completing MyNursingLab. Ideally, they have come to class prepared to be engaged in learning about the concept and the 2-3 concept exemplars. We use Kolb’s cycle to organize our class time periods. We begin the class with a clinical story to “hook their interest.” We have them reflect about what they already know about a patient with these exemplars in their small groups. Then we introduce key information through Powerpoint slides and limit their presentation time to 10-20 minutes. This encapsulates most of the general information that is critical for the student to know about a concept. The Powerpoint is very general or broad, but informative.
This is followed by a variety of activities that align with the objectives of the course and provide ways to keep the students interested. For example, it is hard for students to imagine how the asthmatic patient feels, unless they’ve experienced something like it. An activity that requires students to place a straw in their mouth and walk (or run) 30 feet and back quickly, then resume class (without taking the straw out of their mouth) serves as a very vivid reminder of how that asthmatic child or adult coming into the ER might feel. This exercise may trigger a different response from the nurse than a nurse who did not have this experience.
After the students have experienced “how it feels to have asthma,” students present key facts about asthma, and then work through a simulation where the child or adult comes into the ER with an acute exacerbation of asthma. This activity can help them to tie the feeling of being smothered or not being able to breathe with the correct actions they must take as the nurse.
Another effective classroom strategy on this topic: show scenes in video format of how a family deals with having an asthmatic child, and have students outline a teaching plan for the family. Identify priorities in the teaching plan, and then have groups of students develop individual portions of that plan serve as a way to help them apply what they felt (through the straw activity), know (through readings, discussion, power point), and did (simulation) to a teaching situation.
Another example of an interactive strategy that we have used is to incorporate a neighborhood family (Pearson virtual community) into the class by having students develop a care plan for a family member who has had a hip replacement. This activity helps students apply the nursing process and develop nursing interventions.
In order to move your classroom from a group of non-engaged students, to a vibrant active learning environment where students are excited about learning, you must become comfortable with three things:
1) Require students to come to class prepared, or class will not happen until they are
2) Realize that it is not your fault that students do not learn content
3) Allow students who put forth the required effort prior to class to leave before the end of class.
If the objectives of the class are met in one hour because the students came prepared and they are comfortable with the content — let them out early — now isn’t that a novel idea for nursing instructors?
Learn more about what we do in class to improve student achievement in our recently published educator study.
About the Authors
Suz Wilhelm, RN, PhD, is an assistant professor and assistant dean in the University of Nebraska Medical Center College of Nursing, West Nebraska Division, where she has been a faculty member since 1990. She received her bachelor’s degree in nursing from the University of Northern Colorado and her master’s and doctoral degrees from the University of Wyoming. Dr. Wilhelm’s clinical background includes all areas of obstetrics. She has held nursing positions in several states in the mid-western region, and she conducts breastfeeding research in rural areas. Dr. Wilhelm has taught the under-graduate Maternal-Newborn and Women’s Health course. She has taught in a concept based curriculum for the last 4 years. In addition, she has developed inter-disciplinary simulations for Maternity-Pediatrics. A strong advocate for concept-based learning, Dr. Wilhelm lent her considerable Maternity-Child Nursing and interdisciplinary expertise to ensure that the second edition of Nursing: A Concept-based Approach to Learning effectively threaded these themes throughout its content.
Dr. T. Kim Rodehorst is an associate professor at University of Nebraska Medical Center College of Nursing, West Nebraska Division, where she has been a faculty member since 1988. Kim received her bachelor’s degree from Loretto Heights College in Denver, CO and her master’s degree is in Parent-Child Health and from the University of Colorado. After working as a pediatric nursing instructor for many years, Kim returned to school to receive her Ph.D. in Adult Education and Technology from the University of Wyoming. Kim has developed numerous pediatric simulations over the past 20 years and often includes simulation learning in the classroom. Additionally, she has used a variety of innovative teaching strategies to engage students in their learning. Her interest in helping others learn more about concept based curricula began four years ago when UNMC adopted a concept based curriculum. Dr. Rodehorst has been involved in review and development of both editions of the textbook: Nursing: A Concept-based Approach to Learning.
Lalley, J.P. & Miller, R.H. (2007). The learning pyramid: Does it point teachers in the right direction? Education, 128(1), 64-79.