TDG Reports

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TDG Reports

• The Nethersole School of Nursing

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3 TDGs

• N-IDEAL (2002-2007)
• (Hazlett, CB, Nicholls, J. Lee, D., Chau, J.,
  Chan, S., Tiwari, A., Mok, E., Chan, A.)
• Case-based learning (2006-2007)
• (Chair, S.Y., Twinn, S., Lee, D. Kember, D.)
• Structured learning activities and
  self-reflection in clinical practice (2007)
• (Ip, W.Y., Chien, W.T., Lam, L.W., Lee, I., Lui,
  M. Lee, D.)

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N-IDEAL

• Objectives
• To develop a voluminous high quality test item
  bank for nursing
• To provide nursing faculty assessment training
  workshops

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N-IDEAL

• Deliverables
• A summative high quality item bank (5,124 items)
• A window-based suite of software programmes
  (N-IDEAL)
• Teacher assessment training enhancement workshops
• INAC Life-after-grant(http//www.hkwebnurse.org
  )

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N-IDEAL

• 3 impact studies (CUHK, HKU, PolyU)
• ? teachers and students were positive towards
  the use of assessment items in the bank to
  enhance higher-cognitive learning
• ? these assessment questions did not improve
  students approach to learning (worthy of
  further investigation)

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Case-based Learning

• Aim Evaluate the two approaches (face-to-face vs
  WebCT) of case-based learning on students
  self-learning ability, clinical reasoning ability
  satisfaction.
• Interventions
• For both semesters
• 6 Cases/semester
• Student received the case one week ahead
• 10 groups 1 (A B) group/ each tutor

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Case-based Learning - Interventions

• Semester 1
• Discussed in face-to-face tutorial sessions with
  the present of a tutor.
• Semester 2
• Own discussion forum per subgroup (for the
  teacher and the subgroup members only). All
  discussions were done on WebCT.

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Key Findings 1
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Written comments

• Face-to-face approach
• Interactive approach and enable us to give
  instant responses to the discussions
• Two-way communication among students and teachers
• Helpful in clarifying misunderstanding of concepts

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Written comments

• Created interactions between students, enable
  students to work collaboratively
• Tutors shared their own insight and clinical
  experience with us during the discussions
• Enhanced, enriched and consolidated students
  knowledge
• Time consuming, difficult to find time to meet
  with the group for discussion

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Written comments

• WebCT approach
• No time limit for discussions but quite difficult
  to discuss together in internet
• Save tutorial time. Can easily share opinion at
  any time.
• Quite convenient, but with delayed response
• Need to post what we have already discussed in
  web--gt time consuming

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Written comments

• No direct interaction with group members and
  tutors. I prefer to see them and discuss with
  them to get the direct response.
• Cool feeling in doing web-based approach
• Some students cannot participate, because no PC,
  limited PC skill, busy time
• Those who do not want to contribute can escape
• Not everyone involved equally

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Conclusion

• No significant differences between the two
  approaches on study outcomes from quantitative
  results
• Students favored the face-to-face approach from
  written comments
• Easier to coordinate the face-to-face approach

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Structured learning activities to promote nursing
students self-reflection in clinical practice
courses.

• Ip Wan Yim
• Chien Wai Tong
• Lam Lai Wah
• Lee Iris Fung Kam
• Lui May How Lin
• Lee Diana Tze Fan
• Funded by the Teaching Development Grants for
  2005-08 triennium

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Background

• Self-reflection is important to clinical
  learning.
• Promoting reflective learning is highly
  encouraged in the BN program
• Lack of a systematic approach in teaching and
  evaluation.
• The Johns Structured Reflection Model (2000) can
  guide the development of the project in putting
  self-reflection into clinical practice.

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Aims

• To improve nursing students self-reflection
  ability and skills in managing clinical
  situations by means of a structured learning
  program.

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Objectives

• Provide students with learning experience of
  reflection through an interactive teaching
  workshop.
• Motivate and encourage students to have deep
  reflection under the clinical teachers
  supervision in their clinical practice.
• Assess whether students attending the workshop
  and ongoing guided reflection in clinical
  practice course will improve their reflective
  abilities.
• Identify the strategies for improving the
  reflective learning activity in clinical practice
  courses.

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Methods

• Period of the study Dec, 2006 Oct, 2007
• Design a pre-test/ post-test cohort design.
• Subjects 63 / 173 year 2 students of the BN
  program.
• Procedure
• Ethical approval
• Part-time RA for recruitment data collection

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The Structured Learning Program
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Characteristics of the Sample (N38)
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Preliminary findings

• The structured learning program based on the
  Johns Structured Reflection Model is effective
  in promoting students clinical reflective
  learning.
• More investigations are needed on the followings
  
• High attrition rate
• Barriers and facilitators to the implementation
  of reflective learning in real clinical
  situations
• Time constraint
• Clinical teachers teaching style
• Clinical learning environment

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Thank you !
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Example of case

• Objectives
• Learn how to handle an emergency IV accident in
  this case
• Learn effective ways to prevent IV site infection
  and infiltrations by promoting clients
  cooperation
• Develop rapport in educating the patient and
  family about IV infusion and nil of mouth policy

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Example of case

• The Case
• A 4-year-old boy, Kwok Leung, was admitted into
  the hospital suffering from an acute
  gastroenteritis with watery diarrhea for seven
  times and vomited three times in the last 24
  hours. The doctor ordered nil by mouth and 24
  hours IV infusion. Mrs. Law, the boys mother
  regularly lives in rural mainland China, heard
  the news and rushed to the hospital during
  visiting hours. She brought with her a can of
  Glucolin Gluco-D (??????), mixed it with water
  and fed Kwok Leung, who immediately complained of
  dry mouth when he saw his mother. After drinking
  a sip of the Glucolin, Kwok Leung became
  irritable and fussy and complained of discomfort
  at his IV site. Kwok Leung removed the taping and
  the IV tubing by himself. Mrs. Law did not know
  how to stop the unstable child from his
  misbehavior and loud crying, and the hospital
  staff was soon notified by another relative of
  Kwok Leung.

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Example of case

• Upon seeing this, what should a nurse do?
• Before reapplying the IV tubing, what verbal
  communication should be given to Kwok Leung and
  Mrs. Law to better prepare them psychologically
  and to promote cooperativeness?
• During the interview with Kwok Leung, he revealed
  that the patient boy next to him suffered from a
  swollen and darkened arm after the IV injection.
  That boy also exhibited fussy and irritable
  behavior and cried loudly for a long period of
  time.
• As a nurse, would you take time to explain to
  Kwok Leung and Mrs. Law what happened to the boy
  besides him? What would you tell them?

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Student preparation (semester 1)

• Break into two small case-based learning (CBL)
  groups of each lab. Chair will have the
  students to break into CBL groups before lab day
  to facilitate searching and discussing. Same CBL
  group for the first term.
• Two cases will be done in each lab day
• A total of 6 cases will be done in each term
• Written case format will be used in term 1 and
  web-based cases will be used in term 2
• Cases and briefing will of offered to students by
  Chair two days before each lab
• Each CBL group will have to present each case,
  and each group takes turn to present first.

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Student preparation (semester 1)

• A total of 1.5 2 hours assigned for case-based
  learning presentations (15 minutes final
  preparation, 10-15 presentation group1 on case 1,
  10-15 minutes presentation group 2 on case 1 then
  5-10 minutes for questions/discussion in case 1
  10-15 minutes presentation group 2 on case 2,
  10-15 minutes presentation group 1 on case 2
  5-10 minutes for questions/discussion in case 2).
  10 or 15 minutes for presentation is depending on
  each case, some cases may be longer and some may
  be shorter.
• You can ask opposite group for questions and find
  ways to promote discussions to get higher marks.

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Student preparation (semester 1)

• Students are suggested to rotate for presentation
  in order to get the group participation marks.
• Only overhead projector will be available in each
  lab for presentation
• A copy of presentation contents not more than 2
  pages (A4)/case are required to be submitted to
  the instructor of each lab. Font size should be
  14 or greater
• A copy of references will be submitted to
  instructor
• Presentation will be in English but discussions
  can be conducted in Cantonese.