{"version":"1.0.0","segments":[{"startTime":35.491,"endTime":35.9,"body":"[Music]"},{"startTime":35.9,"endTime":36.31,"body":"[Music]"},{"startTime":36.31,"endTime":36.72,"body":"[Music]"},{"startTime":36.72,"endTime":42.72,"body":"Welcome to this episode of NLN podcast Nursing "},{"startTime":36.72,"endTime":42.72,"body":"Edge Unscripted. I'm your host, Dr. Steven  "},{"startTime":42.72,"endTime":49.12,"body":"Palazzo, a member of the editorial board for "},{"startTime":42.72,"endTime":49.12,"body":"Nursing Education Perspectives. In this episode,  "},{"startTime":49.12,"endTime":54.0,"body":"we will discuss how to foster clinical judgment "},{"startTime":49.12,"endTime":54.0,"body":"through active learning strategies. My guests  "},{"startTime":54.0,"endTime":59.92,"body":"today are Dr. Ashley York, associate professor, "},{"startTime":54.0,"endTime":59.92,"body":"and Laura Wynn, an instructor, both at the  "},{"startTime":59.92,"endTime":65.92,"body":"Moffett and Sanders School of Nursing at Sanford "},{"startTime":59.92,"endTime":65.92,"body":"University in Birmingham, Alabama. We will discuss  "},{"startTime":65.92,"endTime":70.4,"body":"their article, Fostering Clinical Judgment and "},{"startTime":65.92,"endTime":70.4,"body":"Promoting Transition into First Clinical Rotation  "},{"startTime":70.4,"endTime":76.0,"body":"through Active Learning. This article can be found "},{"startTime":70.4,"endTime":76.0,"body":"in the July-August issue of Nursing Education  "},{"startTime":76.0,"endTime":82.8,"body":"Perspectives. Welcome Ashley and Laura. Hi, thanks "},{"startTime":76.0,"endTime":82.8,"body":"for having us. You're very welcome and thank you  "},{"startTime":82.8,"endTime":87.12,"body":"for joining us. First I'll just ask you, what "},{"startTime":82.8,"endTime":87.12,"body":"common barrier hinders the transfer of clinical  "},{"startTime":87.12,"endTime":93.76,"body":"knowledge to practice? I think that's a question "},{"startTime":87.12,"endTime":93.76,"body":"most of us ask ourselves when we're figuring out  "},{"startTime":93.76,"endTime":99.36,"body":"how to take something from the literature and "},{"startTime":93.76,"endTime":99.36,"body":"bring it into clinical practice. I think there's  "},{"startTime":99.36,"endTime":106.88,"body":"lots of different things that affect students. "},{"startTime":99.36,"endTime":106.88,"body":"Many students struggle with applying classroom  "},{"startTime":106.88,"endTime":113.12,"body":"learning to their real life situations. This seems "},{"startTime":106.88,"endTime":113.12,"body":"to be a major struggle with students across every  "},{"startTime":113.12,"endTime":118.32,"body":"type of undergraduate program as well as even "},{"startTime":113.12,"endTime":118.32,"body":"some in master's programs as well. There's a major  "},{"startTime":118.32,"endTime":124.0,"body":"disconnect between the theory that we're teaching "},{"startTime":118.32,"endTime":124.0,"body":"them in the classroom and then the practice  "},{"startTime":124.0,"endTime":129.04,"body":"of actually thinking like a nurse, which is a term "},{"startTime":124.0,"endTime":129.04,"body":"we talk a lot about and mention to our students,  "},{"startTime":129.04,"endTime":136.055,"body":"but they don't really understand how to think like "},{"startTime":129.04,"endTime":136.055,"body":"a nurse or what it means to think like a nurse.  "},{"startTime":136.055,"endTime":142.69,"body":"So first semester students they the ones that "},{"startTime":136.055,"endTime":142.69,"body":"we speak about in this article they really lack  "},{"startTime":142.69,"endTime":149.52,"body":"interpreting patient cues or making decision "},{"startTime":142.69,"endTime":149.52,"body":"making skills based off of real patient data.  "},{"startTime":149.52,"endTime":155.28,"body":"So a lot of it is because they don't have the "},{"startTime":149.52,"endTime":155.28,"body":"real experience. They might not have had a job  "},{"startTime":155.28,"endTime":160.24,"body":"as a patient care tech. They may never worked or "},{"startTime":155.28,"endTime":160.24,"body":"done anything in a health care setting. They may  "},{"startTime":160.24,"endTime":165.92,"body":"have never even cared for children in general "},{"startTime":160.24,"endTime":165.92,"body":"or older adults. So did anybody any type of  "},{"startTime":165.92,"endTime":171.76,"body":"care experience. So with what we kind of looked "},{"startTime":165.92,"endTime":171.76,"body":"at, that's one of the major things we see. They  "},{"startTime":171.76,"endTime":176.16,"body":"also need to develop clinical judgment, which is "},{"startTime":171.76,"endTime":176.16,"body":"one of the big things that we're needing to work  "},{"startTime":176.16,"endTime":184.16,"body":"on. And they might not see from the lab setting "},{"startTime":176.16,"endTime":184.16,"body":"or class as a connection to the actual clinical.  "},{"startTime":184.16,"endTime":189.12,"body":"And then our goal was to try to really help "},{"startTime":184.16,"endTime":189.12,"body":"foster that connection because of the lack of  "},{"startTime":189.12,"endTime":196.4,"body":"the connection that we've seen with our students. "},{"startTime":189.12,"endTime":196.4,"body":"So when I read your article, obviously what stood  "},{"startTime":196.4,"endTime":201.36,"body":"out was a strategy you used called the seven "},{"startTime":196.4,"endTime":201.36,"body":"stations simulation. How did that seven stations  "},{"startTime":201.36,"endTime":205.44,"body":"simulation promote active learning through "},{"startTime":201.36,"endTime":205.44,"body":"content reinforcement, experiential learning,  "},{"startTime":205.44,"endTime":210.64,"body":"and reflection that was mentioned in the article? "},{"startTime":205.44,"endTime":210.64,"body":"Focusing on the content reinforcement, our  "},{"startTime":210.64,"endTime":216.0,"body":"stations that we had, they really aligned with our "},{"startTime":210.64,"endTime":216.0,"body":"course objectives. This was a health assessment  "},{"startTime":216.0,"endTime":222.24,"body":"course. We were really focused on getting them to "},{"startTime":216.0,"endTime":222.24,"body":"do focused assessments, documentation, and health  "},{"startTime":222.24,"endTime":226.8,"body":"promotion. And that's the things they've been "},{"startTime":222.24,"endTime":226.8,"body":"learning didactically and in the lab setting  "},{"startTime":226.8,"endTime":232.32,"body":"already. So, our goal was really trying to get "},{"startTime":226.8,"endTime":232.32,"body":"them to put all of these pieces together because  "},{"startTime":232.32,"endTime":238.08,"body":"a lot of it had been done segmented throughout "},{"startTime":232.32,"endTime":238.08,"body":"the program or they might not have seen that  "},{"startTime":238.08,"endTime":244.24,"body":"full-blown connection. And also, we tried to help "},{"startTime":238.08,"endTime":244.24,"body":"them in the experimental learning area by using  "},{"startTime":244.24,"endTime":251.12,"body":"realistic manikins as well as scenarios for "},{"startTime":244.24,"endTime":251.12,"body":"our mannequins. It just wasn't a piece of plastic  "},{"startTime":251.12,"endTime":256.72,"body":"laying there. We wanted them to be real people "},{"startTime":251.12,"endTime":256.72,"body":"for them. And we also did partner-based vital  "},{"startTime":256.72,"endTime":260.64,"body":"sign checks. So they're actually using a real "},{"startTime":256.72,"endTime":260.64,"body":"person, not a mannequin for that. So there can  "},{"startTime":260.64,"endTime":265.52,"body":"be real variables and they might not have ever "},{"startTime":260.64,"endTime":265.52,"body":"checked that person's vital signs before because  "},{"startTime":265.52,"endTime":270.64,"body":"that might not be the partner that they were "},{"startTime":265.52,"endTime":270.64,"body":"working with throughout the entire semester. We  "},{"startTime":270.64,"endTime":276.32,"body":"also had safety walkthroughs where we were really "},{"startTime":270.64,"endTime":276.32,"body":"just letting them do and not just learn. So, this  "},{"startTime":276.32,"endTime":282.0,"body":"was really trying to put hands-on experience and "},{"startTime":276.32,"endTime":282.0,"body":"as much real life experience as we could give them  "},{"startTime":282.0,"endTime":287.6,"body":"without physically taking them to the hospital "},{"startTime":282.0,"endTime":287.6,"body":"setting. I'm going to let Laura answer a little  "},{"startTime":287.6,"endTime":293.6,"body":"bit more about the reflection portion of it. "},{"startTime":287.6,"endTime":293.6,"body":"Yes. So, not only did we engage them with hands,  "},{"startTime":293.6,"endTime":299.68,"body":"but we also let them reflect on what they were "},{"startTime":293.6,"endTime":299.68,"body":"doing. And we had them do that through guided  "},{"startTime":299.68,"endTime":306.88,"body":"reflection. We had a station six especially they "},{"startTime":299.68,"endTime":306.88,"body":"had to look at different charts and pick out the  "},{"startTime":306.88,"endTime":312.4,"body":"normals and the abnormals and they picked out "},{"startTime":306.88,"endTime":312.4,"body":"normals and abnormals based on physical findings.  "},{"startTime":312.4,"endTime":317.84,"body":"It wasn't until they looked at our answer key and "},{"startTime":312.4,"endTime":317.84,"body":"they saw that we had picked out some things that  "},{"startTime":317.84,"endTime":322.8,"body":"were social determinants of health like somebody "},{"startTime":317.84,"endTime":322.8,"body":"living alone is not going to be able to care for  "},{"startTime":322.8,"endTime":328.48,"body":"themselves as well when they're getting better. "},{"startTime":322.8,"endTime":328.48,"body":"And so they saw that and it made them realize,  "},{"startTime":328.48,"endTime":333.92,"body":"oh, this is a whole person and helped them to "},{"startTime":328.48,"endTime":333.92,"body":"begin to think from a different perspective,  "},{"startTime":333.92,"endTime":340.4,"body":"which is what helps them to grow clinically is "},{"startTime":333.92,"endTime":340.4,"body":"to be able to start to think in a more holistic  "},{"startTime":340.4,"endTime":345.84,"body":"manner. So the reflection piece, we guided them "},{"startTime":340.4,"endTime":345.84,"body":"just a couple of questions and that was really  "},{"startTime":345.84,"endTime":353.12,"body":"engaging in helping them to learn. Great. Would "},{"startTime":345.84,"endTime":353.12,"body":"you walk us through like so I'm a student coming  "},{"startTime":353.12,"endTime":358.48,"body":"in and going through this seven station simulation "},{"startTime":353.12,"endTime":358.48,"body":"just kind of what would I experience or what would  "},{"startTime":358.48,"endTime":365.28,"body":"I expect when I come into the environment? So "},{"startTime":358.48,"endTime":365.28,"body":"when you we had stations set up and we had a  "},{"startTime":365.28,"endTime":370.8,"body":"piece of paper or on their learning system telling "},{"startTime":365.28,"endTime":370.8,"body":"them what the different stations were and we told  "},{"startTime":370.8,"endTime":377.52,"body":"them they could choose which station to go to so "},{"startTime":370.8,"endTime":377.52,"body":"they got to pick and we did a little brief survey.  "},{"startTime":377.52,"endTime":382.24,"body":"This station we're going to do be do vital signs. "},{"startTime":377.52,"endTime":382.24,"body":"If you see that this station is open, you can go  "},{"startTime":382.24,"endTime":387.2,"body":"and do your physical assessment and this station "},{"startTime":382.24,"endTime":387.2,"body":"you can document. So they had to hit all the  "},{"startTime":387.2,"endTime":391.12,"body":"different ones. They had a bingo card so that "},{"startTime":387.2,"endTime":391.12,"body":"they made sure they hit all the different ones.  "},{"startTime":391.12,"endTime":396.08,"body":"And when they were done with the station, we would "},{"startTime":391.12,"endTime":396.08,"body":"sign that station so that when they were finished,  "},{"startTime":396.08,"endTime":403.36,"body":"they knew they were finished. And each station had "},{"startTime":396.08,"endTime":403.36,"body":"explanations for it at that station. And if they  "},{"startTime":403.36,"endTime":409.04,"body":"also needed us, we were there to walk around to "},{"startTime":403.36,"endTime":409.04,"body":"the different stations and give them more guidance  "},{"startTime":409.04,"endTime":415.84,"body":"if they were unsure of what to do. What kind of "},{"startTime":409.04,"endTime":415.84,"body":"feedback did you receive from the students? So,  "},{"startTime":415.84,"endTime":421.2,"body":"we did receive feedback that it helped them to "},{"startTime":415.84,"endTime":421.2,"body":"feel more confident. it pulled the whole semester  "},{"startTime":421.2,"endTime":429.28,"body":"together and that they realize, oh, documentation "},{"startTime":421.2,"endTime":429.28,"body":"is rather important when I'm doing an assessment  "},{"startTime":429.28,"endTime":435.2,"body":"and so is looking at the person as a real person "},{"startTime":429.28,"endTime":435.2,"body":"and not just their vital signs or their assessment  "},{"startTime":435.2,"endTime":440.8,"body":"findings. So, we did get some really good "},{"startTime":435.2,"endTime":440.8,"body":"feedback that they learned a lot and they enjoyed  "},{"startTime":440.8,"endTime":446.96,"body":"doing it hands-on, right? And did they offer any "},{"startTime":440.8,"endTime":446.96,"body":"suggestions for improvements or did you all have  "},{"startTime":446.96,"endTime":451.68,"body":"any suggestions for improvements moving forward? "},{"startTime":446.96,"endTime":451.68,"body":"I'm assuming you're still using this strategy.  "},{"startTime":451.68,"endTime":457.04,"body":"We are using this strategy and we have kind of "},{"startTime":451.68,"endTime":457.04,"body":"made it even more realistic by combining a few of  "},{"startTime":457.04,"endTime":462.32,"body":"the stations. So that we noticed that they were "},{"startTime":457.04,"endTime":462.32,"body":"still very anxious the next semester when they  "},{"startTime":462.32,"endTime":467.84,"body":"went into the actual clinical setting, which is to "},{"startTime":462.32,"endTime":467.84,"body":"be understood, but we wanted to give them a little  "},{"startTime":467.84,"endTime":474.16,"body":"more practice. So we actually have part of the "},{"startTime":467.84,"endTime":474.16,"body":"stations now in a little pretend hospital room.  "},{"startTime":474.16,"endTime":481.84,"body":"So the safety is combined with the assessment and "},{"startTime":474.16,"endTime":481.84,"body":"they can practice more realistically what they're  "},{"startTime":481.84,"endTime":486.56,"body":"going to be doing the next semester and that has "},{"startTime":481.84,"endTime":486.56,"body":"helped them to become a little more confident  "},{"startTime":486.56,"endTime":491.92,"body":"because we're trying to build confidence "},{"startTime":486.56,"endTime":491.92,"body":"and decrease anxiety when they actually go  "},{"startTime":491.92,"endTime":501.2,"body":"into the hospital. Any plans in the future about "},{"startTime":491.92,"endTime":501.2,"body":"measuring change or measuring your outcomes? Yes,  "},{"startTime":501.2,"endTime":506.8,"body":"we have been talking to the people in the next "},{"startTime":501.2,"endTime":506.8,"body":"semester. So we have five semesters in our  "},{"startTime":506.8,"endTime":512.526,"body":"program. We've been talking to the second semester "},{"startTime":506.8,"endTime":512.526,"body":"teachers and we're going to be doing some surveys  "},{"startTime":512.526,"endTime":518.64,"body":"in the first semester and second semester and "},{"startTime":512.526,"endTime":518.64,"body":"try to gauge how they transitioned. That's great.  "},{"startTime":518.64,"endTime":524.08,"body":"Wonderful. Any other things you want to mention "},{"startTime":518.64,"endTime":524.08,"body":"about your strategy used for active learning?  "},{"startTime":524.08,"endTime":530.0,"body":"I do want to mention that even though we have "},{"startTime":524.08,"endTime":530.0,"body":"just this one, the students get to do a lot of  "},{"startTime":530.0,"endTime":536.08,"body":"active learning throughout the semester. So, it's "},{"startTime":530.0,"endTime":536.08,"body":"not their first time. This is just really their  "},{"startTime":536.08,"endTime":541.04,"body":"first kind of put it all together opportunity. "},{"startTime":536.08,"endTime":541.04,"body":"They've had an opportunity to use standardized  "},{"startTime":541.04,"endTime":545.84,"body":"patients. So they have a little bit of opportunity "},{"startTime":541.04,"endTime":545.84,"body":"with simulation there. So, it helps make this  "},{"startTime":545.84,"endTime":552.48,"body":"opportunity a little less stressful. I do feel "},{"startTime":545.84,"endTime":552.48,"body":"like they get really shocked when they actually  "},{"startTime":552.48,"endTime":559.04,"body":"have to go in and actually act like a nurse. Kind "},{"startTime":552.48,"endTime":559.04,"body":"of a deconditioning is what I feel like we've  "},{"startTime":559.04,"endTime":563.36,"body":"been doing with them. We're kind of, you know, "},{"startTime":559.04,"endTime":563.36,"body":"getting them ready for that hospital by giving  "},{"startTime":563.36,"endTime":569.6,"body":"them those little small exposures throughout the "},{"startTime":563.36,"endTime":569.6,"body":"entire semester. And I feel like most of them by  "},{"startTime":569.6,"endTime":574.88,"body":"the end of it, they're having a good time. They "},{"startTime":569.6,"endTime":574.88,"body":"really enjoyed it. They know it's not high stakes.  "},{"startTime":574.88,"endTime":578.08,"body":"They know they have to complete things to "},{"startTime":574.88,"endTime":578.08,"body":"get their grades and their credit for it,  "},{"startTime":578.08,"endTime":583.84,"body":"but I feel like they really kind of enjoy the "},{"startTime":578.08,"endTime":583.84,"body":"overall experience and getting the opportunity  "},{"startTime":583.84,"endTime":588.96,"body":"to do things like a focused assessment because "},{"startTime":583.84,"endTime":588.96,"body":"they're so used to doing something in order,  "},{"startTime":588.96,"endTime":594.72,"body":"the exact same order, and now they're having to "},{"startTime":588.96,"endTime":594.72,"body":"trim it down instead of do all 12 cranial nerves  "},{"startTime":594.72,"endTime":600.88,"body":"that they learned. Well, I want to thank you both "},{"startTime":594.72,"endTime":600.88,"body":"for joining us. It's great that you're able to  "},{"startTime":600.88,"endTime":606.16,"body":"and willing to share some of your information on "},{"startTime":600.88,"endTime":606.16,"body":"your experiences with translating active learning  "},{"startTime":606.16,"endTime":611.12,"body":"in the classroom. I appreciate your time and "},{"startTime":606.16,"endTime":611.12,"body":"expertise and I know our our listeners will  "},{"startTime":611.12,"endTime":616.48,"body":"too. To our listeners, if you have not had the "},{"startTime":611.12,"endTime":616.48,"body":"opportunity, please look for the author's work,  "},{"startTime":616.48,"endTime":620.48,"body":"Fostering Clinical Judgment and Promoting "},{"startTime":616.48,"endTime":620.48,"body":"Transition in the First Clinical Rotation  "},{"startTime":620.48,"endTime":624.72,"body":"Through Active Learning. The article "},{"startTime":620.48,"endTime":624.72,"body":"can be found in the July-August issue  "},{"startTime":624.72,"endTime":630.0,"body":"of Nursing Education Perspectives. And thank "},{"startTime":624.72,"endTime":630.0,"body":"you all the listeners and thank you both to  "},{"startTime":630.0,"endTime":643.52,"body":"our authors for joining us for this "},{"startTime":630.0,"endTime":643.52,"body":"conversation. Much appreciated. Thank you."},{"startTime":643.52,"endTime":644.724,"body":"[Music]"}]}