{"version":"1.0.0","segments":[{"startTime":9.12,"endTime":15.44,"body":"Welcome to another episode of the NLN podcast, "},{"startTime":9.12,"endTime":15.44,"body":"Nursing EDge Unscripted. We are your hosts for"},{"startTime":15.44,"endTime":20.64,"body":"today's episode. I'm Dr. Kellie Bryant and I'm "},{"startTime":15.44,"endTime":20.64,"body":"joined here by my colleague, Dr. Raquel Bertiz"},{"startTime":20.64,"endTime":26.56,"body":"from the National League for Nursing. In this "},{"startTime":20.64,"endTime":26.56,"body":"episode, we will be talking about a very hot"},{"startTime":26.56,"endTime":32.32,"body":"topic and a timely topic. Nursing education's "},{"startTime":26.56,"endTime":32.32,"body":"continued drive for excellence and competency"},{"startTime":32.32,"endTime":39.44,"body":"based education. And this conversation is going to "},{"startTime":32.32,"endTime":39.44,"body":"focus in particular on clinical education. Before"},{"startTime":39.44,"endTime":45.76,"body":"we dive into the full conversation, let's share "},{"startTime":39.44,"endTime":45.76,"body":"some of our reflections right after the taping."},{"startTime":46.96,"endTime":55.04,"body":"We're always looking for practical solutions "},{"startTime":46.96,"endTime":55.04,"body":"on how to operationalize CBE and obviously"},{"startTime":55.04,"endTime":63.92,"body":"from the conversation they do offer like the "},{"startTime":55.04,"endTime":63.92,"body":"concrete steps. So how do you do this? Yeah,"},{"startTime":63.92,"endTime":69.76,"body":"that was a very, very informative podcast. I really "},{"startTime":63.92,"endTime":69.76,"body":"enjoyed speaking to Rose and and and Stephanie."},{"startTime":69.76,"endTime":76.32,"body":"What I loved about it the most was that when "},{"startTime":69.76,"endTime":76.32,"body":"they started talking about the process, you know,"},{"startTime":76.32,"endTime":80.0,"body":"it wasn't that they just jumped into creating "},{"startTime":76.32,"endTime":80.0,"body":"this tool that the fact that they had this two-day"},{"startTime":80.0,"endTime":84.64,"body":"workshop where they kind of mapped out their "},{"startTime":80.0,"endTime":84.64,"body":"curriculum to figure out which competencies or"},{"startTime":84.64,"endTime":90.64,"body":"outcomes belong in whether it's didactic, clinical "},{"startTime":84.64,"endTime":90.64,"body":"or simulation and then were able to come up with,"},{"startTime":90.64,"endTime":95.92,"body":"you know, the the the behaviors and and this this "},{"startTime":90.64,"endTime":95.92,"body":"tool. I think that was an important first step"},{"startTime":95.92,"endTime":101.76,"body":"and the fact that they also involved faculty. "},{"startTime":95.92,"endTime":101.76,"body":"the faculty kind of owned it and then even had"},{"startTime":101.76,"endTime":107.52,"body":"student input. I thought that was a great way of "},{"startTime":101.76,"endTime":107.52,"body":"making sure that, you know, they got that buy in,"},{"startTime":107.52,"endTime":113.92,"body":"right? I like their emphasis on involving clinical "},{"startTime":107.52,"endTime":113.92,"body":"instructors and that clinical instructors are are"},{"startTime":113.92,"endTime":121.44,"body":"vital to any nursing program implementation "},{"startTime":113.92,"endTime":121.44,"body":"and how they need to be prepared. And and I"},{"startTime":121.44,"endTime":128.88,"body":"think that brings us back to many of our issues "},{"startTime":121.44,"endTime":128.88,"body":"with clinical instructor preparation where we"},{"startTime":128.88,"endTime":134.96,"body":"ask them to okay go ahead and swim and but also "},{"startTime":128.88,"endTime":134.96,"body":"yeah it also gave us a new perspective on how to"},{"startTime":134.96,"endTime":140.88,"body":"conduct clinical evaluation because let's face it "},{"startTime":134.96,"endTime":140.88,"body":"a lot of us you know at our universities have this"},{"startTime":140.88,"endTime":148.0,"body":"this long, 10 page tool with the med partially "},{"startTime":140.88,"endTime":148.0,"body":"met and all these outcomes which are like"},{"startTime":148.0,"endTime":152.32,"body":"they were saying are very broad you You "},{"startTime":148.0,"endTime":152.32,"body":"know, I love the fact that now it's based"},{"startTime":152.32,"endTime":156.96,"body":"off of competencies and students add their "},{"startTime":152.32,"endTime":156.96,"body":"input and they're able to identify, you know,"},{"startTime":156.96,"endTime":162.72,"body":"the behaviors that met that competency and they "},{"startTime":156.96,"endTime":162.72,"body":"have an input along with the faculty. So again,"},{"startTime":162.72,"endTime":168.24,"body":"having more of that student centered focus, "},{"startTime":162.72,"endTime":168.24,"body":"I think, is is where we need to move when it"},{"startTime":168.24,"endTime":172.48,"body":"comes to clinical evaluation. So, it's nice "},{"startTime":168.24,"endTime":172.48,"body":"to have a new model, a new way of thinking,"},{"startTime":172.48,"endTime":178.56,"body":"approach to clinical evaluation because I do "},{"startTime":172.48,"endTime":178.56,"body":"think we've been stuck in our our old ways."},{"startTime":181.52,"endTime":186.88,"body":"Let's turn from our reflections to the experts "},{"startTime":181.52,"endTime":186.88,"body":"driving this important conversation. Our guests"},{"startTime":186.88,"endTime":191.76,"body":"today are from Widener University School "},{"startTime":186.88,"endTime":191.76,"body":"of Nursing who have developed an innovative"},{"startTime":191.76,"endTime":197.44,"body":"model in which students use a competency-based "},{"startTime":191.76,"endTime":197.44,"body":"clinical evaluation tool each week as part of"},{"startTime":197.44,"endTime":204.4,"body":"their clinical evaluation. Our guests today are "},{"startTime":197.44,"endTime":204.4,"body":"Dr. Rose Rossi, Professor Emmeritus, and Dr."},{"startTime":204.4,"endTime":210.16,"body":"Stephanie Jeffers, associate dean of undergraduate "},{"startTime":204.4,"endTime":210.16,"body":"programs at Widener University School of Nursing."},{"startTime":210.16,"endTime":216.08,"body":"I want to welcome Rose and Stephanie. Thank you "},{"startTime":210.16,"endTime":216.08,"body":"for joining us today. Thank you for having us."},{"startTime":216.08,"endTime":221.84,"body":"Thank you. All right. So, I'm just going to "},{"startTime":216.08,"endTime":221.84,"body":"dive right in and start with tell us a little"},{"startTime":221.84,"endTime":227.52,"body":"bit about how you came up with this idea to start "},{"startTime":221.84,"endTime":227.52,"body":"this competency based assessment in the clinical"},{"startTime":227.52,"endTime":232.88,"body":"setting. Give us the background on that. Well, "},{"startTime":227.52,"endTime":232.88,"body":"I think first the first thing that we realized"},{"startTime":232.88,"endTime":240.8,"body":"at Widener was we wanted to get all of the "},{"startTime":232.88,"endTime":240.8,"body":"faculty buy in as we were moving to the new AACN"},{"startTime":240.8,"endTime":252.08,"body":"essentials. So this really started by us having a "},{"startTime":240.8,"endTime":252.08,"body":"full faculty meeting at workshop where we laid out"},{"startTime":252.08,"endTime":259.04,"body":"all the domains and all the competencies and the "},{"startTime":252.08,"endTime":259.04,"body":"all the sub-competencies and we asked our faculty"},{"startTime":259.04,"endTime":266.16,"body":"to a map where all of these occurred in each of "},{"startTime":259.04,"endTime":266.16,"body":"their courses and then so that was sort of part"},{"startTime":266.16,"endTime":272.08,"body":"one but part two then we said what does this look "},{"startTime":266.16,"endTime":272.08,"body":"like? what does this look like for your students"},{"startTime":272.08,"endTime":281.2,"body":"based on your courses? So asking faculty to really "},{"startTime":272.08,"endTime":281.2,"body":"begin to think about this in from a competency"},{"startTime":281.2,"endTime":288.24,"body":"perspective as opposed to just a knowledge "},{"startTime":281.2,"endTime":288.24,"body":"perspective I think was a good jumping point and"},{"startTime":288.24,"endTime":294.64,"body":"Steph could really talk about her own course "},{"startTime":288.24,"endTime":294.64,"body":"which is where she did a lot of this work."},{"startTime":294.64,"endTime":301.12,"body":"Well, I would like to say that when Rose said that "},{"startTime":294.64,"endTime":301.12,"body":"we mapped everything out, we literally mean mapped"},{"startTime":301.12,"endTime":309.44,"body":"it out. There were poster boards, papers, we had "},{"startTime":301.12,"endTime":309.44,"body":"Post-it notes so that, you know, we could tag"},{"startTime":309.44,"endTime":314.96,"body":"different areas, different domains, what goes with "},{"startTime":309.44,"endTime":314.96,"body":"which competency. And the faculty would write down"},{"startTime":314.96,"endTime":320.56,"body":"on each of those slips of paper behaviors that "},{"startTime":314.96,"endTime":320.56,"body":"were associated with the competency that they"},{"startTime":320.56,"endTime":328.24,"body":"would expect students to achieve competency in by "},{"startTime":320.56,"endTime":328.24,"body":"the end of the semester in clinical. As far as the"},{"startTime":328.24,"endTime":335.84,"body":"courses at the time, I was faculty in both junior "},{"startTime":328.24,"endTime":335.84,"body":"level and senior level medical surgical nursing."},{"startTime":335.84,"endTime":342.08,"body":"And so with our faculty that t taught in those "},{"startTime":335.84,"endTime":342.08,"body":"courses, we came up with behaviors that were"},{"startTime":342.08,"endTime":349.6,"body":"associated with each domain and then posted them "},{"startTime":342.08,"endTime":349.6,"body":"on all of the corresponding areas on the map."},{"startTime":349.6,"endTime":356.88,"body":"The other thing that was really nice as we did "},{"startTime":349.6,"endTime":356.88,"body":"this is that we broke out which of these behaviors"},{"startTime":356.88,"endTime":365.76,"body":"would we want to measure in clinical in simulation "},{"startTime":356.88,"endTime":365.76,"body":"and which of these behaviors would we measure in"},{"startTime":365.76,"endTime":374.4,"body":"more objective ways objective testing. So having "},{"startTime":365.76,"endTime":374.4,"body":"faculty really begin to break that down I think"},{"startTime":374.4,"endTime":382.48,"body":"helped put it in perspective for them and then for "},{"startTime":374.4,"endTime":382.48,"body":"us. So that was really step one. What this did,"},{"startTime":382.48,"endTime":391.44,"body":"I think, was help the students then own that that "},{"startTime":382.48,"endTime":391.44,"body":"this behavior, these behaviors were theirs to"},{"startTime":391.44,"endTime":399.44,"body":"create and theirs to develop. And it wasn't, I'm "},{"startTime":391.44,"endTime":399.44,"body":"just going to sit back and be a sponge. It was,"},{"startTime":399.44,"endTime":410.0,"body":"oh, I now have to seek out opportunities to try "},{"startTime":399.44,"endTime":410.0,"body":"and meet this behavior. And I think that really"},{"startTime":410.0,"endTime":416.56,"body":"helped engage the students in a way that were "},{"startTime":410.0,"endTime":416.56,"body":"sometimes a little more passive than we would have"},{"startTime":416.56,"endTime":424.56,"body":"liked them to be. That sounds very interesting. "},{"startTime":416.56,"endTime":424.56,"body":"I'm I'm sure I'm pretty sure that we're always"},{"startTime":424.56,"endTime":432.8,"body":"looking for more student engagement and from what "},{"startTime":424.56,"endTime":432.8,"body":"you've said, it sounds like a lot of things you"},{"startTime":432.8,"endTime":440.16,"body":"have done to get to where you are right now. So "},{"startTime":432.8,"endTime":440.16,"body":"I'm curious what were your biggest challenges"},{"startTime":440.16,"endTime":446.4,"body":"with implementing this new approach? I would "},{"startTime":440.16,"endTime":446.4,"body":"say the biggest challenge was educating clinical"},{"startTime":446.4,"endTime":452.64,"body":"instructors. So we had to present it to them as "},{"startTime":446.4,"endTime":452.64,"body":"a new instrument and let's be honest everybody"},{"startTime":452.64,"endTime":458.32,"body":"has difficulty with change. So just providing that "},{"startTime":452.64,"endTime":458.32,"body":"education and saying look this is how we're going"},{"startTime":458.32,"endTime":464.64,"body":"to measure competency the and then we provide "},{"startTime":458.32,"endTime":464.64,"body":"examples under each domain. So for example,"},{"startTime":464.64,"endTime":470.32,"body":"if somebody needed to meet interprofessional "},{"startTime":464.64,"endTime":470.32,"body":"collaboration competencies, how did they interact"},{"startTime":470.32,"endTime":475.92,"body":"with inter the interprofessional team? Did the "},{"startTime":470.32,"endTime":475.92,"body":"student describe interactions in the clinical"},{"startTime":475.92,"endTime":481.92,"body":"setting with the patient? And so we just had to "},{"startTime":475.92,"endTime":481.92,"body":"provide that education to the clinical faculty"},{"startTime":481.92,"endTime":487.6,"body":"and myself, I was a course coordinator for "},{"startTime":481.92,"endTime":487.6,"body":"junior level medical surgical nursing when"},{"startTime":487.6,"endTime":493.84,"body":"we implemented this instrument. And I provided "},{"startTime":487.6,"endTime":493.84,"body":"a lot of support because sometimes the clinical"},{"startTime":493.84,"endTime":498.48,"body":"instructors weren't sure if they were doing the "},{"startTime":493.84,"endTime":498.48,"body":"right thing or providing the right feedback to"},{"startTime":498.48,"endTime":504.32,"body":"the student. How are they evaluating what the "},{"startTime":498.48,"endTime":504.32,"body":"student is writing in their instrument weekly?"},{"startTime":504.32,"endTime":509.92,"body":"So at the beginning it was a little difficult "},{"startTime":504.32,"endTime":509.92,"body":"but they sort of picked it up pretty quickly."},{"startTime":509.92,"endTime":518.88,"body":"And the students also I will say initially they "},{"startTime":509.92,"endTime":518.88,"body":"were focused on tasks and skills. Today I did"},{"startTime":518.88,"endTime":525.6,"body":"a Foley insertion. Yesterday I took vital signs. "},{"startTime":518.88,"endTime":525.6,"body":"Whatever the skill was, they were mostly focusing"},{"startTime":525.6,"endTime":531.84,"body":"on that. But with some prompting from the clinical "},{"startTime":525.6,"endTime":531.84,"body":"instructors, the students began to really reflect."},{"startTime":531.84,"endTime":537.92,"body":"So when you're reflecting, you're thinking about "},{"startTime":531.84,"endTime":537.92,"body":"what you're doing. You're not just doing a skill."},{"startTime":537.92,"endTime":543.68,"body":"And by the end of the semester, I could really "},{"startTime":537.92,"endTime":543.68,"body":"I would read some of these clinical evaluation"},{"startTime":543.68,"endTime":548.8,"body":"tools just to make sure that they were completing "},{"startTime":543.68,"endTime":548.8,"body":"them correctly. And it really seemed like the"},{"startTime":548.8,"endTime":553.84,"body":"students had pride in what they were doing now "},{"startTime":548.8,"endTime":553.84,"body":"because they're like, \"Oh, I did this for my"},{"startTime":553.84,"endTime":560.16,"body":"patient. My patient had difficulty breathing and "},{"startTime":553.84,"endTime":560.16,"body":"I assessed them. I changed their position or I"},{"startTime":560.16,"endTime":566.64,"body":"talked to them if the patient was having anxiety "},{"startTime":560.16,"endTime":566.64,"body":"and it seemed like they were really more invested"},{"startTime":566.64,"endTime":573.12,"body":"in their education as far as completing behaviors "},{"startTime":566.64,"endTime":573.12,"body":"and thinking about what they're doing at clinical."},{"startTime":573.12,"endTime":578.32,"body":"The other challenge we had which I think was "},{"startTime":573.12,"endTime":578.32,"body":"interesting and we didn't quite anticipate"},{"startTime":578.32,"endTime":586.0,"body":"this was the use of technology in our learning "},{"startTime":578.32,"endTime":586.0,"body":"management system because ultimately what we"},{"startTime":586.0,"endTime":596.0,"body":"wanted was one document where students could see "},{"startTime":586.0,"endTime":596.0,"body":"their progression each week. And that was really"},{"startTime":596.0,"endTime":602.24,"body":"difficult to do because we wanted one document "},{"startTime":596.0,"endTime":602.24,"body":"where they could write their, you know, under"},{"startTime":602.24,"endTime":607.28,"body":"their behaviors each week or under each domain "},{"startTime":602.24,"endTime":607.28,"body":"each week what they did so they could see it and"},{"startTime":607.28,"endTime":614.4,"body":"then faculty could comment. And we couldn't quite "},{"startTime":607.28,"endTime":614.4,"body":"get there with our LMS. So, we ended up having"},{"startTime":614.4,"endTime":622.24,"body":"to be a little bit more creative in how that "},{"startTime":614.4,"endTime":622.24,"body":"happened. Because we wanted our instructors to"},{"startTime":622.24,"endTime":629.2,"body":"be able to say, \"Oh, on week one, this is what the "},{"startTime":622.24,"endTime":629.2,"body":"students said when they addressed this behavior"},{"startTime":629.2,"endTime":635.68,"body":"and on week 10, this is what they said.\" And you "},{"startTime":629.2,"endTime":635.68,"body":"could see the growth over time. So that was a"},{"startTime":635.68,"endTime":641.36,"body":"little bit of a challenge that we tried a couple "},{"startTime":635.68,"endTime":641.36,"body":"different things and and we were doing those"},{"startTime":641.36,"endTime":648.32,"body":"things even before we rolled this out. So we had a "},{"startTime":641.36,"endTime":648.32,"body":"number of our faculty who were clinical, you know,"},{"startTime":648.32,"endTime":653.36,"body":"who were the students and I was the instructor "},{"startTime":648.32,"endTime":653.36,"body":"and we'd be like fill this in and let's see how"},{"startTime":653.36,"endTime":661.52,"body":"this goes. So I if I had my wish I would figure "},{"startTime":653.36,"endTime":661.52,"body":"out a different LMS system where this might work"},{"startTime":661.52,"endTime":670.0,"body":"a little bit easier. But I think what we have is "},{"startTime":661.52,"endTime":670.0,"body":"workable and usable and we're not changing our LMS"},{"startTime":670.0,"endTime":678.08,"body":"anytime soon. That's for sure. Yes. So you just "},{"startTime":670.0,"endTime":678.08,"body":"described a beautiful student centered approach"},{"startTime":678.08,"endTime":684.48,"body":"to learning that the students are active in, you "},{"startTime":678.08,"endTime":684.48,"body":"know, assessing where they're at and how they're"},{"startTime":684.48,"endTime":689.76,"body":"meeting their clinical outcomes, which I love. "},{"startTime":684.48,"endTime":689.76,"body":"One question I have is a little bit more specific"},{"startTime":689.76,"endTime":696.72,"body":"about the tool. So, can you tell me a little bit "},{"startTime":689.76,"endTime":696.72,"body":"more about what this tool looked like and how it"},{"startTime":696.72,"endTime":701.92,"body":"was implemented? Meaning, did the students fill "},{"startTime":696.72,"endTime":701.92,"body":"it out first and then the faculty kind of make"},{"startTime":701.92,"endTime":708.08,"body":"comments to it, you know, after the clinical day? "},{"startTime":701.92,"endTime":708.08,"body":"And and my other question is, and what happens at"},{"startTime":708.08,"endTime":713.6,"body":"the end of the semester where there may be some "},{"startTime":708.08,"endTime":713.6,"body":"gaps where the students weren't able to, you know,"},{"startTime":713.6,"endTime":723.28,"body":"demonstrate a certain behavior? How did you "},{"startTime":713.6,"endTime":723.28,"body":"address that? So, the students needed to complete"},{"startTime":723.28,"endTime":729.52,"body":"the clinical evaluation tool where they would "},{"startTime":723.28,"endTime":729.52,"body":"address one or two domains per week. Obviously,"},{"startTime":729.52,"endTime":734.64,"body":"you're not going to meet all of the domains "},{"startTime":729.52,"endTime":734.64,"body":"every single time the students in clinical."},{"startTime":734.64,"endTime":741.28,"body":"So one or two things that really stood out to "},{"startTime":734.64,"endTime":741.28,"body":"them and so they had to reflect on what the"},{"startTime":741.28,"endTime":748.8,"body":"behaviors were that were required or suggested "},{"startTime":741.28,"endTime":748.8,"body":"for that particular domain, write some examples,"},{"startTime":748.8,"endTime":753.36,"body":"and then the clinical instructor would "},{"startTime":748.8,"endTime":753.36,"body":"then provide feedback on that. And there's"},{"startTime":753.36,"endTime":760.96,"body":"a little rubric in the in the learning management "},{"startTime":753.36,"endTime":760.96,"body":"system that says meets expectations or, you know,"},{"startTime":760.96,"endTime":766.48,"body":"needs improvement, that kind of thing. So if the "},{"startTime":760.96,"endTime":766.48,"body":"student was too short with their response or they"},{"startTime":766.48,"endTime":773.2,"body":"didn't provide a lot of detail, instructors would "},{"startTime":766.48,"endTime":773.2,"body":"encourage them to do so for the next time. Or"},{"startTime":773.2,"endTime":778.4,"body":"sometimes it ended up being more like a discussion "},{"startTime":773.2,"endTime":778.4,"body":"post. So like there was conversation back and"},{"startTime":778.4,"endTime":783.12,"body":"forth with the instructor and the student. "},{"startTime":778.4,"endTime":783.12,"body":"It was more than the instructor just saying,"},{"startTime":783.12,"endTime":789.28,"body":"\"Hey, great job.\" It was the instructor sort "},{"startTime":783.12,"endTime":789.28,"body":"of reflecting back on the student what the"},{"startTime":789.28,"endTime":795.6,"body":"student achieved and identifying those skills and "},{"startTime":789.28,"endTime":795.6,"body":"behaviors that were required for that particular"},{"startTime":795.6,"endTime":803.84,"body":"competency. And if there was an area where maybe "},{"startTime":795.6,"endTime":803.84,"body":"the student get a lot didn't get an opportunity"},{"startTime":803.84,"endTime":811.2,"body":"but for example they never encountered an ethical "},{"startTime":803.84,"endTime":811.2,"body":"dilemma. The instructors would then say, \"Okay,"},{"startTime":811.2,"endTime":817.44,"body":"you didn't encounter an ethical dilemma, "},{"startTime":811.2,"endTime":817.44,"body":"but what would you do if?\" And then they"},{"startTime":817.44,"endTime":826.32,"body":"would give them a scenario or a situation and "},{"startTime":817.44,"endTime":826.32,"body":"have them reflect on that situation. And that"},{"startTime":826.32,"endTime":831.76,"body":"way we weren't saying, \"Oh, well, there were no "},{"startTime":826.32,"endTime":831.76,"body":"ethical dilemmas that the students encountered,"},{"startTime":831.76,"endTime":837.36,"body":"therefore we're not going to address this "},{"startTime":831.76,"endTime":837.36,"body":"domain.\" They provided them, you know,"},{"startTime":837.36,"endTime":844.4,"body":"scenarios or opportunities to then discuss "},{"startTime":837.36,"endTime":844.4,"body":"what would you have done if this scenario"},{"startTime":844.4,"endTime":850.24,"body":"happened or you know what would you have done "},{"startTime":844.4,"endTime":850.24,"body":"if you thought the nurse was giving the wrong"},{"startTime":850.24,"endTime":857.68,"body":"medication? What would you have done if this "},{"startTime":850.24,"endTime":857.68,"body":"event happened? And I think even in the feedback"},{"startTime":857.68,"endTime":863.2,"body":"which the instructors were wonderful in is they "},{"startTime":857.68,"endTime":863.2,"body":"would they would say okay so you talked about"},{"startTime":863.2,"endTime":870.4,"body":"this what would you do next time to further "},{"startTime":863.2,"endTime":870.4,"body":"expand what you did and giving students an"},{"startTime":870.4,"endTime":875.36,"body":"opportunity to really think about those things "},{"startTime":870.4,"endTime":875.36,"body":"differently and say okay well okay you did this"},{"startTime":875.36,"endTime":882.627,"body":"this is great this was a great start what's "},{"startTime":875.36,"endTime":882.627,"body":"your next step what would you do after that"},{"startTime":882.627,"endTime":889.52,"body":"allow the students to really begin to think about "},{"startTime":882.627,"endTime":889.52,"body":"how they will continue to grow as a professional"},{"startTime":889.52,"endTime":900.394,"body":"nurse. That sounds really interesting. And I "},{"startTime":889.52,"endTime":900.394,"body":"think I was going to ask you this question but"},{"startTime":900.394,"endTime":908.16,"body":"since you started on that note my curiosity is "},{"startTime":900.394,"endTime":908.16,"body":"all about because you're doing this competency"},{"startTime":908.16,"endTime":917.045,"body":"based evaluation and use of the clinical teaching "},{"startTime":908.16,"endTime":917.045,"body":"tool. How has your clinical teaching kind of like"},{"startTime":917.045,"endTime":923.52,"body":"expanded if that's the right term for that or or "},{"startTime":917.045,"endTime":923.52,"body":"shifted? So, because we're evaluating them this"},{"startTime":923.52,"endTime":932.96,"body":"way, I'm curious, so how are we teaching them now "},{"startTime":923.52,"endTime":932.96,"body":"to get there? I think that clinical instructors"},{"startTime":932.96,"endTime":940.0,"body":"are doing more debriefing with students now and "},{"startTime":932.96,"endTime":940.0,"body":"encouraging reflection to assist students with"},{"startTime":940.0,"endTime":946.72,"body":"identifying areas of strength and areas where the "},{"startTime":940.0,"endTime":946.72,"body":"student might have to improve. And I think that"},{"startTime":946.72,"endTime":952.4,"body":"is helpful to have a dialogue with the student "},{"startTime":946.72,"endTime":952.4,"body":"because you're encouraging them to think about"},{"startTime":952.4,"endTime":958.16,"body":"the rationale for their interventions or the "},{"startTime":952.4,"endTime":958.16,"body":"rationale for particular assessment. And that"},{"startTime":958.16,"endTime":964.08,"body":"is really kind of the key to the competency based "},{"startTime":958.16,"endTime":964.08,"body":"education is you're doing more thinking than doing"},{"startTime":964.08,"endTime":972.0,"body":"tasks and skills. So I think that this shift is "},{"startTime":964.08,"endTime":972.0,"body":"more having more conversations and encouraging"},{"startTime":972.0,"endTime":979.52,"body":"more reflective thinking with the students as far "},{"startTime":972.0,"endTime":979.52,"body":"as the clinical instructors go and to and to add"},{"startTime":979.52,"endTime":985.68,"body":"to what Steph is saying, you know, one of the big "},{"startTime":979.52,"endTime":985.68,"body":"struggles that clinical instructors often have"},{"startTime":985.68,"endTime":993.12,"body":"is they don't want to upset a student by, you "},{"startTime":985.68,"endTime":993.12,"body":"know, giving them poor feedback and they don't"},{"startTime":993.12,"endTime":997.68,"body":"they're not always comfortable giving giving that "},{"startTime":993.12,"endTime":997.68,"body":"constructive feedback or they don't quite know"},{"startTime":997.68,"endTime":1004.8,"body":"what to say. When a student has written something "},{"startTime":997.68,"endTime":1004.8,"body":"down like that and they have something to work on,"},{"startTime":1004.8,"endTime":1009.68,"body":"it's much more collaborative. It's not, oh, me "},{"startTime":1004.8,"endTime":1009.68,"body":"as the clinical instructor saying you didn't do"},{"startTime":1009.68,"endTime":1018.56,"body":"a great job. And I think it's helped our clinical "},{"startTime":1009.68,"endTime":1018.56,"body":"instructors be more comfortable in their role when"},{"startTime":1018.56,"endTime":1023.92,"body":"and and they're great practitioners and sometimes "},{"startTime":1018.56,"endTime":1023.92,"body":"what happens is you have an amazing nurse and"},{"startTime":1023.92,"endTime":1029.84,"body":"now they've stepped into that clinical instructor "},{"startTime":1023.92,"endTime":1029.84,"body":"role and they're trying to learn that skill set of"},{"startTime":1029.84,"endTime":1037.52,"body":"how to be a strong clinical instructor. And this "},{"startTime":1029.84,"endTime":1037.52,"body":"gives them the opportunity to learn how to provide"},{"startTime":1037.52,"endTime":1044.56,"body":"feedback in a way that's positive and constructive "},{"startTime":1037.52,"endTime":1044.56,"body":"and collaborative and doesn't feel negative and"},{"startTime":1044.56,"endTime":1049.92,"body":"punitive to the student because we never want a "},{"startTime":1044.56,"endTime":1049.92,"body":"student to walk away feeling like, \"Oh my god,"},{"startTime":1049.92,"endTime":1056.4,"body":"my clinical instructor thinks I'm not smart and "},{"startTime":1049.92,"endTime":1056.4,"body":"I'm not cut out to do this.\" And the instrument,"},{"startTime":1056.4,"endTime":1062.56,"body":"I think, really helps that collaboration in a "},{"startTime":1056.4,"endTime":1062.56,"body":"way that we didn't have before. other our other"},{"startTime":1062.56,"endTime":1072.48,"body":"tool was truthfully you know did you exceed you "},{"startTime":1062.56,"endTime":1072.48,"body":"know or meet or didn't meet like this behavior"},{"startTime":1072.48,"endTime":1078.24,"body":"and then the other thing that we did because "},{"startTime":1072.48,"endTime":1078.24,"body":"these behaviors make sense and I'm going to be"},{"startTime":1078.24,"endTime":1088.64,"body":"totally transparent our prior clinical evaluation "},{"startTime":1078.24,"endTime":1088.64,"body":"tools were so vague apply the natural social and"},{"startTime":1088.64,"endTime":1094.16,"body":"sciences and humanities to the care of the patient "},{"startTime":1088.64,"endTime":1094.16,"body":"And the instructors were like, \"What does that"},{"startTime":1094.16,"endTime":1100.88,"body":"mean? How do I evaluate that?\" And now we have "},{"startTime":1094.16,"endTime":1100.88,"body":"an instrument that's very clear like we have"},{"startTime":1100.88,"endTime":1108.4,"body":"very specific behaviors we expect our students to "},{"startTime":1100.88,"endTime":1108.4,"body":"do. And so now they understand what their role is."},{"startTime":1108.4,"endTime":1114.0,"body":"The other thing I think that was really helpful in "},{"startTime":1108.4,"endTime":1114.0,"body":"this when we met with all the faculty is that we"},{"startTime":1114.0,"endTime":1122.88,"body":"were able to scaffold behaviors in a way so that "},{"startTime":1114.0,"endTime":1122.88,"body":"we weren't double dipping. So and it was helpful"},{"startTime":1122.88,"endTime":1128.4,"body":"in particular in Steph's situation where she was "},{"startTime":1122.88,"endTime":1128.4,"body":"in junior med surge and senior med surge. So the"},{"startTime":1128.4,"endTime":1133.6,"body":"behaviors for the junior students were different "},{"startTime":1128.4,"endTime":1133.6,"body":"than the behaviors of the senior students."},{"startTime":1133.6,"endTime":1142.08,"body":"And because of that, we could see the growth "},{"startTime":1133.6,"endTime":1142.08,"body":"over time. And we're very fortunate at Widener,"},{"startTime":1142.08,"endTime":1148.56,"body":"we were not in an environment that was very much "},{"startTime":1142.08,"endTime":1148.56,"body":"a top down. Everything comes from the dean rolling"},{"startTime":1148.56,"endTime":1156.96,"body":"down. And because of that I think engaging the "},{"startTime":1148.56,"endTime":1156.96,"body":"faculty in this really made the difference because"},{"startTime":1156.96,"endTime":1165.92,"body":"without engaging the faculty this would never have "},{"startTime":1156.96,"endTime":1165.92,"body":"happened. Well we all worked together during that"},{"startTime":1165.92,"endTime":1172.96,"body":"workshop and so doing that together as a team "},{"startTime":1165.92,"endTime":1172.96,"body":"the faculty now own the clinical evaluation tool"},{"startTime":1172.96,"endTime":1179.52,"body":"especially for their particular specialty area. So "},{"startTime":1172.96,"endTime":1179.52,"body":"they have the input into it and so they know that"},{"startTime":1179.52,"endTime":1185.12,"body":"this is something that they have helped to create "},{"startTime":1179.52,"endTime":1185.12,"body":"and so I feel like that helps them but that's the"},{"startTime":1185.12,"endTime":1190.24,"body":"buy in to have people involved they'll be more "},{"startTime":1185.12,"endTime":1190.24,"body":"vested in they'll be more likely to to implement"},{"startTime":1190.24,"endTime":1194.32,"body":"it. So the fact that you went to the faculty and "},{"startTime":1190.24,"endTime":1194.32,"body":"had to develop it that was that was great and also"},{"startTime":1194.32,"endTime":1198.72,"body":"I love the fact that you involved students too "},{"startTime":1194.32,"endTime":1198.72,"body":"because it sounds like you even had the student"},{"startTime":1198.72,"endTime":1204.16,"body":"you know buy in. So if you ever want to implement "},{"startTime":1198.72,"endTime":1204.16,"body":"something, yeah, those are the steps. And we"},{"startTime":1204.16,"endTime":1210.4,"body":"were really lucky because our sim faculty came, "},{"startTime":1204.16,"endTime":1210.4,"body":"right? Then they got and and I also have to say,"},{"startTime":1210.4,"endTime":1216.72,"body":"you know, we have several of our faculty "},{"startTime":1210.4,"endTime":1216.72,"body":"teach across undergrad and grad, but we have"},{"startTime":1216.72,"endTime":1221.92,"body":"a significant number of faculty who just teach at "},{"startTime":1216.72,"endTime":1221.92,"body":"the graduate level. and they came to the undergrad"},{"startTime":1221.92,"endTime":1228.64,"body":"meeting with us to kind of give us support and "},{"startTime":1221.92,"endTime":1228.64,"body":"come up with suggestions and help people who were"},{"startTime":1228.64,"endTime":1237.12,"body":"struggling of writing you know objectives and "},{"startTime":1228.64,"endTime":1237.12,"body":"you know behavioral outcomes. So I think what"},{"startTime":1237.12,"endTime":1244.8,"body":"Steph is saying is right that whole team approach "},{"startTime":1237.12,"endTime":1244.8,"body":"you know it made it better and I was in Steph's"},{"startTime":1244.8,"endTime":1250.48,"body":"role before Steph was in it and I don't want to "},{"startTime":1244.8,"endTime":1250.48,"body":"be the person being saying this is how you have"},{"startTime":1250.48,"endTime":1257.84,"body":"to do things like that was just never my approach. "},{"startTime":1250.48,"endTime":1257.84,"body":"So I loved the collaborative experience and I have"},{"startTime":1257.84,"endTime":1262.64,"body":"to say by the end of day two we were tired. It "},{"startTime":1257.84,"endTime":1262.64,"body":"was exhausting. Yeah. I was I was going to ask"},{"startTime":1262.64,"endTime":1267.12,"body":"you cuz when you talked about the process, how "},{"startTime":1262.64,"endTime":1267.12,"body":"you mapped out everything to say, you know, which"},{"startTime":1267.12,"endTime":1271.6,"body":"outcomes are met in simulation, didactic versus "},{"startTime":1267.12,"endTime":1271.6,"body":"clinical, how long did it take you? This was"},{"startTime":1271.6,"endTime":1281.52,"body":"like a two day full day. It was two full days. So "},{"startTime":1271.6,"endTime":1281.52,"body":"the first day we literally were mapping out where"},{"startTime":1281.52,"endTime":1286.56,"body":"things were and then we were writing objectives "},{"startTime":1281.52,"endTime":1286.56,"body":"that we were going to use in our syllabi. Right."},{"startTime":1286.56,"endTime":1292.64,"body":"Right. And then day two we were then developing "},{"startTime":1286.56,"endTime":1292.64,"body":"the behaviors everywhere where we said, \"Oh, this"},{"startTime":1292.64,"endTime":1299.6,"body":"lives in clinical.\" Then day two, we were writing "},{"startTime":1292.64,"endTime":1299.6,"body":"the behavior. So by the end of day two, we were"},{"startTime":1299.6,"endTime":1308.48,"body":"all pretty done. And this was at the end of the "},{"startTime":1299.6,"endTime":1308.48,"body":"semester, right? We were done. Yeah. We were like,"},{"startTime":1308.48,"endTime":1316.56,"body":"\"All right, we're done. We've had Excellent.\" "},{"startTime":1308.48,"endTime":1316.56,"body":"So I believe when we had a prior conversation,"},{"startTime":1316.56,"endTime":1323.6,"body":"you have just started this pilot. Was it this "},{"startTime":1316.56,"endTime":1323.6,"body":"summer or last? Yes. So tell me now that you have"},{"startTime":1323.6,"endTime":1328.8,"body":"you know a few semesters under your belt using "},{"startTime":1323.6,"endTime":1328.8,"body":"this new model. What were those aha moments? Was"},{"startTime":1328.8,"endTime":1333.6,"body":"there anything that surprised you whether it's "},{"startTime":1328.8,"endTime":1333.6,"body":"you know logistically how you rolled this out"},{"startTime":1333.6,"endTime":1339.04,"body":"or when you looked at the data from this you know "},{"startTime":1333.6,"endTime":1339.04,"body":"the valuations was there anything that kind of you"},{"startTime":1339.04,"endTime":1345.44,"body":"know surprised you that you weren't expecting? I "},{"startTime":1339.04,"endTime":1345.44,"body":"would say for me it was reading what the students"},{"startTime":1345.44,"endTime":1354.64,"body":"were writing. Over time it became more detailed, "},{"startTime":1345.44,"endTime":1354.64,"body":"a lot of depth, a lot of emotion in it too."},{"startTime":1354.64,"endTime":1360.4,"body":"Especially if they were dealing with situations "},{"startTime":1354.64,"endTime":1360.4,"body":"that were challenging such as, you know,"},{"startTime":1360.4,"endTime":1367.6,"body":"the patient was a rapid response or somebody there "},{"startTime":1360.4,"endTime":1367.6,"body":"was quite a few students that had patients that"},{"startTime":1367.6,"endTime":1375.36,"body":"were aggressive or you know there was safety "},{"startTime":1367.6,"endTime":1375.36,"body":"concerns with the staff and so they really"},{"startTime":1375.36,"endTime":1383.52,"body":"addressed it in a very professional manner and I "},{"startTime":1375.36,"endTime":1383.52,"body":"was happy about that. thing, but also like the way"},{"startTime":1383.52,"endTime":1392.32,"body":"they reflected on what they thought they needed "},{"startTime":1383.52,"endTime":1392.32,"body":"to do as far as interventions or doing assessments"},{"startTime":1392.32,"endTime":1400.72,"body":"really showed me their growth over a period of "},{"startTime":1392.32,"endTime":1400.72,"body":"time. So, I was pleased with that. This semester"},{"startTime":1400.72,"endTime":1407.6,"body":"over the fall we have all of the specialties and "},{"startTime":1400.72,"endTime":1407.6,"body":"meds surge doing their own clinical evaluation"},{"startTime":1407.6,"endTime":1416.32,"body":"tools. So the specialties tweaked their own "},{"startTime":1407.6,"endTime":1416.32,"body":"examples for competencies or they use the same"},{"startTime":1416.32,"endTime":1423.475,"body":"domains but the examples would be different you "},{"startTime":1416.32,"endTime":1423.475,"body":"know for maternity or pediatrics. So I'm waiting"},{"startTime":1423.475,"endTime":1430.16,"body":"until finals are over to review all of those. "},{"startTime":1423.475,"endTime":1430.16,"body":"And I've required requested feedback from faculty"},{"startTime":1430.16,"endTime":1434.72,"body":"about is there anything that we need to change in "},{"startTime":1430.16,"endTime":1434.72,"body":"the language of the document? How did it work for"},{"startTime":1434.72,"endTime":1444.16,"body":"your clinical instructors? And so that we can move "},{"startTime":1434.72,"endTime":1444.16,"body":"it forward. Well, yeah, all of this really sound"},{"startTime":1444.16,"endTime":1456.16,"body":"exciting and so if you could leave your our fellow "},{"startTime":1444.16,"endTime":1456.16,"body":"nurse educators with one takeaway about competency"},{"startTime":1456.16,"endTime":1465.298,"body":"based clinical education, what would it be? I "},{"startTime":1456.16,"endTime":1465.298,"body":"think actively engaging the clinical instructors."},{"startTime":1465.298,"endTime":1474.72,"body":"They're our biggest assets and we want them to "},{"startTime":1465.298,"endTime":1474.72,"body":"feel like they're a vital part of everything we"},{"startTime":1474.72,"endTime":1482.8,"body":"do. And I think by actively engaging them in this "},{"startTime":1474.72,"endTime":1482.8,"body":"process, they feel like they're our partners now"},{"startTime":1482.8,"endTime":1491.44,"body":"and not just this, you know, group on the side. "},{"startTime":1482.8,"endTime":1491.44,"body":"Steph, what do you think? I would say focus on"},{"startTime":1491.44,"endTime":1498.72,"body":"thinking not just doing because competence is "},{"startTime":1491.44,"endTime":1498.72,"body":"about clinical judgment and not just tasks or"},{"startTime":1498.72,"endTime":1506.4,"body":"skills. Oh, what a wonderful way to to end our "},{"startTime":1498.72,"endTime":1506.4,"body":"podcast. I can't believe the 20 minutes went"},{"startTime":1506.4,"endTime":1512.56,"body":"by so quickly. I feel like we can go on and on on "},{"startTime":1506.4,"endTime":1512.56,"body":"this topic. So, I want to thank you both Rose and"},{"startTime":1512.56,"endTime":1519.04,"body":"Stephanie for such a wonderful conversation on "},{"startTime":1512.56,"endTime":1519.04,"body":"a very timely and important topic. I again want"},{"startTime":1519.04,"endTime":1524.32,"body":"to say thank you for joining us and sharing your "},{"startTime":1519.04,"endTime":1524.32,"body":"innovative approach to evaluating in the clinical"},{"startTime":1524.32,"endTime":1529.28,"body":"setting. And for those of you that are joining us "},{"startTime":1524.32,"endTime":1529.28,"body":"today, thank you for listening to our podcast and"},{"startTime":1529.28,"endTime":1535.59,"body":"we look forward to you joining us on our next "},{"startTime":1529.28,"endTime":1535.59,"body":"podcast. Thank you and take care. Thank you."}]}