Wednesday, April 14th, 2010 - 12:03 pm

Nursing students get REAL

By Erika Rose

Nursing students get real

As experiential learning becomes the hallmark of a Purdue Calumet education, the School of Nursing’s senior level capstone course is a shining example of REAL (Reality-based Experiential Academic Learning)-world instruction. To better prepare nursing students for a changing profession, projects and initiatives advanced through the capstone course provide students opportunities to solve REAL problems and institute REAL change.

When Cassie Bass was educated as a nurse some 25 years ago, she poured her heart and soul into a senior project that consisted of a fake scenario involving a fake patient, who, she supposes, probably ended up buried in a file cabinet somewhere or even tossed out.

The veteran nurse at St. Anthony Medical Center in Crown Point admits she is somewhat envious of today’s Purdue University Calumet nursing students, whose education is vastly different than that of her generation.

Unlike Bass’s hypothetical case study, the Purdue Calumet students she and colleague Sue Heinzman are supervising are working on projects that will not end up in a file cabinet. In fact, those projects already have become a catalyst for significant changes in healthcare policies and procedures in the region.

Immersing students into real problems, complex environments

Purdue Calumet nursing faculty innovatively connect students with real problems of actual healthcare institutions, immersing the prospective nurses into today’s complex healthcare environments and enabling them to execute leadership roles alongside administrators, agencies and patients before they graduate.

The Purdue Calumet term for this progressive, hands-on, applied type of education is “experiential learning.” The term is fast becoming synonymous with a Purdue Calumet education. Through its School of Nursing capstone course, Purdue Calumet nursing students and the hospitals and other health care organizations tied to those classes are reaping rich benefits.

What is experiential learning?

In 2008, Purdue Calumet instituted a graduation requirement that all incoming, baccalaureate degree-seeking students would complete two courses that were “experiential” in nature—that is, courses that in a defined, structured manner integrate classroom and textbook learning with the applied learning that occurs within a real world setting or experience.

Faculty members in partnership with community collaborators and organizations from related disciplines immediately mobilized to revise or create courses to fit this bill. To become an official experiential learning course, curriculum must satisfy distinct and rigid standards set forth by the National Society for Experiential Education (NSEE).

Hence, NSEE standards must be integrated into the fabric of the course with experiences of applied learning that are consistent with course objectives, including reflection and discussion in class of the experiences.

Purdue Calumet has embraced seven types of experiential learning opportunities any of which an experiential learning course must include: internships, cooperative education, practicum, cultural immersion (study abroad), undergraduate research and project design.

New and improved nursing capstone

Practicum and clinical lab experience always have been a part of nursing education, and baccalaureate candidates always have culminated their on-the-job training in a senior capstone course. But with high NSEE standards to achieve, combined with changes in the industry, a new, innovative approach to the traditional nursing capstone course has evolved.

In the past, nursing students were paired with a preceptor at a healthcare institution, where they shadowed other nurses and worked largely on developing technical skills. While this type of instruction is still part of a nurse’s education, the capstone course’s instructors, Associate Professors Gail Wegner and Ellen Moore, say the current capstone course adds a component that wasn’t present before — one that focuses largely on project management and community service and positions future nurses directly into leadership roles.

Today’s approach to nursing education is also evidence-based, which means that decisions about how patients are cared for are based on hard data and documented research that proves the merit of or discredits certain practices.

Evidence-based solutions

Current nursing capstone course students are grouped into small teams and assigned a project — a real problem in need of an actual solution – that has been submitted by an area healthcare institution. In response, the students research published evidence, meet with senior administrators, develop a response based on the evidence and present it to representatives of the institution.

Sometimes larger projects are addressed in phases and handed off to a subsequent group of students the following semester. In many cases, project solution reports are presented to policy-making boards who implement the students’ suggestions.

“Nursing now is really becoming more of a shared governance model in which staff nurses have a great deal of input into decision-making,” Professor Moore says. “This provides a mechanism for future nursing professionals to have a voice in determining nursing practice, standards of care, and nursing practice based on the best available evidence.”

Real world projects for real world problems

Now in its fourth semester, the revised capstone course, according to Moore and Wegner, has produced 55 completed projects, all having made significant contributions to improving Northwest Indiana healthcare and policy. Projects students have addressed include:

  • Improving patient safety through a system of standardized, color-coded wrist bands that indicate the nature of a patient’s condition. The problem of various hospitals using different color codes became apparent when a Pennsylvania patient was nearly denied resuscitation by a nurse who previously had worked at another hospital that used a different wristband color-colored system;
  • “Baby Steps,” which involved creating a class designed to help disadvantaged mothers understand their babies’ brain development and how to prepare their child for learning;
  • One aimed at developing new methods of pain control for children undergoing invasive procedures;
  • The study and investigation of smoking at Purdue Calumet, which led to the establishment of a smoke-free campus policy that was implemented last fall;
  • Investigation of causes of various infections that occur in hospitals and subsequent best practices for preventing their transmission to patients;
  • A study of causes of Sudden Infant Death Syndrome (SIDS)—specifically, the effect of parent(s) co-sleeping with their infant;
  • Collaboration with St. Mary Medical Center staff in developing a revised protocol for use by physicians and nurses in identifying patients who are at risk for developing blood clots and to help prevent clots from forming;
  • Development of educational materials about the chronic, inflammatory disease of lupus;
  • Work on implementing a swallowing screening tool for use by suspected stroke victims at Jasper County Hospital.
Nicole Lee (middle) presented findings with Ashley Hershman and Jaclyn Lenehan during Student Research Day on campus April 1 about a new protocol for identifying patients at risk for developing blood clots.

Nicole Lee (middle) presented findings with Ashley Hershman and Jaclyn Lenehan during Student Research Day on campus April 1 about a new protocol for identifying patients at risk for developing blood clots.

Students Paula Townsend (right) and Lena Modieh not only investigated and researched possible causes of hospital infection transmission, but also reported their observations to St. Mary Medical Center nursing staff.

Students Paula Townsend (right) and Lena Modieh not only investigated and researched possible causes of hospital infection transmission, but also reported their observations to St. Mary Medical Center nursing staff.

Instruction reflects the changing face of nursing

Northwest Indiana Area Health Education Center Director Lynn Olszewski describes Purdue Calumet’s new and improved nursing capstone course as very forward thinking and innovative and says it represents good nursing education. She adds that over time, evidence will no doubt reveal that this way of educating nurses is the right way.

Wegner says today’s nurse no longer fits the image of the caregiver at the bedside with a stethoscope and scrubs doing things just because it’s the way they were taught. Today’s nurse has to be ready to take on a leadership role and be willing to respond differently to the status quo when published evidence supports change.

Students empowered to change healthcare delivery

“We want (students) to be able to feel really confident of making those clinical decisions, not only at the bedside, but at the healthcare organization level,” Wegner said. “The only way to give them that experience is to let them collaborate with senior nursing administration and other multidisciplinary key people on system projects.”

Moore points out that the new experiential learning capstone course model empowers nursing students to change the delivery of healthcare at area hospitals.

“We’re ultimately going to be changing healthcare policy,” she said. “We’re teaching students how to be involved in that. . . . This is bringing a different element. It’s really capitalizing on where nursing is going. That’s where the innovation part of it comes in.”

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