Clinical training center

This summer I went on a vacation to Italy. Me and my family stayed in a house for rent, somewhere in the middle of nowhere, at the Italian countryside. The weather was fine, it was hot and sticky, so we mostly choose to hang around the pool… or at least nearby. For two days we visited Rome and then again back to the cooling water.

Guardea_2016 (2)

The vacation lasted for two weeks and we all had a great time. Italy gave me a taste for more since it showed itself from its best side. Next time I would love to see other regions of Italy. One region to visit could be Emilia-Romagna and the city of Bologna. Speaking of Bologna… In 1999 there were 29 European countries how choose to sign a declaration about the standards and quality of higher education qualifications. Nowadays it is more then 45 countries that are connected. The main focus is:

  • the introduction of the three cycle system (bachelor/master/doctorate)
  • strengthened quality assurance and
  • easier recognition of qualifications and periods of study

Did you know that the town of Bologna hosts the oldest university in the world, founded in 1088, the University of Bologna? One of the most important buildings at the university, Archiginnasio, situates the Anatomical Theatre, used at the medical school for anatomy lecturers.

Anatomy_theatre_Palazzo_del_Archiginnasio_by_Terry_Clinton_CCBY_NC2.0
Photo: Anatomy theatre, Palazzo del Archiginnasio by Terry Clinton (CC BY-NC 2.0)

Nowadays, when we teach our students we don´t do the whole “theatre thing”, we invite them to our clinical training center and sometimes I´m a teacher there. The center gives the nursing students a chance to practice their skills in a safe environments before they meet patients. Generally, both students and teachers are enjoying the skill training since we all  have a feeling of finally doing it “for real”. I think it is extremely important that we take advantage of the opportunity to do workshops based on “hands-on” activities. I would like to leave the theory lecturing outside of the training center. The course I teach in has, for the moment, a course design of teaching/learning activities that starts out with a theoretical lecture for approximately 45-60 minutes. Only after the lecture the students are allowed to actually get their hands on the different training scenarios which sometimes can be utterly frustrating for all of us. I would like to change this into a flipped classroom design, but first things first… Let´s start with the learning outcome.

Biggs & Tang (2011) describe different stages of how to design constructively aligned teaching and assessment. First of all, the intended learning outcome, shall be described. The active verb of the learning activity is “administer and handle“. Second, its object or the content is “central venous catheters” and last the standard the students are to attain is “in a way that is patientsafe“. In fact, as it is now, the learning outcome consists of the verb and the content. I would like to add the last part about the patientsafety since the whole core in administer and handle is about how to prevent complications.

Back to the design of teaching/learning activities. To be able to administer and handle something I believe that you have to use your hands and mind together. By flipping it around and letting the students work with the theoretical background of the topic before they come into the training center, they can get most out of their skill training. For me this is a question of quality and efficiency. Therefore, my intention is to record my theoretical lecture in short film clips which the students get access to minimum a week before they´re scheduled to the skill training.

Flip_by_Oscar_Rohena_CCBY_NC_ND2.0

Photo: Flip by Oscar Rohena (CC BY-NC-ND 2.0)

Recently, two of the major journals for nursing education have published a respective review articles about flipped classroom approaches in nursing education (Betihavas et al, 2016; Presti, 2016). Both articles refers to a book by Benner et al in their introductions. The book title says it all: Educating nurses: A call for radical transformation. The authors argues for BIG changes in how we educate nursing students and that we teachers have to acclimatize into the 21th century. We have to embrace student centered methods in our pedagogy. Flipped classroom can be one example of how to meet our students in other ways then we nursing teachers by tradition are used to. Presti (2016) claims that flipped classroom enhance active learning but asks for further research since evidence of learning outcomes are missing. Even Betihavas et al (2016) argues for more evidence but the authors conclude that the flipped classroom has a potential to reform nursing education. Although, fully evidence to the method flipped classroom is lacking I feel confident that optimizing the time in the clinical training center is a good thing thus the learning outcome is to administer och handle. Of course I have to evaluate the flipped method and if it doesn´t work out I would like to give a theoretical pre-lecture face-to-face before entering the training center.

References
Betihavas, V. Bridgman, H. Kornhaber, R. & Cross, M. (2016) The evidence for “flipping out”: a systematic review of the flipped classroom in nursing education. Nurse Educ Today, Mar(38), 15-21.

Biggs, J. B. & Tang, C. (2011) Teaching for quality learning at university. (Fourth edition). Maidenhead, Open University Press.

Bologna process (2016) European higher education area. Official website.

Bolognaprocessen (2016) Bolognaprocessen/det europeiska området för högre utbildning. Universitets- och högskolerådet, Stockholm. (In Swedish)

Presti, CR. (2016) The flipped learning approach in nursing education: a literature review. J Nurs Educ, 55(5), 252-257.

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