And then suddenly it happens… One colleague asks about how to use digital quizzes in the classroom… Kaboom! I´m pleased and beyond happiness. I gladly share the knowledge and experiences that I have with my colleague. So I thought, why not share it here too?!
Here´s how I do it… When lecturing nursing students in acid base balance, I start out with the commonly used (oh so boring…) power point presentation. I´ve really tried to make it appetizing with a good structure, fancy photos and everything, but still… it is what it is. After the initial feeling of being a “motivation butcher” (with the power point) I try to get the students back on track with some real life patient cases. Right now I have four of them, in accordance with the four disturbance of the acid base balance. Together we figure out which disturbance the patient have, relevant treatment and how to prevent it to occur. Last but not least… I end the hole lecture with a simple quiz. I tell the students that it is voluntary to participate and that they are free to go if they like. Stunningly, almost everyone willingly stay. I guess it has something to do with curiosity and an instinct to compete…? The tool I use for the purpose is nothing less then Kahoot. It is free and it is easy to use. You simply create an account and within 5-15 minutes you have done your first quiz. At first I had 20 multiple choice questions but that was too much, thus some students lost interest after approximately 10. Now I have 12 and I think that is a good quantity of questions. After each question Kahoot shows the correct answer and then top ten of fastest participant. As the quiz progresses the tension increases. At the end we have three winners. They all have to stand up and receive our tribute, consistent of applause, cheering, hugs and some silly prizes linked to acid base. Coca cola = acid, bicarbonate = base and SUPER-SOUR candy = containing an enormous amount of hydrogen ions.
This is higher education (undergraduate degree) and I am well aware of that this multiple choice quiz has nothing to do with critical thinking or research but I do believe it has something to do with motivation. I experience that the students do well on their assessment and they seem to remember the lecture as something good and joyful. I´m not sure they remember exactly how the kidney compensate for unprecedented levels of hydrogen ions but I believe that the students possess a basic understanding for acid base balance. When becoming nurses, most likely, they remember how to fill in the gaps of their knowledge, dependent on the current needs, and hopefully, still think of acid base as something understandable and engaging.
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.
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.
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.
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.
Earlier today at the course “Academic teaching” (which I participate) we were discussion diversity. The learning outcome for me regarding to this topic is:
“Develop different strategies for equal treatment in the meeting with students / participants in heterogeneous groups.”
So, I´ve been thinking of how to embed this in my teaching to nursing students. The topic I teach is about how to administer and handle central venous catheters. One of the learning outcomes is that the students are expected to reflect over risks and how to avoid them.
The university I work in has a strategic platform (Strategy 2020) and Malmö University wants to base its work on four core values; diversity, creativity, quality and commitment to the community. I came up with the idea of using cases to reflect diversity.
In Sweden (were I live and work) we of course have a law for higher education (SFS 1992:1434). For instance, the students are expected to develop their ability to critical thinking and problem solving.
Lynn (1999) writes about the differences between case teaching and research cases. Lynn argues that when teachers use cases from research as an example or illustration the whole idea of case as a method fails thus the thinking has already been done and the conclusion is already made. The research case is more like a lecture where there is “a true” solution to the problem. Therefor, when using case as a method for develop skills in critical thinking the cases have to contain questions to raise. There should be no right answer and the students should be exposed to different problems, issues and choices. Lynn means that the students are supposed to come up with a solution and proposed action regarding to the present dilemma to succeed and develop their critical thinking.
When writing the cases I have to keep this in mind! I don´t want them to have only one right answer. Back to diversity. I will use name, age and gender as a base and they will all represent a diversity of people. Each case will have a picture of the “patient” and I will choose the pictures carefully so that they shows my intended diversity. I will give you one example of a case.
Aisha, a female patient, is treated with total parenteral nutrition (TPN). She has a central venous catheters on her neck (it´s like been given “food” straight in to your blood). Aisha is wearing veil. The veil is “hiding” her central venous catheter so you can´t see the venous access or it´s connections.
-What should you, as a nurse, do?
It is very important to be able to observe the venous access and it´s connections on a daily bases. When having a ongoing infusion (TPN) it´s even more required.
I can think of some different paths to go in the discussion. The students can choose to talk about the ethic part of wearing a veil (the patients religious need vs. patients safety need). I will try to provoke the students a bit if they “chicken out” on the dilemma and I want them to give me an answer of how they think and why. I would also like them to talk about hygiene. The right answer is that the veil has to be change every day… but how will they make this happen? As I see it, they can choose different solutions to the problems.
I’m eager to try this out and I think (and hope) that we can talk to each other and have really constructive discussions of how to solve the different dilemmas. I am aware of that this is an example of how to work with diversity in teaching material. A further challenge would be to describe and have a well founded intention to work with diversity in the group of students, but that´s another blog post.
References Lynn, L (1999). Teaching and learning with cases. A guidebook. Seven bridges press, New York.
SFS 1992:1434 (2016) Högskolelagen. Utbildningsdepartementet, Stockholm. (In Swedish)
It seems like I have a mission to complete. I promised to return with feedback from a meeting – and here it is. Earlier, in April, I wrote a blog post where I used the analogue of the three musketeers. I contacted a colleges at another institution who is teaching the same topic as I am. My colleague agreed to meet me and to talk about collaboration.
The meeting started out with me explaining why I have made contact, what my purpose of the meeting was. I found myself arguing for not having any hidden agenda, just wanting to collaborate without any demands and expectations. A very strange way of making a case. I really do, have to improve myself in these situations in the future!
Anyway, my colleague is a clever guy, and he was able to filter my bad description of the intention to collaborate. We decided to 1) establish our initiative with our leaders, to 2) invite other colleagues to a physical meeting in some weeks and to 3) set up a group on Yammer, for digital everyday connection if needed, where we can share and collaborate.
Even though we are located on different floors, Us on 4th floor and Them on 5th floor, we do think, oddly enough, that we can collaborate and be the best colleagues ever. Although, we have an entire canal (1 floor/roof) dividing us in two, I prefer to see it as we share a whole canal (1 floor/roof) and that the “scaffolding” ought to make us stronger. May the force be with us!
Yeah! So here I am – finally participating in the #ONL161 course, PBL group 7. I´ve been following the course since the beginning (always wanting to participate) but challenges in life made it impossible. Now is the right time and I am on the edge of being overexcited. Yes, my expectations are high and I hope to be inspired by my group members as well as the whole #ONL161 crowd. My fear is that I don´t manage to find time for the learning activities. Anyhow, I will do my best!