Dr. MaryDee Fisher – Nursing

Project Overview

This project involved a redefinition of existing assignments in an online MSN course (Fall 2, 2017 – NUR/HCI 503), and in an online RN to BSN course the subsequent semester (Spring 1, 2018 NUR 412). Both assignments promote content learning. However, in order to better emulate the required teamwork required for clinical practice, both projects were redefined to afford learners the transformational opportunity related to a paired project within a collaborative learning space.

Planning Process

Both projects were redefined in order to afford learners a more realistic learning opportunity that mimics teamwork, specifically collaboration and communication elements, required for actual clinical practice.

The original MSN assignment was intended to create a draft of an automated Electronic Report of aggregate dashboard data that could be used to assess patient outcomes or staff compliance within the clinical arena. Learners in this course were from both the HealthCare Informatics and MSN graduate programs.

The original RN to BSN assignment was designed to have students use a Quality Improvement tool (FMEA) to analyze a clinical quality or safety issue related to the process of care delivery. All online learners in this course were or had been practicing as direct bedside caregivers.

In redesigning the project, some elements that underwent consideration include:

  1. How will this type of assignment (project) be completed in the actual clinical situation?
  2. How should/could the students be paired for the assignment? (self-select; random; specific assignment methodology)
  3. Is it a reasonable expectation for students to complete a paired project, given the lifestyles of online and various level learners?
  4. How might embracing of vs resistance to the assignment best occur with students?
  5. How to successfully cue for peer to peer communications?
  6. How can student choice be offered with a selection of collaborative learning space?
  7. In what format should the assignment be submitted (word doc vs link to actual space)?
  8. How will grading be accomplished? Individual vs. grouped?
  9. Peer Review needed for overall collegial (communications and collaboration) workings? How to incorporate feedback? What percentage of project grade?

Both assignments previously existed in the courses to meet specific learning outcomes.

In the MSN course related to Informatics Foundation and Health Care Technology, several learning objectives were enhanced by project implementation. They include:

  1. Analyze current and emerging technology utilized at point of care within a structured health setting and within a virtual community environment that supports safe practice.
  2. Discuss opportunities and strategies for extracting data from various systems to assess patient outcomes supporting a higher level of evidence-based care.
  3. Identify how technology and electronic data sources can be used to evaluate the effectiveness of clinical prevention interventions that affect individual and population-based health outcomes.

In the RN to BSN course related to Nursing Communication & Quality Improvement, specific learning objectives involving were targeted and enriched. They include:

  1. Demonstrate leadership and communication skills to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team.
  2. Participate in quality and patient safety initiatives, recognizing that these are complex system issues.
  3. Apply concepts of quality and safety using structure, process, and outcome measures to effectively implement and monitor patient safety initiatives.
  4. Demonstrate knowledge of interprofessional roles communication and effective teamwork.

Related to the personal goals of the author, a collaborative learning space had not been previously utilized and offering this project created a forced opportunity to learn about them.

The Substitution, Augmentation, Modification and Redefinition (SAMR) Model was used in planning both of the assignment revisions.  Use the teaching-learning process to instill technology in the design process enhanced communication and collaboration skills.

Implementation

Steps to completion (ins & outs):

  1. Understand the value of collaborative learning spaces.
  2. Revise assignment guidelines and rubrics.
  3. Create peer review form.
  4. Secure resources from Hoonuit for collaborative learning space and place in courses with clear direction.
  5. Craft detailed directions for parings – who will do, by when and why will do.
  6. Reflect on and design a plan on when to offer repeated announcements and encouragement for project completion.

Plan B was to revert to individual assignment as per previously used in both courses.

Assessment

Both projects were summatively assessed in formal fashions.

The Peer Review form, required for project submission, solicited feedback on five quantitative behaviors for evaluation and qualitative questions specifically r/t teamwork effectiveness, teamwork behaviors and overall team functioning.

Value of the group assignment was overwhelmingly reinforced in both courses on these peer review forms. Interestingly, students did not always rate each other as 5/5 on the quantitative behaviors. Qualitative comments included those related to: working well together; the need for flexibility, as there is more than one way to get things done; technology being invaluable; need to utilize strengths of team members; learning about constructive criticism; communication is key, one needs to pay attention to the style used, and it is a the center of teamwork; need to establish a good rapport; importance of trust and respect; opportunity to practice leadership skills;  enjoyed opportunity to work with someone form another profession; importance of clearly understanding other’s expectations.

Course Evaluations for the 503 course included qualitative comments such as: indicating learning to work in a group was one of the most important things learned in the course and enjoying working with other students on a project that at first seems overwhelming.  412 course evaluations are not at the time of this writing.

Anecdotally, the quality of assignment submissions was elevated overall in the MSN/HCI course; likely not as significantly in the BSN course for this challenging QI assignment.

Project Reflections and Next Steps

What worked and what didn’t work?

Worked – Clear guidelines expectations and rubric for assignments; communications related to the rationale for pairings; responding promptly and patiently to student inquiries; affording/encouraging students to hold one another accountable.

Worked, not so well – Not adjusting the peer review points for percentage moving from MSN to BSN course (math able to be calculated however).

Continue to strive towards more collaborative versus group learning where learners are mutually dependent on one another, yet held individually accountable. Promote increased group effort versus divide and conquer mentality; encourage an emphasis on process, in addition to the final product. With collaborative projects, the learners co-create knowledge and meaningful learning.

What would you change for next time?

In MSN course – leave as is if appropriate mix of HCI and MSN students.

In RN to BSN course – provide weekly reminders about the upcoming project and specifically direct to communicate one on one with their partner early in the course.

How would you modify the project?

Consider student submitting a link to the collaborative learning space instead of submitting in Word; afford the opportunity to self-select partner; tweak guidelines to further promote collaborative project outcomes.

What did you learn?

Technology can be slowly integrated into assignments to afford to learn by students and faculty alike; all techno changes do not have to be flashy; reinforced need to stay focused on learning outcomes and goals; and not all digital native students maybe be as technologically advanced and savvy as others.

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