Do your students struggle with critical thinking? Do your students struggle with, “in this situation, I will first do….? then do……? and lastly do……? What takes priority? How will I know?” If your students struggle with prioritization, then this learning activity is for you!
Introduction to Clinical Practice is the first nursing clinical that students will encounter in either the Practical or Associate Degree Nursing programs. The setting for this clinical is the long-term care environment and often where students will encounter clients who may take a numerous amount of medications. Nursing Pharmacology is taught in the first semester as well—–students will start with pharmacology and then move in to clinical once they have some information under their belts. As instructors, we strive to bring the “classroom into the clinical”! Last semester, I had the pleasure of taking over a Pharmacology classroom for a colleague while teaching the clinical associated with the pharmacology class. LIGHTS BULBS WENT OFF! I knew students were struggling with pharmacology in the clinical setting as well as the classroom setting; how could I remedy this? Well, let me tell you what I did!
While watching “Maleficent”, I decided to get my scrapbooking material out. I had BRIGHT colored paper, my circle cutters, AND GLITTER GLUE! Shiny object syndrome was in full affect for me. I tend to recall things better with color and shininess (is that a word?), so maybe my students would too! I began cutting multiple circles of many many different bright colors. I grabbed my marker and started writing medication names on those circles. Before I knew it, the glitter glue was on those circles as I traced the medication names with the glitter glue and my table was FULL of “pills”. Once they dried, I punched holes in the top and put a ring through them. I now had a “wheel of pills”. So you are probably wondering, “what in the world are you going to do with those things?” Well, let me tell you………………………………….
I carried this “wheel of pills” in my scrub pockets at clinical. Randomly throughout clinical, I would pull out the “Wheel of pills”, approach a student and ask them to “pick a pill”. I would then proceed to ask them to tell me what the medication was and what they know about that medication. At first, students were panicked. HOWEVER, eventually, the students started asking me to pull the “Wheel of pills” out and to ask them questions. Towards the end of clinical near the end of the semester with a Pharmacology FINAL exam looming over them, students would play games with the “Wheel of Pills”. It was great to see them accept this strategy so readily as was watching them bring that classroom learning into clinical AND clinical learning into the classroom! It has been a HUGE success and I will for sure continue with it!
How often have you said to your students, “don’t just memorize this, but learn it for life”? I know that I say it almost every day, but does it really stick? I can honestly answer that. Teaching throughout both the Practical Nursing and Associate Degree Nursing programs from start to finish, the answer to that is NO!!!!!!! Well, alright, we always have SOME students who do commit their skills to memory and never forget what step comes when; but, we also have those students who memorize the check off list and forget it the minute the check off is complete. How can we get our students to understand that we really are speaking the truth? How could I, the instructor, assist my students in reviewing their skills and truly understanding what the steps are? And more importantly, why is it important for them to remember their skills steps? Well, let me tell you!
After my students take their State Board exam for nursing(NCLEX), I often follow up with them and ask questions as to how the Boards went. I ask questions that are very detailed oriented: what kind of questions did you have, how many were “select all that apply”, how many of each type/area of nursing(pharmacology, Med/Surg, Mental Health, OB, Fundamentals, Math, etc). and so on. I believe this helps me to develop new activities that will prep my students for the biggest exam of their lives and familiarize themselves with what to expect. Imagine my surprise this year, when I learned that the NCLEX exam had several of my students put nursing skills in the correct order of performance! Immediately, I knew exactly what I was going to do to assist my students to be successful in this area! Basic Nursing Skills is taught in the first semester of both programs and I teach the clinical that is associated with that class: Introduction to Clinical Practice. This clinical is taught in the long-term care environment. There are times that this clinical has some “down-time” and I knew this activity would be perfect to complete at this level! I have taken the Basic Nursing Skills check off lists, cut out each individual step and placed them on flashcards. During clinical, I will randomly give a student a set of flashcards with the directions to place them in correct chronological order! What an amazing opportunity to take the classroom learning and apply it to the real-life clinical setting; in the words of a wise Nurse Educator, “This is where the rubber meets the road”! I cannot wait to try this during the semester. Completing this teaching strategy will allow me to assist my students in being successful. Repeatedly exposing them to the nursing skills will allow them to commit these important tasks to memory and help them to be prepared for their NCLEX exam! Stay tuned for the results!
One of my strategies for stimulating critical thinking is the relentless use of two questions: “So what?” and, “Why do you care?” These two are closely followed by a third: “Why?” They also serve as a classroom assessment to see that the students are actually with me during discussion.
In teaching nursing, I am often explaining a particular clinical finding and trying to help students link it to the underlying physiologic process or pathology. I find it is not the questions alone, but rather my almost obnoxious pursuit using these questions that pushes the student to connect the dots. Often, the final answer will be almost desperately …”because if I don’t, the patient could die!”
Yes! NOW you’ve got it!