Clinical decision making case studies in medical-surgical nursing instructors manual


QUALITY AND SAFETY EDUCATION FOR NURSES (QSEN)

For example, knowing about IBD can explain why the student is frequently in the bathroom.

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The instructor can then provide a better clinical experience for these students. Clinical instructors can feel overwhelmed by the number of patients under their and their students' care. The instructor needs to remember that the clinical nurse is also responsible for the patient's care.

Students should keep patient safety issues in mind. Performing a new procedure with a student can be challenging. Review the procedure with the student before you go into the patient's room. Be calm and speak quietly. If students break sterile technique, for instance, stop them gently. Above all, ensure patient safety. Nursing students are focused on learning skills. Always take advantage of opportunities to educate them about procedures when they arise. If your school has a clinical simulation lab, find out how the simulation experience is scheduled.

Sometimes the simulation coordinator schedules a few students at a time, but in other cases, the entire clinical group and the instructor may go to campus to participate in simulation. Even if the student hasn't learned a procedure in the clinical simulation lab, it's acceptable to demonstrate these skills during clinical. For example, if a patient in the unit has a tracheostomy, you can demonstrate tracheostomy care and suctioning to the whole group of students with the patient's permission , or guide one student through the procedure after ensuring the student is properly prepared.

If a student can't perform a skill that was learned previously, such as measuring BP, send him or her back to the clinical simulation lab coordinator for more practice. Find out if you're expected to organize any observation days. For example, in our junior year medical-surgical rotation, the instructor plans for an observation day in the OR. For senior students, the instructors plan a critical care day in an ICU, postanesthesia care unit, critical care unit, or the ED.

Clarify the student's role and objectives during observation experiences. Do they have an assignment?

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Do they present a report during postconference? Always encourage them to be involved and ask questions. Find out if the unit nurses have an interesting patient or a procedure that your students can perform, such as intermittent urinary catheterization. I've had the oncology nurse educator present a special program for my students.

The respiratory therapist is a great resource who knows which patients on the unit have abnormal lung sounds and may be willing to let all the students hear their breath sounds. Always be alert to potential teaching opportunities! Before the start of postconference, students should expect to complete their work or help others finish up. Postconference is a great way to debrief the students on what they just experienced, especially after an emotional event such as a code or patient death.

You can plan to review a topic that complements what students learned in class. Often, just discussing patient care helps students learn.

Build trust with the staff by checking in with them throughout the day and after the students leave for the day. Ensure that all work has been completed and give them a chance to provide private feedback about your students' performance. Instructors help students understand theory, not by providing an answer to their questions, but by helping the student find the answer themselves. Ask why something has occurred. Give students time to think and avoid asking too many questions at once. If they don't know the answer, guide them to where they can find it.

Are references available on the unit? Is an online drug guide accessible? Can they access their phones for nursing applications? Critical thinking is embedded in almost all aspects of the clinical education process related to nursing. Educators cannot teach nurses how to think critically if they do not take it upon themselves to actively engage in learning and applying their knowledge.

Both the learner and educator must work together to use concept mapping to promote and develop critical thinking skills, it is not a one sided educational tool.

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So for the purpose of this thesis Constructionist Theoretical CT Perspective will be discussed in relation to a learner and Situated Clinical Decision-making SCDM Framework will be discussed from an educator perspective, and both will be used to help interpret the findings. The CT Perspective and the SCDM Framework support the fact that concept mapping is positively related to the development of critical thinking in student and novice nurses.

Concept mapping has been mentioned as an educational strategy for developing meaningful learning and critical thinking abilities in learners. Constructionist Theoretical Perspective.

Application processing

The basis of concept mapping aligns with a Constructionist Theoretical CT Perspective in that it all must begin with an active learner. Therefore, the learner develops knowledge through the integration of new information with their past knowledge and experience to create a process for meaningful learning Phelps, Constructivist theory is related to how nurses should approach learning, suggesting that an active approach opposed to passively waiting to be taught, can develop their critical thinking skills in the process Potgieter, For that reason our first step as educators, looking to develop the critical thinking abilities in student and novice nurses, is to encourage an active approach to learning and shape the way we teach around the promotion of actively applying knowledge.

Situated Clinical Decision-Making Framework. From an educational perspective, the concept map serves as a tool for educators to analyze the problem solving, decision-making approach, and critical thinking abilities of novice nurses and students. Once we are able to get our students to adopt an active learning style, we as educators can use the Situated Clinical Decision-Making SCDM framework, which is more applicable in facilitating the development of critical thinking skills amongst nursing students and novice nurses.

The components of the SCDM framework incorporate thinking processes, decision-making processes, foundational knowledge, and context. The use of this theoretical model by nursing educators assists them in evaluating the decision-making skills of their student nurses. Based on the outcome of the evaluations, educators can choose the most pertinent learning strategies to provide nurses with opportunities to work on their clinical decision-making and critical thinking capabilities. Therefore the issue of development of critical thinking in relation to nursing students and the educators involved is best supported through the application of both Constructivist theory and Situated Clinical Decision-Making framework.

Meaningful Learning Theory. Knowledge acquisition can be divided into different categories of learning: receptive, discovery, rote, and meaningful learning Ausubel, In receptive learning information is presented in a formal manner and is internalized through rote or meaningful learning. Discovery learning is where the learner is discovering the information as it occurs and internalizing it through rote or meaningful learning.


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Rote learning is memorizing information without processing the content, which can fade away if the learner does not frequently go over the information. Meaningful learning is when the learner assimilates new information and concepts with their existing knowledge and experiences Ausubel, Ausubel introduced a method of cognitive organization, which must be in place for meaningful learning to occur.

This study will help highlight how concept mapping helps develop this cognitive organizational process, which in turn, improves critical thinking.

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Nurse educators have used certain techniques and methods to foster critical thinking that touch on all four categories of learning. Case studies, care plans, problem-based learning, and concept mapping are all examples.

Case Studies In Medical Surgical Nursing Instructors Manual

Concept mapping has been identified as a key educational method for fostering meaningful learning and critical thinking abilities. Summary It is essential that nurses have the ability to think critically in order to function, adapt, and provide optimal care to their patients, especially in our constantly evolving and highly complex healthcare system.


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  • Therefore it is our professional responsibility to ensure our new nurses in the workforce our prepared for the demands, by ensuring we do our best to develop their ability to think critically. For that reason, this meta-analysis on the use of concept maps in the development of critical thinking ability, will serve to further explore and strengthen the effect of this educational strategy.

    The key concepts and terms in this study are reviewed and defined. Additionally, the literature related to the teaching methodology of concept mapping in nursing education and its association with critical thinking is discussed. Critical Thinking Defined The majority of critical thinking definitions include cognitive skills such as problem solving, knowledge, reasoning and logical thought processes Jones, Staib states critical thinking is an evolving process of reasoning, knowledge, attitudes, reflection, and application.

    This knowledge is used to analyze and organize patient information, building upon pre-existing knowledge, to prioritize the plan of care by holistically viewing the patient, or looking at the bigger picture Oermann, ; Alfaro-Lefevre, ; Tyler, In the clinical setting, nursing students and novice nurses are presented with large quantities of detailed information, in short periods of time, and expected to access and act on that knowledge in complex and demanding situations. As a result, a nurse who utilizes cognitive skills and critical thinking within the clinical environment will have the clinical competence to practice successfully in this demanding setting.

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